会诊管理中门诊会诊申请确认和门诊会诊申请管理模块全部功能的实现。包括数据库设计，前端UI设计，后端接口开发。

2026-02-11 13:40:32 +08:00
parent b826afb17c
commit c5d75f053b
25 changed files with 3249 additions and 365 deletions
--- a/openhis-ui-vue3/src/layout/components/Sidebar/SidebarItem.vue
+++ b/openhis-ui-vue3/src/layout/components/Sidebar/SidebarItem.vue
@@ -86,6 +86,19 @@ function resolvePath(routePath, routeQuery) {
    return props.basePath
  }
  if (routeQuery) {
+    try {
+      // 检查 routeQuery 是否已经是对象
+      if (typeof routeQuery === 'object') {
+        return { path: getNormalPath(props.basePath + '/' + routePath), query: routeQuery }
+      }
+      // 尝试解析 JSON 字符串
+      let query = JSON.parse(routeQuery);
+      return { path: getNormalPath(props.basePath + '/' + routePath), query: query }
+    } catch (e) {
+      // 如果解析失败，将其作为普通字符串处理
+      console.warn('Failed to parse routeQuery as JSON:', routeQuery, e);
+      return getNormalPath(props.basePath + '/' + routePath)
+    }
    try {
      let query = JSON.parse(routeQuery);
      return { path: getNormalPath(props.basePath + '/' + routePath), query: query }
@@ -93,6 +106,19 @@ function resolvePath(routePath, routeQuery) {
      console.error('Failed to parse routeQuery:', routeQuery, e);
      return getNormalPath(props.basePath + '/' + routePath)
    }
+    try {
+      // 检查 routeQuery 是否已经是对象
+      if (typeof routeQuery === 'object') {
+        return { path: getNormalPath(props.basePath + '/' + routePath), query: routeQuery }
+      }
+      // 尝试解析 JSON 字符串
+      let query = JSON.parse(routeQuery);
+      return { path: getNormalPath(props.basePath + '/' + routePath), query: query }
+    } catch (e) {
+      // 如果解析失败，将其作为普通字符串处理
+      console.warn('Failed to parse routeQuery as JSON:', routeQuery, e);
+      return getNormalPath(props.basePath + '/' + routePath)
+    }
  }
  return getNormalPath(props.basePath + '/' + routePath)
 }
--- a/openhis-ui-vue3/src/router/index.js
+++ b/openhis-ui-vue3/src/router/index.js
@@ -237,6 +237,21 @@ export const dynamicRoutes = [
            },
        ],
    },
+    {
+        path: '/doctorstation',
+        component: Layout,
+        redirect: '/doctorstation/index',
+        name: 'DoctorStation',
+        meta: { title: '医生工作站', icon: 'operation' },
+        children: [
+            {
+                path: 'pending-emr',
+                component: () => import('@/views/doctorstation/pendingEmr.vue'),
+                name: 'PendingEmr',
+                meta: { title: '待写病历', icon: 'document', permissions: ['doctorstation:pending-emr:view'] }
+            }
+        ]
+    },
    {
        path: '/features',
        component: Layout,
@@ -298,6 +313,40 @@ export const dynamicRoutes = [
                meta: { title: '门诊日结', icon: 'document' }
            }
        ]
+    },
+    {
+        path: '/consultationmanagement',
+        component: Layout,
+        name: 'ConsultationManagement',
+        meta: { title: '会诊管理', icon: 'operation' },
+        children: [
+            {
+                path: 'consultationapplication',
+                component: () => import('@/views/consultationmanagement/consultationapplication/index.vue'),
+                name: 'ConsultationApplication',
+                meta: { title: '门诊会诊申请管理', icon: 'document' }
+            },
+            {
+                path: 'consultationconfirmation',
+                component: () => import('@/views/consultationmanagement/consultationconfirmation/index.vue'),
+                name: 'ConsultationConfirmation',
+                meta: { title: '门诊会诊申请确认', icon: 'document' }
+            }
+        ]
+    },
+    {
+        path: '/medicationmanagement',
+        component: Layout,
+        name: 'MedicationManagement',
+        meta: { title: '药房管理', icon: 'medication' },
+        children: [
+            {
+                path: 'dayEndSettlement',
+                component: () => import('@/views/medicationmanagement/dayEndSettlement/index.vue'),
+                name: 'DayEndSettlement',
+                meta: { title: '日结结算单管理', icon: 'document' }
+            }
+        ]
    }
 ];

