fix(core): 修复审计字段缺失和组件状态管理问题

- 在Account、ChargeItem、EncounterParticipant和Encounter服务中添加审计字段验证
- 确保tenantId、createBy和createTime字段在插入数据库前正确设置
- 修复EMR模块中删除模板API的导出问题
- 更新患者信息状态管理，统一使用localPatientInfo替换patientInfo
- 在EMR组件中实现防抖机制优化历史记录刷新性能
- 修复病历模板切换时的表单数据重置逻辑
- 在首页统计组件中使用markRaw包装图标组件
- 为住院记录模板添加默认表单数据结构
- 修复SVG患者图标路径错误

openhis-server-new/openhis-application/src/main/java/com/openhis/web/paymentmanage/appservice/impl/PaymentRecServiceImpl.java

@@ -1419,6 +1419,19 @@ public class PaymentRecServiceImpl implements IPaymentRecService {
             }
         }
 
+        // 确保所有PaymentRecDetail对象的审计字段被设置，防止违反NOT NULL约束
+        for (PaymentRecDetail detail : paymentRecDetails) {
+            if (detail.getTenantId() == null) {
+                detail.setTenantId(SecurityUtils.getLoginUser().getTenantId());
+            }
+            if (detail.getCreateBy() == null || detail.getCreateBy().isEmpty()) {
+                detail.setCreateBy(SecurityUtils.getLoginUser().getUsername());
+            }
+            if (detail.getCreateTime() == null) {
+                detail.setCreateTime(new Date());
+            }
+        }
+
         paymentRecDetailService.saveBatch(paymentRecDetails);
     }
 
@@ -1754,6 +1767,17 @@ public class PaymentRecServiceImpl implements IPaymentRecService {
         BeanUtils.copyProperties(outpatientRegistrationAddParam.getChargeItemFormData(), chargeItem);
         chargeItem.setContextEnum(ChargeItemContext.REGISTER.getValue());// 挂号
 
+        // 确保必需的审计字段被设置，防止违反NOT NULL约束
+        if (chargeItem.getTenantId() == null) {
+            chargeItem.setTenantId(SecurityUtils.getLoginUser().getTenantId());
+        }
+        if (chargeItem.getCreateBy() == null || chargeItem.getCreateBy().isEmpty()) {
+            chargeItem.setCreateBy(SecurityUtils.getLoginUser().getUsername());
+        }
+        if (chargeItem.getCreateTime() == null) {
+            chargeItem.setCreateTime(new Date());
+        }
+
         YbPsnSetlWay finCategory = YbPsnSetlWay.getByValue(outpatientRegistrationAddParam.getYbPsnSetlWay());
         if (finCategory == null) {
             throw new ServiceException("请选择收费方式");
@@ -1818,11 +1842,23 @@ public class PaymentRecServiceImpl implements IPaymentRecService {
         // 保存就诊信息
         Encounter encounter = new Encounter();
         BeanUtils.copyProperties(encounterFormData, encounter);
-        // 将挂号医生ID提前塞入 encounter 的 registrarId，便于生成“科室+医生+当日”序号
+        // 将挂号医生ID提前塞入 encounter 的 registrarId，便于生成"科室+医生+当日"序号
         if (encounterParticipantFormData.getPractitionerId() != null) {
             encounter.setRegistrarId(encounterParticipantFormData.getPractitionerId());
         }
         encounter.setBusNo(outpatientRegistrationSettleParam.getBusNo());
+
+        // 确保必需的审计字段被设置，防止违反NOT NULL约束
+        if (encounter.getTenantId() == null) {
+            encounter.setTenantId(SecurityUtils.getLoginUser().getTenantId());
+        }
+        if (encounter.getCreateBy() == null || encounter.getCreateBy().isEmpty()) {
+            encounter.setCreateBy(SecurityUtils.getLoginUser().getUsername());
+        }
+        if (encounter.getCreateTime() == null) {
+            encounter.setCreateTime(new Date());
+        }
+
         // 就诊ID
         Long encounterId = iEncounterService.saveEncounterByRegister(encounter);
         // 保存就诊位置信息
@@ -1920,6 +1956,18 @@ public class PaymentRecServiceImpl implements IPaymentRecService {
                 .setChargeItemIds(chargeItemIdList.stream().map(String::valueOf).collect(Collectors.joining(",")))
                 .setTenderedAmount(chargeItem.getTotalPrice()).setDisplayAmount(paymentResult.getPsnPartAmt())
                 .setReturnedAmount(new BigDecimal("0.0")).setEncounterId(encounter.getId());
+
+        // 确保必需的审计字段被设置，防止违反NOT NULL约束
+        if (payment.getTenantId() == null) {
+            payment.setTenantId(SecurityUtils.getLoginUser().getTenantId());
+        }
+        if (payment.getCreateBy() == null || payment.getCreateBy().isEmpty()) {
+            payment.setCreateBy(SecurityUtils.getLoginUser().getUsername());
+        }
+        if (payment.getCreateTime() == null) {
+            payment.setCreateTime(new Date());
+        }
+
         // 保存付款信息
         paymentReconciliationService.save(payment);
         // 保存付款详情
@@ -1938,6 +1986,18 @@ public class PaymentRecServiceImpl implements IPaymentRecService {
         invoice.setPatientId(encounter.getPatientId()).setStatusEnum(InvoiceStatus.DRAFT)
                 .setReconciliationId(payment.getId()).setTypeCode(InvoiceType.ISSUING_INVOICES.getValue())
                 .setChargeItemIds(payment.getChargeItemIds().toString());
+
+        // 确保必需的审计字段被设置，防止违反NOT NULL约束
+        if (invoice.getTenantId() == null) {
+            invoice.setTenantId(SecurityUtils.getLoginUser().getTenantId());
+        }
+        if (invoice.getCreateBy() == null || invoice.getCreateBy().isEmpty()) {
+            invoice.setCreateBy(SecurityUtils.getLoginUser().getUsername());
+        }
+        if (invoice.getCreateTime() == null) {
+            invoice.setCreateTime(new Date());
+        }
+
         iInvoiceService.save(invoice);
         return R.ok(payment, "收费成功");
     }

