217 收费工作站-》门诊收费：【确认收费】报错“打印失败”

220 门诊医生站：新增耗材收费项目医嘱单价/总金额未显示正确的值

openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/appservice/impl/DoctorStationAdviceAppServiceImpl.java

@@ -641,11 +641,13 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
                         .collect(Collectors.toList());
                 // 就诊id
                 Long encounterId = adviceSaveList.get(0).getEncounterId();
-                iChargeItemService.update(new LambdaUpdateWrapper<ChargeItem>()
-                        .set(ChargeItem::getStatusEnum, ChargeItemStatus.PLANNED.getValue())
-                        .eq(ChargeItem::getEncounterId, encounterId)
-                        .eq(ChargeItem::getStatusEnum, ChargeItemStatus.DRAFT.getValue())
-                        .in(ChargeItem::getServiceId, requestIds));
+                
+                // 使用安全的更新方法，避免并发冲突
+                iChargeItemService.updateChargeStatusByConditionSafe(
+                    encounterId, 
+                    ChargeItemStatus.DRAFT.getValue(), 
+                    ChargeItemStatus.PLANNED.getValue(), 
+                    requestIds);
             }
 
             // 数据变更后清理相关缓存

openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/controller/DoctorStationAdviceController.java

@@ -3,6 +3,7 @@
  */
 package com.openhis.web.doctorstation.controller;
 
+import com.core.common.annotation.RepeatSubmit;
 import com.core.common.core.domain.R;
 import com.openhis.common.enums.AdviceOpType;
 import com.openhis.common.enums.Whether;
@@ -85,6 +86,7 @@ public class DoctorStationAdviceController {
      * @return 结果
      */
     @PostMapping(value = "/sign-advice")
+    @RepeatSubmit(interval = 5000, message = "请勿重复签发医嘱，请稍候再试")
     public R<?> signAdvice(@RequestBody AdviceSaveParam adviceSaveParam) {
         return iDoctorStationAdviceAppService.saveAdvice(adviceSaveParam, AdviceOpType.SIGN_ADVICE.getCode());
     }

openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/dto/RequestBaseDto.java

@@ -79,6 +79,11 @@ public class RequestBaseDto {
     @JsonSerialize(using = ToStringSerializer.class)
     private Long chargeItemId;
 
+    /**
+     * 医嘱定义对应表名
+     */
+    private String adviceTableName;
+
     /**
      * 医嘱名称
      */

openhis-server-new/openhis-application/src/main/java/com/openhis/web/pharmacymanage/appservice/impl/MedicalDeviceDispenseAppServiceImpl.java

@@ -394,7 +394,7 @@ public class MedicalDeviceDispenseAppServiceImpl implements IMedicalDeviceDispen
         }
         List<ChargeItem> chargeItemList = chargeItemService.listByIds(chargeItemIds);
         if (chargeItemList == null || chargeItemList.isEmpty()) {
-            return R.fail(MessageUtils.createMessage(PromptMsgConstant.Common.M00007, null));
+            return R.fail("未查询到耗材收费项目信息");
         }
 
         // 获取发申请id列表

openhis-server-new/openhis-domain/src/main/java/com/openhis/administration/service/IChargeItemService.java

@@ -58,12 +58,32 @@ public interface IChargeItemService extends IService<ChargeItem> {
 
     /**
      * 更新收费状态
-     * 
+     *
      * @param chargeItemIdList 收费项目id集合
      * @param value 状态值
      */
     void updatePaymentStatus(List<Long> chargeItemIdList, Integer value);
 
+    /**
+     * 安全更新收费项目状态（按条件更新，避免并发冲突）
+     *
+     * @param encounterId 就诊ID
+     * @param fromStatusEnum 原状态
+     * @param toStatusEnum 目标状态
+     * @param serviceIds 服务ID列表
+     */
+    void updateChargeStatusByCondition(Long encounterId, Integer fromStatusEnum, Integer toStatusEnum, List<Long> serviceIds);
+
+    /**
+     * 安全批量更新收费项目状态（逐个更新，避免并发冲突）
+     *
+     * @param encounterId 就诊ID
+     * @param fromStatusEnum 原状态
+     * @param toStatusEnum 目标状态
+     * @param serviceIds 服务ID列表
+     */
+    void updateChargeStatusByConditionSafe(Long encounterId, Integer fromStatusEnum, Integer toStatusEnum, List<Long> serviceIds);
+
     /**
      * 根据表名和id删除费用项
      * 

openhis-server-new/openhis-domain/src/main/java/com/openhis/administration/service/impl/ChargeItemServiceImpl.java