--- a/openhis-ui-vue3/src/views/consultationmanagement/consultationapplication/api.js
+++ b/openhis-ui-vue3/src/views/consultationmanagement/consultationapplication/api.js
@@ -0,0 +1,125 @@
+import request from '@/utils/request'
+
+/**
+ * 获取会诊申请列表（简单查询）
+ * @param {Object} params 查询参数
+ */
+export function getConsultationList(params) {
+  return request({
+    url: '/consultation/list',
+    method: 'get',
+    params
+  })
+}
+
+/**
+ * 查询会诊申请列表（支持多条件查询）
+ * @param {Object} data 查询条件
+ */
+export function queryConsultationList(data) {
+  return request({
+    url: '/consultation/query',
+    method: 'post',
+    data
+  })
+}
+
+/**
+ * 分页查询会诊申请列表（支持多条件查询）
+ * @param {Object} data 查询条件
+ * @param {Number} pageNum 页码
+ * @param {Number} pageSize 每页大小
+ */
+export function queryConsultationListPage(data, pageNum, pageSize) {
+  return request({
+    url: '/consultation/queryPage',
+    method: 'post',
+    data,
+    params: { pageNum, pageSize },
+    headers: {
+      repeatSubmit: false  // 关键：告诉后端不要进行防重复提交检查
+    }
+  })
+}
+
+/**
+ * 保存会诊申请（新增或修改）
+ * @param {Object} data 会诊申请数据
+ */
+export function saveConsultation(data) {
+  return request({
+    url: '/consultation/save',
+    method: 'post',
+    data
+  })
+}
+
+/**
+ * 提交会诊申请
+ * @param {String} consultationId 会诊申请单号
+ */
+export function submitConsultation(consultationId) {
+  return request({
+    url: '/consultation/submit',
+    method: 'post',
+    params: { consultationId }
+  })
+}
+
+/**
+ * 作废会诊申请
+ * @param {String} consultationId 会诊申请单号
+ * @param {String} cancelReason 作废原因
+ */
+export function cancelConsultation(consultationId, cancelReason) {
+  return request({
+    url: '/consultation/cancel',
+    method: 'post',
+    params: { consultationId, cancelReason }
+  })
+}
+
+/**
+ * 结束会诊申请
+ * @param {String} consultationId 会诊申请单号
+ */
+export function completeConsultation(consultationId) {
+  return request({
+    url: '/consultation/complete',
+    method: 'post',
+    params: { consultationId }
+  })
+}
+
+/**
+ * 获取科室医生树
+ */
+export function getDepartmentTree() {
+  return request({
+    url: '/consultation/departmentTree',
+    method: 'get'
+  })
+}
+
+/**
+ * 获取主诊断
+ * @param {Number} encounterId 就诊ID
+ */
+export function getMainDiagnosis(encounterId) {
+  return request({
+    url: '/consultation/mainDiagnosis',
+    method: 'get',
+    params: { encounterId }
+  })
+}
+
+/**
+ * 获取会诊项目列表
+ */
+export function getConsultationActivities() {
+  return request({
+    url: '/consultation/activities',
+    method: 'get'
+  })
+}
+
--- a/openhis-ui-vue3/src/views/consultationmanagement/consultationapplication/index.vue
+++ b/openhis-ui-vue3/src/views/consultationmanagement/consultationapplication/index.vue
@@ -0,0 +1,743 @@
+<template>
+  <div class="consultation-application-container">
+    <!-- 页面标题 -->
+    <div class="page-header">
+      <span class="tab-title">门诊会诊申请管理</span>
+    </div>
+
+    <!-- 查询条件 -->
+    <div class="search-section">
+      <el-form :model="queryParams" inline>
+        <el-form-item label="时间类型">
+          <el-select v-model="queryParams.timeType" placeholder="请选择" style="width: 120px">
+            <el-option label="会诊时间" value="consultation" />
+            <el-option label="开始时间" value="start" />
+            <el-option label="结束时间" value="end" />
+          </el-select>
+        </el-form-item>
+
+        <el-form-item label="开始时间">
+          <el-date-picker
+            v-model="queryParams.startTime"
+            type="datetime"
+            placeholder="年/月/日 --:--"
+            format="YYYY/MM/DD HH:mm"
+            value-format="YYYY-MM-DD HH:mm:ss"
+            style="width: 180px"
+          />
+        </el-form-item>
+
+        <el-form-item label="结束时间">
+          <el-date-picker
+            v-model="queryParams.endTime"
+            type="datetime"
+            placeholder="年/月/日 --:--"
+            format="YYYY/MM/DD HH:mm"
+            value-format="YYYY-MM-DD HH:mm:ss"
+            style="width: 180px"
+          />
+        </el-form-item>
+
+        <el-form-item label="申请科室">
+          <el-input
+            v-model="queryParams.applyDept"
+            placeholder="请输入或输入科室"
+            clearable
+            style="width: 150px"
+          />
+        </el-form-item>
+
+        <el-form-item label="申请医生">
+          <el-input
+            v-model="queryParams.applyDoctor"
+            placeholder="请输入或输入医生"
+            clearable
+            style="width: 150px"
+          />
+        </el-form-item>
+
+        <el-form-item label="紧急程度">
+          <el-select v-model="queryParams.urgency" placeholder="全部" style="width: 120px">
+            <el-option label="全部" value="" />
+            <el-option label="一般" value="1" />
+            <el-option label="紧急" value="2" />
+          </el-select>
+        </el-form-item>
+
+        <el-form-item label="会诊状态">
+          <el-select v-model="queryParams.consultationStatus" placeholder="全部" style="width: 120px">
+            <el-option label="全部" value="" />
+            <el-option label="未提交" value="0" />
+            <el-option label="提交" value="10" />
+            <el-option label="结束" value="40" />
+          </el-select>
+        </el-form-item>
+
+        <el-form-item label="病人姓名">
+          <el-input
+            v-model="queryParams.patientName"
+            placeholder="请输入病人姓名"
+            clearable
+            style="width: 150px"
+          />
+        </el-form-item>
+
+        <el-form-item>
+          <el-button type="primary" @click="handleQuery">
+            <el-icon><Search /></el-icon> 查询
+          </el-button>
+          <el-button @click="handleReset">
+            <el-icon><Refresh /></el-icon> 重置
+          </el-button>
+          <el-button type="success" @click="handlePrint">
+            <el-icon><Printer /></el-icon> 打印
+          </el-button>
+        </el-form-item>
+      </el-form>
+    </div>
+
+    <!-- 数据表格 -->
+    <div class="table-section">
+      <el-table
+        :data="tableData"
+        border
+        stripe
+        highlight-current-row
+        @current-change="handleRowChange"
+        v-loading="loading"
+        height="400"
+      >
+        <el-table-column type="index" label="ID" width="60" align="center" />
+        <el-table-column label="急" width="60" align="center">
+          <template #default="scope">
+            <el-checkbox :model-value="scope.row.consultationUrgency === '2'" disabled />
+          </template>
+        </el-table-column>
+        <el-table-column prop="patientName" label="病人姓名" min-width="100" />
+        <el-table-column prop="consultationDate" label="会诊时间" min-width="160">
+          <template #default="scope">
+            {{ formatDateTime(scope.row.consultationDate) }}
+          </template>
+        </el-table-column>
+        <el-table-column prop="department" label="申请科室" min-width="120" />
+        <el-table-column prop="invitedObject" label="邀请对象" min-width="150" show-overflow-tooltip />
+        <el-table-column prop="consultationRequestDate" label="申请时间" min-width="160">
+          <template #default="scope">
+            {{ formatDateTime(scope.row.consultationRequestDate) }}
+          </template>
+        </el-table-column>
+        <el-table-column prop="requestingPhysician" label="申请医师" min-width="100" />
+        <el-table-column label="提交" width="70" align="center">
+          <template #default="scope">
+            <el-checkbox :model-value="scope.row.consultationStatus >= 10" disabled />
+          </template>
+        </el-table-column>
+        <el-table-column label="结束" width="70" align="center">
+          <template #default="scope">
+            <el-checkbox :model-value="scope.row.consultationStatus >= 40" disabled />
+          </template>
+        </el-table-column>
+        <el-table-column label="操作" width="200" fixed="right" align="center">
+          <template #default="scope">
+            <el-button
+              type="primary"
+              size="small"
+              :icon="Edit"
+              @click="handleEdit(scope.row)"
+              :disabled="scope.row.consultationStatus >= 40"
+              title="编辑"
+            />
+            <el-button
+              type="info"
+              size="small"
+              :icon="View"
+              @click="handleView(scope.row)"
+              title="查看"
+            />
+            <el-button
+              type="danger"
+              size="small"
+              :icon="Delete"
+              @click="handleDelete(scope.row)"
+              :disabled="scope.row.consultationStatus >= 40"
+              title="作废"
+            />
+          </template>
+        </el-table-column>
+      </el-table>
+
+      <!-- 分页组件 -->
+      <div class="pagination-container">
+        <el-pagination
+          v-model:current-page="pagination.currentPage"
+          v-model:page-size="pagination.pageSize"
+          :page-sizes="[10, 20, 30, 50, 100]"
+          :total="pagination.total"
+          :disabled="loading"
+          layout="total, sizes, prev, pager, next, jumper"
+          @size-change="handleSizeChange"
+          @current-change="handleCurrentChange"
+        />
+      </div>
+    </div>
+
+    <!-- 编辑/查看弹窗 -->
+    <el-dialog
+      v-model="dialogVisible"
+      :title="dialogTitle"
+      width="800px"
+      :close-on-click-modal="false"
+      @close="handleDialogClose"
+    >
+      <el-form
+        ref="formRef"
+        :model="formData"
+        :rules="formRules"
+        label-width="120px"
+        :disabled="isViewMode"
+      >
+        <el-row :gutter="16">
+          <el-col :span="12">
+            <el-form-item label="申请单号">
+              <el-input v-model="formData.consultationId" disabled />