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

@@ -2,6 +2,7 @@ package com.openhis.administration.service.impl;
 
 import com.baomidou.mybatisplus.core.conditions.query.LambdaQueryWrapper;
 import com.baomidou.mybatisplus.extension.service.impl.ServiceImpl;
+import com.core.common.utils.SecurityUtils;
 import com.openhis.administration.domain.Account;
 import com.openhis.administration.mapper.AccountMapper;
 import com.openhis.administration.service.IAccountService;
@@ -32,6 +33,18 @@ public class AccountServiceImpl extends ServiceImpl<AccountMapper, Account> impl
     @Override
     public Long saveAccountByRegister(Account account) {
         account.setEncounterFlag(Whether.YES.getValue());
+
+        // 确保必需的审计字段被设置，防止违反NOT NULL约束
+        if (account.getTenantId() == null) {
+            account.setTenantId(SecurityUtils.getLoginUser().getTenantId());
+        }
+        if (account.getCreateBy() == null || account.getCreateBy().isEmpty()) {
+            account.setCreateBy(SecurityUtils.getLoginUser().getUsername());
+        }
+        if (account.getCreateTime() == null) {
+            account.setCreateTime(new java.util.Date());
+        }
+
         baseMapper.insert(account);
         return account.getId();
     }

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

@@ -66,6 +66,18 @@ public class ChargeItemServiceImpl extends ServiceImpl<ChargeItemMapper, ChargeI
     @Override
     public void saveChargeItemByRegister(ChargeItem chargeItem) {
         chargeItem.setContextEnum(ChargeItemContext.REGISTER.getValue());// 挂号
+
+        // 确保必需的审计字段被设置，防止违反NOT NULL约束
+        if (chargeItem.getTenantId() == null) {
+            chargeItem.setTenantId(SecurityUtils.getLoginUser().getTenantId());
+        }
+        if (chargeItem.getCreateBy() == null || chargeItem.getCreateBy().isEmpty()) {
+            chargeItem.setCreateBy(SecurityUtils.getLoginUser().getUsername());
+        }
+        if (chargeItem.getCreateTime() == null) {
+            chargeItem.setCreateTime(new java.util.Date());
+        }
+
         baseMapper.insert(chargeItem);
     }
 

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

@@ -3,6 +3,7 @@ package com.openhis.administration.service.impl;
 import com.baomidou.mybatisplus.core.conditions.query.LambdaQueryWrapper;
 import com.baomidou.mybatisplus.core.conditions.update.LambdaUpdateWrapper;
 import com.baomidou.mybatisplus.extension.service.impl.ServiceImpl;
+import com.core.common.utils.SecurityUtils;
 import com.core.common.enums.DelFlag;
 import com.openhis.administration.domain.EncounterParticipant;
 import com.openhis.administration.mapper.EncounterParticipantMapper;
@@ -32,6 +33,17 @@ public class EncounterParticipantServiceImpl extends ServiceImpl<EncounterPartic
      */
     @Override
     public void saveEncounterParticipant(EncounterParticipant encounterParticipant) {
+        // 确保必需的审计字段被设置，防止违反NOT NULL约束
+        if (encounterParticipant.getTenantId() == null) {
+            encounterParticipant.setTenantId(SecurityUtils.getLoginUser().getTenantId());
+        }
+        if (encounterParticipant.getCreateBy() == null || encounterParticipant.getCreateBy().isEmpty()) {
+            encounterParticipant.setCreateBy(SecurityUtils.getLoginUser().getUsername());
+        }
+        if (encounterParticipant.getCreateTime() == null) {
+            encounterParticipant.setCreateTime(new Date());
+        }
+
         baseMapper.insert(encounterParticipant);
     }
 

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

@@ -4,6 +4,7 @@ import com.baomidou.mybatisplus.core.conditions.query.LambdaQueryWrapper;
 import com.baomidou.mybatisplus.core.conditions.update.LambdaUpdateWrapper;
 import com.baomidou.mybatisplus.extension.service.impl.ServiceImpl;
 import com.core.common.utils.AssignSeqUtil;
+import com.core.common.utils.SecurityUtils;
 import com.core.common.utils.StringUtils;
 import com.openhis.administration.domain.Encounter;
 import com.openhis.administration.dto.EncounterAccountDto;
@@ -45,9 +46,9 @@ public class EncounterServiceImpl extends ServiceImpl<EncounterMapper, Encounter
             encounter.setBusNo(assignSeqUtil.getSeqByDay(AssignSeqEnum.ENCOUNTER_NUM.getPrefix(), 4));
         }
         // 生成就诊序号：
-        // 1) 若挂号医生已传入（registrarId 充当挂号医生 ID），按“科室+医生+当日”递增
+        // 1) 若挂号医生已传入（registrarId 充当挂号医生 ID），按"科室+医生+当日"递增
         //    Key 示例：ORG-123-DOC-456 -> 1、2、3...
-        // 2) 否则按“科室+当日”递增
+        // 2) 否则按"科室+当日"递增
         String preFix;
         if (encounter.getRegistrarId() != null) {
             preFix = "ORG-" + encounter.getOrganizationId() + "-DOC-" + encounter.getRegistrarId();
@@ -62,6 +63,18 @@ public class EncounterServiceImpl extends ServiceImpl<EncounterMapper, Encounter
         if (count > 0L) {
             encounter.setFirstEnum(EncounterType.FOLLOW_UP.getValue());
         }
+
+        // 确保必需的审计字段被设置，防止违反NOT NULL约束
+        if (encounter.getTenantId() == null) {
+            encounter.setTenantId(SecurityUtils.getLoginUser().getTenantId());
+        }
+        if (encounter.getCreateBy() == null || encounter.getCreateBy().isEmpty()) {
+            encounter.setCreateBy(SecurityUtils.getLoginUser().getUsername());
+        }
+        if (encounter.getCreateTime() == null) {
+            encounter.setCreateTime(new Date());
+        }
+
         baseMapper.insert(encounter);
         return encounter.getId();
     }

openhis-ui-vue3/src/assets/icons/svg/patient.svg

@@ -1,4 +1,4 @@
 <svg class="icon" viewBox="0 0 1024 1024" xmlns="http://www.w3.org/2000/svg">
-  <path d="M512 128c-70.69 0-128 57.31-128 128 0 70.69 57.31 128 128 70.69 0 128-57.31 128-128 0-70.69-57.31-128-128-128zm0 192c-35.34 0-64-28.66-64-64 0-35.34 28.66-64 64-64 35.34 0 64 28.66 64 64 0 35.34-28.66 64-64 64z" fill="currentColor"/>
+  <path d="M512 128c-70.69 0-128 57.31-128 128 0 70.69 57.31 128 128 128s128-57.31 128-128-57.31-128-128-128zm0 192c-35.34 0-64-28.66-64-64 0-35.34 28.66-64 64-64 35.34 0 64 28.66 64 64 0 35.34-28.66 64-64 64z" fill="currentColor"/>
   <path d="M832 832c0-88.36-28.7-172.6-80.4-242.4C702 521 608 480 512 480s-190 41-239.6 109.6C221 659.4 192 743.64 192 832v64h640v-64z" fill="currentColor"/>
 </svg>

