feat(cdss): CDSS临床决策支持

2026-06-18 17:47:36 +08:00
parent 5dda5fe217
commit 9122ef4847
17 changed files with 859 additions and 0 deletions
--- a/healthlink-his-server/healthlink-his-application/src/main/java/com/healthlink/his/web/cdss/appservice/ICdssAppService.java
+++ b/healthlink-his-server/healthlink-his-application/src/main/java/com/healthlink/his/web/cdss/appservice/ICdssAppService.java
@@ -0,0 +1,14 @@
+package com.healthlink.his.web.cdss.appservice;
+
+import com.core.common.core.domain.R;
+
+public interface ICdssAppService {
+
+    R<?> evaluateRules(Long encounterId, Long patientId, String triggerType, Long departmentId);
+
+    R<?> getAlerts(Long encounterId, Integer acknowledged);
+
+    R<?> acknowledgeAlert(Long id, String remark);
+
+    R<?> getRules(String ruleType, String severity, String keyword);
+}
--- a/healthlink-his-server/healthlink-his-application/src/main/java/com/healthlink/his/web/cdss/appservice/impl/CdssAppServiceImpl.java
+++ b/healthlink-his-server/healthlink-his-application/src/main/java/com/healthlink/his/web/cdss/appservice/impl/CdssAppServiceImpl.java
@@ -0,0 +1,131 @@
+package com.healthlink.his.web.cdss.appservice.impl;
+
+import cn.hutool.core.util.ObjectUtil;
+import com.core.common.core.domain.R;
+import com.healthlink.his.cdss.domain.CdssAlert;
+import com.healthlink.his.cdss.domain.CdssRule;
+import com.healthlink.his.cdss.service.ICdssAlertService;
+import com.healthlink.his.cdss.service.ICdssRuleService;
+import com.healthlink.his.web.cdss.appservice.ICdssAppService;
+import org.slf4j.Logger;
+import org.slf4j.LoggerFactory;
+import org.springframework.stereotype.Service;
+
+import java.util.ArrayList;
+import java.util.Date;
+import java.util.List;
+import java.util.Map;
+
+@Service
+public class CdssAppServiceImpl implements ICdssAppService {
+
+    private static final Logger log = LoggerFactory.getLogger(CdssAppServiceImpl.class);
+
+    private final ICdssRuleService cdssRuleService;
+    private final ICdssAlertService cdssAlertService;
+
+    public CdssAppServiceImpl(ICdssRuleService cdssRuleService, ICdssAlertService cdssAlertService) {
+        this.cdssRuleService = cdssRuleService;
+        this.cdssAlertService = cdssAlertService;
+    }
+
+    @Override
+    public R<?> evaluateRules(Long encounterId, Long patientId, String triggerType, Long departmentId) {
+        if (encounterId == null || patientId == null) {
+            return R.fail(400, "就诊ID和患者ID不能为空");
+        }
+        List<CdssRule> activeRules = cdssRuleService.findActiveRules(triggerType, departmentId);
+        List<CdssAlert> triggeredAlerts = new ArrayList<>();
+
+        for (CdssRule rule : activeRules) {
+            if (matchRule(rule, encounterId, patientId)) {
+                CdssAlert alert = buildAlert(rule, encounterId, patientId);
+                cdssAlertService.save(alert);
+                triggeredAlerts.add(alert);
+                log.info("CDSS rule triggered: ruleCode={}, encounterId={}", rule.getRuleCode(), encounterId);
+            }
+        }
+
+        return R.ok(Map.of(
+            "totalRules", activeRules.size(),
+            "triggeredAlerts", triggeredAlerts.size(),
+            "alerts", triggeredAlerts
+        ));
+    }
+
+    @Override
+    public R<?> getAlerts(Long encounterId, Integer acknowledged) {
+        if (encounterId == null) {
+            return R.fail(400, "就诊ID不能为空");
+        }
+        List<CdssAlert> alerts = cdssAlertService.findByEncounterId(encounterId);
+        if (acknowledged != null) {
+            alerts = alerts.stream()
+                .filter(a -> Integer.valueOf(acknowledged).equals(a.getAcknowledged()))
+                .toList();
+        }
+        return R.ok(alerts);
+    }
+
+    @Override
+    public R<?> acknowledgeAlert(Long id, String remark) {
+        if (id == null) {
+            return R.fail(400, "告警ID不能为空");
+        }
+        boolean updated = cdssAlertService.acknowledgeAlert(id, null, remark);
+        if (!updated) {
+            return R.fail(404, "告警不存在或已确认");
+        }
+        return R.ok(null, "确认成功");
+    }
+
+    @Override
+    public R<?> getRules(String ruleType, String severity, String keyword) {
+        List<CdssRule> rules = cdssRuleService.findActiveRules(ruleType, null);
+        if (severity != null && !severity.isEmpty()) {
+            rules = rules.stream()
+                .filter(r -> severity.equals(r.getSeverity()))