+            </el-form-item>
+          </el-col>
+          <el-col :span="12">
+            <el-form-item label="申请时间">
+              <el-input :model-value="formatDateTime(formData.consultationRequestDate)" disabled />
+            </el-form-item>
+          </el-col>
+        </el-row>
+
+        <el-row :gutter="16">
+          <el-col :span="12">
+            <el-form-item label="病人姓名">
+              <el-input v-model="formData.patientName" disabled />
+            </el-form-item>
+          </el-col>
+          <el-col :span="12">
+            <el-form-item label="性别">
+              <el-input :model-value="formData.genderEnum === 1 ? '男' : '女'" disabled />
+            </el-form-item>
+          </el-col>
+        </el-row>
+
+        <el-row :gutter="16">
+          <el-col :span="12">
+            <el-form-item label="年龄">
+              <el-input v-model="formData.age" disabled />
+            </el-form-item>
+          </el-col>
+          <el-col :span="12">
+            <el-form-item label="就诊卡号">
+              <el-input v-model="formData.patientIdentifierNo" disabled />
+            </el-form-item>
+          </el-col>
+        </el-row>
+
+        <el-row :gutter="16">
+          <el-col :span="12">
+            <el-form-item label="申请医师" prop="requestingPhysician">
+              <el-input v-model="formData.requestingPhysician" />
+            </el-form-item>
+          </el-col>
+          <el-col :span="12">
+            <el-form-item label="会诊时间" prop="consultationDate">
+              <el-date-picker
+                v-model="formData.consultationDate"
+                type="datetime"
+                placeholder="年/月/日 --:--"
+                format="YYYY/MM/DD HH:mm"
+                value-format="YYYY-MM-DD HH:mm:ss"
+                style="width: 100%"
+              />
+            </el-form-item>
+          </el-col>
+        </el-row>
+
+        <el-row :gutter="16">
+          <el-col :span="12">
+            <el-form-item label="申请科室">
+              <el-input v-model="formData.department" disabled />
+            </el-form-item>
+          </el-col>
+          <el-col :span="12">
+            <el-form-item label="门诊诊断">
+              <el-input v-model="formData.provisionalDiagnosis" />
+            </el-form-item>
+          </el-col>
+        </el-row>
+
+        <el-form-item label="患者病史及会诊目的" prop="consultationPurpose">
+          <el-input
+            v-model="formData.consultationPurpose"
+            type="textarea"
+            :rows="4"
+            placeholder="请输入患者病史及会诊目的"
+          />
+        </el-form-item>
+
+        <el-row :gutter="16">
+          <el-col :span="12">
+            <el-form-item label="会诊邀请对象">
+              <el-input v-model="formData.invitedObject" disabled />
+            </el-form-item>
+          </el-col>
+          <el-col :span="12">
+            <el-form-item label="会诊邀请参加医师">
+              <el-input placeholder="请输入参加医师姓名" disabled />
+            </el-form-item>
+          </el-col>
+        </el-row>
+
+        <div class="section-title">会诊记录</div>
+        <el-form-item label="会诊意见">
+          <el-input
+            v-model="formData.consultationOpinion"
+            type="textarea"
+            :rows="4"
+            placeholder="会诊意见"
+            disabled
+          />
+        </el-form-item>
+
+        <el-row :gutter="16">
+          <el-col :span="12">
+            <el-form-item label="所属医生">
+              <el-input v-model="formData.attendingPhysician" disabled />
+            </el-form-item>
+          </el-col>
+          <el-col :span="12">
+            <el-form-item label="代表科室">
+              <el-input v-model="formData.representDepartment" disabled />
+            </el-form-item>
+          </el-col>
+        </el-row>
+
+        <el-row :gutter="16">
+          <el-col :span="12">
+            <el-form-item label="签名医生">
+              <el-input v-model="formData.signPhysician" disabled />
+            </el-form-item>
+          </el-col>
+          <el-col :span="12">
+            <el-form-item label="签名时间">
+              <el-date-picker
+                v-model="formData.signTime"
+                type="datetime"
+                placeholder="年/月/日 --:--"
+                format="YYYY/MM/DD HH:mm"
+                disabled
+                style="width: 100%"
+              />
+            </el-form-item>
+          </el-col>
+        </el-row>
+      </el-form>
+
+      <template #footer>
+        <span class="dialog-footer">
+          <el-button @click="dialogVisible = false">{{ isViewMode ? '关闭' : '取消' }}</el-button>
+          <el-button v-if="!isViewMode" type="primary" @click="handleSave" :loading="saving">
+            保存
+          </el-button>
+        </span>
+      </template>
+    </el-dialog>
+  </div>
+</template>
+
+<script setup name="ConsultationApplication">
+import { ref, reactive, onMounted, computed } from 'vue'
+import { ElMessage, ElMessageBox } from 'element-plus'
+import { Search, Refresh, Printer, Edit, View, Delete } from '@element-plus/icons-vue'
+import { queryConsultationListPage, cancelConsultation, saveConsultation } from './api'
+
+const loading = ref(false)
+const saving = ref(false)
+const tableData = ref([])
+const currentRow = ref(null)
+const dialogVisible = ref(false)
+const isViewMode = ref(false)
+const formRef = ref(null)
+
+// 用于取消请求的控制器
+let abortController = null
+
+// 分页参数
+const pagination = reactive({
+  currentPage: 1,
+  pageSize: 10,
+  total: 0
+})
+
+const queryParams = reactive({
+  timeType: 'consultation',
+  startTime: '',
+  endTime: '',
+  applyDept: '',
+  applyDoctor: '',
+  urgency: '',
+  consultationStatus: '',
+  patientName: ''
+})
+
+const formData = ref({
+  id: null,
+  consultationId: '',
+  patientName: '',
+  genderEnum: null,
+  age: null,
+  patientIdentifierNo: '',
+  requestingPhysician: '',
+  consultationDate: '',
+  department: '',
+  provisionalDiagnosis: '',
+  consultationPurpose: '',
+  invitedObject: '',
+  consultationOpinion: '',
+  attendingPhysician: '',
+  representDepartment: '',
+  signPhysician: '',
+  signTime: null,
+  consultationRequestDate: null
+})
+
+const formRules = {
+  requestingPhysician: [
+    { required: true, message: '请输入申请医师', trigger: 'blur' }
+  ],
+  consultationDate: [
+    { required: true, message: '请选择会诊时间', trigger: 'change' }
+  ],
+  consultationPurpose: [
+    { required: true, message: '请输入患者病史及会诊目的', trigger: 'blur' }
+  ]
+}
+
+const dialogTitle = computed(() => {
+  return isViewMode.value ? '会诊申请查看' : '会诊申请编辑'
+})
+
+const formatDateTime = (date) => {
+  if (!date) return ''
+  const d = new Date(date)
+  if (isNaN(d.getTime())) return ''
+  
+  const pad = (value) => String(value).padStart(2, '0')
+  const yyyy = d.getFullYear()
+  const mm = pad(d.getMonth() + 1)
+  const dd = pad(d.getDate())
+  const hh = pad(d.getHours())
+  const mi = pad(d.getMinutes())
+  const ss = pad(d.getSeconds())
+  return `${yyyy}-${mm}-${dd} ${hh}:${mi}:${ss}`
+}
+
+const handleQuery = async () => {
+  // 验证时间范围
+  if (queryParams.startTime && queryParams.endTime) {
+    const start = new Date(queryParams.startTime)
+    const end = new Date(queryParams.endTime)
+    if (end < start) {
+      ElMessage.warning('结束时间不能早于开始时间')
+      return
+    }
+  }
+  
+  // 重置到第一页
+  pagination.currentPage = 1
+  await loadData()
+}
+
+const handleReset = () => {
+  Object.keys(queryParams).forEach(key => {
+    if (key === 'timeType') {
+      queryParams[key] = 'consultation'
+    } else {
+      queryParams[key] = ''
+    }
+  })
+  pagination.currentPage = 1
+  loadData()
+}
+
+const handleSizeChange = (val) => {
+  pagination.pageSize = val
+  pagination.currentPage = 1
+  loadData()
+}
+
+const handleCurrentChange = (val) => {
+  // 如果正在加载，忽略此次操作
+  if (loading.value) {
+    return
+  }
+  pagination.currentPage = val
+  loadData()
+}
+
+const handlePrint = () => {
+  if (!currentRow.value) {
+    ElMessage.warning('请先选择一条记录')
+    return
+  }
+  window.print()
+}
+
+const handleRowChange = (row) => {
+  currentRow.value = row
+}
+
+const handleEdit = (row) => {
+  // 检查是否已结束
+  if (row.consultationStatus >= 40) {
+    ElMessage.warning('已结束的会诊申请不可编辑')
+    return
+  }
+  
+  isViewMode.value = false
+  formData.value = { ...row }
+  dialogVisible.value = true
+}
+
+const handleView = (row) => {
+  isViewMode.value = true
+  formData.value = { ...row }
+  dialogVisible.value = true
+}
+
+const handleDialogClose = () => {
+  formRef.value?.clearValidate()
+  formData.value = {
+    id: null,
+    consultationId: '',
+    patientName: '',
+    genderEnum: null,
+    age: null,
+    patientIdentifierNo: '',
+    requestingPhysician: '',
+    consultationDate: '',
+    department: '',
+    provisionalDiagnosis: '',
+    consultationPurpose: '',
+    invitedObject: '',
+    consultationOpinion: '',
+    attendingPhysician: '',
+    representDepartment: '',
+    signPhysician: '',
+    signTime: null,
+    consultationRequestDate: null
+  }
+}
+
+const handleSave = async () => {
+  try {
+    // 表单验证
+    await formRef.value.validate()
+    
+    saving.value = true
+    const res = await saveConsultation(formData.value)
+    
+    if (res.code === 200) {
+      ElMessage.success('保存成功')
+      dialogVisible.value = false
+      await loadData()
+    } else {
+      ElMessage.error(res.msg || '保存失败，请重试')
+    }
+  } catch (error) {
+    if (error !== 'cancel') {
+      console.error('保存失败:', error)
+      ElMessage.error('保存失败，请重试')
+    }
+  } finally {
+    saving.value = false
+  }
+}
+
+const handleDelete = async (row) => {
+  // 检查是否已结束
+  if (row.consultationStatus >= 40) {
+    ElMessage.warning('已结束的会诊申请不可作废')
+    return
+  }