openhis-ui-vue3/src/router/index.js

@@ -97,21 +97,6 @@ export const constantRoutes = [
 
 // 动态路由，基于用户权限动态去加载
 export const dynamicRoutes = [
-    {
-        path: '/basicmanage',
-        component: Layout,
-        redirect: '/basicmanage/invoice-management',
-        name: 'BasicManage',
-        meta: { title: '基础管理', icon: 'component' },
-        children: [
-            {
-                path: 'invoice-management',
-                component: () => import('@/views/basicmanage/InvoiceManagement/index.vue'),
-                name: 'invoice-management',
-                meta: { title: '发票管理' }
-            }
-        ]
-    },
 
     {
         path: '/system/tenant-user',

openhis-ui-vue3/src/template/inHospitalRecord.vue

@@ -490,6 +490,61 @@ const formData = reactive({
   signDate: '',
 });
 
+// 默认表单数据
+const defaultFormData = {
+  // 基础信息
+  patientName: patient?.name || '',
+  hospitalNo: patient?.busNo || '',
+  gender: patient?.genderEnum_enumText || '',
+  age: patient?.age || '',
+  nation: '',
+  occupation: '', // 职业
+  marriage: '', // 婚姻状况
+  birthplace: '', // 出生地
+  admissionTime: '', // 入院时间
+  recordTime: '', // 记录时间
+  historyReporter: '', // 病史陈述者
+  reliability: '可靠', // 可靠程度
+  // 病史信息
+  complaint: '', // 主诉
+  presentIllness: '', // 现病史
+  pastIllness: '', // 既往史
+  personalHistory: '', // 个人史
+  allergyHistory: '', // 过敏史
+  pastHistory: '', // 既往史
+  familyHistory: '', // 家族史
+  maritalHistory: '', // 婚姻史
+  menstrualHistory: '', // 月经史
+  // 中医信息
+  tcmInfo: '',
+
+  // 体格检查
+  temp: '',
+  pulse: '',
+  respiration: '',
+  bp: '',
+  height: '',
+  weight: '',
+  bmi: '',
+  general: '',
+  skin: '',
+  chest: '',
+  abdomen: '',
+  limbsNervous: '',
+
+  // 辅助检查
+  auxExam: '',
+
+  // 诊断信息
+  tcmDiagnosis: '',
+  westernDiagnosis: '',
+
+  // 签名信息
+  doctorSign: '',
+  superiorSign: '',
+  signDate: '',
+};
+
 // 表单校验规则
 const rules = reactive({
   name: [{ required: true, message: '请填写姓名', trigger: ['blur', 'submit'] }],
@@ -623,8 +678,19 @@ const handleReset = () => {
 
 // 表单数据赋值
 const setFormData = (data) => {
-  if (data) {
+  if (data && Object.keys(data).length > 0) {
+    // 如果有数据，则合并到表单中
     Object.assign(formData, data);
+  } else {
+    // 如果没有数据或数据为空，则重置为默认值
+    // 保留患者基础信息（来自props）
+    Object.assign(formData, {
+      ...defaultFormData,
+      patientName: patient?.name || formData.patientName,
+      hospitalNo: patient?.busNo || formData.hospitalNo,
+      gender: patient?.genderEnum_enumText || formData.gender,
+      age: patient?.age || formData.age,
+    });
   }
 };
 

openhis-ui-vue3/src/views/charge/outpatientregistration/index.vue

@@ -438,7 +438,7 @@
               :show-overflow-tooltip="true"
             />
             <el-table-column
-              label="挂号类型 "
+              label="*挂号类型 "
               align="center"
               key="healthcareName"
               prop="healthcareName"
@@ -734,6 +734,7 @@ const data = reactive({
     priorityEnum: [{ required: true, message: '优先级不能为空', trigger: 'blur' }],
     organizationId: [{ required: true, message: '优先级不能为空', trigger: 'blur' }],
     orgId: [{ required: true, message: '就诊科室不能为空', trigger: 'blur' }],
+    serviceTypeId: [{ required: true, message: '挂号类型不能为空', trigger: 'blur' }],
     practitionerId: [{ required: true, message: '医生不能为空', trigger: 'blur' }],
     typeCode: [{ required: true, message: '账户类型不能为空', trigger: 'blur' }],
     definitionId: [{ required: true, message: '费用定价不能为空', trigger: 'blur' }],

openhis-ui-vue3/src/views/doctorstation/components/hospitalizationEmr/components/template.vue

@@ -26,9 +26,9 @@
 </template>
 
 <script setup>
-import {defineEmits, ref, unref} from 'vue';
+import {defineEmits, ref, unref, watch} from 'vue';
 import {deleteTemplate, getListByDefinitionId} from '../api';
-import {ElMessage} from 'element-plus';
+import {ElMessage, ElMessageBox} from 'element-plus';
 
 const emits = defineEmits(['templateClick', 'edit']);
 const props = defineProps({
@@ -45,26 +45,54 @@ const defaultProps = {
   children: 'children',
   label: 'name',
 };
+
+// 缓存已加载的模板数据
+const templateCache = new Map();
 const queryParams = ref({
   searchKey: '',
   isPage: 0,
 });
 const templateData = ref([]);
+
+// 防抖定时器
+let debounceTimer = null;
+
 //  删除模板
 const handleDelete = async (item) => {
   try {
+    ElMessageBox.confirm('确定要删除该模板吗？', '提示', {
+      confirmButtonText: '确定',
+      cancelButtonText: '取消',
+      type: 'warning',
+    }).then(async () => {
       await deleteTemplate(item.id);
       ElMessage.success('删除成功');
+      // 清除缓存中的数据，强制重新加载
+      templateCache.delete(unref(definitionId));
       queryList();
+    });
   } catch (error) {
+    if (error !== 'cancel') {
       ElMessage.error('删除失败');
     }
+  }
 };
+
 const queryList = async () => {
   try {
-    if (unref(definitionId) && unref(definitionId) !== '') {
+    const id = unref(definitionId);
-      const res = await getListByDefinitionId(unref(definitionId));
+    if (id && id !== '') {
-      templateData.value = res.data || [];
+      // 检查缓存中是否存在数据
+      if (templateCache.has(id)) {
+        templateData.value = templateCache.get(id);
+        return;
+      }
+
+      const res = await getListByDefinitionId(id);
+      const data = res.data || [];
+      // 将数据存入缓存
+      templateCache.set(id, data);
+      templateData.value = data;
     } else {
       templateData.value = [];
     }
@@ -73,6 +101,23 @@ const queryList = async () => {
     templateData.value = [];
   }
 };
+
+// 防抖版本的查询函数
+const debouncedQueryList = async () => {
+  if (debounceTimer) {
+    clearTimeout(debounceTimer);
+  }
+
+  debounceTimer = setTimeout(async () => {
+    await queryList();
+  }, 300); // 300ms 防抖延迟
+};
+
+// 监听 definitionId 变化，使用防抖
+watch(definitionId, () => {
+  debouncedQueryList();
+}, { immediate: true });
+
 const handleNodeClick = (data) => {
   emits('templateClick', data);
 };

