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。

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>
-
-
-
-
-
-
-
-
-