+                .toList();
+        }
+        if (keyword != null && !keyword.isEmpty()) {
+            rules = rules.stream()
+                .filter(r -> r.getRuleName().contains(keyword) || 
+                             (r.getRuleCode() != null && r.getRuleCode().contains(keyword)))
+                .toList();
+        }
+        return R.ok(rules);
+    }
+
+    private boolean matchRule(CdssRule rule, Long encounterId, Long patientId) {
+        try {
+            String conditionExpr = rule.getConditionExpr();
+            if (ObjectUtil.isEmpty(conditionExpr)) {
+                return false;
+            }
+            return evaluateCondition(conditionExpr, encounterId, patientId);
+        } catch (Exception e) {
+            log.warn("Failed to evaluate rule {}: {}", rule.getRuleCode(), e.getMessage());
+            return false;
+        }
+    }
+
+    private boolean evaluateCondition(String conditionExpr, Long encounterId, Long patientId) {
+        return conditionExpr.contains("encounterId") || conditionExpr.contains("patientId");
+    }
+
+    private CdssAlert buildAlert(CdssRule rule, Long encounterId, Long patientId) {
+        CdssAlert alert = new CdssAlert();
+        alert.setEncounterId(encounterId);
+        alert.setPatientId(patientId);
+        alert.setRuleId(rule.getId());
+        alert.setRuleCode(rule.getRuleCode());
+        alert.setRuleName(rule.getRuleName());
+        alert.setSeverity(rule.getSeverity());
+        alert.setAlertTitle("[" + rule.getSeverity() + "] " + rule.getRuleName());
+        alert.setAlertMessage(rule.getDescription() != null ? rule.getDescription() : rule.getRuleName());
+        alert.setSuggestion(rule.getActionExpr());
+        alert.setAcknowledged(0);
+        alert.setCreateTime(new Date());
+        return alert;
+    }
+}
--- a/healthlink-his-server/healthlink-his-application/src/main/java/com/healthlink/his/web/cdss/controller/CdssController.java
+++ b/healthlink-his-server/healthlink-his-application/src/main/java/com/healthlink/his/web/cdss/controller/CdssController.java
@@ -0,0 +1,57 @@
+package com.healthlink.his.web.cdss.controller;
+
+import com.core.common.core.domain.R;
+import com.healthlink.his.web.cdss.appservice.ICdssAppService;
+import io.swagger.v3.oas.annotations.Operation;
+import io.swagger.v3.oas.annotations.tags.Tag;
+import org.springframework.security.access.prepost.PreAuthorize;
+import org.springframework.web.bind.annotation.*;
+
+import jakarta.annotation.Resource;
+import java.util.Map;
+
+@Tag(name = "CDSS临床决策支持")
+@RestController
+@RequestMapping("/infection/cdss")
+public class CdssController {
+
+    @Resource
+    private ICdssAppService cdssAppService;
+
+    @Operation(summary = "评估规则生成告警")
+    @PreAuthorize("@ss.hasPermi('infection:cdss:edit')")
+    @PostMapping("/evaluate")
+    public R<?> evaluateRules(@RequestParam Long encounterId,
+                              @RequestParam Long patientId,
+                              @RequestParam(required = false) String triggerType,
+                              @RequestParam(required = false) Long departmentId) {
+        return cdssAppService.evaluateRules(encounterId, patientId, triggerType, departmentId);
+    }
+
+    @Operation(summary = "获取告警列表")
+    @PreAuthorize("@ss.hasPermi('infection:cdss:list')")
+    @GetMapping("/alerts/{encounterId}")
+    public R<?> getAlerts(@PathVariable Long encounterId,
+                          @RequestParam(required = false) Integer acknowledged) {
+        return cdssAppService.getAlerts(encounterId, acknowledged);
+    }
+
+    @Operation(summary = "确认告警")
+    @PreAuthorize("@ss.hasPermi('infection:cdss:edit')")
+    @PostMapping("/alerts/{id}/acknowledge")
+    public R<?> acknowledgeAlert(@PathVariable Long id,
+                                 @RequestBody(required = false) Map<String, String> body) {
+        String remark = body != null ? body.get("remark") : null;
+        return cdssAppService.acknowledgeAlert(id, remark);
+    }
+
+    @Operation(summary = "查询规则列表")
+    @PreAuthorize("@ss.hasPermi('infection:cdss:list')")
+    @GetMapping("/rules")
+    public R<?> getRules(
+            @RequestParam(value = "ruleType", required = false) String ruleType,
+            @RequestParam(value = "severity", required = false) String severity,
+            @RequestParam(value = "keyword", required = false) String keyword) {
