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@@ -0,0 +1,787 @@
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+{
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+ "Key": "FollowUpTuberculosisFirstRecord",
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+ "Name": "肺结核患者第一次入户随访记录表",
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+ "Content": [
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+ {
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+ "label": "基本信息",
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+ "defaultValue": [],
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+ "span": 12,
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+ "key": "BasicInfo",
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+ "type": "input",
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+ "border": false,
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+ "disabledValue": "1",
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+ "options": [],
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+ "children": [
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+ {
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+ "label": "患者类型",
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+ "defaultValue": [],
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+ "span": 24,
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+ "key": "Patients_Type",
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+ "type": "radio",
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+ "border": false,
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+ "disabledValue": "0",
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+ "options": [
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+ {
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+ "label": "初治",
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+ "value": "1"
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+ },
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+ {
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+ "label": "复治",
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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": "BasicInfo",
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+ "buttonName": null,
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+ "childrenKey": null,
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+ "groupKeys": []
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+ },
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+ {
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+ "label": "痰菌情况",
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+ "defaultValue": [],
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+ "span": 24,
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+ "key": "Sputum",
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+ "type": "radio",
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+ "border": false,
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+ "disabledValue": "0",
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+ "options": [
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+ {
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+ "label": "阳性",
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+ "value": "1"
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+ },
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+ {
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+ "label": "阴性",
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+ "value": "2"
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+ },
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+ {
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+ "label": "未查痰",
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+ "value": "3"
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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": "BasicInfo",
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+ "buttonName": null,
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+ "childrenKey": null,
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+ "groupKeys": []
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+ },
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+ {
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+ "label": "耐药情况",
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+ "defaultValue": [],
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+ "span": 24,
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+ "key": "Drug_Fast",
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+ "type": "radio",
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+ "border": false,
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+ "disabledValue": "0",
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+ "options": [
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+ {
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+ "label": "耐药",
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+ "value": "1"
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+ },
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+ {
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+ "label": "非耐药",
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+ "value": "2"
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+ },
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+ {
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+ "label": "未检测",
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+ "value": "3"
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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": "BasicInfo",
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+ "buttonName": null,
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+ "childrenKey": null,
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+ "groupKeys": []
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+ }
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+ ],
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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": "",
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+ "buttonName": null,
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+ "childrenKey": null,
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+ "groupKeys": []
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+ },
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+ {
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+ "label": "症状",
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+ "defaultValue": [],
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+ "span": 24,
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+ "key": "Symptomatic",
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+ "type": "input",
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+ "border": false,
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+ "disabledValue": "1",
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+ "options": [],
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+ "children": [
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+ {
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+ "label": "症状及体征",
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+ "defaultValue": [],
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+ "span": 24,
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+ "key": "Symptom",
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+ "type": "checkBoxIncludeOther",
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+ "border": false,
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+ "disabledValue": "1",
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+ "options": [
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+ {
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+ "label": "没有症状",
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+ "value": "0"
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+ },
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+ {
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+ "label": " 咳嗽咳痰",
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+ "value": "1"
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+ },
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+ {
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+ "label": "低热盗汗",
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+ "value": "2"
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+ },
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+ {
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+ "label": "咯血或血痰",
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+ "value": "3"
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+ },
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+ {
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+ "label": "胸痛消瘦",
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+ "value": "4"
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+ },
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+ {
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+ "label": "恶心纳差",
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+ "value": "5"
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+ },
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+ {
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+ "label": "头痛失眠",
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+ "value": "6"
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+ },
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+ {
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+ "label": "视物模糊",
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+ "value": "7"
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+ },
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+ {
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+ "label": "皮肤瘙痒、皮疹",
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+ "value": "8"
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+ },
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+ {
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+ "label": "耳鸣、听力下降",
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+ "value": "9"
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+ },
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+ {
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+ "label": "其他",
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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": 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": "Symptomatic",
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+ "buttonName": null,
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+ "childrenKey": ["Symptom_Other"],
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+ "groupKeys": ["10"]
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+ }
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+ ],
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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": "",
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+ "buttonName": null,
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+ "childrenKey": null,
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+ "groupKeys": []
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+ },
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+ {
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+ "label": "用药",
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+ "defaultValue": [],
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+ "span": 24,
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+ "key": "Medication",
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+ "type": "radio",
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+ "border": false,
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+ "disabledValue": "1",
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+ "options": [],
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+ "children": [
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+ {
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+ "label": "化疗方案",
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+ "defaultValue": [],
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+ "span": 24,
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+ "key": "Chemotherapy",
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+ "type": "input",
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+ "border": false,
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+ "disabledValue": "1",
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+ "options": [],
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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": "Medication",
