86门诊医生站-》西药方

2026-01-26 13:25:02 +08:00
parent c1efd84332
commit c878dc19d7
7 changed files with 1035 additions and 972 deletions
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/appservice/impl/DoctorStationAdviceAppServiceImpl.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/appservice/impl/DoctorStationAdviceAppServiceImpl.java
@@ -40,6 +40,7 @@ import com.openhis.workflow.service.IServiceRequestService;
 import lombok.extern.slf4j.Slf4j;
 import org.springframework.beans.factory.annotation.Autowired;
 import org.springframework.stereotype.Service;
+import org.springframework.transaction.annotation.Transactional;

 import javax.annotation.Resource;
 import java.math.BigDecimal;
@@ -118,7 +119,8 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
        String safeSearchKey = searchKey != null ? searchKey : "";
        String safeAdviceTypesStr = "";
        if (adviceTypes != null && !adviceTypes.isEmpty()) {
-            safeAdviceTypesStr = String.join(",", adviceTypes.stream().map(String::valueOf).collect(Collectors.toList()));
+            safeAdviceTypesStr = String.join(",",
+                    adviceTypes.stream().map(String::valueOf).collect(Collectors.toList()));
        }
        String safeOrganizationId = organizationId != null ? organizationId.toString() : "";
        String safePricingFlag = pricingFlag != null ? pricingFlag.toString() : "";
@@ -141,8 +143,8 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
            orderPricingSource = orderPricing;
        }
        // 开药时药房允许多选开关
-        String pharmacyMultipleChoiceSwitch
-                = TenantOptionUtil.getOptionContent(TenantOptionDict.PHARMACY_MULTIPLE_CHOICE_SWITCH);
+        String pharmacyMultipleChoiceSwitch = TenantOptionUtil
+                .getOptionContent(TenantOptionDict.PHARMACY_MULTIPLE_CHOICE_SWITCH);
        // 药房允许多选
        boolean pharmacyMultipleChoice = Whether.YES.getCode().equals(pharmacyMultipleChoiceSwitch);

@@ -152,7 +154,8 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
        IPage<AdviceBaseDto> adviceBaseInfo = doctorStationAdviceAppMapper.getAdviceBaseInfo(
                new Page<>(pageNo, pageSize), PublicationStatus.ACTIVE.getValue(), organizationId,
                CommonConstants.TableName.MED_MEDICATION_DEFINITION, CommonConstants.TableName.ADM_DEVICE_DEFINITION,
-                CommonConstants.TableName.WOR_ACTIVITY_DEFINITION, pricingFlag, adviceDefinitionIdParamList, adviceTypes,
+                CommonConstants.TableName.WOR_ACTIVITY_DEFINITION, pricingFlag, adviceDefinitionIdParamList,
+                adviceTypes,
                queryWrapper);
        List<AdviceBaseDto> adviceBaseDtoList = adviceBaseInfo.getRecords();

@@ -162,22 +165,22 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
        }

        // 医嘱定义ID集合
-        List<Long> adviceDefinitionIdList
-                = adviceBaseDtoList.stream().map(AdviceBaseDto::getAdviceDefinitionId).collect(Collectors.toList());
+        List<Long> adviceDefinitionIdList = adviceBaseDtoList.stream().map(AdviceBaseDto::getAdviceDefinitionId)
+                .collect(Collectors.toList());
        // 费用定价主表ID集合
-        List<Long> chargeItemDefinitionIdList
-                = adviceBaseDtoList.stream().map(AdviceBaseDto::getChargeItemDefinitionId).collect(Collectors.toList());
+        List<Long> chargeItemDefinitionIdList = adviceBaseDtoList.stream().map(AdviceBaseDto::getChargeItemDefinitionId)
+                .collect(Collectors.toList());
        // 医嘱库存集合
-        List<AdviceInventoryDto> adviceInventoryList
-                = doctorStationAdviceAppMapper.getAdviceInventory(locationId, adviceDefinitionIdList,
-                        CommonConstants.SqlCondition.ABOUT_INVENTORY_TABLE_STR, PublicationStatus.ACTIVE.getValue());
+        List<AdviceInventoryDto> adviceInventoryList = doctorStationAdviceAppMapper.getAdviceInventory(locationId,
+                adviceDefinitionIdList,
+                CommonConstants.SqlCondition.ABOUT_INVENTORY_TABLE_STR, PublicationStatus.ACTIVE.getValue());
        // 待发放个数信息
        List<AdviceInventoryDto> adviceDraftInventoryList = doctorStationAdviceAppMapper.getAdviceDraftInventory(
                CommonConstants.TableName.MED_MEDICATION_DEFINITION, CommonConstants.TableName.ADM_DEVICE_DEFINITION,
                DispenseStatus.DRAFT.getValue(), DispenseStatus.PREPARATION.getValue());
        // 预减库存
-        List<AdviceInventoryDto> adviceInventory
-                = adviceUtils.subtractInventory(adviceInventoryList, adviceDraftInventoryList);
+        List<AdviceInventoryDto> adviceInventory = adviceUtils.subtractInventory(adviceInventoryList,
+                adviceDraftInventoryList);
        // 查询取药科室配置
        List<AdviceInventoryDto> medLocationConfig = doctorStationAdviceAppMapper.getMedLocationConfig(organizationId);
        // 将配置转为 {categoryCode -> 允许的locationId集合}
@@ -212,7 +215,8 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
            for (int i = 0; i < chargeItemDefinitionIdList.size(); i += batchSize) {
                int endIndex = Math.min(i + batchSize, chargeItemDefinitionIdList.size());
                List<Long> batch = chargeItemDefinitionIdList.subList(i, endIndex);
-                mainCharge.addAll(doctorStationAdviceAppMapper.getMainCharge(batch, PublicationStatus.ACTIVE.getValue()));
+                mainCharge
+                        .addAll(doctorStationAdviceAppMapper.getMainCharge(batch, PublicationStatus.ACTIVE.getValue()));
            }
        }
        String unitCode = ""; // 包装单位
@@ -228,13 +232,14 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp

                // fallthrough to 耗材处理逻辑（保持原有逻辑）
                // 每一条医嘱的库存集合信息 , 包装单位库存前端计算
-                List<AdviceInventoryDto> inventoryList = adviceInventory.stream().filter(e ->
-                        baseDto.getAdviceDefinitionId() != null && e.getItemId() != null
-                        && baseDto.getAdviceDefinitionId().equals(e.getItemId())
-                        && baseDto.getAdviceTableName() != null && e.getItemTable() != null
-                        && baseDto.getAdviceTableName().equals(e.getItemTable())
-                        && (pharmacyMultipleChoice
-                        || (baseDto.getPositionId() == null || (e.getLocationId() != null && baseDto.getPositionId().equals(e.getLocationId())))))
+                List<AdviceInventoryDto> inventoryList = adviceInventory
+                        .stream().filter(e -> baseDto.getAdviceDefinitionId() != null && e.getItemId() != null
+                                && baseDto.getAdviceDefinitionId().equals(e.getItemId())
+                                && baseDto.getAdviceTableName() != null && e.getItemTable() != null
+                                && baseDto.getAdviceTableName().equals(e.getItemTable())
+                                && (pharmacyMultipleChoice
+                                        || (baseDto.getPositionId() == null || (e.getLocationId() != null
+                                                && baseDto.getPositionId().equals(e.getLocationId())))))
                        .collect(Collectors.toList());
                // 库存信息
                baseDto.setInventoryList(inventoryList);
@@ -251,13 +256,15 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
                    // 第一步：在medLocationConfig中匹配categoryCode
                    AdviceInventoryDto result1 = medLocationConfig.stream()
                            .filter(dto -> baseDto.getCategoryCode() != null && dto.getCategoryCode() != null
-                                    && baseDto.getCategoryCode().equals(dto.getCategoryCode())).findFirst()
+                                    && baseDto.getCategoryCode().equals(dto.getCategoryCode()))
+                            .findFirst()
                            .orElse(null);
                    if (result1 != null) {
                        // 第二步：在inventoryList中匹配locationId
                        AdviceInventoryDto result2 = inventoryList.stream()
                                .filter(dto -> result1.getLocationId() != null && dto.getLocationId() != null
-                                        && result1.getLocationId().equals(dto.getLocationId())).findFirst()
+                                        && result1.getLocationId().equals(dto.getLocationId()))
+                                .findFirst()
                                .orElse(null);
                        if (result2 != null && result2.getLotNumber() != null) {
                            baseDto.setDefaultLotNumber(result2.getLotNumber());
@@ -296,13 +303,14 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
                baseDto.setPriceList(priceDtoList);
            } else if (CommonConstants.TableName.ADM_DEVICE_DEFINITION.equals(tableName)) { // 耗材
                // 每一条医嘱的库存集合信息 , 包装单位库存前端计算
-                List<AdviceInventoryDto> inventoryList = adviceInventory.stream().filter(e ->
-                        baseDto.getAdviceDefinitionId() != null && e.getItemId() != null
-                        && baseDto.getAdviceDefinitionId().equals(e.getItemId())
-                        && baseDto.getAdviceTableName() != null && e.getItemTable() != null
-                        && baseDto.getAdviceTableName().equals(e.getItemTable())
-                        && (pharmacyMultipleChoice
-                        || (baseDto.getPositionId() == null || (e.getLocationId() != null && baseDto.getPositionId().equals(e.getLocationId())))))
+                List<AdviceInventoryDto> inventoryList = adviceInventory
+                        .stream().filter(e -> baseDto.getAdviceDefinitionId() != null && e.getItemId() != null
+                                && baseDto.getAdviceDefinitionId().equals(e.getItemId())
+                                && baseDto.getAdviceTableName() != null && e.getItemTable() != null
+                                && baseDto.getAdviceTableName().equals(e.getItemTable())
+                                && (pharmacyMultipleChoice
+                                        || (baseDto.getPositionId() == null || (e.getLocationId() != null
+                                                && baseDto.getPositionId().equals(e.getLocationId())))))
                        .collect(Collectors.toList());
                // 库存信息
                baseDto.setInventoryList(inventoryList);
@@ -319,13 +327,15 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
                    // 第一步：在medLocationConfig中匹配categoryCode
                    AdviceInventoryDto result1 = medLocationConfig.stream()
                            .filter(dto -> baseDto.getCategoryCode() != null && dto.getCategoryCode() != null
-                                    && baseDto.getCategoryCode().equals(dto.getCategoryCode())).findFirst()
+                                    && baseDto.getCategoryCode().equals(dto.getCategoryCode()))
+                            .findFirst()
                            .orElse(null);
                    if (result1 != null) {
                        // 第二步：在inventoryList中匹配locationId
                        AdviceInventoryDto result2 = inventoryList.stream()
                                .filter(dto -> result1.getLocationId() != null && dto.getLocationId() != null
-                                        && result1.getLocationId().equals(dto.getLocationId())).findFirst()
+                                        && result1.getLocationId().equals(dto.getLocationId()))
+                                .findFirst()
                                .orElse(null);
                        if (result2 != null && result2.getLotNumber() != null) {
                            baseDto.setDefaultLotNumber(result2.getLotNumber());
@@ -363,13 +373,15 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
                // 价格信息
                baseDto.setPriceList(priceDtoList);
            } else if (CommonConstants.TableName.WOR_ACTIVITY_DEFINITION.equals(tableName)) { // 诊疗
-                List<AdvicePriceDto> priceList
-                        = mainCharge.stream().filter(e -> baseDto.getChargeItemDefinitionId() != null && e.getDefinitionId() != null
+                List<AdvicePriceDto> priceList = mainCharge.stream()
+                        .filter(e -> baseDto.getChargeItemDefinitionId() != null && e.getDefinitionId() != null
                                && baseDto.getChargeItemDefinitionId().equals(e.getDefinitionId()))
-                                .collect(Collectors.toList());
+                        .collect(Collectors.toList());
                // 价格信息
                baseDto.setPriceList(priceList);
-                // 活动类型：字典转换框架会自动填充 activityType_dictText，无需手动设置
+                // 活动类型
+                baseDto.setActivityType_enumText(
+                        EnumUtils.getInfoByValue(ActivityType.class, baseDto.getActivityType()));
            }
        }

@@ -380,7 +392,7 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
     * 查询医嘱绑定信息
     *
     * @param typeCode 1:用法绑东西 2:诊疗绑东西
-     * @param itemNo 用法的code 或者 诊疗定义id
+     * @param itemNo   用法的code 或者 诊疗定义id
     * @return 医嘱绑定信息
     */
    @Override
@@ -392,10 +404,11 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
     * 门诊保存/签发医嘱
     *
     * @param adviceSaveParam 医嘱表单信息
-     * @param adviceOpType 医嘱操作类型
+     * @param adviceOpType    医嘱操作类型
     * @return 结果
     */
    @Override
+    @Transactional(rollbackFor = Exception.class)
    public R<?> saveAdvice(AdviceSaveParam adviceSaveParam, String adviceOpType) {
        try {
            // 患者挂号对应的科室id
@@ -416,10 +429,10 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
             * 保存时,校验库存
             */
            if (AdviceOpType.SAVE_ADVICE.getCode().equals(adviceOpType)) {
-                List<AdviceSaveDto> medUpdateList
-                        = medicineList.stream().filter(e -> e.getRequestId() != null).collect(Collectors.toList());
-                List<AdviceSaveDto> devUpdateList
-                        = deviceList.stream().filter(e -> e.getRequestId() != null).collect(Collectors.toList());
+                List<AdviceSaveDto> medUpdateList = medicineList.stream().filter(e -> e.getRequestId() != null)
+                        .collect(Collectors.toList());
+                List<AdviceSaveDto> devUpdateList = deviceList.stream().filter(e -> e.getRequestId() != null)
+                        .collect(Collectors.toList());
                // 编辑时,释放本身占用的库存发放
                for (AdviceSaveDto adviceSaveDto : medUpdateList) {
                    iMedicationDispenseService.deleteMedicationDispense(adviceSaveDto.getRequestId());
@@ -428,9 +441,10 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
                    iDeviceDispenseService.deleteDeviceDispense(adviceSaveDto.getRequestId());
                }