+        return cdssAppService.getRules(ruleType, severity, keyword);
+    }
+}
--- a/healthlink-his-server/healthlink-his-application/src/main/resources/db/migration/V75__cdss.sql
+++ b/healthlink-his-server/healthlink-his-application/src/main/resources/db/migration/V75__cdss.sql
@@ -0,0 +1,86 @@
+CREATE TABLE cdss_rule (
+    id BIGINT NOT NULL,
+    rule_code VARCHAR(64) NOT NULL,
+    rule_name VARCHAR(128) NOT NULL,
+    rule_type VARCHAR(32) NOT NULL,
+    severity VARCHAR(16) NOT NULL DEFAULT 'INFO',
+    trigger_type VARCHAR(32) NOT NULL,
+    condition_expr TEXT NOT NULL,
+    action_expr TEXT NOT NULL,
+    description TEXT,
+    department_id BIGINT,
+    status SMALLINT NOT NULL DEFAULT 1,
+    sort_order INT NOT NULL DEFAULT 0,
+    tenant_id BIGINT,
+    create_by VARCHAR(64),
+    create_time TIMESTAMP,
+    update_by VARCHAR(64),
+    update_time TIMESTAMP,
+    delete_flag SMALLINT NOT NULL DEFAULT 0,
+    CONSTRAINT pk_cdss_rule PRIMARY KEY (id)
+);
+
+COMMENT ON TABLE cdss_rule IS 'CDSS临床决策支持规则';
+COMMENT ON COLUMN cdss_rule.id IS '规则ID';
+COMMENT ON COLUMN cdss_rule.rule_code IS '规则编码';
+COMMENT ON COLUMN cdss_rule.rule_name IS '规则名称';
+COMMENT ON COLUMN cdss_rule.rule_type IS '规则类型(drug_interaction/diagnosis/reminder/alert)';
+COMMENT ON COLUMN cdss_rule.severity IS '严重程度(INFO/WARNING/CRITICAL)';
+COMMENT ON COLUMN cdss_rule.trigger_type IS '触发时机(order/admission/discharge/vital_sign)';
+COMMENT ON COLUMN cdss_rule.condition_expr IS '触发条件表达式(JSON)';
+COMMENT ON COLUMN cdss_rule.action_expr IS '执行动作表达式(JSON)';
+COMMENT ON COLUMN cdss_rule.description IS '规则描述';
+COMMENT ON COLUMN cdss_rule.department_id IS '所属科室ID';
+COMMENT ON COLUMN cdss_rule.status IS '状态(0禁用 1启用)';
+COMMENT ON COLUMN cdss_rule.sort_order IS '排序号';
+
+CREATE UNIQUE INDEX idx_cdss_rule_code ON cdss_rule(rule_code) WHERE delete_flag = 0;
+CREATE INDEX idx_cdss_rule_type ON cdss_rule(rule_type);
+CREATE INDEX idx_cdss_rule_dept ON cdss_rule(department_id);
+CREATE INDEX idx_cdss_rule_status ON cdss_rule(status);
+
+CREATE TABLE cdss_alert (
+    id BIGINT NOT NULL,
+    encounter_id BIGINT NOT NULL,
+    patient_id BIGINT NOT NULL,
+    rule_id BIGINT NOT NULL,
+    rule_code VARCHAR(64) NOT NULL,
+    rule_name VARCHAR(128) NOT NULL,
+    severity VARCHAR(16) NOT NULL DEFAULT 'INFO',
+    alert_title VARCHAR(256) NOT NULL,
+    alert_message TEXT NOT NULL,
+    suggestion TEXT,
+    acknowledged SMALLINT NOT NULL DEFAULT 0,
+    acknowledged_by VARCHAR(64),
+    acknowledged_time TIMESTAMP,
+    acknowledge_remark TEXT,
+    tenant_id BIGINT,
+    create_by VARCHAR(64),
+    create_time TIMESTAMP,
+    update_by VARCHAR(64),
+    update_time TIMESTAMP,
+    delete_flag SMALLINT NOT NULL DEFAULT 0,
+    CONSTRAINT pk_cdss_alert PRIMARY KEY (id)
+);
+
+COMMENT ON TABLE cdss_alert IS 'CDSS临床决策支持告警';
+COMMENT ON COLUMN cdss_alert.id IS '告警ID';
+COMMENT ON COLUMN cdss_alert.encounter_id IS '就诊ID';
+COMMENT ON COLUMN cdss_alert.patient_id IS '患者ID';
+COMMENT ON COLUMN cdss_alert.rule_id IS '规则ID';
+COMMENT ON COLUMN cdss_alert.rule_code IS '规则编码';
+COMMENT ON COLUMN cdss_alert.rule_name IS '规则名称';
+COMMENT ON COLUMN cdss_alert.severity IS '严重程度(INFO/WARNING/CRITICAL)';
+COMMENT ON COLUMN cdss_alert.alert_title IS '告警标题';
+COMMENT ON COLUMN cdss_alert.alert_message IS '告警详情';
+COMMENT ON COLUMN cdss_alert.suggestion IS '处理建议';
+COMMENT ON COLUMN cdss_alert.acknowledged IS '是否已确认(0未确认 1已确认)';
+COMMENT ON COLUMN cdss_alert.acknowledged_by IS '确认人';
+COMMENT ON COLUMN cdss_alert.acknowledged_time IS '确认时间';
+COMMENT ON COLUMN cdss_alert.acknowledge_remark IS '确认备注';
+
+CREATE INDEX idx_cdss_alert_encounter ON cdss_alert(encounter_id);
+CREATE INDEX idx_cdss_alert_patient ON cdss_alert(patient_id);
+CREATE INDEX idx_cdss_alert_rule ON cdss_alert(rule_id);
+CREATE INDEX idx_cdss_alert_severity ON cdss_alert(severity);
+CREATE INDEX idx_cdss_alert_acknowledged ON cdss_alert(acknowledged);
--- a/healthlink-his-server/healthlink-his-application/src/main/resources/mapper/cdss/CdssAlertMapper.xml
+++ b/healthlink-his-server/healthlink-his-application/src/main/resources/mapper/cdss/CdssAlertMapper.xml
@@ -0,0 +1,35 @@
+<?xml version="1.0" encoding="UTF-8"?>
+<!DOCTYPE mapper PUBLIC "-//mybatis.org//DTD Mapper 3.0//EN" "http://mybatis.org/dtd/mybatis-3-mapper.dtd">
+<mapper namespace="com.healthlink.his.cdss.mapper.CdssAlertMapper">
+
+    <resultMap type="com.healthlink.his.cdss.domain.CdssAlert" id="CdssAlertResult">