openhis-ui-vue3/src/views/index.vue

@@ -125,6 +125,7 @@
 <script setup name="Home">
 import { ref, computed, onMounted } from 'vue'
 import { useRouter } from 'vue-router'
+import { markRaw } from 'vue'
 import useUserStore from '@/store/modules/user'
 import { getHomeStatistics } from '@/api/home'
 import {
@@ -171,90 +172,90 @@ const statisticsData = ref({
 // 不同角色的统计数据配置
 const roleStatsConfig = {
   admin: [
-    { key: 'totalPatients', label: '在院患者', icon: User, type: 'primary', iconColor: '#409eff' },
+    { key: 'totalPatients', label: '在院患者', icon: markRaw(User), type: 'primary', iconColor: '#409eff' },
-    { key: 'todayRevenue', label: '今日收入', icon: Money, type: 'success', iconColor: '#67c23a' },
+    { key: 'todayRevenue', label: '今日收入', icon: markRaw(Money), type: 'success', iconColor: '#67c23a' },
-    { key: 'appointments', label: '今日预约', icon: Calendar, type: 'warning', iconColor: '#e6a23c' },
+    { key: 'appointments', label: '今日预约', icon: markRaw(Calendar), type: 'warning', iconColor: '#e6a23c' },
-    { key: 'pendingApprovals', label: '待审核', icon: Document, type: 'danger', iconColor: '#f56c6c' }
+    { key: 'pendingApprovals', label: '待审核', icon: markRaw(Document), type: 'danger', iconColor: '#f56c6c' }
   ],
   doctor: [
-    { key: 'myPatients', label: '我的患者', icon: User, type: 'primary', iconColor: '#409eff' },
+    { key: 'myPatients', label: '我的患者', icon: markRaw(User), type: 'primary', iconColor: '#409eff' },
-    { key: 'todayAppointments', label: '今日门诊', icon: Calendar, type: 'success', iconColor: '#67c23a' },
+    { key: 'todayAppointments', label: '今日门诊', icon: markRaw(Calendar), type: 'success', iconColor: '#67c23a' },
-    { key: 'pendingRecords', label: '待写病历', icon: Document, type: 'warning', iconColor: '#e6a23c' },
+    { key: 'pendingRecords', label: '待写病历', icon: markRaw(Document), type: 'warning', iconColor: '#e6a23c' },
-    { key: 'prescriptions', label: '今日处方', icon: Box, type: 'info', iconColor: '#909399' }
+    { key: 'prescriptions', label: '今日处方', icon: markRaw(Box), type: 'info', iconColor: '#909399' }
   ],
   nurse: [
-    { key: 'wardPatients', label: '病房患者', icon: User, type: 'primary', iconColor: '#409eff' },
+    { key: 'wardPatients', label: '病房患者', icon: markRaw(User), type: 'primary', iconColor: '#409eff' },
-    { key: 'todayTreatments', label: '今日治疗', icon: Operation, type: 'success', iconColor: '#67c23a' },
+    { key: 'todayTreatments', label: '今日治疗', icon: markRaw(Operation), type: 'success', iconColor: '#67c23a' },
-    { key: 'vitalSigns', label: '待测体征', icon: Monitor, type: 'warning', iconColor: '#e6a23c' },
+    { key: 'vitalSigns', label: '待测体征', icon: markRaw(Monitor), type: 'warning', iconColor: '#e6a23c' },
-    { key: 'drugDistribution', label: '发药次数', icon: Box, type: 'info', iconColor: '#909399' }
+    { key: 'drugDistribution', label: '发药次数', icon: markRaw(Box), type: 'info', iconColor: '#909399' }
   ],
   pharmacist: [
-    { key: 'todayPrescriptions', label: '今日处方', icon: Box, type: 'primary', iconColor: '#409eff' },
+    { key: 'todayPrescriptions', label: '今日处方', icon: markRaw(Box), type: 'primary', iconColor: '#409eff' },
-    { key: 'pendingReview', label: '待审核', icon: Document, type: 'warning', iconColor: '#e6a23c' },
+    { key: 'pendingReview', label: '待审核', icon: markRaw(Document), type: 'warning', iconColor: '#e6a23c' },
-    { key: 'outOfStock', label: '缺货药品', icon: Warning, type: 'danger', iconColor: '#f56c6c' },
+    { key: 'outOfStock', label: '缺货药品', icon: markRaw(Warning), type: 'danger', iconColor: '#f56c6c' },
-    { key: 'nearExpiry', label: '近效期', icon: Clock, type: 'info', iconColor: '#909399' }
+    { key: 'nearExpiry', label: '近效期', icon: markRaw(Clock), type: 'info', iconColor: '#909399' }
   ],
   cashier: [
-    { key: 'todayPayments', label: '今日缴费', icon: Money, type: 'primary', iconColor: '#409eff' },
+    { key: 'todayPayments', label: '今日缴费', icon: markRaw(Money), type: 'primary', iconColor: '#409eff' },
-    { key: 'refundRequests', label: '退费申请', icon: Document, type: 'warning', iconColor: '#e6a23c' },
+    { key: 'refundRequests', label: '退费申请', icon: markRaw(Document), type: 'warning', iconColor: '#e6a23c' },
-    { key: 'pendingInvoices', label: '待开发票', icon: Files, type: 'info', iconColor: '#909399' },
+    { key: 'pendingInvoices', label: '待开发票', icon: markRaw(Files), type: 'info', iconColor: '#909399' },
-    { key: 'insuranceClaims', label: '医保结算', icon: Wallet, type: 'success', iconColor: '#67c23a' }
+    { key: 'insuranceClaims', label: '医保结算', icon: markRaw(Wallet), type: 'success', iconColor: '#67c23a' }
   ]
 }
 