+  
+  try {
+    await ElMessageBox.confirm('确定要作废该会诊申请吗？', '提示', {
+      confirmButtonText: '确定',
+      cancelButtonText: '取消',
+      type: 'warning'
+    })
+    
+    loading.value = true
+    const res = await cancelConsultation(row.consultationId, '用户作废')
+    
+    if (res.code === 200) {
+      ElMessage.success('作废成功')
+      await loadData()
+    } else {
+      ElMessage.error(res.msg || '作废失败')
+    }
+  } catch (error) {
+    if (error !== 'cancel') {
+      console.error('作废失败:', error)
+      ElMessage.error('作废失败')
+    }
+  } finally {
+    loading.value = false
+  }
+}
+
+const loadData = async () => {
+  // 如果正在加载，取消上一个请求
+  if (loading.value && abortController) {
+    abortController.abort()
+  }
+  
+  try {
+    loading.value = true
+    
+    // 创建新的 AbortController
+    abortController = new AbortController()
+    
+    // 构建查询参数
+    const queryData = {
+      department: queryParams.applyDept,
+      requestingPhysician: queryParams.applyDoctor,
+      consultationStatus: queryParams.consultationStatus,
+      patientName: queryParams.patientName,
+      consultationRequestDate: queryParams.startTime,
+      consultationUrgency: queryParams.urgency
+    }
+    
+    console.log('查询参数:', queryData, '页码:', pagination.currentPage, '每页:', pagination.pageSize)
+    
+    const res = await queryConsultationListPage(queryData, pagination.currentPage, pagination.pageSize)
+    
+    console.log('查询结果:', res)
+    
+    if (res.code === 200) {
+      tableData.value = res.data.records || []
+      pagination.total = res.data.total || 0
+      
+      // 如果没有查询结果，显示提示
+      if (tableData.value.length === 0 && pagination.currentPage === 1) {
+        ElMessage.info('暂无查询结果')
+      }
+    } else {
+      // 忽略"数据正在处理"的错误提示
+      if (!res.msg || !res.msg.includes('数据正在处理')) {
+        ElMessage.error(res.msg || '加载数据失败')
+      }
+      tableData.value = []
+      pagination.total = 0
+    }
+  } catch (error) {
+    // 忽略取消请求的错误
+    if (error.name === 'AbortError' || error.name === 'CanceledError') {
+      console.log('请求已取消')
+      return
+    }
+    
+    console.error('加载数据失败:', error)
+    
+    // 忽略"数据正在处理"的错误提示
+    const errorMsg = error.message || error.msg || '网络错误'
+    if (!errorMsg.includes('数据正在处理')) {
+      ElMessage.error('加载数据失败: ' + errorMsg)
+    }
+    
+    tableData.value = []
+    pagination.total = 0
+  } finally {
+    loading.value = false
+    abortController = null
+  }
+}
+
+onMounted(() => {
+  loadData()
+})
+</script>
+
+<style scoped>
+.consultation-application-container {
+  padding: 20px;
+  background: #fff;
+  min-height: calc(100vh - 84px);
+}
+
+.page-header {
+  padding-bottom: 12px;
+  border-bottom: 2px solid #e5e7eb;
+  margin-bottom: 20px;
+}
+
+.tab-title {
+  display: inline-block;
+  font-size: 18px;
+  font-weight: 700;
+  color: #2563eb;
+  border-bottom: 3px solid #2563eb;
+  padding-bottom: 8px;
+}
+
+.search-section {
+  margin-bottom: 20px;
+  padding: 16px;
+  background: #f9fafb;
+  border-radius: 8px;
+}
+
+.table-section {
+  margin-top: 20px;
+}
+
+.pagination-container {
+  margin-top: 16px;
+  display: flex;
+  justify-content: flex-end;
+}
+
+.section-title {
+  font-size: 16px;
+  font-weight: 600;
+  color: #333;
+  margin: 20px 0 16px 0;
+  padding-bottom: 8px;
+  border-bottom: 2px solid #e5e7eb;
+}
+
+.dialog-footer {
+  display: flex;
+  justify-content: flex-end;
+  gap: 12px;
+}
+
+@media print {
+  .search-section,
+  .pagination-container,
+  .el-table__column--selection,
+  .el-table-column--action {
+    display: none !important;
+  }
+}
+
+/* 表单样式优化 */
+:deep(.el-form-item__label) {
+  font-weight: 500;
+  color: #606266;
+}
+
+:deep(.el-input.is-disabled .el-input__inner) {
+  background-color: #f5f7fa;
+  color: #909399;
+}
+
+:deep(.el-textarea.is-disabled .el-textarea__inner) {
+  background-color: #f5f7fa;
+  color: #909399;
+}
+</style>
+
--- a/openhis-ui-vue3/src/views/consultationmanagement/consultationconfirmation/api.js
+++ b/openhis-ui-vue3/src/views/consultationmanagement/consultationconfirmation/api.js
@@ -0,0 +1,74 @@
+import request from '@/utils/request'
+
+/**
+ * 获取待确认的会诊列表（当前医生被邀请的会诊）
+ */
+export function getPendingConfirmationList() {
+  return request({
+    url: '/consultation/confirmation/pending',
+    method: 'get'
+  })
+}
+
+/**
+ * 确认会诊
+ * @param {Object} data 会诊确认数据
+ */
+export function confirmConsultation(data) {
+  return request({
+    url: '/consultation/confirmation/confirm',
+    method: 'post',
+    data
+  })
+}
+
+/**
+ * 取消确认会诊
+ * @param {String} consultationId 会诊申请单号
+ */
+export function cancelConfirmation(consultationId) {
+  return request({
+    url: '/consultation/confirmation/cancelConfirm',
+    method: 'post',
+    params: { consultationId }
+  })
+}
+
+/**
+ * 签名会诊
+ * @param {String} consultationId 会诊申请单号
+ */
+export function signConsultation(consultationId) {
+  return request({
+    url: '/consultation/confirmation/sign',
+    method: 'post',
+    params: { consultationId }
+  })
+}
+
+/**
+ * 获取会诊确认详情
+ * @param {String} consultationId 会诊申请单号
+ */
+export function getConfirmationDetail(consultationId) {
+  return request({
+    url: '/consultation/confirmation/detail',
+    method: 'get',
+    params: { consultationId }
+  })
+}
+
+/**
+ * 获取会诊意见列表
+ * @param {String} consultationId 会诊申请单号
+ */
+export function getConsultationOpinions(consultationId) {
+  return request({
+    url: '/consultation/confirmation/opinions',
+    method: 'get',
+    params: { consultationId }
+  })
+}
+
+
+
--- a/openhis-ui-vue3/src/views/consultationmanagement/consultationconfirmation/index.vue
+++ b/openhis-ui-vue3/src/views/consultationmanagement/consultationconfirmation/index.vue
@@ -30,28 +30,37 @@
        stripe
        highlight-current-row
        @current-change="handleRowChange"
+        v-loading="loading"
      >
        <el-table-column type="index" width="60" label="序号" align="center" />
        <el-table-column label="紧急" width="70" align="center">
          <template #default="scope">
-            <el-checkbox v-model="scope.row.urgent" />
+            <el-checkbox v-model="scope.row.urgent" disabled />
          </template>
        </el-table-column>
        <el-table-column prop="consultationId" label="申请单号" min-width="160" />
        <el-table-column prop="patientName" label="病人姓名" min-width="100" />
-        <el-table-column prop="consultationTime" label="会诊时间" min-width="160" />
-        <el-table-column prop="invitee" label="邀请对象" min-width="120" />
+        <el-table-column prop="consultationDate" label="会诊时间" min-width="160">
+          <template #default="scope">
+            {{ formatDateTime(scope.row.consultationDate) }}
+          </template>
+        </el-table-column>
+        <el-table-column prop="invitedObject" label="邀请对象" min-width="120" />
        <el-table-column prop="applyDept" label="申请科室" min-width="120" />
        <el-table-column prop="applyDoctor" label="申请医师" min-width="120" />
-        <el-table-column prop="applyTime" label="申请时间" min-width="160" />
+        <el-table-column prop="applyTime" label="申请时间" min-width="160">
+          <template #default="scope">
+            {{ formatDateTime(scope.row.applyTime) }}
+          </template>
+        </el-table-column>
        <el-table-column label="确认" width="70" align="center">
          <template #default="scope">
-            <el-checkbox v-model="scope.row.confirmed" disabled />
+            <el-checkbox :model-value="scope.row.myInvitedStatus >= 20" disabled />
          </template>
        </el-table-column>
        <el-table-column label="签名" width="70" align="center">
          <template #default="scope">
-            <el-checkbox v-model="scope.row.signed" disabled />
+            <el-checkbox :model-value="scope.row.myInvitedStatus >= 30" disabled />
          </template>
        </el-table-column>
      </el-table>
@@ -68,7 +77,7 @@
          </el-col>
          <el-col :span="6">
            <el-form-item label="性别">
-              <el-input v-model="formData.gender" disabled />
+              <el-input v-model="formData.genderText" disabled />
            </el-form-item>
          </el-col>
          <el-col :span="6">
@@ -78,7 +87,7 @@
          </el-col>
          <el-col :span="6">
            <el-form-item label="就诊卡号">
-              <el-input v-model="formData.cardNo" disabled />
+              <el-input v-model="formData.patientIdentifierNo" disabled />
            </el-form-item>
          </el-col>
          <el-col :span="6">
@@ -93,7 +102,7 @@
          </el-col>
          <el-col :span="6">
            <el-form-item label="会诊时间">
-              <el-input v-model="formData.consultationTime" disabled />
+              <el-input :model-value="formatDateTime(formData.consultationDate)" disabled />
            </el-form-item>
          </el-col>
          <el-col :span="6">
@@ -103,52 +112,92 @@
          </el-col>
          <el-col :span="6">
            <el-form-item label="会诊邀请对象">
-              <el-input v-model="formData.invitee" disabled />
+              <el-input v-model="formData.invitedObject" disabled />
            </el-form-item>
          </el-col>
          <el-col :span="6">
            <el-form-item label="提交医生">
-              <el-input v-model="formData.applyDoctor" disabled />
+              <el-input v-model="formData.submittingPhysician" disabled />
            </el-form-item>
          </el-col>
          <el-col :span="6">
            <el-form-item label="提交时间">
-              <el-input v-model="formData.applyTime" disabled />
+              <el-input :model-value="formatDateTime(formData.submittingTime)" disabled />
            </el-form-item>
          </el-col>
        </el-row>