-                List<AdviceSaveDto> needCheckList
-                        = adviceSaveList.stream().filter(e -> !DbOpType.DELETE.getCode().equals(e.getDbOpType())
-                        && !ItemType.ACTIVITY.getValue().equals(e.getAdviceType())).collect(Collectors.toList());
+                List<AdviceSaveDto> needCheckList = adviceSaveList.stream()
+                        .filter(e -> !DbOpType.DELETE.getCode().equals(e.getDbOpType())
+                                && !ItemType.ACTIVITY.getValue().equals(e.getAdviceType()))
+                        .collect(Collectors.toList());
                // 校验库存
                String tipRes = adviceUtils.checkInventory(needCheckList);
                if (tipRes != null) {
@@ -445,8 +459,8 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
            /**
             * 处理药品请求
             */
-            List<String> medRequestIdList
-                    = this.handMedication(medicineList, curDate, adviceOpType, organizationId, signCode);
+            List<String> medRequestIdList = this.handMedication(medicineList, curDate, adviceOpType, organizationId,
+                    signCode);

            /**
             * 处理诊疗项目请求
@@ -463,7 +477,8 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
                // 签发的医嘱id集合
                List<Long> requestIds = adviceSaveList.stream()
                        .filter(e -> !DbOpType.DELETE.getCode().equals(e.getDbOpType()) && e.getRequestId() != null)
-                        .collect(Collectors.toList()).stream().map(AdviceSaveDto::getRequestId).collect(Collectors.toList());
+                        .collect(Collectors.toList()).stream().map(AdviceSaveDto::getRequestId)
+                        .collect(Collectors.toList());
                // 就诊id
                Long encounterId = adviceSaveList.get(0).getEncounterId();
                iChargeItemService.update(new LambdaUpdateWrapper<ChargeItem>()
@@ -477,7 +492,7 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
            clearRelatedCache();

            return R.ok(medRequestIdList,
-                    MessageUtils.createMessage(PromptMsgConstant.Common.M00002, new Object[]{"门诊医嘱"}));
+                    MessageUtils.createMessage(PromptMsgConstant.Common.M00002, new Object[] { "门诊医嘱" }));
        } catch (Exception e) {
            // 异常处理
            throw e;
@@ -499,6 +514,10 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
            Long organizationId, String signCode) {
        // 当前登录账号的科室id
        Long orgId = SecurityUtils.getLoginUser().getOrgId();
+        // 获取当前登录用户的tenantId
+        Integer tenantId = SecurityUtils.getLoginUser().getTenantId();
+        // 获取当前登录用户名
+        String currentUsername = SecurityUtils.getUsername();
        // 保存操作
        boolean is_save = AdviceOpType.SAVE_ADVICE.getCode().equals(adviceOpType);
        // 签发操作
@@ -508,9 +527,10 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
        // 声明费用项
        ChargeItem chargeItem;
        // 新增 + 修改
-        List<AdviceSaveDto> insertOrUpdateList
-                = medicineList.stream().filter(e -> (DbOpType.INSERT.getCode().equals(e.getDbOpType())
-                || DbOpType.UPDATE.getCode().equals(e.getDbOpType()))).collect(Collectors.toList());
+        List<AdviceSaveDto> insertOrUpdateList = medicineList.stream()
+                .filter(e -> (DbOpType.INSERT.getCode().equals(e.getDbOpType())
+                        || DbOpType.UPDATE.getCode().equals(e.getDbOpType())))
+                .collect(Collectors.toList());
        // 删除
        List<AdviceSaveDto> deleteList = medicineList.stream()
                .filter(e -> DbOpType.DELETE.getCode().equals(e.getDbOpType())).collect(Collectors.toList());
@@ -535,7 +555,8 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
                    adviceSaveDto.getRequestId());
            // 删除基于这个药品生成的需要执行的诊疗请求
            iServiceRequestService.remove(
-                    new LambdaQueryWrapper<ServiceRequest>().eq(ServiceRequest::getBasedOnId, adviceSaveDto.getRequestId())
+                    new LambdaQueryWrapper<ServiceRequest>()
+                            .eq(ServiceRequest::getBasedOnId, adviceSaveDto.getRequestId())
                            .isNotNull(ServiceRequest::getBasedOnTable)
                            .eq(ServiceRequest::getStatusEnum, RequestStatus.COMPLETED.getValue()));
        }
@@ -552,8 +573,10 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
            medicationRequest.setId(adviceSaveDto.getRequestId()); // 主键id
            medicationRequest.setStatusEnum(is_save ? RequestStatus.DRAFT.getValue() : RequestStatus.ACTIVE.getValue()); // 请求状态
            medicationRequest.setPrescriptionNo(adviceSaveDto.getPrescriptionNo()); // 处方号
-            medicationRequest.setTenantId(SecurityUtils.getLoginUser().getTenantId()); // 显式设置租户ID
            medicationRequest.setGroupId(adviceSaveDto.getGroupId()); // 组号
+            medicationRequest.setTenantId(tenantId); // 设置租户id
+            medicationRequest.setCreateBy(currentUsername); // 设置创建人
+            medicationRequest.setCreateTime(curDate); // 设置创建时间
            if (is_sign) {
                medicationRequest.setSignCode(signCode);
            }
@@ -598,8 +621,8 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
            }
            if (is_save) {
                // 处理药品发放
-                Long dispenseId
-                        = iMedicationDispenseService.handleMedicationDispense(medicationRequest, adviceSaveDto.getDbOpType());
+                Long dispenseId = iMedicationDispenseService.handleMedicationDispense(medicationRequest,
+                        adviceSaveDto.getDbOpType());

                // 保存药品费用项
                chargeItem = new ChargeItem();
@@ -624,6 +647,9 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
                chargeItem.setConditionId(adviceSaveDto.getConditionId()); // 诊断id
                chargeItem.setEncounterDiagnosisId(adviceSaveDto.getEncounterDiagnosisId()); // 就诊诊断id
                chargeItem.setDispenseId(dispenseId); // 发放ID
+                chargeItem.setTenantId(tenantId);           // 设置租户ID (修复本次报错)
+                chargeItem.setCreateBy(currentUsername);    // 设置创建人
+                chargeItem.setCreateTime(curDate);          // 设置创建时间

                chargeItem.setQuantityValue(adviceSaveDto.getQuantity()); // 数量
                chargeItem.setQuantityUnit(adviceSaveDto.getUnitCode()); // 单位
@@ -648,6 +674,10 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
    private void handDevice(List<AdviceSaveDto> deviceList, Date curDate, String adviceOpType) {
        // 当前登录账号的科室id
        Long orgId = SecurityUtils.getLoginUser().getOrgId();
+        // 获取当前登录用户的tenantId
+        Integer tenantId = SecurityUtils.getLoginUser().getTenantId();
+        // 获取当前登录用户名
+        String currentUsername = SecurityUtils.getUsername();
        // 保存操作
        boolean is_save = AdviceOpType.SAVE_ADVICE.getCode().equals(adviceOpType);
        // 签发操作
@@ -656,9 +686,10 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
        // 声明费用项
        ChargeItem chargeItem;
        // 新增 + 修改
-        List<AdviceSaveDto> insertOrUpdateList
-                = deviceList.stream().filter(e -> (DbOpType.INSERT.getCode().equals(e.getDbOpType())
-                || DbOpType.UPDATE.getCode().equals(e.getDbOpType()))).collect(Collectors.toList());
+        List<AdviceSaveDto> insertOrUpdateList = deviceList.stream()
+                .filter(e -> (DbOpType.INSERT.getCode().equals(e.getDbOpType())
+                        || DbOpType.UPDATE.getCode().equals(e.getDbOpType())))
+                .collect(Collectors.toList());
        // 删除
        List<AdviceSaveDto> deleteList = deviceList.stream()
                .filter(e -> DbOpType.DELETE.getCode().equals(e.getDbOpType())).collect(Collectors.toList());
@@ -691,6 +722,9 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
            // 显式设置审计字段，防止自动填充机制失效
            deviceRequest.setCreateBy(SecurityUtils.getLoginUser().getUsername());
            deviceRequest.setCreateTime(new Date());
+            deviceRequest.setTenantId(tenantId); // 设置租户id
+            deviceRequest.setCreateBy(currentUsername); // 设置创建人
+            deviceRequest.setCreateTime(curDate); // 设置创建时间