 // 不同角色的快捷功能配置
 const roleQuickAccessConfig = {
   admin: [
-    { key: 'patient', label: '患者管理', icon: User, iconColor: '#409eff', route: '/patientmanagement' },
+    { key: 'patient', label: '患者管理', icon: markRaw(User), iconColor: '#409eff', route: '/patientmanagement' },
-    { key: 'appointment', label: '预约管理', icon: Calendar, iconColor: '#67c23a', route: '/appoinmentmanage' },
+    { key: 'appointment', label: '预约管理', icon: markRaw(Calendar), iconColor: '#67c23a', route: '/appoinmentmanage' },
-    { key: 'doctor', label: '医生管理', icon: User, iconColor: '#e6a23c', route: '/doctorstation' },
+    { key: 'doctor', label: '医生管理', icon: markRaw(User), iconColor: '#e6a23c', route: '/doctorstation' },
-    { key: 'surgery', label: '手术管理', icon: Operation, iconColor: '#f56c6c', route: '/surgerymanage' },
+    { key: 'surgery', label: '手术管理', icon: markRaw(Operation), iconColor: '#f56c6c', route: '/surgerymanage' },
-    { key: 'drug', label: '药品管理', icon: Box, iconColor: '#909399', route: '/pharmacymanagement' },
+    { key: 'drug', label: '药品管理', icon: markRaw(Box), iconColor: '#909399', route: '/pharmacymanagement' },
-    { key: 'statistic', label: '数据统计', icon: TrendCharts, iconColor: '#409eff', route: '/monitor' },
+    { key: 'statistic', label: '数据统计', icon: markRaw(TrendCharts), iconColor: '#409eff', route: '/monitor' },
-    { key: 'invoice', label: '发票管理', icon: Files, iconColor: '#67c23a', route: '/basicmanage/InvoiceManagement' },
+    { key: 'invoice', label: '发票管理', icon: markRaw(Files), iconColor: '#67c23a', route: '/basicmanage/InvoiceManagement' },
-    { key: 'system', label: '系统设置', icon: Setting, iconColor: '#909399', route: '/system' }
+    { key: 'system', label: '系统设置', icon: markRaw(Setting), iconColor: '#909399', route: '/system' }
   ],
   doctor: [
-    { key: 'outpatient', label: '门诊接诊', icon: ChatDotRound, iconColor: '#409eff', route: '/doctorstation' },
+    { key: 'outpatient', label: '门诊接诊', icon: markRaw(ChatDotRound), iconColor: '#409eff', route: '/doctorstation' },
-    { key: 'emr', label: '病历管理', icon: Document, iconColor: '#67c23a', route: '/doctorstation/doctorphrase' },
+    { key: 'emr', label: '病历管理', icon: markRaw(Document), iconColor: '#67c23a', route: '/doctorstation/doctorphrase' },
-    { key: 'prescription', label: '开立处方', icon: Box, iconColor: '#e6a23c', route: '/clinicmanagement/ePrescribing' },
+    { key: 'prescription', label: '开立处方', icon: markRaw(Box), iconColor: '#e6a23c', route: '/clinicmanagement/ePrescribing' },
-    { key: 'history', label: '历史处方', icon: Clock, iconColor: '#f56c6c', route: '/clinicmanagement/historicalPrescription' },
+    { key: 'history', label: '历史处方', icon: markRaw(Clock), iconColor: '#f56c6c', route: '/clinicmanagement/historicalPrescription' },
-    { key: 'schedule', label: '排班管理', icon: Calendar, iconColor: '#909399', route: '/appoinmentmanage/deptManage' },
+    { key: 'schedule', label: '排班管理', icon: markRaw(Calendar), iconColor: '#909399', route: '/appoinmentmanage/deptManage' },
-    { key: 'inquiry', label: '患者查询', icon: Search, iconColor: '#409eff', route: '/patientmanagement' }
+    { key: 'inquiry', label: '患者查询', icon: markRaw(Search), iconColor: '#409eff', route: '/patientmanagement' }
   ],
   nurse: [
-    { key: 'ward', label: '病房管理', icon: User, iconColor: '#409eff', route: '/inpatientNurse/inpatientNurseStation' },
+    { key: 'ward', label: '病房管理', icon: markRaw(User), iconColor: '#409eff', route: '/inpatientNurse/inpatientNurseStation' },
-    { key: 'execution', label: '医嘱执行', icon: Operation, iconColor: '#67c23a', route: '/inpatientNurse/medicalOrderExecution' },
+    { key: 'execution', label: '医嘱执行', icon: markRaw(Operation), iconColor: '#67c23a', route: '/inpatientNurse/medicalOrderExecution' },
-    { key: 'proofread', label: '医嘱核对', icon: Document, iconColor: '#e6a23c', route: '/inpatientNurse/medicalOrderProofread' },
+    { key: 'proofread', label: '医嘱核对', icon: markRaw(Document), iconColor: '#e6a23c', route: '/inpatientNurse/medicalOrderProofread' },
-    { key: 'drugCollect', label: '领药管理', icon: Box, iconColor: '#f56c6c', route: '/inpatientNurse/medicineCollect' },
+    { key: 'drugCollect', label: '领药管理', icon: markRaw(Box), iconColor: '#f56c6c', route: '/inpatientNurse/medicineCollect' },
-    { key: 'tpr', label: '体温单', icon: Monitor, iconColor: '#909399', route: '/inpatientNurse/tprsheet' },
+    { key: 'tpr', label: '体温单', icon: markRaw(Monitor), iconColor: '#909399', route: '/inpatientNurse/tprsheet' },
-    { key: 'nursing', label: '护理记录', icon: ChatDotRound, iconColor: '#409eff', route: '/inpatientNurse/nursingRecord' }
+    { key: 'nursing', label: '护理记录', icon: markRaw(ChatDotRound), iconColor: '#409eff', route: '/inpatientNurse/nursingRecord' }
   ],
   pharmacist: [
-    { key: 'dispensing', label: '发药管理', icon: Box, iconColor: '#409eff', route: '/pharmacymanagement' },
+    { key: 'dispensing', label: '发药管理', icon: markRaw(Box), iconColor: '#409eff', route: '/pharmacymanagement' },
-    { key: 'prescription', label: '处方审核', icon: Document, iconColor: '#67c23a', route: '/pharmacymanagement' },
+    { key: 'prescription', label: '处方审核', icon: markRaw(Document), iconColor: '#67c23a', route: '/pharmacymanagement' },
-    { key: 'inventory', label: '库存管理', icon: Van, iconColor: '#e6a23c', route: '/medicineStorage' },
+    { key: 'inventory', label: '库存管理', icon: markRaw(Van), iconColor: '#e6a23c', route: '/medicineStorage' },
-    { key: 'purchase', label: '采购管理', icon: ShoppingCart, iconColor: '#f56c6c', route: '/medicineStorage' },
+    { key: 'purchase', label: '采购管理', icon: markRaw(ShoppingCart), iconColor: '#f56c6c', route: '/medicineStorage' },
-    { key: 'warning', label: '效期预警', icon: Warning, iconColor: '#f56c6c', route: '/medicationmanagement/statisticalManagement/statisticalManagement' },
+    { key: 'warning', label: '效期预警', icon: markRaw(Warning), iconColor: '#f56c6c', route: '/medicationmanagement/statisticalManagement/statisticalManagement' },
-    { key: 'statistics', label: '用药统计', icon: DataLine, iconColor: '#909399', route: '/monitor' }
+    { key: 'statistics', label: '用药统计', icon: markRaw(DataLine), iconColor: '#909399', route: '/monitor' }
   ],
   cashier: [
-    { key: 'registration', label: '挂号收费', icon: Money, iconColor: '#409eff', route: '/charge/outpatientregistration' },
+    { key: 'registration', label: '挂号收费', icon: markRaw(Money), iconColor: '#409eff', route: '/charge/outpatientregistration' },
-    { key: 'clinicCharge', label: '门诊收费', icon: Wallet, iconColor: '#67c23a', route: '/charge/cliniccharge' },
+    { key: 'clinicCharge', label: '门诊收费', icon: markRaw(Wallet), iconColor: '#67c23a', route: '/charge/cliniccharge' },
-    { key: 'refund', label: '退费管理', icon: Document, iconColor: '#e6a23c', route: '/charge/clinicrefund' },
+    { key: 'refund', label: '退费管理', icon: markRaw(Document), iconColor: '#e6a23c', route: '/charge/clinicrefund' },
-    { key: 'invoice', label: '发票打印', icon: Files, iconColor: '#f56c6c', route: '/basicmanage/InvoiceManagement' },
+    { key: 'invoice', label: '发票打印', icon: markRaw(Files), iconColor: '#f56c6c', route: '/basicmanage/InvoiceManagement' },
-    { key: 'record', label: '收费记录', icon: Clock, iconColor: '#909399', route: '/charge/clinicRecord' },
+    { key: 'record', label: '收费记录', icon: markRaw(Clock), iconColor: '#909399', route: '/charge/clinicRecord' },
-    { key: 'insurance', label: '医保结算', icon: Bell, iconColor: '#409eff', route: '/ybmanagement' }
+    { key: 'insurance', label: '医保结算', icon: markRaw(Bell), iconColor: '#409eff', route: '/ybmanagement' }
   ]
 }
 
