raolu
/
PC-application


			
				
					
						
						
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							<!DOCTYPE html>
<html>

<head>
    <meta charset="UTF-8">
    <title>肺结核患者第一次入户随访记录表</title>
    <meta name="author" content="yihu.com" />
    <meta name="format-detection" content="telephone=no" />
    <meta name="viewport" content="width=device-width, initial-scale=1.0, minimum-scale=1.0, maximum-scale=1.0, user-scalable=0"
    />
    <meta name="apple-mobile-web-app-capable" content="yes" />
    <meta name="apple-mobile-web-app-status-bar-style" content="black" />
    <link rel="shortcut icon" href="../../../favicon.ico">
    <link rel="stylesheet" type="text/css" href="../../../css/element-ui.css" />
    <link rel="stylesheet" type="text/css" href="../../../css/cross.css" />
    <link rel="stylesheet" type="text/css" href="../../../css/bootstrap.min.css" />
    <link href="../../../plugins/toastr/toastr.min.css" rel="stylesheet">
    <link href="../css/fangshi-detail.css" rel="stylesheet">
</head>

<body>
    <div id="app">
        <table class="table table-bordered">
            <tr>
                <td class="col-w300 c-t-center">随访时间</td>
                <td colspan="3">
                    <el-date-picker :readonly="!editable" v-model="data2" type="date" placeholder="选择日期">
                    </el-date-picker>
                </td>
            </tr>
            <tr>
                <td class="col-w300 c-t-center">随访方式</td>
                <td colspan="3">
                    <el-radio :disabled="!editable" v-model="radio" label="1">门诊</el-radio>
                    <el-radio :disabled="!editable" v-model="radio" label="2">家庭</el-radio>
                </td>
            </tr>
            <tr>
                <td class="col-w300 c-t-center">患者类型</td>
                <td colspan="3">
                    <el-radio :disabled="!editable" v-model="radio" label="1">初治</el-radio>
                    <el-radio :disabled="!editable" v-model="radio" label="2">复治</el-radio>
                </td>
            </tr>
            <tr>
                <td class="col-w300 c-t-center">痰菌情况</td>
                <td colspan="3">
                    <el-radio :disabled="!editable" v-model="radio" label="1">阳性</el-radio>
                    <el-radio :disabled="!editable" v-model="radio" label="2">阴性</el-radio>
                    <el-radio :disabled="!editable" v-model="radio" label="3">未查痰</el-radio>
                </td>
            </tr>
            <tr>
                <td class="col-w300 c-t-center">耐药情况</td>
                <td colspan="3">
                    <el-radio :disabled="!editable" v-model="radio" label="1">耐药</el-radio>
                    <el-radio :disabled="!editable" v-model="radio" label="2">非耐药</el-radio>
                    <el-radio :disabled="!editable" v-model="radio" label="2">未检测</el-radio>
                </td>
            </tr>
            <tr>
                <td class="col-w300">症状及体征：
                    <el-checkbox-group v-model="check" :disabled="!editable">
                        <el-checkbox label="1" style="margin-left:30px;">没有盗汗</el-checkbox>
                        <el-checkbox label="1">咳嗽咳痰</el-checkbox>
                        <el-checkbox label="1">低热盗汗</el-checkbox>
                        <el-checkbox label="1">咳血或血痰</el-checkbox>
                        <el-checkbox label="1">胸痛消瘦</el-checkbox>
                        <el-checkbox label="1">恶心纳差</el-checkbox>
                        <el-checkbox label="1">头痛失眠</el-checkbox>
                        <el-checkbox label="1">视物模糊</el-checkbox>
                        <el-checkbox label="1">皮肤瘙痒、皮疹</el-checkbox>
                        <el-checkbox label="1">耳鸣、听力下降</el-checkbox>
                    </el-checkbox-group>
                </td>
                <td colspan="3" style="vertical-align: initial;">
                    其他：
                    <el-input type="textarea" :readonly="!editable" v-model="input" placeholder="" clearable></el-input>
                </td>
            </tr>
            <tr>
                <td class="table2Td" colspan="3">
                    <table class="table2">
                        <tr>
                            <td class="c-t-center" rowspan="3" style="border-bottom: 0;width: 100px;">用药</td>
                            <td class="c-t-center" style="width: 200px;">
                                化疗方案
                            </td>
                            <td class="c-t-center">
                                <el-input :readonly="!editable" v-model="input" placeholder="" clearable></el-input>