            // 保存时,处理数据(请求,发放,账单)
            if (is_save) {
@@ -720,12 +754,15 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
            iDeviceRequestService.saveOrUpdate(deviceRequest);
            if (is_save) {
                // 处理耗材发放
-                Long dispenseId
-                        = iDeviceDispenseService.handleDeviceDispense(deviceRequest, adviceSaveDto.getDbOpType());
+                Long dispenseId = iDeviceDispenseService.handleDeviceDispense(deviceRequest,
+                        adviceSaveDto.getDbOpType());

                // 保存耗材费用项
                chargeItem = new ChargeItem();
                chargeItem.setId(adviceSaveDto.getChargeItemId()); // 费用项id
+                chargeItem.setTenantId(tenantId);           // 补全租户ID
+                chargeItem.setCreateBy(currentUsername);    // 补全创建人
+                chargeItem.setCreateTime(curDate);          // 补全创建时间
                chargeItem.setStatusEnum(ChargeItemStatus.DRAFT.getValue()); // 收费状态
                chargeItem.setBusNo(AssignSeqEnum.CHARGE_ITEM_NO.getPrefix().concat(deviceRequest.getBusNo()));
                chargeItem.setGenerateSourceEnum(GenerateSource.DOCTOR_PRESCRIPTION.getValue()); // 生成来源
@@ -768,6 +805,10 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
            String signCode) {
        // 当前登录账号的科室id
        Long orgId = SecurityUtils.getLoginUser().getOrgId();
+        // 获取当前登录用户的tenantId
+        Integer tenantId = SecurityUtils.getLoginUser().getTenantId();
+        // 获取当前登录用户名
+        String currentUsername = SecurityUtils.getUsername();
        // 保存操作
        boolean is_save = AdviceOpType.SAVE_ADVICE.getCode().equals(adviceOpType);
        // 签发操作
@@ -776,9 +817,10 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
        // 声明费用项
        ChargeItem chargeItem;
        // 新增 + 修改
-        List<AdviceSaveDto> insertOrUpdateList
-                = activityList.stream().filter(e -> (DbOpType.INSERT.getCode().equals(e.getDbOpType())
-                || DbOpType.UPDATE.getCode().equals(e.getDbOpType()))).collect(Collectors.toList());
+        List<AdviceSaveDto> insertOrUpdateList = activityList.stream()
+                .filter(e -> (DbOpType.INSERT.getCode().equals(e.getDbOpType())
+                        || DbOpType.UPDATE.getCode().equals(e.getDbOpType())))
+                .collect(Collectors.toList());
        // 删除
        List<AdviceSaveDto> deleteList = activityList.stream()
                .filter(e -> DbOpType.DELETE.getCode().equals(e.getDbOpType())).collect(Collectors.toList());
@@ -797,7 +839,8 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
        for (AdviceSaveDto adviceSaveDto : deleteList) {
            iServiceRequestService.removeById(adviceSaveDto.getRequestId());// 删除诊疗
            iServiceRequestService.remove(
-                    new LambdaQueryWrapper<ServiceRequest>().eq(ServiceRequest::getParentId, adviceSaveDto.getRequestId()));// 删除诊疗套餐对应的子项
+                    new LambdaQueryWrapper<ServiceRequest>().eq(ServiceRequest::getParentId,
+                            adviceSaveDto.getRequestId()));// 删除诊疗套餐对应的子项
            // 删除费用项
            iChargeItemService.deleteByServiceTableAndId(CommonConstants.TableName.WOR_SERVICE_REQUEST,
                    adviceSaveDto.getRequestId());
@@ -807,6 +850,9 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
            serviceRequest = new ServiceRequest();
            serviceRequest.setId(adviceSaveDto.getRequestId()); // 主键id
            serviceRequest.setStatusEnum(is_save ? RequestStatus.DRAFT.getValue() : RequestStatus.ACTIVE.getValue());// 请求状态
+            serviceRequest.setTenantId(tenantId); // 设置租户id
+            serviceRequest.setCreateBy(currentUsername); // 设置创建人
+            serviceRequest.setCreateTime(curDate); // 设置创建时间
            serviceRequest.setTenantId(SecurityUtils.getLoginUser().getTenantId()); // 显式设置租户ID
            if (is_sign) {
                serviceRequest.setSignCode(signCode);
@@ -845,6 +891,9 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
            if (is_save) {
                chargeItem = new ChargeItem();
                chargeItem.setId(adviceSaveDto.getChargeItemId()); // 费用项id
+                chargeItem.setTenantId(tenantId);           // 补全租户ID
+                chargeItem.setCreateBy(currentUsername);    // 补全创建人
+                chargeItem.setCreateTime(curDate);          // 补全创建时间
                chargeItem.setStatusEnum(ChargeItemStatus.DRAFT.getValue()); // 收费状态
                chargeItem.setBusNo(AssignSeqEnum.CHARGE_ITEM_NO.getPrefix().concat(serviceRequest.getBusNo()));
                chargeItem.setGenerateSourceEnum(GenerateSource.DOCTOR_PRESCRIPTION.getValue()); // 生成来源
@@ -868,11 +917,6 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
                chargeItem.setUnitPrice(adviceSaveDto.getUnitPrice()); // 单价
                chargeItem.setTotalPrice(adviceSaveDto.getTotalPrice()); // 总价

-                // 显式设置审计字段，防止自动填充机制失效
-                chargeItem.setTenantId(SecurityUtils.getLoginUser().getTenantId());
-                chargeItem.setCreateBy(SecurityUtils.getLoginUser().getUsername());
-                chargeItem.setCreateTime(new Date());
-
                iChargeItemService.saveOrUpdate(chargeItem);