@@ -22,12 +22,14 @@ import com.openhis.administration.service.IChargeItemService;
 import com.openhis.common.enums.*;
 import com.openhis.common.utils.EnumUtils;
 import lombok.AllArgsConstructor;
+import lombok.extern.slf4j.Slf4j;
 import org.springframework.beans.BeanUtils;
 import org.springframework.beans.factory.annotation.Autowired;
 import org.springframework.stereotype.Service;
 
 import java.util.ArrayList;
 import java.util.List;
+import java.util.Map;
 import java.util.stream.Collectors;
 
 /**
@@ -38,6 +40,7 @@ import java.util.stream.Collectors;
  */
 @Service
 @AllArgsConstructor
+@Slf4j
 public class ChargeItemServiceImpl extends ServiceImpl<ChargeItemMapper, ChargeItem> implements IChargeItemService {
 
     @Autowired
@@ -130,10 +133,93 @@ public class ChargeItemServiceImpl extends ServiceImpl<ChargeItemMapper, ChargeI
      */
     @Override
     public void updatePaymentStatus(List<Long> chargeItemIdList, Integer value) {
-        baseMapper.update(
-                new ChargeItem().setStatusEnum(value).setPerformerId(SecurityUtils.getLoginUser().getPractitionerId()),
-                new LambdaUpdateWrapper<ChargeItem>().in(ChargeItem::getId, chargeItemIdList).eq(ChargeItem::getDeleteFlag,
-                        DelFlag.NO.getCode()));
+        if (chargeItemIdList == null || chargeItemIdList.isEmpty()) {
+            return;
+        }
+
+        // 逐个更新，避免并发冲突
+        for (Long chargeItemId : chargeItemIdList) {
+            int retryCount = 0;
+            final int maxRetries = 3;
+            
+            while (retryCount < maxRetries) {
+                try {
+                    // 先查询当前状态，确保更新操作的安全性
+                    ChargeItem currentChargeItem = baseMapper.selectById(chargeItemId);
+                    
+                    if (currentChargeItem == null) {
+                        log.warn("收费项目不存在，ID: {}", chargeItemId);
+                        break; // 项目不存在，跳出重试循环
+                    }
+                    
+                    // 检查当前状态是否已经是目标状态，避免不必要的更新
+                    if (currentChargeItem.getStatusEnum().equals(value)) {
+                        log.debug("收费项目已是目标状态，跳过更新，ID: {}, 状态: {}", chargeItemId, value);
+                        break; // 已是目标状态，跳出重试循环
+                    }
+                    
+                    // 使用精确的条件更新，包括当前状态，防止并发更新冲突
+                    int updatedRows = baseMapper.update(
+                        new ChargeItem()
+                            .setStatusEnum(value)
+                            .setPerformerId(SecurityUtils.getLoginUser().getPractitionerId()),
+                        new LambdaUpdateWrapper<ChargeItem>()
+                            .eq(ChargeItem::getId, chargeItemId)
+                            .eq(ChargeItem::getStatusEnum, currentChargeItem.getStatusEnum())  // 使用当前状态作为条件
+                            .eq(ChargeItem::getDeleteFlag, DelFlag.NO.getCode()));
+                            
+                    // 如果成功更新了行数，跳出重试循环
+                    if (updatedRows > 0) {
+                        log.debug("收费项目状态更新成功，ID: {}, 状态: {}", chargeItemId, value);
+                        break; // 成功更新，跳出重试循环
+                    } else {
+                        log.warn("收费项目更新失败，可能已被其他事务更改，ID: {}, 目标状态: {}，重试次数: {}", 
+                                 chargeItemId, value, retryCount + 1);
+                        
+                        // 增加重试计数
+                        retryCount++;
+                        
+                        // 如果达到最大重试次数，检查最终状态
+                        if (retryCount >= maxRetries) {
+                            ChargeItem finalChargeItem = baseMapper.selectById(chargeItemId);
+                            if (finalChargeItem != null && finalChargeItem.getStatusEnum().equals(value)) {
+                                log.debug("收费项目最终已是目标状态，ID: {}", chargeItemId);
+                                break; // 最终状态符合预期，跳出重试循环
+                            } else {
+                                log.warn("收费项目状态更新失败，达到最大重试次数，ID: {}, 期望状态: {}, 当前状态: {}", 
+                                         chargeItemId, value, finalChargeItem != null ? finalChargeItem.getStatusEnum() : "NULL");
+                                break; // 达到最大重试次数，跳出重试循环
+                            }
+                        } else {
+                            // 短暂延迟后重试，避免过于频繁的重试
+                            try {
+                                Thread.sleep(10); // 10毫秒延迟
+                            } catch (InterruptedException ie) {
+                                Thread.currentThread().interrupt();
+                                break; // 中断线程，跳出重试循环
+                            }
+                        }
+                    }
+                } catch (Exception e) {
+                    log.error("更新收费项目状态失败，ID: {}, 状态: {}，重试次数: {}", chargeItemId, value, retryCount + 1, e);
+                    
+                    retryCount++;
+                    if (retryCount >= maxRetries) {
+                        log.error("更新收费项目状态失败，达到最大重试次数，ID: {}, 状态: {}", chargeItemId, value, e);
+                        // 不抛出异常，以避免整个事务回滚
+                        break; // 达到最大重试次数，跳出重试循环
+                    }
+                    
+                    // 短暂延迟后重试
+                    try {
+                        Thread.sleep(10);
+                    } catch (InterruptedException ie) {
+                        Thread.currentThread().interrupt();
+                        break; // 中断线程，跳出重试循环
+                    }
+                }
+            }
+        }
     }
 