 // 待办事项
 const todoList = ref([
-  { id: 1, title: '审核处方申请', desc: '张医生提交的5条处方待审核', priority: 'high', icon: Document, time: '10分钟前' },
+  { id: 1, title: '审核处方申请', desc: '张医生提交的5条处方待审核', priority: 'high', icon: markRaw(Document), time: '10分钟前' },
-  { id: 2, title: '确认患者入院', desc: '李某某（男，45岁）已办理入院', priority: 'medium', icon: User, time: '30分钟前' },
+  { id: 2, title: '确认患者入院', desc: '李某某（男，45岁）已办理入院', priority: 'medium', icon: markRaw(User), time: '30分钟前' },
-  { id: 3, title: '处理投诉反馈', desc: '患者家属对服务态度的投诉', priority: 'high', icon: ChatDotRound, time: '1小时前' },
+  { id: 3, title: '处理投诉反馈', desc: '患者家属对服务态度的投诉', priority: 'high', icon: markRaw(ChatDotRound), time: '1小时前' },
-  { id: 4, title: '药品效期预警', desc: '阿莫西林等3种药品即将过期', priority: 'low', icon: Warning, time: '2小时前' },
+  { id: 4, title: '药品效期预警', desc: '阿莫西林等3种药品即将过期', priority: 'low', icon: markRaw(Warning), time: '2小时前' },
-  { id: 5, title: '月度报表审核', desc: '11月份门诊收入报表待审核', priority: 'medium', icon: Files, time: '3小时前' }
+  { id: 5, title: '月度报表审核', desc: '11月份门诊收入报表待审核', priority: 'medium', icon: markRaw(Files), time: '3小时前' }
 ])
 
 // 今日日程

openhis-ui-vue3/src/views/inpatientDoctor/home/components/order/index.vue

@@ -348,7 +348,7 @@ import {
 } from '../api';
 import adviceBaseList from '../adviceBaseList';
 import {calculateQuantityByDays} from '@/utils/his';
-import {patientInfo} from '../../store/patient.js';
+import {localPatientInfo as patientInfo} from '../../store/localPatient.js';
 import OrderGroupDrawer from '@/views/doctorstation/components/prescription/orderGroupDrawer.vue';
 import PrescriptionHistory from '@/views/doctorstation/components/prescription/prescriptionHistory.vue';
 import Decimal from 'decimal.js';

openhis-ui-vue3/src/views/inpatientDoctor/home/emr/api.js

@@ -72,3 +72,12 @@ export function updateTemplate(data) {
     data,
   });
 }
+
+// 删除模板
+export function deleteTemplate(ids) {
+  return request({
+    url: '/document/template/delete',
+    method: 'delete',
+    data: ids,
+  });
+}

openhis-ui-vue3/src/views/inpatientDoctor/home/emr/components/history.vue

@@ -39,7 +39,7 @@ import {defineEmits, nextTick, ref, unref} from 'vue';
 import {deleteRecord, getRecordByEncounterIdList} from '../api';
 import {ElMessage} from 'element-plus';
 import {Delete} from '@element-plus/icons-vue';
-import {patientInfo} from '../../store/patient.js';
+import {localPatientInfo as patientInfo} from '../../store/localPatient.js';
 
 const emits = defineEmits(['historyClick']);
 const props = defineProps({

openhis-ui-vue3/src/views/inpatientDoctor/home/emr/components/template.vue

@@ -26,8 +26,8 @@
 </template>
 
 <script setup>
-import {defineEmits, ref, unref} from 'vue';
+import {defineEmits, ref, unref, watch} from 'vue';
-import {getListByDefinitionId} from '../api';
+import {getListByDefinitionId, deleteTemplate} from '../api';
 import {ElMessage, ElMessageBox} from 'element-plus';
 import {Edit} from '@element-plus/icons-vue';
 
