{"text_format":"1","workbook":"xlsx","n_sheets":1,"sheets":["ＣＴ同意書"],"not_rendered":{"charts":0,"images":0,"macros":1,"external_links":0,"defined_names":1,"comments":0,"pivot_tables":0},"unopened":[],"bounds":{"document_bytes":16777216,"sheet_cells":100000,"rows_first":2000,"rows_last":500,"rows_between":2000,"halvings":0,"cell_chars":16384,"cell_head_chars":4096},"cells_cut":0,"cells_raw":0,"read":"whole","date_system":"1900"}

{"sheet":"ＣＴ同意書","index":0,"n_rows":39,"n_cols":18,"rows_kept":39,"cut":false,"hidden":false,"merged":[[0,1,0,20],[11,2,11,7],[11,8,11,10],[11,11,11,13],[11,14,11,16],[11,17,11,19],[30,3,30,18],[12,2,12,7],[12,8,12,10],[12,11,12,13],[12,14,12,16],[12,17,12,19],[13,2,13,7],[13,8,13,10],[13,11,13,13],[13,14,13,16],[13,17,13,19],[25,2,25,3],[25,4,25,9],[25,11,25,18],[27,2,28,19],[29,3,29,18],[36,10,36,16],[36,17,36,19],[38,2,38,19],[31,3,31,18],[32,3,33,5],[32,6,33,8],[32,12,33,18],[34,3,35,8],[34,10,34,16]]}
[null,"【ＣＴ検査】　説明同意書"]
[]
[]
[null,"【ＣＴ検査の有用性】"]
[null,null,"ＣＴ検査は身体の周りからエックス線を当て、体内の情報を収集し、それをコンピュータ処理して"]
[null,null," 身体の断層画像を得る検査です。"]
[]
[]
[null,"【ＣＴ検査の被ばくについて】"]
[null,null,"ＣＴ検査の放射線被ばく線量は他の検査より高いと言われています。そのため当院では適正な放射線量の"]
[null,null,"管理のため日本の標準診断参考レベル（DRLs2020）に準じて検査を行っています。"]
[null,null,"DLP（mGy・cm）",null,null,null,null,null,"頭部",null,null,"胸部",null,null,"胸部から骨盤",null,null,"上腹部から骨盤"]
[null,null,"診断参考レベル（DRLs2020）",null,null,null,null,null,1350,null,null,510,null,null,1200,null,null,880]
[null,null,"当院データ（標準体型）",null,null,null,null,null,1068,null,null,423,null,null,1069,null,null,794]
[]
[]
[null,"【妊娠について（女性のみお答えください）】"]
[null,null,"妊娠している可能性がある、または現在妊娠している",null,null,null,null,null,null,null,null,null,"はい",null,"いいえ",null,"わからない"]
[]
[]
[]
[]
[]
[]
[]
[null,null,"医療機関",null,null,null,null,null,null,null,null," 説明医師（署名）"]
[]
[null,null,"同意書"]
[]
[null,null,null,"私は、現在の病状及びＣＴ検査の必要性とその内容、これに伴う危険性等について説明を受け、理解しました"]
[null,null,null,"のでその実施を同意します。"]
[null,null,null,"尚、実施中に緊急の処置を行う必要性が生じた場合には適宜処置される事についても同意します。"]
[null,null,null,"□　同意する",null,null,"□　同意しない",null,null,null,null,null,"西暦　　　　　　　年　　　　月　　　　日"]
[]
[null,null,null,"社会福祉法人　聖隷福祉事業団\n聖隷佐倉市民病院　病院長　殿",null,null,null,null,null,null," 患者氏名"]
[]
[null,null,null,null,null,null,null,null,null,null,"代理人（署名）",null,null,null,null,null,null,"（続柄　　　　　　）"]
[null,null,null,"※　同意を拒否されても、また撤回されても診療上の不利益を受けることはありません。"]
[null,null,"2021/11/30　地域医療連携室　作成"]