        <el-form-item label="病史及目的">
-          <el-input v-model="formData.history" type="textarea" :rows="3" disabled />
+          <el-input v-model="formData.consultationPurpose" type="textarea" :rows="3" disabled />
        </el-form-item>

-        <el-form-item label="会诊确认参加医师" required>
-          <el-input v-model="formData.confirmingPhysician" placeholder="请输入会诊确认参加医师" />
+        <el-form-item label="门诊诊断">
+          <el-input v-model="formData.provisionalDiagnosis" type="textarea" :rows="2" disabled />
        </el-form-item>

        <el-form-item label="会诊意见" required>
-          <el-input v-model="formData.opinion" type="textarea" :rows="4" placeholder="请输入会诊意见" />
+          <el-input 
+            v-model="formData.consultationOpinion" 
+            type="textarea" 
+            :rows="4" 
+            placeholder="请输入会诊意见" 
+            :disabled="!canEdit"
+          />
+        </el-form-item>
+
+        <!-- 会诊意见列表 -->
+        <el-form-item label="所有会诊意见">
+          <div class="opinions-container">
+            <el-timeline v-if="opinionList.length > 0">
+              <el-timeline-item
+                v-for="opinion in opinionList"
+                :key="opinion.physicianId"
+                :timestamp="formatDateTime(opinion.confirmTime)"
+                placement="top"
+              >
+                <el-card shadow="hover">
+                  <div class="opinion-header">
+                    <span class="physician-info">
+                      <el-tag type="info" size="small">{{ opinion.deptName }}</el-tag>
+                      <span style="margin-left: 8px; font-weight: bold;">{{ opinion.physicianName }}</span>
+                    </span>
+                    <el-tag v-if="opinion.isSigned" type="success" size="small">
+                      <el-icon><Check /></el-icon> 已签名
+                    </el-tag>
+                    <el-tag v-else type="warning" size="small">已确认</el-tag>
+                  </div>
+                  <div class="opinion-content">
+                    {{ opinion.opinion }}
+                  </div>
+                  <div v-if="opinion.signatureTime" class="opinion-footer">
+                    签名时间：{{ formatDateTime(opinion.signatureTime) }}
+                  </div>
+                </el-card>
+              </el-timeline-item>
+            </el-timeline>
+            <el-empty v-else description="暂无会诊意见" :image-size="80" />
+          </div>
        </el-form-item>

        <el-row :gutter="16">
          <el-col :span="6">
            <el-form-item label="所属医生">
-              <el-input v-model="formData.confirmDoctor" disabled />
+              <el-input v-model="formData.confirmingPhysicianName" disabled />
            </el-form-item>
          </el-col>
          <el-col :span="6">
            <el-form-item label="代表科室">
-              <el-input v-model="formData.confirmDept" disabled />
+              <el-input v-model="formData.confirmingDeptName" disabled />
            </el-form-item>
          </el-col>
          <el-col :span="6">
            <el-form-item label="签名医生">
-              <el-input v-model="formData.signDoctor" disabled />
+              <el-input v-model="formData.signature" disabled />
            </el-form-item>
          </el-col>
          <el-col :span="6">
            <el-form-item label="签名时间">
-              <el-input v-model="formData.signTime" disabled />
+              <el-input :model-value="formatDateTime(formData.signatureDate)" disabled />
            </el-form-item>
          </el-col>
        </el-row>
@@ -158,94 +207,85 @@
 </template>

 <script setup name="consultationConfirmation">
-import { computed, ref } from 'vue'
-import { ElMessage } from 'element-plus'
+import { computed, ref, onMounted, watch } from 'vue'
+import { ElMessage, ElMessageBox } from 'element-plus'
+import { Check } from '@element-plus/icons-vue'
 import useUserStore from '@/store/modules/user'
+import {
+  getPendingConfirmationList,
+  confirmConsultation,
+  cancelConfirmation,
+  signConsultation,
+  getConsultationOpinions
+} from './api'

 const userStore = useUserStore()