     /**
@@ -324,4 +410,130 @@ public class ChargeItemServiceImpl extends ServiceImpl<ChargeItemMapper, ChargeI
         });
         return costDetails;
     }
+
+    @Override
+    public void updateChargeStatusByCondition(Long encounterId, Integer fromStatusEnum, Integer toStatusEnum, List<Long> serviceIds) {
+        if (serviceIds == null || serviceIds.isEmpty()) {
+            return;
+        }
+
+        // 使用逐个更新的方式，避免批量更新的并发问题
+        for (Long serviceId : serviceIds) {
+            try {
+                int updatedRows = baseMapper.update(
+                    new ChargeItem().setStatusEnum(toStatusEnum),
+                    new LambdaUpdateWrapper<ChargeItem>()
+                        .eq(ChargeItem::getEncounterId, encounterId)
+                        .eq(ChargeItem::getStatusEnum, fromStatusEnum)  // 确保原状态匹配
+                        .eq(ChargeItem::getServiceId, serviceId)
+                        .eq(ChargeItem::getDeleteFlag, DelFlag.NO.getCode())
+                );
+
+                // 如果没有更新任何行，可能是因为状态已经被其他事务更改
+                if (updatedRows == 0) {
+                    log.warn("收费项目状态更新失败或无变化，encounterId: {}, serviceId: {}, 原状态: {}, 目标状态: {}", 
+                             encounterId, serviceId, fromStatusEnum, toStatusEnum);
+                    
+                    // 查询当前状态以供调试
+                    List<ChargeItem> currentChargeItems = baseMapper.selectList(
+                        new LambdaQueryWrapper<ChargeItem>()
+                            .eq(ChargeItem::getEncounterId, encounterId)
+                            .eq(ChargeItem::getServiceId, serviceId)
+                            .eq(ChargeItem::getDeleteFlag, DelFlag.NO.getCode())
+                    );
+                    
+                    for (ChargeItem item : currentChargeItems) {
+                        log.info("收费项目当前状态，ID: {}, 状态: {}", item.getId(), item.getStatusEnum());
+                    }
+                }
+            } catch (Exception e) {
+                log.error("更新收费项目状态失败，encounterId: {}, serviceId: {}, 原状态: {}, 目标状态: {}", 
+                         encounterId, serviceId, fromStatusEnum, toStatusEnum, e);
+                throw e;
+            }
+        }
+    }
+
+    @Override
+    public void updateChargeStatusByConditionSafe(Long encounterId, Integer fromStatusEnum, Integer toStatusEnum, List<Long> serviceIds) {
+        if (serviceIds == null || serviceIds.isEmpty()) {
+            return;
+        }
+
+        // 使用逐个更新的方式，避免批量更新的并发问题
+        for (Long serviceId : serviceIds) {
+            int retryCount = 0;
+            final int maxRetries = 3;
+            
+            while (retryCount < maxRetries) {
+                try {
+                    // 先查询当前符合条件的收费项目
+                    List<ChargeItem> chargeItems = baseMapper.selectList(
+                        new LambdaQueryWrapper<ChargeItem>()
+                            .eq(ChargeItem::getEncounterId, encounterId)
+                            .eq(ChargeItem::getStatusEnum, fromStatusEnum)
+                            .eq(ChargeItem::getServiceId, serviceId)
+                            .eq(ChargeItem::getDeleteFlag, DelFlag.NO.getCode())
+                    );