                            </td>
                        </tr>
                        <tr>
                            <td class="c-t-center">用法</td>
                            <td>
                                <el-input :readonly="!editable" v-model="input" placeholder="" clearable></el-input>
                            </td>
                        </tr>
                        <tr>
                            <td class="c-t-center">药品剂型</td>
                            <td>
                                <el-input :readonly="!editable" v-model="input" placeholder="" clearable></el-input>
                            </td>
                        </tr>
                    </table>
                </td>
            </tr>
            <tr>
                <td class="col-w300 c-t-center">督导人员选择</td>
                <td colspan="2">
                    <el-radio :disabled="!editable" v-model="radio" label="1">医生</el-radio>
                    <el-radio :disabled="!editable" v-model="radio" label="2">家属</el-radio>
                    <el-radio :disabled="!editable" v-model="radio" label="2">自服药</el-radio>
                    <el-radio :disabled="!editable" v-model="radio" label="2">其他</el-radio>
                </td>
            </tr>
            <tr>
                <td class="table2Td" colspan="3">
                    <table class="table2">
                        <tr>
                            <td class="c-t-center" rowspan="2" style="border-bottom: 0;width: 100px;">家庭居住环境评估</td>
                            <td class="c-t-center" style="width: 200px;">
                                单独的居室
                            </td>
                            <td>
                                <el-radio :disabled="!editable" v-model="radio" label="2">有</el-radio>
                                <el-radio :disabled="!editable" v-model="radio" label="2">无</el-radio>
                            </td>
                        </tr>
                        <tr>
                            <td class="c-t-center">通风情况</td>
                            <td>
                                <el-radio :disabled="!editable" v-model="radio" label="2">良好</el-radio>
                                <el-radio :disabled="!editable" v-model="radio" label="2">一般</el-radio>
                                <el-radio :disabled="!editable" v-model="radio" label="2">差</el-radio>
                            </td>
                        </tr>
                        <tr>
                            <td class="c-t-center" rowspan="2" style="border-bottom: 0;width: 100px;">生活方式评估</td>
                            <td class="c-t-center" style="width: 200px;">
                                吸烟
                            </td>
                            <td>
                                <input type="text"> 支/天
                            </td>
                        </tr>
                        <tr>
                            <td class="c-t-center">喝酒</td>
                            <td>
                                <input type="text"> 两/天
                            </td>
                        </tr>
                    </table>
                </td>
            </tr>
            <tr>
                <td class="table2Td" colspan="3">
                    <table class="table2">
                        <tr>
                            <td class="col-w300 c-t-center" rowspan="10" style="width:50px;">健康教育及培训</td>
                            <td style="width:250px;">
                                取药地点、时间
                            </td>
                            <td>
                                地点：
                                <el-input type="textarea" :readonly="!editable" v-model="input" placeholder="" clearable></el-input>
                                <br> 时间:
                                <el-date-picker :readonly="!editable" v-model="data2" type="date" placeholder="选择日期">
                                </el-date-picker>
                            </td>
                        </tr>
                        <tr>
                            <td>服药记录卡的填写</td>
                            <td>
                                <el-radio :disabled="!editable" v-model="radio" label="2">掌握</el-radio>
                                <el-radio :disabled="!editable" v-model="radio" label="2">未掌握</el-radio>
                            </td>
                        </tr>
                        <tr>
                            <td>服药方法及药品存放</td>
                            <td>
                                <el-radio :disabled="!editable" v-model="radio" label="2">掌握</el-radio>