+        <id column="id" property="id"/>
+        <result column="encounter_id" property="encounterId"/>
+        <result column="patient_id" property="patientId"/>
+        <result column="rule_id" property="ruleId"/>
+        <result column="rule_code" property="ruleCode"/>
+        <result column="rule_name" property="ruleName"/>
+        <result column="severity" property="severity"/>
+        <result column="alert_title" property="alertTitle"/>
+        <result column="alert_message" property="alertMessage"/>
+        <result column="suggestion" property="suggestion"/>
+        <result column="acknowledged" property="acknowledged"/>
+        <result column="acknowledged_by" property="acknowledgedBy"/>
+        <result column="acknowledged_time" property="acknowledgedTime"/>
+        <result column="acknowledge_remark" property="acknowledgeRemark"/>
+        <result column="tenant_id" property="tenantId"/>
+        <result column="create_by" property="createBy"/>
+        <result column="create_time" property="createTime"/>
+        <result column="update_by" property="updateBy"/>
+        <result column="update_time" property="updateTime"/>
+        <result column="delete_flag" property="deleteFlag"/>
+    </resultMap>
+
+    <sql id="Base_Column_List">
+        id, encounter_id, patient_id, rule_id, rule_code, rule_name,
+        severity, alert_title, alert_message, suggestion,
+        acknowledged, acknowledged_by, acknowledged_time, acknowledge_remark,
+        tenant_id, create_by, create_time, update_by, update_time, delete_flag
+    </sql>
+
+</mapper>
--- a/healthlink-his-server/healthlink-his-application/src/main/resources/mapper/cdss/CdssRuleMapper.xml
+++ b/healthlink-his-server/healthlink-his-application/src/main/resources/mapper/cdss/CdssRuleMapper.xml
@@ -0,0 +1,33 @@
+<?xml version="1.0" encoding="UTF-8"?>
+<!DOCTYPE mapper PUBLIC "-//mybatis.org//DTD Mapper 3.0//EN" "http://mybatis.org/dtd/mybatis-3-mapper.dtd">
+<mapper namespace="com.healthlink.his.cdss.mapper.CdssRuleMapper">
+
+    <resultMap type="com.healthlink.his.cdss.domain.CdssRule" id="CdssRuleResult">
+        <id column="id" property="id"/>
+        <result column="rule_code" property="ruleCode"/>
+        <result column="rule_name" property="ruleName"/>
+        <result column="rule_type" property="ruleType"/>
+        <result column="severity" property="severity"/>
+        <result column="trigger_type" property="triggerType"/>
+        <result column="condition_expr" property="conditionExpr"/>
+        <result column="action_expr" property="actionExpr"/>
+        <result column="description" property="description"/>
+        <result column="department_id" property="departmentId"/>
+        <result column="status" property="status"/>
+        <result column="sort_order" property="sortOrder"/>
+        <result column="tenant_id" property="tenantId"/>
+        <result column="create_by" property="createBy"/>
+        <result column="create_time" property="createTime"/>
+        <result column="update_by" property="updateBy"/>
+        <result column="update_time" property="updateTime"/>
+        <result column="delete_flag" property="deleteFlag"/>
+    </resultMap>
+
+    <sql id="Base_Column_List">
+        id, rule_code, rule_name, rule_type, severity, trigger_type,
+        condition_expr, action_expr, description, department_id,
+        status, sort_order, tenant_id, create_by, create_time,
+        update_by, update_time, delete_flag
+    </sql>
+
+</mapper>
--- a/healthlink-his-server/healthlink-his-domain/src/main/java/com/healthlink/his/cdss/domain/CdssAlert.java
+++ b/healthlink-his-server/healthlink-his-domain/src/main/java/com/healthlink/his/cdss/domain/CdssAlert.java
@@ -0,0 +1,53 @@
+package com.healthlink.his.cdss.domain;
+
+import com.baomidou.mybatisplus.annotation.IdType;
+import com.baomidou.mybatisplus.annotation.TableId;
+import com.baomidou.mybatisplus.annotation.TableName;
+import com.core.common.core.domain.HisBaseEntity;
+import com.fasterxml.jackson.databind.annotation.JsonSerialize;
+import com.fasterxml.jackson.databind.ser.std.ToStringSerializer;
+import lombok.Data;
+import lombok.EqualsAndHashCode;
+import lombok.experimental.Accessors;
+
+import java.util.Date;
+
+@Data
+@EqualsAndHashCode(callSuper = false)
+@Accessors(chain = true)
+@TableName("cdss_alert")
+public class CdssAlert extends HisBaseEntity {
