开颅颅内肿瘤切除术知情同意书英文版.doc

Craniotomy for intracranial tumor resection informed consentPatient nameGenderAgeMedical record numberDisease presentation and treatment recommendationsDoctors have advised me With tumor，Need Anesthesia Surgery。Neurosurgery of intracranial tumor is one of the most common diseases, divided into two major categories of primary and secondary. Primary brain tumors can occur in brain tissue, meninges, cranial nerves, pituitary gland, blood vessels and embryo residue organizations. Refers to the body of secondary tumors in other parts of the formation of cancer metastasis or invasion of intracranial metastases. Cancer etiology is not clear at present that induce tumor factors: genetic factors, physical factors, chemical factors and oncogenic viruses. Intracranial tumors often cause increased intracranial pressure and pressure on the surrounding brain tissue or damage caused by the emergence of symptoms of nervous system orientation.Without treatment, the tumor gradually grew up with, can cause progressive increase in intracranial pressure, when the tumor or cystic tumor bleeding, and can demonstrate acute intracranial hypertension, severe or advanced cancer are often hernia the formation. This is often the direct cause of death led to the patient.Many treatment of intracranial tumors, surgery is still in todays most commonly used in brain tumor is the most effective treatment. Surgery aims to relieve intracranial pressure and reduce the pressure on the surrounding brain tissue and thus to improve the symptoms, a clear pathological diagnosis, provide a basis for further treatment.Depending on the specific surgical technique is different from the patients condition, the doctor told me to discuss with my doctor about my surgery, the specific content.Potential surgical risks and measuresDoctors told me the following craniotomy resection of brain tumors may occur a number of risks, some risks may not be unusual in this list, depending on the specific type of surgery the patients situation is different, the doctor told me that with my doctor discuss the specific content of my surgery, if I have special problems to discuss with my doctor.1 I understand that there is any risk of anesthesia.(2) I understand that any drugs used are likely to cause side effects, including mild nausea, rash and other symptoms to severe anaphylactic shock, even life-threatening.3 I understand the possible risks of this surgery and doctors:1) massive hemorrhage, disseminated intravascular coagulation, surgery can not be, shock or even death.2) patients because of lesions or health reasons, the termination of surgery.3) intraoperative acute brain swelling, severe cases can lead to death.4) surgery according to the specific circumstances in deciding whether to go to hemicraniectomy.5) may occur after disturbance of consciousness, paralysis of limbs, hemianopia, partial body sensory deficits, aphasia, seizures, mental mental disorders.6) The hypothalamus injury, long-term coma, gastrointestinal bleeding, high fever, diabetes insipidus, water and electrolyte imbalance, severe cases can be life-threatening.7) the tumor can not be completely removed or not removed, postoperative residual, relapse, requiring further radiotherapy treatment or reoperation.8) of the original symptoms and signs do not improve, or actually worsened, the original disease-induced deterioration.9) returns the result of malignant pathology, radiotherapy and chemotherapy and long-term prognosis to be poor.10) cerebrospinal fluid leakage, if necessary, secondary surgical repair.11) intracranial hematoma, malignant brain edema, if necessary, re-craniotomy or decompressive craniectomy, and the remaining part of skull defects, affecting the appearance.12) intracranial infection, severe lumbar puncture be repeated lumbar puncture or catheter drainage, increased hospitalization time and costs.13) after a sudden increase existing underlying diseases, or after acute or chronic heart, lung, liver, kidneys and other vital organ failure and life-threatening.Special RisksI understand that according to my personal condition, I may or risk of complications following special： Once these risks and accidents occur, the doctor will take a positive response.Informed choice in patientsMy doctor has told me the way to conduct the surgery, the surgery and possible complications and risks, there may be other treatments and answered my questions about the surgery.I agree with the doctors in the surgery can be scheduled according to my condition of the surgical approach to make adjustments.I understand I need a number of doctors surgery together.I have not been 100% successful surgery promises.I authorize the physician of the surgical removal of diseased organs, tissues or specimens for disposal, including pathology, cytology, and medical waste disposal.Patient signature Signature Date If the patient is unable to sign informed consent, requesting authorization relatives in this signature:Relatives of patients with authorized signature Relationship with patients Signature Date