                // 第一次保存时,处理诊疗套餐的子项信息
@@ -894,6 +938,7 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
                    }
                }
            }
+
            // 只有在签发时
            if (is_sign) {
                // 发送跨系统申请
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/appservice/impl/DoctorStationDiagnosisAppServiceImpl.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/appservice/impl/DoctorStationDiagnosisAppServiceImpl.java
@@ -215,6 +215,12 @@ public class DoctorStationDiagnosisAppServiceImpl implements IDoctorStationDiagn
            condition.setYbNo(saveDiagnosisChildParam.getYbNo());
            condition.setRecordedDatetime(new Date());
            condition.setRecorderId(SecurityUtils.getLoginUser().getPractitionerId());// 记录人
+            // 设置租户ID，避免数据库约束错误
+            condition.setTenantId(SecurityUtils.getLoginUser().getTenantId());
+            // 设置创建人，避免数据库约束错误
+            condition.setCreateBy(SecurityUtils.getLoginUser().getUsername());
+            // 设置创建时间，避免数据库约束错误
+            condition.setCreateTime(new Date());
            iConditionService.saveOrUpdate(condition);
            saveDiagnosisChildParam.setConditionId(condition.getId());
        }
@@ -230,6 +236,12 @@ public class DoctorStationDiagnosisAppServiceImpl implements IDoctorStationDiagn
            encounterDiagnosis.setMedTypeCode(saveDiagnosisChildParam.getMedTypeCode());// 医疗类型
            encounterDiagnosis.setDiagnosisDesc(saveDiagnosisChildParam.getDiagnosisDesc()); // 诊断描述
            encounterDiagnosis.setIptDiseTypeCode(saveDiagnosisChildParam.getIptDiseTypeCode()); // 患者疾病诊断类型代码
+            // 设置租户ID，避免数据库约束错误
+            encounterDiagnosis.setTenantId(SecurityUtils.getLoginUser().getTenantId());
+            // 设置创建人，避免数据库约束错误
+            encounterDiagnosis.setCreateBy(SecurityUtils.getLoginUser().getUsername());
+            // 设置创建时间，避免数据库约束错误
+            encounterDiagnosis.setCreateTime(new Date());
            iEncounterDiagnosisService.saveOrUpdate(encounterDiagnosis);
        }
        return R.ok(null, MessageUtils.createMessage(PromptMsgConstant.Common.M00002, new Object[] {"诊断"}));
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/dto/AdviceBaseDto.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/dto/AdviceBaseDto.java
@@ -111,6 +111,10 @@ public class AdviceBaseDto {
    @Dict(dictCode = "activity_category_code")
    private Integer activityType;
    private String activityType_dictText;
+    /**
+     * 活动类型枚举文本 (手动赋值用)
+     */
+    private String activityType_enumText;

    /**
     * 是否皮试
--- a/openhis-server-new/openhis-domain/src/main/java/com/openhis/medication/service/impl/MedicationDispenseServiceImpl.java
+++ b/openhis-server-new/openhis-domain/src/main/java/com/openhis/medication/service/impl/MedicationDispenseServiceImpl.java
@@ -6,6 +6,7 @@ import com.baomidou.mybatisplus.extension.service.impl.ServiceImpl;
 import com.core.common.enums.DelFlag;
 import com.core.common.utils.AssignSeqUtil;
 import com.core.common.utils.DateUtils;
+import com.core.common.utils.SecurityUtils;
 import com.openhis.common.enums.AssignSeqEnum;
 import com.openhis.common.enums.DispenseStatus;
 import com.openhis.medication.domain.MedicationDispense;
@@ -29,301 +30,344 @@ import java.util.List;
 */
@Service
 public class MedicationDispenseServiceImpl extends ServiceImpl<MedicationDispenseMapper, MedicationDispense>
-        implements IMedicationDispenseService {
+                implements IMedicationDispenseService {

-    @Resource
-    AssignSeqUtil assignSeqUtil;
+        @Resource
+        AssignSeqUtil assignSeqUtil;

-    /**
-     * 处理药品发放信息
-     *
-     * @param medicationRequest 药品请求信息
-     * @param dbOpType db操作类型
-     * @return 发放id
-     */
-    @Override
-    public Long handleMedicationDispense(MedicationRequest medicationRequest, String dbOpType) {
-        MedicationDispense medicationDispense = new MedicationDispense();
-        // 药品发放id
-        medicationDispense.setBusNo(assignSeqUtil.getSeqByDay(AssignSeqEnum.MEDICATION_DIS_NO.getPrefix(), 4));
-        // 药品发放状态
-        medicationDispense.setStatusEnum(DispenseStatus.DRAFT.getValue());
-        // 状态变更时间
-        medicationDispense.setStatusChangedTime(DateUtils.getNowDate());
-        // 发药类型
-        medicationDispense.setDispenseEnum(medicationRequest.getCategoryEnum());
-        // 药品编码
-        medicationDispense.setMedicationId(medicationRequest.getMedicationId());
-        // 请求数量
-        medicationDispense.setQuantity(medicationRequest.getQuantity());
-        // 请求单位编码
-        medicationDispense.setUnitCode(medicationRequest.getUnitCode());
-        // 产品批号
-        medicationDispense.setLotNumber(medicationRequest.getLotNumber());
-        // 患者id
-        medicationDispense.setPatientId(medicationRequest.getPatientId());
-        // 就诊id
-        medicationDispense.setEncounterId(medicationRequest.getEncounterId());
-        // 支持用药信息
-        medicationDispense.setSupportInfo(medicationRequest.getSupportInfo());
-        // 发药人
-        medicationDispense.setPractitionerId(medicationRequest.getPractitionerId());
-        // 发放药房
-        medicationDispense.setLocationId(medicationRequest.getPerformLocation());
-        // 药品请求id
-        medicationDispense.setMedReqId(medicationRequest.getId());
-        // 已发药数量
-        medicationDispense.setDispenseQuantity(BigDecimal.ZERO);
-        // 用法
-        medicationDispense.setMethodCode(medicationRequest.getMethodCode());
-        // 用药频次
-        medicationDispense.setFrequencyCode(medicationRequest.getRateCode());
-        // 单次剂量
-        medicationDispense.setDose(medicationRequest.getDose());
-        // 剂量单位
-        medicationDispense.setDoseUnitCode(medicationRequest.getDoseUnitCode());
-        // 单次最大剂量
-        medicationDispense.setMaxUnit(medicationRequest.getMaxDose());
+        /**
+         * 处理药品发放信息
+         *
+         * @param medicationRequest 药品请求信息
+         * @param dbOpType          db操作类型
+         * @return 发放id
+         */
+        @Override
+        public Long handleMedicationDispense(MedicationRequest medicationRequest, String dbOpType) {
+                MedicationDispense medicationDispense = new MedicationDispense();
+                // 药品发放id
+                medicationDispense.setBusNo(assignSeqUtil.getSeqByDay(AssignSeqEnum.MEDICATION_DIS_NO.getPrefix(), 4));
+                // 药品发放状态
+                medicationDispense.setStatusEnum(DispenseStatus.DRAFT.getValue());
+                // 状态变更时间
+                medicationDispense.setStatusChangedTime(DateUtils.getNowDate());

-        // 获取当前时间
-        LocalDateTime now = LocalDateTime.now();
-        // 增加2小时
-        LocalDateTime newTime = now.plusHours(2);
-        // 转换为Date对象（如果需要保持使用Date类型）
-        Date limitTime = Date.from(newTime.atZone(ZoneId.systemDefault()).toInstant());
-        // 设置限制发药时间
-        medicationDispense.setLimitTime(limitTime);
+                // 【关键修改】设置创建时间，解决数据库 not-null 报错
+                medicationDispense.setCreateTime(DateUtils.getNowDate());