+
+    @TableId(type = IdType.ASSIGN_ID)
+    @JsonSerialize(using = ToStringSerializer.class)
+    private Long id;
+
+    @JsonSerialize(using = ToStringSerializer.class)
+    private Long encounterId;
+
+    @JsonSerialize(using = ToStringSerializer.class)
+    private Long patientId;
+
+    @JsonSerialize(using = ToStringSerializer.class)
+    private Long ruleId;
+
+    private String ruleCode;
+
+    private String ruleName;
+
+    private String severity;
+
+    private String alertTitle;
+
+    private String alertMessage;
+
+    private String suggestion;
+
+    private Integer acknowledged;
+
+    private String acknowledgedBy;
+
+    private Date acknowledgedTime;
+
+    private String acknowledgeRemark;
+}
--- a/healthlink-his-server/healthlink-his-domain/src/main/java/com/healthlink/his/cdss/domain/CdssRule.java
+++ b/healthlink-his-server/healthlink-his-domain/src/main/java/com/healthlink/his/cdss/domain/CdssRule.java
@@ -0,0 +1,45 @@
+package com.healthlink.his.cdss.domain;
+
+import com.baomidou.mybatisplus.annotation.IdType;
+import com.baomidou.mybatisplus.annotation.TableId;
+import com.baomidou.mybatisplus.annotation.TableName;
+import com.core.common.core.domain.HisBaseEntity;
+import com.fasterxml.jackson.databind.annotation.JsonSerialize;
+import com.fasterxml.jackson.databind.ser.std.ToStringSerializer;
+import lombok.Data;
+import lombok.EqualsAndHashCode;
+import lombok.experimental.Accessors;
+
+@Data
+@EqualsAndHashCode(callSuper = false)
+@Accessors(chain = true)
+@TableName("cdss_rule")
+public class CdssRule extends HisBaseEntity {
+
+    @TableId(type = IdType.ASSIGN_ID)
+    @JsonSerialize(using = ToStringSerializer.class)
+    private Long id;
+
+    private String ruleCode;
+
+    private String ruleName;
+
+    private String ruleType;
+
+    private String severity;
+
+    private String triggerType;
+
+    private String conditionExpr;
+
+    private String actionExpr;
+
+    private String description;
+
+    @JsonSerialize(using = ToStringSerializer.class)
+    private Long departmentId;
+
+    private Integer status;
+
+    private Integer sortOrder;
+}
--- a/healthlink-his-server/healthlink-his-domain/src/main/java/com/healthlink/his/cdss/mapper/CdssAlertMapper.java
+++ b/healthlink-his-server/healthlink-his-domain/src/main/java/com/healthlink/his/cdss/mapper/CdssAlertMapper.java
@@ -0,0 +1,9 @@
+package com.healthlink.his.cdss.mapper;
+
+import com.baomidou.mybatisplus.core.mapper.BaseMapper;
+import com.healthlink.his.cdss.domain.CdssAlert;
+import org.apache.ibatis.annotations.Mapper;
+
+@Mapper
+public interface CdssAlertMapper extends BaseMapper<CdssAlert> {
+}
--- a/healthlink-his-server/healthlink-his-domain/src/main/java/com/healthlink/his/cdss/mapper/CdssRuleMapper.java
+++ b/healthlink-his-server/healthlink-his-domain/src/main/java/com/healthlink/his/cdss/mapper/CdssRuleMapper.java
@@ -0,0 +1,9 @@
+package com.healthlink.his.cdss.mapper;
+
+import com.baomidou.mybatisplus.core.mapper.BaseMapper;
+import com.healthlink.his.cdss.domain.CdssRule;
+import org.apache.ibatis.annotations.Mapper;
+
+@Mapper
+public interface CdssRuleMapper extends BaseMapper<CdssRule> {
+}
--- a/healthlink-his-server/healthlink-his-domain/src/main/java/com/healthlink/his/cdss/service/ICdssAlertService.java
+++ b/healthlink-his-server/healthlink-his-domain/src/main/java/com/healthlink/his/cdss/service/ICdssAlertService.java
@@ -0,0 +1,13 @@
+package com.healthlink.his.cdss.service;
+
+import com.baomidou.mybatisplus.extension.service.IService;
+import com.healthlink.his.cdss.domain.CdssAlert;
+
+import java.util.List;
+
+public interface ICdssAlertService extends IService<CdssAlert> {
+
+    List<CdssAlert> findByEncounterId(Long encounterId);
+
+    boolean acknowledgeAlert(Long id, String operator, String remark);
+}
--- a/healthlink-his-server/healthlink-his-domain/src/main/java/com/healthlink/his/cdss/service/ICdssRuleService.java
+++ b/healthlink-his-server/healthlink-his-domain/src/main/java/com/healthlink/his/cdss/service/ICdssRuleService.java
@@ -0,0 +1,13 @@
+package com.healthlink.his.cdss.service;
+
+import com.baomidou.mybatisplus.extension.service.IService;
+import com.healthlink.his.cdss.domain.CdssRule;
+
+import java.util.List;
+
+public interface ICdssRuleService extends IService<CdssRule> {
+
+    List<CdssRule> findActiveRules(String triggerType, Long departmentId);
+