-const buildMockRows = () => ([
-  {
-    consultationId: 'CS20250812001',
-    urgent: false,
-    patientName: '陈明',
-    gender: '男',
-    age: '45',
-    cardNo: 'CARD20250812001',
-    consultationTime: '2025-08-12 17:48',
-    invitee: '演示测试',
-    applyDept: '内科',
-    applyDoctor: '徐斌',
-    applyTime: '2025-08-12 16:30',
-    history: '胸闷、气短一周，既往有高血压史。',
-    confirmingPhysician: '',
-    opinion: '',
-    confirmed: false,
-    signed: false
-  },
-  {
-    consultationId: 'CS20250812002',
-    urgent: true,
-    patientName: '赵敏',
-    gender: '女',
-    age: '32',
-    cardNo: 'CARD20250812002',
-    consultationTime: '2025-08-12 18:10',
-    invitee: '李医生',
-    applyDept: '神经内科',
-    applyDoctor: '王婷',
-    applyTime: '2025-08-12 16:50',
-    history: '头晕伴视物模糊3天。',
-    confirmingPhysician: '',
-    opinion: '',
-    confirmed: false,
-    signed: false
-  }
-])
-
-const tableData = ref(buildMockRows())
+const loading = ref(false)
+const tableData = ref([])
 const currentRow = ref(null)
+const opinionList = ref([]) // 会诊意见列表

 const formData = ref({
+  id: null,
+  consultationRequestId: null,
  consultationId: '',
-  urgent: false,
  patientName: '',
-  gender: '',
+  genderText: '',
  age: '',
-  cardNo: '',
-  consultationTime: '',
-  invitee: '',
+  patientIdentifierNo: '',
  applyDept: '',
  applyDoctor: '',
-  applyTime: '',
-  history: '',
+  applyTime: null,
+  consultationDate: null,
+  urgent: false,
+  invitedObject: '',
+  consultationPurpose: '',
+  provisionalDiagnosis: '',
  confirmingPhysician: '',
-  opinion: '',
-  confirmDoctor: '',
-  confirmDept: '',
-  signDoctor: '',
-  signTime: ''
+  consultationOpinion: '',
+  confirmingPhysicianName: '',
+  confirmingDeptName: '',
+  signature: '',
+  signatureDate: null,
+  submittingPhysician: '',
+  submittingTime: null,
+  consultationStatus: 0
 })

 const confirmButtonText = computed(() => {
  if (!currentRow.value) {
    return '确认'
  }
-  return currentRow.value.confirmed ? '取消确认' : '确认'
+  // 基于当前医生的个人状态判断（使用ConsultationStatusEnum：20=已确认）
+  return currentRow.value.myInvitedStatus >= 20 ? '取消确认' : '确认'
 })

 const canSign = computed(() => {
-  return !!currentRow.value && currentRow.value.confirmed && !currentRow.value.signed
+  // 只要当前医生已确认但未签名，就可以签名（不需要等待所有医生都确认）
+  // 使用ConsultationStatusEnum：20=已确认，30=已签名
+  return !!currentRow.value && 
+         currentRow.value.myInvitedStatus >= 20 &&  // 已确认
+         currentRow.value.myInvitedStatus < 30      // 但还未签名
 })

-const formatDateTime = (date = new Date()) => {
+const canEdit = computed(() => {
+  // 当前医生未确认时可以编辑（使用ConsultationStatusEnum：10=已提交/待确认，20=已确认）
+  return !!currentRow.value && (!currentRow.value.myInvitedStatus || currentRow.value.myInvitedStatus < 20)
+})
+
+const formatDateTime = (date) => {
+  if (!date) return ''
+  const d = new Date(date)
+  if (isNaN(d.getTime())) return ''
+  
  const pad = (value) => String(value).padStart(2, '0')
-  const yyyy = date.getFullYear()
-  const mm = pad(date.getMonth() + 1)
-  const dd = pad(date.getDate())
-  const hh = pad(date.getHours())
-  const mi = pad(date.getMinutes())
-  const ss = pad(date.getSeconds())
+  const yyyy = d.getFullYear()
+  const mm = pad(d.getMonth() + 1)
+  const dd = pad(d.getDate())
+  const hh = pad(d.getHours())
+  const mi = pad(d.getMinutes())
+  const ss = pad(d.getSeconds())
  return `${yyyy}-${mm}-${dd} ${hh}:${mi}:${ss}`
 }

@@ -255,84 +295,207 @@ const getDoctorDept = () => userStore.orgName || '当前科室'
 const applyRowToForm = (row) => {
  if (!row) {
    Object.keys(formData.value).forEach((key) => {
-      formData.value[key] = key === 'urgent' ? false : ''
+      if (key === 'urgent') {
+        formData.value[key] = false
+      } else if (key === 'consultationStatus') {
+        formData.value[key] = 0
+      } else {
+        formData.value[key] = key === 'id' || key === 'consultationRequestId' ? null : ''
+      }
    })
    return
  }
-  formData.value.consultationId = row.consultationId
-  formData.value.urgent = row.urgent
-  formData.value.patientName = row.patientName
-  formData.value.gender = row.gender
-  formData.value.age = row.age
-  formData.value.cardNo = row.cardNo
-  formData.value.consultationTime = row.consultationTime
-  formData.value.invitee = row.invitee
-  formData.value.applyDept = row.applyDept
-  formData.value.applyDoctor = row.applyDoctor
-  formData.value.applyTime = row.applyTime
-  formData.value.history = row.history
-  formData.value.confirmingPhysician = row.confirmingPhysician
-  formData.value.opinion = row.opinion
-  formData.value.confirmDoctor = row.confirmDoctor || ''
-  formData.value.confirmDept = row.confirmDept || ''
-  formData.value.signDoctor = row.signDoctor || ''
-  formData.value.signTime = row.signTime || ''
+  
+  formData.value = {
+    id: row.id,
+    consultationRequestId: row.consultationRequestId,
+    consultationId: row.consultationId,
+    patientName: row.patientName,
+    genderText: row.genderText,
+    age: row.age,
+    patientIdentifierNo: row.patientIdentifierNo,
+    applyDept: row.applyDept,
+    applyDoctor: row.applyDoctor,
+    applyTime: row.applyTime,
+    consultationDate: row.consultationDate,
+    urgent: row.urgent,
+    invitedObject: row.invitedObject,
+    consultationPurpose: row.consultationPurpose,
+    provisionalDiagnosis: row.provisionalDiagnosis,
+    confirmingPhysician: row.confirmingPhysician || '',
+    consultationOpinion: '',  // 先清空，后面从 opinionList 中获取
+    confirmingPhysicianName: row.confirmingPhysicianName || '',
+    confirmingDeptName: row.confirmingDeptName || '',
+    signature: row.signature || '',
+    signatureDate: row.signatureDate,
+    submittingPhysician: row.submittingPhysician,
+    submittingTime: row.submittingTime,
+    consultationStatus: row.consultationStatus
+  }
+  
+  // 从会诊意见列表中获取当前医生的信息
+  if (opinionList.value.length > 0) {
+    const currentPhysicianId = userStore.practitionerId || userStore.user?.practitionerId
+    const myOpinion = opinionList.value.find(op => op.physicianId === currentPhysicianId)
+    
+    if (myOpinion) {
+      // 如果当前医生已确认，回显其信息
+      formData.value.confirmingPhysicianName = myOpinion.physicianName
+      formData.value.confirmingDeptName = myOpinion.deptName
+      
+      // 回显会诊意见（去掉前缀"科室-医生："）
+      if (myOpinion.opinion) {
+        // 格式：科室-医生：意见内容
+        const opinionText = myOpinion.opinion
+        const colonIndex = opinionText.indexOf('：')
+        if (colonIndex > 0) {
+          // 提取冒号后面的内容
+          formData.value.consultationOpinion = opinionText.substring(colonIndex + 1)
+        } else {
+          formData.value.consultationOpinion = opinionText
+        }
+      }
+      
+      if (myOpinion.isSigned) {
+        formData.value.signature = myOpinion.physicianName
+        formData.value.signatureDate = myOpinion.signatureTime
+      }
+    }
+  }
 }

-const handleRowChange = (row) => {
+const handleRowChange = async (row) => {
  currentRow.value = row
+  
+  // 先加载会诊意见列表
+  if (row) {
+    await loadConsultationOpinions(row.consultationId)
+  } else {
+    opinionList.value = []
+  }
+  
+  // 然后应用数据到表单（这样可以使用 opinionList 中的数据）
  applyRowToForm(row)
 }