-        baseMapper.insert(medicationDispense);
+                // 发药类型
+                medicationDispense.setDispenseEnum(medicationRequest.getCategoryEnum());
+                // 药品编码
+                medicationDispense.setMedicationId(medicationRequest.getMedicationId());
+                // 请求数量
+                medicationDispense.setQuantity(medicationRequest.getQuantity());
+                // 请求单位编码
+                medicationDispense.setUnitCode(medicationRequest.getUnitCode());
+                // 产品批号
+                medicationDispense.setLotNumber(medicationRequest.getLotNumber());
+                // 患者id
+                medicationDispense.setPatientId(medicationRequest.getPatientId());
+                // 就诊id
+                medicationDispense.setEncounterId(medicationRequest.getEncounterId());
+                // 支持用药信息
+                medicationDispense.setSupportInfo(medicationRequest.getSupportInfo());
+                // 发药人
+                medicationDispense.setPractitionerId(medicationRequest.getPractitionerId());
+                // 发放药房
+                medicationDispense.setLocationId(medicationRequest.getPerformLocation());
+                // 药品请求id
+                medicationDispense.setMedReqId(medicationRequest.getId());
+                // 已发药数量
+                medicationDispense.setDispenseQuantity(BigDecimal.ZERO);
+                // 用法
+                medicationDispense.setMethodCode(medicationRequest.getMethodCode());
+                // 用药频次
+                medicationDispense.setFrequencyCode(medicationRequest.getRateCode());
+                // 单次剂量
+                medicationDispense.setDose(medicationRequest.getDose());
+                // 剂量单位
+                medicationDispense.setDoseUnitCode(medicationRequest.getDoseUnitCode());
+                // 单次最大剂量
+                medicationDispense.setMaxUnit(medicationRequest.getMaxDose());

-//        if (DbOpType.INSERT.getCode().equals(dbOpType)) {
-//            baseMapper.insert(medicationDispense);
-//        } else if (DbOpType.UPDATE.getCode().equals(dbOpType)) {
-//            baseMapper.update(medicationDispense, new LambdaUpdateWrapper<MedicationDispense>()
-//                .eq(MedicationDispense::getMedReqId, medicationRequest.getId()));
-//        }
-        return medicationDispense.getId();
-    }
+                // 获取当前时间
+                LocalDateTime now = LocalDateTime.now();
+                // 增加2小时
+                LocalDateTime newTime = now.plusHours(2);
+                // 转换为Date对象
+                Date limitTime = Date.from(newTime.atZone(ZoneId.systemDefault()).toInstant());
+                // 设置限制发药时间
+                medicationDispense.setLimitTime(limitTime);

-    /**
-     * 医嘱执行生成药品发放,状态为待配药
-     *
-     * @param medicationRequest 药品医嘱请求
-     * @param procedureId 执行记录id
-     * @param plannedDispenseTime 预定发药时间
-     * @return 发放id
-     */
-    @Override
-    public Long generateMedicationDispense(MedicationRequest medicationRequest, Long procedureId,
-            Date plannedDispenseTime) {
-        MedicationDispense medicationDispense = new MedicationDispense();
-        // 执行id
-        medicationDispense.setProcedureId(procedureId);
-        // 预定发药时间
-        medicationDispense.setPlannedDispenseTime(plannedDispenseTime);
-        // 药品发放id
-        medicationDispense.setBusNo(assignSeqUtil.getSeqByDay(AssignSeqEnum.MEDICATION_DIS_NO.getPrefix(), 4));
-        // 药品发放状态
-        medicationDispense.setStatusEnum(DispenseStatus.PREPARATION.getValue());
-        // 状态变更时间
-        medicationDispense.setStatusChangedTime(DateUtils.getNowDate());
-        // 发药类型
-        medicationDispense.setDispenseEnum(medicationRequest.getCategoryEnum());
-        // 药品编码
-        medicationDispense.setMedicationId(medicationRequest.getMedicationId());
-        // 请求数量
-        medicationDispense.setQuantity(medicationRequest.getQuantity());
-        // 请求单位编码
-        medicationDispense.setUnitCode(medicationRequest.getUnitCode());
-        // 产品批号
-        medicationDispense.setLotNumber(medicationRequest.getLotNumber());
-        // 患者id
-        medicationDispense.setPatientId(medicationRequest.getPatientId());
-        // 就诊id
-        medicationDispense.setEncounterId(medicationRequest.getEncounterId());
-        // 支持用药信息
-        medicationDispense.setSupportInfo(medicationRequest.getSupportInfo());
-        // 发药人
-        medicationDispense.setPractitionerId(medicationRequest.getPractitionerId());
-        // 发放药房
-        medicationDispense.setLocationId(medicationRequest.getPerformLocation());
-        // 药品请求id
-        medicationDispense.setMedReqId(medicationRequest.getId());
-        // 已发药数量
-        medicationDispense.setDispenseQuantity(BigDecimal.ZERO);
-        // 用法
-        medicationDispense.setMethodCode(medicationRequest.getMethodCode());
-        // 用药频次
-        medicationDispense.setFrequencyCode(medicationRequest.getRateCode());
-        // 单次剂量
-        medicationDispense.setDose(medicationRequest.getDose());
-        // 剂量单位
-        medicationDispense.setDoseUnitCode(medicationRequest.getDoseUnitCode());
-        // 单次最大剂量
-        medicationDispense.setMaxUnit(medicationRequest.getMaxDose());
-        // 获取当前时间
-        LocalDateTime now = LocalDateTime.now();
-        // 增加12小时
-        LocalDateTime newTime = now.plusHours(12);
-        // 转换为Date对象（如果需要保持使用Date类型）
-        Date limitTime = Date.from(newTime.atZone(ZoneId.systemDefault()).toInstant());
-        // 设置限制发药时间
-        medicationDispense.setLimitTime(limitTime);
+                // 【关键修改】手动设置租户ID和创建人，确保 create_by 非空
+                try {
+                        // 尝试获取当前登录用户
+                        medicationDispense.setTenantId(SecurityUtils.getLoginUser().getTenantId());
+                        medicationDispense.setCreateBy(SecurityUtils.getUsername());
+                } catch (Exception e) {
+                        // 如果获取失败（如系统自动执行），使用默认值兜底，防止数据库报错
+                        medicationDispense.setTenantId(1);
+                        medicationDispense.setCreateBy("system");
+                }

-        baseMapper.insert(medicationDispense);
+                // 执行插入
+                // 注意：如果您需要区分新增和修改，请取消下面注释并根据 dbOpType 判断
+                // if (DbOpType.UPDATE.getCode().equals(dbOpType)) {
+                //      baseMapper.update(medicationDispense, new LambdaUpdateWrapper<MedicationDispense>()
+                //          .eq(MedicationDispense::getMedReqId, medicationRequest.getId()));
+                // } else {
+                baseMapper.insert(medicationDispense);
+                // }

-        return medicationDispense.getId();
-    }
+                return medicationDispense.getId();
+        }