                                <el-radio :disabled="!editable" v-model="radio" label="2">未掌握</el-radio>
                            </td>
                        </tr>
                        <tr>
                            <td>肺结核治疗疗程</td>
                            <td>
                                <el-radio :disabled="!editable" v-model="radio" label="2">掌握</el-radio>
                                <el-radio :disabled="!editable" v-model="radio" label="2">未掌握</el-radio>
                            </td>
                        </tr>
                        <tr>
                            <td>不规律服药危害</td>
                            <td>
                                <el-radio :disabled="!editable" v-model="radio" label="2">掌握</el-radio>
                                <el-radio :disabled="!editable" v-model="radio" label="2">未掌握</el-radio>
                            </td>
                        </tr>
                        <tr>
                            <td>服药后不良反应及处理</td>
                            <td>
                                <el-radio :disabled="!editable" v-model="radio" label="2">掌握</el-radio>
                                <el-radio :disabled="!editable" v-model="radio" label="2">未掌握</el-radio>
                            </td>
                        </tr>
                        <tr>
                            <td>治疗期间复诊查痰</td>
                            <td>
                                <el-radio :disabled="!editable" v-model="radio" label="2">掌握</el-radio>
                                <el-radio :disabled="!editable" v-model="radio" label="2">未掌握</el-radio>
                            </td>
                        </tr>
                        <tr>
                            <td>外出期间如何坚持服药</td>
                            <td>
                                <el-radio :disabled="!editable" v-model="radio" label="2">掌握</el-radio>
                                <el-radio :disabled="!editable" v-model="radio" label="2">未掌握</el-radio>
                            </td>
                        </tr>
                        <tr>
                            <td>生活习惯及注意事项</td>
                            <td>
                                <el-radio :disabled="!editable" v-model="radio" label="2">掌握</el-radio>
                                <el-radio :disabled="!editable" v-model="radio" label="2">未掌握</el-radio>
                            </td>
                        </tr>
                        <tr>
                            <td>密切接触者检查</td>
                            <td>
                                <el-radio :disabled="!editable" v-model="radio" label="2">掌握</el-radio>
                                <el-radio :disabled="!editable" v-model="radio" label="2">未掌握</el-radio>
                            </td>
                        </tr>
                    </table>
                </td>
            </tr>
            <tr>
                <td class="col-w300 c-t-center">下次随访时间</td>
                <td>
                    <el-date-picker :readonly="!editable" v-model="data2" type="date" placeholder="选择日期">
                    </el-date-picker>
                </td>
            </tr>
            <tr>
                <td class="col-w300 c-t-center">评估医生签名</td>
                <td>
                    <el-radio :disabled="!editable" v-model="radio" label="1">耐药</el-radio>
                    <el-radio :disabled="!editable" v-model="radio" label="2">非耐药</el-radio>
                    <el-radio :disabled="!editable" v-model="radio" label="2">未检测</el-radio>
                </td>
            </tr>
        </table>
    </div>
    <script src="../../../js/vue.js" type="text/javascript" charset="utf-8"></script>
    <script src="../../../js/jquery-2.2.4.js" type="text/javascript" charset="utf-8"></script>
    <script src="../../../plugins/toastr/toastr.min.js"></script>
    <script src="../../../js/es6-promise.js" type="text/javascript" charset="utf-8"></script>
    <script src="../../../js/underscore.js" type="text/javascript" charset="utf-8"></script>
    <script src="../../../js/element-ui.js" type="text/javascript" charset="utf-8"></script>
    <!--<script src="../../../api/http-request.js" type="text/javascript" charset="utf-8"></script>-->
    <script>
        new Vue({
            el: "#app",
            data: function () {
                return {
                    editable: true,
                    data2: "",
                    radio: "",
                    input: '',
                    check: '',
                }
            }
        })
    </script>
</body>

</html>