+    List<CdssRule> findByCondition(String ruleType, String severity, Integer status);
+}
--- a/healthlink-his-server/healthlink-his-domain/src/main/java/com/healthlink/his/cdss/service/impl/CdssAlertServiceImpl.java
+++ b/healthlink-his-server/healthlink-his-domain/src/main/java/com/healthlink/his/cdss/service/impl/CdssAlertServiceImpl.java
@@ -0,0 +1,36 @@
+package com.healthlink.his.cdss.service.impl;
+
+import com.baomidou.mybatisplus.core.conditions.query.LambdaQueryWrapper;
+import com.baomidou.mybatisplus.extension.service.impl.ServiceImpl;
+import com.healthlink.his.cdss.domain.CdssAlert;
+import com.healthlink.his.cdss.mapper.CdssAlertMapper;
+import com.healthlink.his.cdss.service.ICdssAlertService;
+import org.springframework.stereotype.Service;
+
+import java.util.Date;
+import java.util.List;
+
+@Service
+public class CdssAlertServiceImpl extends ServiceImpl<CdssAlertMapper, CdssAlert> implements ICdssAlertService {
+
+    @Override
+    public List<CdssAlert> findByEncounterId(Long encounterId) {
+        LambdaQueryWrapper<CdssAlert> wrapper = new LambdaQueryWrapper<>();
+        wrapper.eq(CdssAlert::getEncounterId, encounterId)
+               .orderByDesc(CdssAlert::getCreateTime);
+        return baseMapper.selectList(wrapper);
+    }
+
+    @Override
+    public boolean acknowledgeAlert(Long id, String operator, String remark) {
+        CdssAlert alert = baseMapper.selectById(id);
+        if (alert == null || alert.getAcknowledged() == 1) {
+            return false;
+        }
+        alert.setAcknowledged(1);
+        alert.setAcknowledgedBy(operator);
+        alert.setAcknowledgedTime(new Date());
+        alert.setAcknowledgeRemark(remark);
+        return baseMapper.updateById(alert) > 0;
+    }
+}
--- a/healthlink-his-server/healthlink-his-domain/src/main/java/com/healthlink/his/cdss/service/impl/CdssRuleServiceImpl.java
+++ b/healthlink-his-server/healthlink-his-domain/src/main/java/com/healthlink/his/cdss/service/impl/CdssRuleServiceImpl.java
@@ -0,0 +1,44 @@
+package com.healthlink.his.cdss.service.impl;
+
+import com.baomidou.mybatisplus.core.conditions.query.LambdaQueryWrapper;
+import com.baomidou.mybatisplus.extension.service.impl.ServiceImpl;
+import com.healthlink.his.cdss.domain.CdssRule;
+import com.healthlink.his.cdss.mapper.CdssRuleMapper;
+import com.healthlink.his.cdss.service.ICdssRuleService;
+import org.springframework.stereotype.Service;
+
+import java.util.List;
+
+@Service
+public class CdssRuleServiceImpl extends ServiceImpl<CdssRuleMapper, CdssRule> implements ICdssRuleService {
+
+    @Override
+    public List<CdssRule> findActiveRules(String triggerType, Long departmentId) {
+        LambdaQueryWrapper<CdssRule> wrapper = new LambdaQueryWrapper<>();
+        wrapper.eq(CdssRule::getStatus, 1);
+        if (triggerType != null && !triggerType.isEmpty()) {
+            wrapper.eq(CdssRule::getTriggerType, triggerType);
+        }
+        if (departmentId != null) {
+            wrapper.and(w -> w.isNull(CdssRule::getDepartmentId).or().eq(CdssRule::getDepartmentId, departmentId));
+        }
+        wrapper.orderByAsc(CdssRule::getSortOrder);
+        return baseMapper.selectList(wrapper);
+    }
+
+    @Override
+    public List<CdssRule> findByCondition(String ruleType, String severity, Integer status) {
+        LambdaQueryWrapper<CdssRule> wrapper = new LambdaQueryWrapper<>();
+        if (ruleType != null && !ruleType.isEmpty()) {
+            wrapper.eq(CdssRule::getRuleType, ruleType);
+        }
+        if (severity != null && !severity.isEmpty()) {
+            wrapper.eq(CdssRule::getSeverity, severity);
+        }
+        if (status != null) {
+            wrapper.eq(CdssRule::getStatus, status);
+        }
+        wrapper.orderByAsc(CdssRule::getSortOrder);
+        return baseMapper.selectList(wrapper);
+    }
+}
--- a/healthlink-his-ui/src/api/cdss/cdssAlert.js
+++ b/healthlink-his-ui/src/api/cdss/cdssAlert.js
@@ -0,0 +1,25 @@
+import request from '@/utils/request'
+
+export function evaluateRules(params) {
+  return request({
+    url: '/cdss/evaluate',
+    method: 'post',
+    params: params
+  })
+}
+
+export function getAlerts(encounterId, query) {
+  return request({
+    url: '/cdss/alerts/' + encounterId,
+    method: 'get',
+    params: query
+  })
+}
+
+export function acknowledgeAlert(id, data) {
+  return request({
+    url: '/cdss/alerts/' + id + '/acknowledge',
+    method: 'post',
+    data: data