-const handleConfirm = () => {
+// 加载会诊意见列表
+const loadConsultationOpinions = async (consultationId) => {
+  try {
+    const res = await getConsultationOpinions(consultationId)
+    if (res.code === 200) {
+      opinionList.value = res.data || []
+    }
+  } catch (error) {
+    console.error('加载会诊意见失败', error)
+  }
+}
+
+const handleConfirm = async () => {
  if (!currentRow.value) {
    return
  }
-  if (!currentRow.value.confirmed) {
-    if (!formData.value.opinion.trim()) {
+  
+  try {
+    // 如果已确认，则取消确认（使用ConsultationStatusEnum：20=已确认，30=已签名）
+    if (currentRow.value.myInvitedStatus >= 20) {
+      // 已签名不能取消确认
+      if (currentRow.value.myInvitedStatus >= 30) {
+        ElMessage.warning('已签名的会诊无法取消确认')
+        return
+      }
+      
+      await ElMessageBox.confirm('确定要取消确认吗？', '提示', {
+        confirmButtonText: '确定',
+        cancelButtonText: '取消',
+        type: 'warning'
+      })
+      
+      loading.value = true
+      const res = await cancelConfirmation(currentRow.value.consultationId)
+      
+      if (res.code === 200) {
+        ElMessage.success('取消确认成功')
+        await loadData()
+      } else {
+        ElMessage.error(res.msg || '取消确认失败')
+      }
+    } else {
+      // 确认会诊
+      if (!formData.value.consultationOpinion.trim()) {
      ElMessage.warning('请先填写会诊意见')
      return
    }
-    if (!formData.value.confirmingPhysician.trim()) {
-      ElMessage.warning('请先填写会诊确认参加医师')
-      return
+      
+      loading.value = true
+      const data = {
+        consultationId: formData.value.consultationId,
+        consultationOpinion: formData.value.consultationOpinion,
+        confirmingPhysician: getDoctorName(),  // 自动使用当前医生姓名
+        confirmingDeptName: getDoctorDept()    // 自动使用当前科室
+      }
+      
+      const res = await confirmConsultation(data)
+      
+      if (res.code === 200) {
+        ElMessage.success('会诊确认成功')
+        await loadData()
+      } else {
+        ElMessage.error(res.msg || '会诊确认失败')
+      }
    }
-    currentRow.value.confirmed = true
-    currentRow.value.confirmingPhysician = formData.value.confirmingPhysician
-    currentRow.value.opinion = formData.value.opinion
-    currentRow.value.confirmDoctor = getDoctorName()
-    currentRow.value.confirmDept = getDoctorDept()
-    formData.value.confirmDoctor = currentRow.value.confirmDoctor
-    formData.value.confirmDept = currentRow.value.confirmDept
-    ElMessage.success('会诊已确认')
-    return
+  } catch (error) {
+    if (error !== 'cancel') {
+      console.error('操作失败:', error)
+      ElMessage.error('操作失败')
+    }
+  } finally {
+    loading.value = false
  }
-  if (currentRow.value.signed) {
-    ElMessage.warning('已签名的会诊无法取消确认')
-    return
-  }
-  currentRow.value.confirmed = false
-  currentRow.value.confirmDoctor = ''
-  currentRow.value.confirmDept = ''
-  formData.value.confirmDoctor = ''
-  formData.value.confirmDept = ''
-  ElMessage.success('已取消确认')
 }

-const handleSign = () => {
+const handleSign = async () => {
  if (!currentRow.value) {
    return
  }
-  if (!currentRow.value.confirmed) {
-    ElMessage.warning('请先确认会诊申请')
+  
+  // 检查当前医生是否已确认（使用ConsultationStatusEnum：20=已确认，30=已签名）
+  if (!currentRow.value.myInvitedStatus || currentRow.value.myInvitedStatus < 20) {
+    ElMessage.warning('请先确认会诊后再签名')
    return
  }
-  currentRow.value.signed = true
-  currentRow.value.signDoctor = getDoctorName()
-  currentRow.value.signTime = formatDateTime()
-  formData.value.signDoctor = currentRow.value.signDoctor
-  formData.value.signTime = currentRow.value.signTime
-  ElMessage.success('签名完成')
+  
+  // 检查是否已签名
+  if (currentRow.value.myInvitedStatus >= 30) {
+    ElMessage.warning('您已经签名过了')
+    return
+  }
+  
+  // 🎯 移除整体状态检查：只要当前医生已确认就可以签名，不需要等待所有医生都确认
+  
+  try {
+    await ElMessageBox.confirm('确定要签名吗？签名后将无法修改会诊意见。', '提示', {
+      confirmButtonText: '确定',
+      cancelButtonText: '取消',
+      type: 'warning'
+    })
+    
+    loading.value = true
+    const res = await signConsultation(currentRow.value.consultationId)
+    
+    if (res.code === 200) {
+      ElMessage.success('签名成功')
+      await loadData()
+    } else {
+      ElMessage.error(res.msg || '签名失败')
+    }
+  } catch (error) {
+    if (error !== 'cancel') {
+      console.error('签名失败:', error)
+      ElMessage.error('签名失败')
+    }
+  } finally {
+    loading.value = false
+  }
 }

 const handlePrint = () => {
@@ -343,12 +506,50 @@ const handlePrint = () => {
  window.print()
 }

-const handleRefresh = () => {
-  tableData.value = buildMockRows()
-  currentRow.value = null
-  applyRowToForm(null)
+const handleRefresh = async () => {
+  await loadData()
  ElMessage.success('已刷新')
 }
+
+const loadData = async () => {
+  try {
+    loading.value = true
+    const res = await getPendingConfirmationList()
+    
+    if (res.code === 200) {
+      tableData.value = res.data || []
+      
+      // 如果当前选中的行还在列表中，重新选中
+      if (currentRow.value) {
+        const updatedRow = tableData.value.find(
+          item => item.consultationId === currentRow.value.consultationId
+        )
+        if (updatedRow) {
+          currentRow.value = updatedRow
+          // 重新加载会诊意见
+          await loadConsultationOpinions(updatedRow.consultationId)
+          // 然后应用数据到表单
+          applyRowToForm(updatedRow)
+        } else {
+  currentRow.value = null
+  applyRowToForm(null)
+          opinionList.value = []
+        }
+      }
+    } else {
+      ElMessage.error(res.msg || '加载数据失败')
+    }
+  } catch (error) {
+    console.error('加载数据失败:', error)
+    ElMessage.error('加载数据失败')
+  } finally {
+    loading.value = false
+  }
+}
+
+onMounted(() => {
+  loadData()
+})
 </script>

 <style scoped>
@@ -390,13 +591,46 @@ const handleRefresh = () => {
    padding: 0;
  }
 }
+
+.opinions-container {
+  width: 100%;
+  max-height: 500px;
+  overflow-y: auto;
+  padding: 10px;
+  background-color: #f9fafb;
+  border-radius: 4px;
+}
+
+.opinion-header {
+  display: flex;
+  justify-content: space-between;
+  align-items: center;
+  margin-bottom: 12px;
+}
+
+.physician-info {
+  display: flex;
+  align-items: center;
+}
+
+.opinion-content {
+  padding: 12px;
+  background-color: #f5f7fa;
+  border-radius: 4px;
+  line-height: 1.6;
+  color: #333;
+  white-space: pre-wrap;
+  word-break: break-word;
+}
+
+.opinion-footer {
+  margin-top: 8px;
+  font-size: 12px;
+  color: #909399;
+  text-align: right;
+}
+
+.el-timeline {
+  padding-left: 0;
+}
 </style>
-
-
-
-
-
-
-
-
-
--- a/openhis-ui-vue3/src/views/doctorstation/components/consultation.vue
+++ b/openhis-ui-vue3/src/views/doctorstation/components/consultation.vue
@@ -8,7 +8,7 @@
      </div>
      <div class="right-actions">
        <el-button type="danger" @click="handleComplete" :disabled="!selectedRow || selectedRow.consultationStatus !== 30">结束</el-button>
-        <el-button type="success" @click="handleSave">保存</el-button>
+        <el-button type="success" @click="handleSave" :disabled="selectedRow && selectedRow.consultationStatus > 0">保存</el-button>
      </div>
    </div>