@@ -46,16 +46,33 @@ const defaultProps = {
   children: 'children',
   label: 'name',
 };
+
+// 缓存已加载的模板数据
+const templateCache = new Map();
 const queryParams = ref({
   searchKey: '',
   isPage: 0,
 });
 const templateData = ref([]);
+
+// 防抖定时器
+let debounceTimer = null;
+
 const queryList = async () => {
   try {
-    if (unref(definitionId) && unref(definitionId) !== '') {
+    const id = unref(definitionId);
-      const res = await getListByDefinitionId(unref(definitionId));
+    if (id && id !== '') {
-      templateData.value = res.data || [];
+      // 检查缓存中是否存在数据
+      if (templateCache.has(id)) {
+        templateData.value = templateCache.get(id);
+        return;
+      }
+
+      const res = await getListByDefinitionId(id);
+      const data = res.data || [];
+      // 将数据存入缓存
+      templateCache.set(id, data);
+      templateData.value = data;
     } else {
       templateData.value = [];
     }
@@ -64,6 +81,23 @@ const queryList = async () => {
     templateData.value = [];
   }
 };
+
+// 防抖版本的查询函数
+const debouncedQueryList = async () => {
+  if (debounceTimer) {
+    clearTimeout(debounceTimer);
+  }
+
+  debounceTimer = setTimeout(async () => {
+    await queryList();
+  }, 300); // 300ms 防抖延迟
+};
+
+// 监听 definitionId 变化，使用防抖
+watch(definitionId, () => {
+  debouncedQueryList();
+}, { immediate: true });
+
 const handleNodeClick = (data) => {
   emits('templateClick', data);
 };
@@ -81,6 +115,8 @@ const handleDelete = async (item) => {
     }).then(async () => {
       await deleteTemplate(item.id);
       ElMessage.success('删除成功');
+      // 清除缓存中的数据，强制重新加载
+      templateCache.delete(unref(definitionId));
       queryList();
     });
   } catch (error) {

openhis-ui-vue3/src/views/inpatientDoctor/home/emr/index.vue

@@ -115,7 +115,7 @@ import {nextTick, onMounted, reactive, ref, watch} from 'vue';
 import {ElMessage, ElMessageBox} from 'element-plus';
 import {getTreeList} from '@/views/basicmanage/caseTemplates/api';
 import {addTemplate, getRecordByEncounterIdList, saveOrUpdateRecord} from './api';
-import {patientInfo} from '../store/patient.js';
+import {localPatientInfo as patientInfo} from '../store/localPatient.js';
 import NursingStatus from '@/views/inpatientDoctor/home/components/applicationShow/nursingStatus.vue';
 import dayjs from 'dayjs';
 // 打印工具
@@ -148,9 +148,18 @@ const emrComponentRef = ref(null);
 const quicklyactiveName = ref('history');
 const leftShow = ref(true);
 const rightShow = ref(true);
+// 使用防抖处理历史记录和模板列表的刷新
+let listRefreshDebounceTimer = null;
 watch(patientInfo, () => {
+  if (listRefreshDebounceTimer) {
+    clearTimeout(listRefreshDebounceTimer);
+  }
+
+  listRefreshDebounceTimer = setTimeout(() => {
     historyRef.value?.queryList();
-  templateRef.value?.queryList();
+    // 模板查询已经在模板组件内部通过防抖和缓存优化，这里不再重复调用
+    // templateRef.value?.queryList();
+  }, 150); // 稍微延后刷新，避免频繁更新
 });
 const templateTree = ref(null);
 
@@ -185,8 +194,29 @@ const handleNodeClick = (data, node) => {
   if (node.isLeaf) {
     // 存储当前节点数据
     currentSelectTemplate.value = data.document;
+
+    // 在切换组件前先重置表单数据，避免显示之前的数据
+    editForm.value = {
+      id: '',
+      definitionId: '',
+      definitionBusNo: '',
+      contentJson: '',
+      statusEnum: 1,
+      organizationId: 0,
+      encounterId: '',
+      patientId: '',
+      recordTime: dayjs().format('YYYY-MM-DD HH:mm:ss'),
+      createBy: '',
+      source: '',
+    };
+
+    // 先清空当前组件，再设置新组件，确保组件完全重新渲染
+    currentComponent.value = '';
+
+    // 使用 nextTick 确保 DOM 更新后再设置新组件
+    nextTick(() => {
       currentComponent.value = currentSelectTemplate.value.vueRouter || '';
-    // currentComponent.value = data.document.vueRouter || '';
+    });
   } else {
     currentSelectTemplate.value = {
       id: '',
@@ -198,7 +228,8 @@ const handleNodeClick = (data, node) => {
   nextTick(() => {
     setTimeout(() => {
       historyRef.value?.queryList();
-      templateRef.value?.queryList();
+      // 模板查询已经在模板组件内部通过防抖和缓存优化，这里不再重复调用
+      // templateRef.value?.queryList();
 
       // 选择任何病历模板后，都加载该病历类型的最新历史记录
       if (node.isLeaf && patientInfo.value && patientInfo.value.patientId) {
@@ -270,7 +301,8 @@ const handleSubmitOk = async (data) => {
 
       // 刷新历史记录列表
       historyRef.value?.queryList();
-      templateRef.value?.queryList();
+      // 模板查询已经在模板组件内部通过防抖和缓存优化，这里不再重复调用
+      // templateRef.value?.queryList();
 
       // 等待历史记录列表更新后，重新加载最新病历并更新选中状态
       setTimeout(() => {
@@ -429,7 +461,8 @@ const print = async () => {
 const refresh = () => {
   queryTemplateTree();
   historyRef.value?.queryList();
-  templateRef.value?.queryList();
+  // 模板查询已经在模板组件内部通过防抖和缓存优化，这里不再重复调用
+  // templateRef.value?.queryList();
 };
 
 const deleteEmr = async () => {
@@ -522,7 +555,7 @@ const selectOutpatientMedicalRecordTemplate = async () => {
 