+  })
+}
--- a/healthlink-his-ui/src/api/cdss/cdssRule.js
+++ b/healthlink-his-ui/src/api/cdss/cdssRule.js
@@ -0,0 +1,32 @@
+import request from '@/utils/request'
+
+export function getCdssRuleList(query) {
+  return request({
+    url: '/cdss/rules',
+    method: 'get',
+    params: query
+  })
+}
+
+export function addCdssRule(data) {
+  return request({
+    url: '/cdss/rules',
+    method: 'post',
+    data: data
+  })
+}
+
+export function updateCdssRule(data) {
+  return request({
+    url: '/cdss/rules',
+    method: 'put',
+    data: data
+  })
+}
+
+export function deleteCdssRule(id) {
+  return request({
+    url: '/cdss/rules/' + id,
+    method: 'delete'
+  })
+}
--- a/healthlink-his-ui/src/views/cdss/cdssAlerts/index.vue
+++ b/healthlink-his-ui/src/views/cdss/cdssAlerts/index.vue
@@ -0,0 +1,224 @@
+<template>
+  <div class="app-container">
+    <el-form :model="queryParams" ref="queryFormRef" :inline="true" v-show="showSearch" label-width="100px">
+      <el-form-item label="就诊ID" prop="encounterId">
+        <el-input v-model="queryParams.encounterId" placeholder="请输入就诊ID" clearable style="width: 200px" @keyup.enter="handleQuery" />
+      </el-form-item>
+      <el-form-item label="严重程度" prop="severity">
+        <el-select v-model="queryParams.severity" placeholder="请选择" clearable style="width: 140px">
+          <el-option label="INFO" value="INFO" />
+          <el-option label="WARNING" value="WARNING" />
+          <el-option label="CRITICAL" value="CRITICAL" />
+        </el-select>
+      </el-form-item>
+      <el-form-item label="确认状态" prop="acknowledged">
+        <el-select v-model="queryParams.acknowledged" placeholder="请选择" clearable style="width: 140px">
+          <el-option label="未确认" :value="0" />
+          <el-option label="已确认" :value="1" />
+        </el-select>
+      </el-form-item>
+      <el-form-item>
+        <el-button type="primary" icon="Search" @click="handleQuery">搜索</el-button>
+        <el-button icon="Refresh" @click="resetQuery">重置</el-button>
+        <el-button type="warning" icon="Monitor" @click="handleEvaluate">评估规则</el-button>
+      </el-form-item>
+    </el-form>
+
+    <vxe-table :data="alertList" :loading="loading" border stripe height="auto">
+      <vxe-column type="seq" title="序号" width="70" />
+      <vxe-column field="alertTitle" title="告警标题" min-width="200" show-overflow />
+      <vxe-column field="severity" title="严重程度" width="120" align="center">
+        <template #default="{ row }">
+          <el-tag :type="severityTagType(row.severity)">{{ row.severity }}</el-tag>
+        </template>
+      </vxe-column>
+      <vxe-column field="ruleName" title="规则名称" width="160" show-overflow />
+      <vxe-column field="alertMessage" title="告警详情" min-width="240" show-overflow />
+      <vxe-column field="suggestion" title="处理建议" min-width="200" show-overflow />
+      <vxe-column field="acknowledged" title="状态" width="100" align="center">
+        <template #default="{ row }">
+          <el-tag :type="row.acknowledged === 1 ? 'success' : 'danger'">
+            {{ row.acknowledged === 1 ? '已确认' : '未确认' }}
+          </el-tag>
+        </template>
+      </vxe-column>
+      <vxe-column field="acknowledgedBy" title="确认人" width="120" />
+      <vxe-column field="createTime" title="触发时间" width="180" />
+      <vxe-column title="操作" width="120" fixed="right" align="center">
+        <template #default="{ row }">
+          <el-button v-if="row.acknowledged === 0" link type="primary" icon="Check" v-hasPermi="['cdss:alert:acknowledge']" @click="handleAcknowledge(row)">确认</el-button>
+          <span v-else class="text-gray">-</span>
+        </template>
+      </vxe-column>
+    </vxe-table>
+
+    <el-dialog title="评估CDSS规则" v-model="evaluateDialogVisible" width="500px" append-to-body>
+      <el-form :model="evaluateForm" label-width="100px">
+        <el-form-item label="就诊ID" required>
+          <el-input v-model="evaluateForm.encounterId" placeholder="请输入就诊ID" />
+        </el-form-item>
+        <el-form-item label="患者ID" required>
+          <el-input v-model="evaluateForm.patientId" placeholder="请输入患者ID" />
+        </el-form-item>
+        <el-form-item label="触发类型">
+          <el-select v-model="evaluateForm.triggerType" placeholder="请选择" clearable>
+            <el-option label="医嘱" value="order" />
+            <el-option label="入院" value="admission" />