@@ -62,15 +62,19 @@
                取消提交
              </el-button>
            </template>
+            <!-- 已确认状态：显示待签名按钮 -->
+            <template v-else-if="row.consultationStatus === 20">
+              <el-button type="success" size="small" @click="handleView(row)">
+                待签名
+              </el-button>
+            </template>
            <!-- 已签名状态：显示结束按钮 -->
            <template v-else-if="row.consultationStatus === 30">
-<!--              <el-button type="danger" size="small" @click="handleCompleteRow(row)">-->
-<!--                结束-->
-<!--              </el-button>-->
              <el-button
                  type="danger"
                  size="small"
-                  @click="handleCompleteRow(row)"  style="background-color: #f56c6c; border-color: #f56c6c;"
+                  @click="handleCompleteRow(row)"
+                  style="background-color: #f56c6c; border-color: #f56c6c;"
              >
                结束
              </el-button>
@@ -234,39 +238,37 @@
            />
          </el-form-item>

-          <el-row :gutter="20">
-            <el-col :span="8">
-              <el-form-item label="所属医生：">
-                <el-input v-model="formData.attendingPhysician" placeholder="会诊后填写" disabled />
-              </el-form-item>
-            </el-col>
-            <el-col :span="8">
-              <el-form-item label="代表科室：">
-                <el-input v-model="formData.representDepartment" placeholder="会诊后填写" disabled />
-              </el-form-item>
-            </el-col>
-            <el-col :span="8">
-              <el-form-item label="签名医生：">
-                <el-input v-model="formData.signPhysician" placeholder="会诊后填写" disabled />
-              </el-form-item>
-            </el-col>
-          </el-row>
-
-          <el-row :gutter="20">
-            <el-col :span="24">
-              <el-form-item label="签名时间：">
-                <el-date-picker
-                  v-model="formData.signTime"
-                  type="datetime"
-                  placeholder="年/月/日 --:--"
+          <!-- 🎯 新增：参与医生列表（表格形式） -->
+          <el-form-item label="参与医生签名：" v-if="participatingPhysicians.length > 0">
+            <el-table 
+              :data="participatingPhysicians" 
+              border 
+              stripe 
                  style="width: 100%"
-                  format="YYYY/MM/DD HH:mm"
-                  value-format="YYYY-MM-DD HH:mm:ss"
-                  disabled
-                />
+              max-height="300"
+            >
+              <el-table-column type="index" label="序号" width="60" align="center" />
+              <el-table-column prop="deptName" label="科室" width="120" align="center" />
+              <el-table-column prop="physicianName" label="医生" width="100" align="center" />
+              <el-table-column prop="confirmTime" label="确认时间" width="160" align="center">
+                <template #default="{ row }">
+                  {{ formatDateTime(row.confirmTime) }}
+                </template>
+              </el-table-column>
+              <el-table-column prop="signatureTime" label="签名时间" width="160" align="center">
+                <template #default="{ row }">
+                  {{ formatDateTime(row.signatureTime) }}
+                </template>
+              </el-table-column>
+              <el-table-column label="状态" width="80" align="center">
+                <template #default="{ row }">
+                  <el-tag v-if="row.invitedStatus >= 3" type="success">已签名</el-tag>
+                  <el-tag v-else-if="row.invitedStatus >= 1" type="warning">已确认</el-tag>
+                  <el-tag v-else type="info">待确认</el-tag>
+                </template>
+              </el-table-column>
+            </el-table>
              </el-form-item>
-            </el-col>
-          </el-row>
        </el-form>
      </div>

@@ -289,7 +291,7 @@
            清空
          </el-button>
        </div>
-        
+
        <!-- 科室医生树（带复选框） -->
        <div class="invite-section">
          <div class="section-label">选择会诊科室和医生</div>
@@ -323,7 +325,7 @@
                <div v-show="expandedDepts.includes(dept.id)" class="physicians-list">
                  <div 
                    v-for="physician in dept.children" 
-                    :key="physician.id" 
+                :key="physician.id"
                    class="physician-item"
                  >
                    <el-checkbox 
@@ -332,11 +334,11 @@
                    >
                      {{ physician.label }}
                    </el-checkbox>
-                  </div>
+            </div>
                  <div v-if="!dept.children || dept.children.length === 0" class="no-physicians">
                    该科室暂无医生
-                  </div>
-                </div>
+            </div>
+          </div>
              </div>
            </div>
          </el-scrollbar>
@@ -432,6 +434,9 @@ const expandedDepts = ref([]);
 // 选中的医生列表（用于显示和提交）
 const selectedPhysiciansList = ref([]);

+// 🎯 新增：参与医生列表（用于显示已确认/已签名的医生）
+const participatingPhysicians = ref([]);
+
 // 会诊列表
 const consultationList = ref([]);

@@ -716,6 +721,14 @@ const handleRowClick = (row) => {
      isUrgent: row.consultationUrgency === '2',  // 2=紧急
      consultationPurpose: row.consultationPurpose,
      createTime: row.consultationRequestDate || row.createTime,  // 申请时间
+      
+      // 🎯 填充会诊记录字段（如果会诊已完成或已签名）
+      invitedPhysiciansText: row.invitedPhysiciansText || '',
+      consultationOpinion: row.consultationOpinion || '',
+      attendingPhysician: row.attendingPhysician || '',
+      representDepartment: row.representDepartment || '',
+      signPhysician: row.signPhysician || '',
+      signTime: row.signTime || null,
    });
    
    console.log('填充后的表单数据:', formData);
@@ -730,8 +743,22 @@ const handleRowClick = (row) => {
      }));
      
      console.log('填充的医生列表:', selectedPhysiciansList.value);
+      
+      // 🎯 填充参与医生列表（显示确认和签名状态）
+      participatingPhysicians.value = row.invitedList.map(inv => ({
+        physicianId: inv.physicianId,
+        physicianName: inv.physicianName,
+        deptId: inv.deptId,
+        deptName: inv.deptName,
+        invitedStatus: inv.invitedStatus || 0,
+        confirmTime: inv.confirmTime || null,
+        signatureTime: inv.signatureTime || null,
+      }));
+      
+      console.log('参与医生列表:', participatingPhysicians.value);
    } else {
      selectedPhysiciansList.value = [];
+      participatingPhysicians.value = [];
    }
  }
 };
@@ -781,6 +808,7 @@ const handleNew = () => {
  
  // 清空选中状态
  selectedPhysiciansList.value = [];
+  participatingPhysicians.value = [];
  
  // 加载主诊断
  loadMainDiagnosis();
@@ -1090,6 +1118,19 @@ defineExpose({
  fetchConsultationList,
 });

+// 🎯 格式化日期时间
+const formatDateTime = (dateTime) => {
+  if (!dateTime) return '-';
+  const date = new Date(dateTime);
+  const year = date.getFullYear();
+  const month = String(date.getMonth() + 1).padStart(2, '0');
+  const day = String(date.getDate()).padStart(2, '0');
+  const hours = String(date.getHours()).padStart(2, '0');
+  const minutes = String(date.getMinutes()).padStart(2, '0');
+  const seconds = String(date.getSeconds()).padStart(2, '0');
+  return `${year}/${month}/${day} ${hours}:${minutes}:${seconds}`;
+};
+
 // 监听 activeTab 变化
 watch(
  () => props.activeTab,
@@ -1302,11 +1343,11 @@ onMounted(() => {
                transition: transform 0.3s;
              }
              
-              .dept-name {
+            .dept-name {
                flex: 1;
-                font-size: 14px;
+              font-size: 14px;
                font-weight: 500;
-                color: #303133;
+              color: #303133;
              }
              
              .selected-badge {
@@ -1333,26 +1374,26 @@ onMounted(() => {
              
              .physician-item {
                padding: 6px 10px;
+              
+              :deep(.el-checkbox) {
+                width: 100%;
                
-                :deep(.el-checkbox) {
-                  width: 100%;
-                  
-                  .el-checkbox__label {
-                    font-size: 13px;
+                .el-checkbox__label {
+                  font-size: 13px;
                    color: #606266;
-                  }
-                  
+          }
+          
                  &.is-checked .el-checkbox__label {
                    color: #409eff;
                    font-weight: 500;
                  }
-                }
-              }
-              
+            }
+          }
+          
              .no-physicians {
-                color: #909399;
+            color: #909399;
                font-size: 12px;
-                text-align: center;
+            text-align: center;
                padding: 10px 0;
              }
            }