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+[
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+ {
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+ "label": "姓名",
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+ "defaultValue": null,
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+ "span": 12,
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+ "key": "Name",
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+ "type": "input",
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+ "border": null,
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+ "disabledValue": null,
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+ "options": [],
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+ "children": null,
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+ "append": "",
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+ "placeholder": "",
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+ "required": null,
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+ "show-limit": false,
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+ "parentKey": null,
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+ "buttonName": null,
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+ "childrenKey": null
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+ },
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+ {
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+ "label": "性别",
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+ "defaultValue": null,
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+ "span": 24,
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+ "key": "Sex",
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+ "type": "radio",
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+ "border": null,
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+ "disabledValue": null,
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+ "options": [
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+ {
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+ "label": "男",
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+ "value": "1"
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+ },
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+ {
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+ "label": "女",
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+ "value": "2"
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+ }
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+ ],
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+ "children": null,
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+ "append": null,
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+ "placeholder": null,
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+ "required": null,
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+ "show-limit": null,
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+ "parentKey": null,
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+ "buttonName": null,
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+ "childrenKey": null
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+ },
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+ {
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+ "label": "年龄",
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+ "defaultValue": null,
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+ "span": 12,
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+ "key": "Age",
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+ "type": "numberInput",
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+ "border": null,
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+ "disabledValue": null,
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+ "options": [],
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+ "children": null,
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+ "append": "",
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+ "placeholder": "",
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+ "required": null,
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+ "show-limit": false,
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+ "parentKey": null,
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+ "buttonName": null,
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+ "childrenKey": null
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+ },
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+ {
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+ "label": "诊断",
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+ "defaultValue": null,
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+ "span": 12,
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+ "key": "Diagnosis",
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+ "type": "input",
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+ "border": null,
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+ "disabledValue": null,
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+ "options": [],
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+ "children": null,
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+ "append": "",
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+ "placeholder": "",
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+ "required": null,
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+ "show-limit": false,
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+ "parentKey": null,
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+ "buttonName": null,
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+ "childrenKey": null
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+ },
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+ {
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+ "label": " 食管癌是常见的消化道恶性肿瘤之一。食管癌的主要症状包括胸骨后不适、有烧灼感及针刺感或牵拉样痛，打嗝、进食疼痛、吞咽困难等。\r\n 食管癌的危险因素主要包括：吃饭过快，常吃粗糙、过硬、过热的食物以及腌制、霉变食物等，缺乏维生素和微量元素，吸烟，长期大量饮酒，超重、肥胖，患贲门失弛缓症、胃食管反流病等慢性食管疾病，以及遗传因素，等等。\r\n 采取健康生活方式，积极治疗和康复训练，有助于改善生活质量。",
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+ "defaultValue": null,
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+ "span": 12,
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+ "key": "Hint_Label",
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+ "type": "label",
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+ "border": null,
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+ "disabledValue": null,
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+ "options": [],
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+ "children": null,
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+ "append": "",
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+ "placeholder": "",
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+ "required": null,
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+ "show-limit": false,
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+ "parentKey": null,
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+ "buttonName": null,
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+ "childrenKey": null
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+ },
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+ {
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+ "label": "健康生活方式",
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+ "defaultValue": null,
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+ "span": 12,
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+ "key": "HealthyLifestyle",
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+ "type": "checkbox",
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+ "border": null,
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+ "disabledValue": null,
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+ "options": [
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+ {
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+ "label": "不吸烟(吸烟者戒烟）。",
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+ "value": "1"
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+ },
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+ {
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+ "label": "避免接触二手烟。",
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+ "value": "2"
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+ },
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+ {
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+ "label": "不饮酒。",
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+ "value": "3"
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+ },
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+ {
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+ "label": "食物多样，多吃新鲜蔬菜、水果、奶类、豆制品，适量吃鱼、禽、蛋、瘦肉。",
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+ "value": "4"
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+ },
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+ {
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+ "label": "不吃过冷、过热、过硬食物，少吃油炸、辛辣食物。",
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+ "value": "5"
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+ },
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+ {
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+ "label": "不吃霉变食物，少吃烟熏和腌制肉制品。",
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+ "value": "6"
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+ },
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+ {
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+ "label": "细嚼慢咽，少食多餐，饭后漱口，防止残存食物引起食管黏膜水肿或感染。",
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+ "value": "7"
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+ },
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+ {
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+ "label": "避免过度疲劳，保证睡眠充足。",
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+ "value": "8"
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+ },
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+ {
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+ "label": "身体状况允许时可在医生指导下进行适量运动，以不引起劳累和不适为宜。",
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+ "value": "9"
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+ },
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+ {
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+ "label": "保持心情舒畅，情绪稳定，减轻精神压力。",
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+ "value": "10"
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+ }
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+ ],
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+ "children": null,
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+ "append": "",
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+ "placeholder": "",
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+ "required": null,
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+ "show-limit": false,
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+ "parentKey": null,
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+ "buttonName": null,