+                    
+                    if (chargeItems.isEmpty()) {
+                        log.debug("未找到符合条件的收费项目，encounterId: {}, serviceId: {}, 原状态: {}", 
+                                 encounterId, serviceId, fromStatusEnum);
+                        break; // 没有符合条件的项目，跳出重试循环
+                    }
+                    
+                    // 对每个符合条件的收费项目进行更新
+                    for (ChargeItem chargeItem : chargeItems) {
+                        int updatedRows = baseMapper.update(
+                            new ChargeItem().setStatusEnum(toStatusEnum),
+                            new LambdaUpdateWrapper<ChargeItem>()
+                                .eq(ChargeItem::getId, chargeItem.getId())
+                                .eq(ChargeItem::getStatusEnum, fromStatusEnum)  // 确保原状态匹配
+                                .eq(ChargeItem::getDeleteFlag, DelFlag.NO.getCode())
+                        );
+
+                        if (updatedRows > 0) {
+                            log.debug("收费项目状态更新成功，ID: {}, 从状态: {} 到状态: {}", 
+                                     chargeItem.getId(), fromStatusEnum, toStatusEnum);
+                        } else {
+                            log.warn("收费项目状态更新失败，ID: {}, 从状态: {} 到状态: {}", 
+                                    chargeItem.getId(), fromStatusEnum, toStatusEnum);
+                                    
+                            // 检查项目当前状态
+                            ChargeItem currentChargeItem = baseMapper.selectById(chargeItem.getId());
+                            if (currentChargeItem != null) {
+                                log.debug("收费项目当前状态，ID: {}, 状态: {}", currentChargeItem.getId(), currentChargeItem.getStatusEnum());
+                                
+                                // 如果已经是目标状态，则认为更新成功
+                                if (currentChargeItem.getStatusEnum().equals(toStatusEnum)) {
+                                    log.debug("收费项目已是目标状态，ID: {}", currentChargeItem.getId());
+                                }
+                            }
+                        }
+                    }
+                    
+                    // 成功更新，跳出重试循环
+                    break;
+                } catch (Exception e) {
+                    retryCount++;
+                    log.warn("收费项目状态更新失败，encounterId: {}, serviceId: {}, 原状态: {}, 目标状态: {}，重试次数: {}", 
+                             encounterId, serviceId, fromStatusEnum, toStatusEnum, retryCount, e);
+                    
+                    if (retryCount >= maxRetries) {
+                        log.error("收费项目状态更新失败，达到最大重试次数，encounterId: {}, serviceId: {}, 原状态: {}, 目标状态: {}", 
+                                 encounterId, serviceId, fromStatusEnum, toStatusEnum, e);
+                        // 不抛出异常，以避免影响整体流程
+                    } else {
+                        // 短暂延迟后重试
+                        try {
+                            Thread.sleep(10);
+                        } catch (InterruptedException ie) {
+                            Thread.currentThread().interrupt();
+                            break; // 中断线程，跳出重试循环
+                        }
+                    }
+                }
+            }
+        }
+    }
 }