-    /**
-     * 删除药品发放信息
-     *
-     * @param medReqId 药品请求id
-     */
-    @Override
-    public void deleteMedicationDispense(Long medReqId) {
-        baseMapper.delete(new LambdaQueryWrapper<MedicationDispense>().eq(MedicationDispense::getMedReqId, medReqId));
-    }
+        /**
+         * 医嘱执行生成药品发放,状态为待配药
+         *
+         * @param medicationRequest   药品医嘱请求
+         * @param procedureId         执行记录id
+         * @param plannedDispenseTime 预定发药时间
+         * @return 发放id
+         */
+        @Override
+        public Long generateMedicationDispense(MedicationRequest medicationRequest, Long procedureId,
+                        Date plannedDispenseTime) {
+                MedicationDispense medicationDispense = new MedicationDispense();
+                // 执行id
+                medicationDispense.setProcedureId(procedureId);
+                // 预定发药时间
+                medicationDispense.setPlannedDispenseTime(plannedDispenseTime);
+                // 药品发放id
+                medicationDispense.setBusNo(assignSeqUtil.getSeqByDay(AssignSeqEnum.MEDICATION_DIS_NO.getPrefix(), 4));
+                // 药品发放状态
+                medicationDispense.setStatusEnum(DispenseStatus.PREPARATION.getValue());
+                // 状态变更时间
+                medicationDispense.setStatusChangedTime(DateUtils.getNowDate());
+                // 发药类型
+                medicationDispense.setDispenseEnum(medicationRequest.getCategoryEnum());
+                // 药品编码
+                medicationDispense.setMedicationId(medicationRequest.getMedicationId());
+                // 请求数量
+                medicationDispense.setQuantity(medicationRequest.getQuantity());
+                // 请求单位编码
+                medicationDispense.setUnitCode(medicationRequest.getUnitCode());
+                // 产品批号
+                medicationDispense.setLotNumber(medicationRequest.getLotNumber());
+                // 患者id
+                medicationDispense.setPatientId(medicationRequest.getPatientId());
+                // 就诊id
+                medicationDispense.setEncounterId(medicationRequest.getEncounterId());
+                // 支持用药信息
+                medicationDispense.setSupportInfo(medicationRequest.getSupportInfo());
+                // 发药人
+                medicationDispense.setPractitionerId(medicationRequest.getPractitionerId());
+                // 发放药房
+                medicationDispense.setLocationId(medicationRequest.getPerformLocation());
+                // 药品请求id
+                medicationDispense.setMedReqId(medicationRequest.getId());
+                // 已发药数量
+                medicationDispense.setDispenseQuantity(BigDecimal.ZERO);
+                // 用法
+                medicationDispense.setMethodCode(medicationRequest.getMethodCode());
+                // 用药频次
+                medicationDispense.setFrequencyCode(medicationRequest.getRateCode());
+                // 单次剂量
+                medicationDispense.setDose(medicationRequest.getDose());
+                // 剂量单位
+                medicationDispense.setDoseUnitCode(medicationRequest.getDoseUnitCode());
+                // 单次最大剂量
+                medicationDispense.setMaxUnit(medicationRequest.getMaxDose());

-    /**
-     * 更新未发放药品状态：停止发放
-     *
-     * @param medDisIdList 发放id列表
-     * @param refund 停止原因：退费
-     */
-    @Override
-    public void updateStopDispenseStatus(List<Long> medDisIdList, Integer refund) {
-        baseMapper.update(
-                new MedicationDispense().setStatusEnum(DispenseStatus.STOPPED.getValue()).setNotPerformedReasonEnum(refund),
-                new LambdaUpdateWrapper<MedicationDispense>().in(MedicationDispense::getId, medDisIdList));
-    }
+                // 获取当前时间
+                LocalDateTime now = LocalDateTime.now();
+                // 增加12小时
+                LocalDateTime newTime = now.plusHours(12);
+                // 转换为Date对象（如果需要保持使用Date类型）
+                Date limitTime = Date.from(newTime.atZone(ZoneId.systemDefault()).toInstant());
+                // 设置限制发药时间
+                medicationDispense.setLimitTime(limitTime);
+                // 手动设置租户ID和创建人
+                try {
+                        medicationDispense.setTenantId(SecurityUtils.getLoginUser().getTenantId());
+                        medicationDispense.setCreateBy(SecurityUtils.getUsername());
+                } catch (Exception e) {
+                        // 如果获取登录用户信息失败，使用默认值
+                        medicationDispense.setTenantId(1); // 默认租户ID
+                        medicationDispense.setCreateBy("system"); // 默认创建人
+                }

-    /**
-     * 更新药品状态：待配药
-     *
-     * @param medicationRequestIdList 请求id列表
-     */
-    @Override
-    public void updatePreparationDispenseStatus(List<Long> medicationRequestIdList) {
-        baseMapper.update(null,
-                new LambdaUpdateWrapper<MedicationDispense>()
-                        .set(MedicationDispense::getStatusEnum, DispenseStatus.PREPARATION.getValue())
-                        .set(MedicationDispense::getStatusChangedTime, DateUtils.getNowDate())
-                        .in(MedicationDispense::getMedReqId, medicationRequestIdList));
-    }
+                baseMapper.insert(medicationDispense);

-    /**
-     * 更新药品状态：暂停
-     *
-     * @param medReqIdList 请求id列表
-     */
-    @Override
-    public void updateOnHoldDispenseStatus(List<Long> medReqIdList) {
-        baseMapper.update(null,
-                new LambdaUpdateWrapper<MedicationDispense>()
-                        .set(MedicationDispense::getStatusEnum, DispenseStatus.ON_HOLD.getValue())
-                        .set(MedicationDispense::getStatusChangedTime, DateUtils.getNowDate())
-                        .in(MedicationDispense::getMedReqId, medReqIdList));
-    }
+                return medicationDispense.getId();
+        }

-    /**
-     * 验证是否发过药
-     *
-     * @param medicationDefId 药品定义id
-     * @return 验证结果
-     */
-    @Override
-    public boolean verifyAbleEdit(Long medicationDefId) {
-        return baseMapper.exists(
-                new LambdaQueryWrapper<MedicationDispense>().eq(MedicationDispense::getMedicationId, medicationDefId)
-                        .and(q -> q.eq(MedicationDispense::getStatusEnum, DispenseStatus.COMPLETED.getValue()).or()
-                        .eq(MedicationDispense::getStatusEnum, DispenseStatus.REFUNDED.getValue()))
-                        .eq(MedicationDispense::getDeleteFlag, DelFlag.NO.getCode()));
-    }
+        /**
+         * 删除药品发放信息
+         *
+         * @param medReqId 药品请求id
+         */
+        @Override
+        public void deleteMedicationDispense(Long medReqId) {
+                baseMapper.delete(new LambdaQueryWrapper<MedicationDispense>().eq(MedicationDispense::getMedReqId,
+                                medReqId));
+        }

-    /**
-     * 通过请求id获取药品发放信息
-     *
-     * @param requestIdList 请求id
-     * @return 发放信息
-     */
-    @Override
-    public List<MedicationDispense> selectByRequestIdList(List<Long> requestIdList) {
-        return baseMapper
-                .selectList(new LambdaQueryWrapper<MedicationDispense>().in(MedicationDispense::getMedReqId, requestIdList)
-                        .eq(MedicationDispense::getDeleteFlag, DelFlag.NO.getCode()));
-    }
+        /**
+         * 更新未发放药品状态：停止发放
+         *
+         * @param medDisIdList 发放id列表
+         * @param refund       停止原因：退费
+         */
+        @Override
+        public void updateStopDispenseStatus(List<Long> medDisIdList, Integer refund) {
+                baseMapper.update(
+                                new MedicationDispense().setStatusEnum(DispenseStatus.STOPPED.getValue())
+                                                .setNotPerformedReasonEnum(refund),
+                                new LambdaUpdateWrapper<MedicationDispense>().in(MedicationDispense::getId,
+                                                medDisIdList));
+        }