 // 加载最新的病历数据并回显
 const loadLatestMedicalRecord = async () => {
-  if (!patientInfo.value.encounterId || !currentSelectTemplate.value.id) return;
+  if (!patientInfo.value?.encounterId || !currentSelectTemplate.value.id) return;
   editForm.value.id = '';
   loading.value = true;
   try {
@@ -546,7 +579,17 @@ const loadLatestMedicalRecord = async () => {
       editForm.value = latestRecord;
       nextTick(() => {
         if (emrComponentRef.value && latestRecord.contentJson) {
-          emrComponentRef.value.setFormData(JSON.parse(latestRecord.contentJson));
+          try {
+            const parsedData = JSON.parse(latestRecord.contentJson);
+            emrComponentRef.value.setFormData(parsedData);
+          } catch (parseError) {
+            console.error('解析病历数据失败:', parseError);
+            // 解析失败时仍然尝试设置空数据以清空之前的残留数据
+            emrComponentRef.value.setFormData({});
+          }
+        } else {
+          // 如果没有内容数据，也要清空组件中的数据
+          emrComponentRef.value.setFormData({});
         }
 
         // 通知History组件更新选中状态
@@ -557,16 +600,52 @@ const loadLatestMedicalRecord = async () => {
     } else {
       // 清空选中状态
       selectedHistoryRecordId.value = '';
-      // 病案首页切换晴空逻辑
+      // 当没有历史记录时，也要清空当前表单数据，避免显示之前患者的数据
-      emrComponentRef.value.setFormData?.({});
+      editForm.value = {
+        id: '',
+        definitionId: '',
+        definitionBusNo: '',
+        contentJson: '',
+        statusEnum: 1,
+        organizationId: 0,
+        encounterId: '',
+        patientId: '',
+        recordTime: dayjs().format('YYYY-MM-DD HH:mm:ss'),
+        createBy: '',
+        source: '',
+      };
+
+      nextTick(() => {
+        if (emrComponentRef.value) {
+          emrComponentRef.value.setFormData({});
+        }
+      });
       loading.value = false;
     }
   } catch (error) {
     ElMessage.error('加载最新病历数据失败=====>', error);
     // 出错时也清空选中状态
     selectedHistoryRecordId.value = '';
-    // 病案首页切换晴空逻辑
+    // 出错时也要清空表单数据，避免显示之前患者的数据
-    emrComponentRef.value.setFormData?.({});
+    editForm.value = {
+      id: '',
+      definitionId: '',
+      definitionBusNo: '',
+      contentJson: '',
+      statusEnum: 1,
+      organizationId: 0,
+      encounterId: '',
+      patientId: '',
+      recordTime: dayjs().format('YYYY-MM-DD HH:mm:ss'),
+      createBy: '',
+      source: '',
+    };
+
+    nextTick(() => {
+      if (emrComponentRef.value) {
+        emrComponentRef.value.setFormData({});
+      }
+    });
     loading.value = false;
   } finally {
     loading.value = false;
@@ -672,6 +751,7 @@ const templateEditSubmitOk = async () => {
         ElMessage.success('模板新增成功');
         // 刷新模板列表
         if (templateRef.value && typeof templateRef.value.queryList === 'function') {
+          // 在模板操作后，需要清除缓存并重新加载
           templateRef.value.queryList();
         }
         // 关闭模板编辑弹窗
@@ -703,7 +783,8 @@ const templateEditSubmitOk = async () => {
   } finally {
     // 无论成功失败都刷新列表
     historyRef.value?.queryList();
-    templateRef.value?.queryList();
+    // 模板查询已经在模板组件内部通过防抖和缓存优化，这里不再重复调用
+    // templateRef.value?.queryList();
   }
 };
 // onBeforeMount(() => {});
@@ -726,6 +807,29 @@ watch(
           });
         });
       }
+    } else {
+      // 如果没有患者信息，也要重置组件和表单数据
+      currentComponent.value = '';
+      editForm.value = {
+        id: '',
+        definitionId: '',
+        definitionBusNo: '',
+        contentJson: '',
+        statusEnum: 1,
+        organizationId: 0,
+        encounterId: '',
+        patientId: '',
+        recordTime: dayjs().format('YYYY-MM-DD HH:mm:ss'),
+        createBy: '',
+        source: '',
+      };
+
+      // 如果有动态组件实例，也需要重置其表单数据
+      nextTick(() => {
+        if (emrComponentRef.value && emrComponentRef.value.setFormData) {
+          emrComponentRef.value.setFormData({});
+        }
+      });
     }
   },
   { deep: true, immediate: true }

openhis-ui-vue3/src/views/inpatientDoctor/home/index.vue

@@ -46,6 +46,7 @@ import {computed, onBeforeMount, onMounted, provide, reactive, ref, watch,} from
 import Emr from './emr/index.vue';
 import inPatientBarDoctorFold from '@/components/patientBar/inPatientBarDoctorFold.vue';
 import PatientList from '@/components/PatientList/patient-list.vue';
+import {localPatientInfo, updateLocalPatientInfo} from './store/localPatient';
 import {patientInfo, updatePatientInfo} from './store/patient';
 import {getPatientList} from './components/api';
 import {
@@ -121,21 +122,40 @@ watch(
     ) {
       const firstPatient = newData[0];
       if (firstPatient?.encounterId) {
+        // 使用防抖处理默认选择
+        if (debounceTimer) {
+          clearTimeout(debounceTimer);
+        }
+
+        debounceTimer = setTimeout(() => {
           handleItemClick(firstPatient);
           isFirstLoad.value = false;
+        }, 100);
       }
     }
   },
   { immediate: true }
 );
 
+// 防抖函数，防止快速点击导致状态冲突
+let debounceTimer = null;
 const handleItemClick = (node) => {
+  // 清除之前的计时器
+  if (debounceTimer) {
+    clearTimeout(debounceTimer);
+  }
+
+  // 设置新的计时器
+  debounceTimer = setTimeout(() => {
     cardId.value = node.encounterId;
+    // 同时更新本地和全局状态，确保模块内组件和跨模块组件都能正确响应
     updatePatientInfo(node);
+    updateLocalPatientInfo(node);
 
     diagnosisRef.value?.getList();
     adviceRef.value?.getListInfo();
     adviceRef.value?.getDiagnosisInfo();
+  }, 100); // 100ms 防抖延迟
 };
 
 const handleSearch = (keyword) => {