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+ "childrenKey": null
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+ },
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+ {
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+ "label": "治疗与康复",
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+ "defaultValue": null,
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+ "span": 12,
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+ "key": "HealthyLifestyle",
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+ "type": "checkbox",
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+ "border": null,
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+ "disabledValue": null,
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+ "options": [
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+ {
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+ "label": "需要长期药物治疗者严格按照医嘱服药，口服化疗药避免漏服、多服。",
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+ "value": "1"
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+ },
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+ {
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+ "label": "手术后患者应在医生的指导下进行适当地康复训练，鼓励尽早下床活动。",
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+ "value": "2"
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+ },
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+ {
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+ "label": "接受治疗期间和治疗后，根据病情和医生建议密切观察血常规、电解质、肝肾功能、肿瘤相关指标变化情况，及其他不良反应，如有异常及时就诊。",
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+ "value": "3"
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+ },
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+ {
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+ "label": "治疗结束后，患者定期复查，如果出现前胸、后背疼痛，腋下、锁骨上淋巴结肿大，声音嘶哑等情况，要及时到医院复诊。",
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+ "value": "4"
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+ }
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+ ],
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+ "children": null,
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+ "append": "",
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+ "placeholder": "",
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+ "required": null,
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+ "show-limit": false,
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+ "parentKey": null,
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+ "buttonName": null,
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+ "childrenKey": null
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+ },
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+ {
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+ "label": "急症处理",
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+ "defaultValue": null,
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+ "span": 12,
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+ "key": "EmergencyTreatment",
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+ "type": "checkbox",
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+ "border": null,
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+ "disabledValue": "",
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+ "options": [
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+ {
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+ "label": "如病情加重，尤其是出现下列情况，应尽快到医院就诊：\r\n（1）剧烈呕吐或呕血。\r\n（2）术后患者出现剧烈的持续性咳嗽，或憋气、严重呼吸困难。\r\n（3）晕厥或昏迷。\r\n（4）出现严重电解质紊乱（如低血钾、低血钠等)的症状，如乏力、腹胀、心悸、反应迟钝、嗜睡，甚至昏迷等。\r\n（5）化疗后出现严重骨髓抑制，如白细胞减少、中性粒细胞减少、血小板减少、贫血等，或伴有发热、呼吸困难、心慌、喘憋、皮肤散在的出血点等症状。\r\n（6）其他严重情况。",
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+ "value": "1"
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+ }
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+ ],
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+ "children": null,
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+ "append": "",
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+ "placeholder": "",
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+ "required": null,
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+ "show-limit": false,
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+ "parentKey": null,
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+ "buttonName": null,
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+ "childrenKey": null
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+ },
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+ {
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+ "label": "其他指导建议",
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+ "defaultValue": null,
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+ "span": 12,
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+ "key": "Other",
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+ "type": "textareaInput",
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+ "border": null,
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+ "disabledValue": null,
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+ "options": [],
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+ "children": null,
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+ "append": "",
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+ "placeholder": "",
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+ "required": null,
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+ "show-limit": false,
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+ "parentKey": null,
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+ "buttonName": null,
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+ "childrenKey": null
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+ },
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+ {
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+ "label": "医生/指导人员签名:",
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+ "defaultValue": null,
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+ "span": 12,
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+ "key": "Signature",
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+ "type": "signature",
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+ "border": null,
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+ "disabledValue": null,
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+ "options": [],
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+ "children": null,
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+ "append": "",
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+ "placeholder": "",
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+ "required": null,
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+ "show-limit": false,
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+ "parentKey": null,
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+ "buttonName": null,
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+ "childrenKey": null
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+ },
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+ {
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+ "label": "咨询电话:",
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+ "defaultValue": null,
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+ "span": 12,
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+ "key": "Phone",
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+ "type": "numberInput",
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+ "border": null,
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+ "disabledValue": null,
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+ "options": [],
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+ "children": null,
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+ "append": "",
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+ "placeholder": "",
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+ "required": null,
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+ "show-limit": false,
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+ "parentKey": null,
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+ "buttonName": null,
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+ "childrenKey": null
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+ },
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+ {
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+ "label": "日期",
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+ "defaultValue": null,
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+ "span": 12,
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+ "key": "DateTime",
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+ "type": "dateTime",
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+ "border": null,
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+ "disabledValue": null,
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+ "options": [],
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+ "children": null,
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+ "append": "",
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+ "placeholder": "",
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+ "required": null,
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+ "show-limit": false,
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+ "parentKey": null,
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+ "buttonName": null,
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+ "childrenKey": null
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+ },
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+ {
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+ "label": "食管癌患者健康教育处方使用说明 \r\n ★使用对象：食管癌患者。 \r\n ★使用方法 \r\n 1.本处方不能替代医务人员开具的医疗处方，主要用于患者健康生活方式指导。 \r\n 2.医务人员应结合患者的病情、健康危险因素等，为其提供有针对性的健康指导。",
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+ "defaultValue": null,
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+ "span": 12,
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+ "key": "DescriptionLabel",
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+ "type": "label",
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+ "border": null,
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+ "disabledValue": null,
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+ "options": [],
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+ "children": null,
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+ "append": "",
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+ "placeholder": "",
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+ "required": null,
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+ "show-limit": false,
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+ "parentKey": null,
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+ "buttonName": null,
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+ "childrenKey": null
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+ }
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+]
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