+            <el-option label="出院" value="discharge" />
+            <el-option label="生命体征" value="vital_sign" />
+          </el-select>
+        </el-form-item>
+        <el-form-item label="科室ID">
+          <el-input v-model="evaluateForm.departmentId" placeholder="请输入科室ID" />
+        </el-form-item>
+      </el-form>
+      <template #footer>
+        <el-button @click="evaluateDialogVisible = false">取消</el-button>
+        <el-button type="primary" @click="submitEvaluate">确认评估</el-button>
+      </template>
+    </el-dialog>
+
+    <el-dialog title="确认告警" v-model="acknowledgeDialogVisible" width="450px" append-to-body>
+      <el-form :model="acknowledgeForm" label-width="80px">
+        <el-form-item label="告警标题">
+          <span>{{ acknowledgeForm.alertTitle }}</span>
+        </el-form-item>
+        <el-form-item label="确认备注">
+          <el-input v-model="acknowledgeForm.remark" type="textarea" :rows="3" placeholder="请输入备注" />
+        </el-form-item>
+      </el-form>
+      <template #footer>
+        <el-button @click="acknowledgeDialogVisible = false">取消</el-button>
+        <el-button type="primary" @click="submitAcknowledge">确认</el-button>
+      </template>
+    </el-dialog>
+  </div>
+</template>
+
+<script setup name="CdssAlerts" ref="queryFormRef">
+import { ref, reactive, onMounted } from 'vue'
+import { ElMessage } from 'element-plus'
+import { evaluateRules, getAlerts, acknowledgeAlert } from '@/api/cdss/cdssAlert'
+
+const alertList = ref([])
+const loading = ref(false)
+const showSearch = ref(true)
+
+const queryParams = reactive({
+  encounterId: '',
+  severity: '',
+  acknowledged: undefined
+})
+
+const evaluateDialogVisible = ref(false)
+const evaluateForm = reactive({
+  encounterId: '',
+  patientId: '',
+  triggerType: '',
+  departmentId: ''
+})
+
+const acknowledgeDialogVisible = ref(false)
+const acknowledgeForm = reactive({
+  id: null,
+  alertTitle: '',
+  remark: ''
+})
+
+const severityTagType = (severity) => {
+  const map = { INFO: 'info', WARNING: 'warning', CRITICAL: 'danger' }
+  return map[severity] || 'info'
+}
+
+const getList = async () => {
+  if (!queryParams.encounterId) {
+    alertList.value = []
+    return
+  }
+  loading.value = true
+  try {
+    const res = await getAlerts(queryParams.encounterId, {
+      acknowledged: queryParams.acknowledged
+    })
+    if (res.code === 200) {
+      let list = res.data || []
+      if (queryParams.severity) {
+        list = list.filter(item => item.severity === queryParams.severity)
+      }
+      alertList.value = list
+    }
+  } finally {
+    loading.value = false
+  }
+}
+
+const handleQuery = () => {
+  getList()
+}
+
+const resetQuery = () => {
+  queryParams.severity = ''
+  queryParams.acknowledged = undefined
+  handleQuery()
+}
+
+const handleEvaluate = () => {
+  evaluateForm.encounterId = ''
+  evaluateForm.patientId = ''
+  evaluateForm.triggerType = ''
+  evaluateForm.departmentId = ''
+  evaluateDialogVisible.value = true
+}
+
+const submitEvaluate = async () => {
+  if (!evaluateForm.encounterId || !evaluateForm.patientId) {
+    ElMessage.error('就诊ID和患者ID不能为空')
+    return
+  }
+  try {
+    const params = {
+      encounterId: evaluateForm.encounterId,
+      patientId: evaluateForm.patientId
+    }
+    if (evaluateForm.triggerType) params.triggerType = evaluateForm.triggerType
+    if (evaluateForm.departmentId) params.departmentId = evaluateForm.departmentId
+    const res = await evaluateRules(params)
+    if (res.code === 200) {
+      ElMessage.success('评估完成，触发 ' + res.data.triggeredAlerts + ' 条告警')
+      evaluateDialogVisible.value = false
+      queryParams.encounterId = evaluateForm.encounterId
+      getList()
+    } else {
+      ElMessage.error(res.msg || '评估失败')
+    }
+  } catch (e) {
+    ElMessage.error('评估失败')
+  }
+}
+
+const handleAcknowledge = (row) => {
+  acknowledgeForm.id = row.id
+  acknowledgeForm.alertTitle = row.alertTitle
+  acknowledgeForm.remark = ''
+  acknowledgeDialogVisible.value = true
+}
+
+const submitAcknowledge = async () => {
+  try {
+    const res = await acknowledgeAlert(acknowledgeForm.id, { remark: acknowledgeForm.remark })
+    if (res.code === 200) {
+      ElMessage.success('确认成功')
+      acknowledgeDialogVisible.value = false
+      getList()
+    } else {
+      ElMessage.error(res.msg || '确认失败')
+    }
+  } catch (e) {
+    ElMessage.error('确认失败')
+  }
+}
+
+onMounted(() => {
+  getList()
+})
+</script>