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+ "buttonName": null,
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+ "childrenKey": null,
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+ "groupKeys": []
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+ },
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+ {
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+ "label": "用法",
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+ "defaultValue": [],
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+ "span": 24,
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+ "key": "Usage",
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+ "type": "radio",
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+ "border": false,
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+ "disabledValue": "1",
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+ "options": [
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+ {
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+ "label": "每日",
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+ "value": "1"
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+ },
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+ {
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+ "label": "间歇",
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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": "Medication",
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+ "buttonName": null,
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+ "childrenKey": null,
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+ "groupKeys": null
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+ },
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+ {
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+ "label": "药品剂型",
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+ "defaultValue": [],
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+ "span": 24,
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+ "key": "Drug_Form",
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+ "type": "radio",
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+ "border": false,
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+ "disabledValue": "0",
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+ "options": [
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+ {
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+ "label": "固定剂量复合制剂",
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+ "value": "1"
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+ },
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+ {
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+ "label": "散装药",
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+ "value": "2"
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+ },
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+ {
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+ "label": "板式组合药",
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+ "value": "3"
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+ },
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+ {
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+ "label": "注射剂",
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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": 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": "Medication",
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+ "buttonName": null,
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+ "childrenKey": null,
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+ "groupKeys": null
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+ },
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+ {
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+ "label": "督导人员选择",
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+ "defaultValue": [],
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+ "span": 24,
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+ "key": "Supervisor",
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+ "type": "radio",
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+ "border": false,
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+ "disabledValue": "0",
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+ "options": [
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+ {
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+ "label": "医生",
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+ "value": "1"
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+ },
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+ {
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+ "label": "家属",
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+ "value": "2"
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+ },
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+ {
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+ "label": "自服药",
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+ "value": "3"
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+ },
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+ {
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+ "label": "其他",
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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": 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": "Medication",
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+ "buttonName": null,
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+ "childrenKey": ["Supervisor_Other"],
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+ "groupKeys": ["4"]
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+ }
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+ ],
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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": "",
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+ "buttonName": null,
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+ "childrenKey": null,
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+ "groupKeys": []
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+ },
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+ {
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+ "label": "家庭居住环境评估",
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+ "defaultValue": [],
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+ "span": 24,
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+ "key": "HomeLivingEnvironmentAssessment",
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+ "type": "input",
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+ "border": false,
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+ "disabledValue": "1",
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+ "options": [],
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+ "children": [
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+ {
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+ "label": "单独的居室",
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+ "defaultValue": [],
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+ "span": 24,
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+ "key": "Bedroom",
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+ "type": "radio",
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+ "border": false,
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+ "disabledValue": "1",
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+ "options": [
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+ {
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+ "label": "有",
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+ "value": "1"
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+ },
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+ {
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+ "label": "无",
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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": "HomeLivingEnvironmentAssessment",
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+ "buttonName": null,
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+ "childrenKey": [],
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+ "groupKeys": []
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+ },
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+ {
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+ "label": "通风情况",
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+ "defaultValue": [],
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+ "span": 24,
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+ "key": "Ventilate",
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+ "type": "radio",
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+ "border": false,
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+ "disabledValue": "1",
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+ "options": [
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+ {
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+ "label": "良好",
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+ "value": "1"
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+ },
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+ {
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+ "label": "一般",
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+ "value": "2"
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+ },
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+ {
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+ "label": "差",
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+ "value": "3"
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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": "HomeLivingEnvironmentAssessment",
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+ "buttonName": null,
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+ "childrenKey": null,
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+ "groupKeys": []
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+ "append": null,
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+ "groupKeys": []
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+ },
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+ {
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+ "label": "生活方式评估",
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+ "defaultValue": [],
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+ "span": 24,
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+ "key": "LifestyleAssessment",
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+ "type": "input",
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+ "border": false,
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+ "disabledValue": "1",
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+ "options": [],
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+ "children": [
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+ {
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+ "label": "吸烟",
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+ "defaultValue": null,
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+ "span": 12,
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+ "key": "Smoke",
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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": "支",
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+ "placeholder": "",
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+ "required": null,
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+ "show-limit": false,
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+ "parentKey": "LifestyleAssessment",
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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": "饮酒",
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+ "defaultValue": null,
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+ "span": 12,
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+ "key": "Drink",
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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": "两",
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+ "placeholder": "",
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+ "required": null,
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+ "show-limit": false,
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+ "parentKey": "LifestyleAssessment",
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+ "buttonName": null,
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+ "childrenKey": null
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+ }
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+ "groupKeys": []
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+}
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