-    /**
-     * 更新药品状态：已汇总
-     *
-     * @param medDispenseId 发放id列表
-     */
-    @Override
-    public void updateDispenseStatusSummarized(List<Long> medDispenseId, String busNo) {
-        baseMapper.update(null,
-                new LambdaUpdateWrapper<MedicationDispense>()
-                        .set(MedicationDispense::getStatusEnum, DispenseStatus.SUMMARIZED.getValue())
-                        .set(MedicationDispense::getStatusChangedTime, DateUtils.getNowDate())
-                        .set(MedicationDispense::getSummaryNo, busNo).in(MedicationDispense::getId, medDispenseId)
-                        .eq(MedicationDispense::getDeleteFlag, DelFlag.NO.getCode()));
-    }
+        /**
+         * 更新药品状态：待配药
+         *
+         * @param medicationRequestIdList 请求id列表
+         */
+        @Override
+        public void updatePreparationDispenseStatus(List<Long> medicationRequestIdList) {
+                baseMapper.update(null,
+                                new LambdaUpdateWrapper<MedicationDispense>()
+                                                .set(MedicationDispense::getStatusEnum,
+                                                                DispenseStatus.PREPARATION.getValue())
+                                                .set(MedicationDispense::getStatusChangedTime, DateUtils.getNowDate())
+                                                .in(MedicationDispense::getMedReqId, medicationRequestIdList));
+        }

-    /**
-     * 通过执行id获取药品发放信息
-     *
-     * @param procedureIdList 执行id列表
-     * @return 发放信息
-     */
-    @Override
-    public List<MedicationDispense> getMedDispenseByProcedureId(List<Long> procedureIdList) {
-        return baseMapper.selectList(
-                new LambdaQueryWrapper<MedicationDispense>().in(MedicationDispense::getProcedureId, procedureIdList)
-                        .eq(MedicationDispense::getDeleteFlag, DelFlag.NO.getCode()));
-    }
+        /**
+         * 更新药品状态：暂停
+         *
+         * @param medReqIdList 请求id列表
+         */
+        @Override
+        public void updateOnHoldDispenseStatus(List<Long> medReqIdList) {
+                baseMapper.update(null,
+                                new LambdaUpdateWrapper<MedicationDispense>()
+                                                .set(MedicationDispense::getStatusEnum,
+                                                                DispenseStatus.ON_HOLD.getValue())
+                                                .set(MedicationDispense::getStatusChangedTime, DateUtils.getNowDate())
+                                                .in(MedicationDispense::getMedReqId, medReqIdList));
+        }

-    /**
-     * 取消汇总
-     *
-     * @param summaryNoList 汇总单号
-     * @return 取消结果
-     */
-    @Override
-    public boolean cancelMedicationSummary(List<String> summaryNoList) {
-        int result = baseMapper.update(null,
-                new LambdaUpdateWrapper<MedicationDispense>()
-                        .set(MedicationDispense::getStatusEnum, DispenseStatus.PREPARATION.getValue())
-                        .set(MedicationDispense::getSummaryNo, null).in(MedicationDispense::getSummaryNo, summaryNoList)
-                        .eq(MedicationDispense::getDeleteFlag, DelFlag.NO.getCode()));
-        return result > 0;
-    }
+        /**
+         * 验证是否发过药
+         *
+         * @param medicationDefId 药品定义id
+         * @return 验证结果
+         */
+        @Override
+        public boolean verifyAbleEdit(Long medicationDefId) {
+                return baseMapper.exists(
+                                new LambdaQueryWrapper<MedicationDispense>()
+                                                .eq(MedicationDispense::getMedicationId, medicationDefId)
+                                                .and(q -> q.eq(MedicationDispense::getStatusEnum,
+                                                                DispenseStatus.COMPLETED.getValue()).or()
+                                                                .eq(MedicationDispense::getStatusEnum,
+                                                                                DispenseStatus.REFUNDED.getValue()))
+                                                .eq(MedicationDispense::getDeleteFlag, DelFlag.NO.getCode()));
+        }

-    /**
-     * 更新药品发放状态
-     *
-     * @param dispenseIdList 发放id列表
-     * @param dispenseStatus 发放状态
-     */
-    @Override
-    public void updateDispenseStatus(List<Long> dispenseIdList, Integer dispenseStatus) {
-        baseMapper.update(null,
-                new LambdaUpdateWrapper<MedicationDispense>().set(MedicationDispense::getStatusEnum, dispenseStatus)
-                        .set(MedicationDispense::getStatusChangedTime, DateUtils.getNowDate())
-                        .in(MedicationDispense::getId, dispenseIdList)
-                        .eq(MedicationDispense::getDeleteFlag, DelFlag.NO.getCode()));
-    }
+        /**
+         * 通过请求id获取药品发放信息
+         *
+         * @param requestIdList 请求id
+         * @return 发放信息
+         */
+        @Override
+        public List<MedicationDispense> selectByRequestIdList(List<Long> requestIdList) {
+                return baseMapper
+                                .selectList(new LambdaQueryWrapper<MedicationDispense>()
+                                                .in(MedicationDispense::getMedReqId, requestIdList)
+                                                .eq(MedicationDispense::getDeleteFlag, DelFlag.NO.getCode()));
+        }

-    /**
-     * 通过汇总单号获取药品发放信息
-     *
-     * @param summaryNoList 汇总单号列表
-     * @return 发放信息
-     */
-    @Override
-    public List<MedicationDispense> getMedDispenseBySummaryNo(List<String> summaryNoList) {
-        return baseMapper
-                .selectList(new LambdaQueryWrapper<MedicationDispense>().in(MedicationDispense::getSummaryNo, summaryNoList)
-                        .eq(MedicationDispense::getDeleteFlag, DelFlag.NO.getCode())
-                        .eq(MedicationDispense::getStatusEnum, DispenseStatus.SUMMARIZED.getValue()));
-    }
+        /**
+         * 更新药品状态：已汇总
+         *
+         * @param medDispenseId 发放id列表
+         */
+        @Override
+        public void updateDispenseStatusSummarized(List<Long> medDispenseId, String busNo) {
+                baseMapper.update(null,
+                                new LambdaUpdateWrapper<MedicationDispense>()
+                                                .set(MedicationDispense::getStatusEnum,
+                                                                DispenseStatus.SUMMARIZED.getValue())
+                                                .set(MedicationDispense::getStatusChangedTime, DateUtils.getNowDate())
+                                                .set(MedicationDispense::getSummaryNo, busNo)
+                                                .in(MedicationDispense::getId, medDispenseId)
+                                                .eq(MedicationDispense::getDeleteFlag, DelFlag.NO.getCode()));
+        }
+
+        /**
+         * 通过执行id获取药品发放信息
+         *
+         * @param procedureIdList 执行id列表
+         * @return 发放信息
+         */
+        @Override
+        public List<MedicationDispense> getMedDispenseByProcedureId(List<Long> procedureIdList) {
+                return baseMapper.selectList(
+                                new LambdaQueryWrapper<MedicationDispense>()
+                                                .in(MedicationDispense::getProcedureId, procedureIdList)
+                                                .eq(MedicationDispense::getDeleteFlag, DelFlag.NO.getCode()));
+        }
+
+        /**
+         * 取消汇总
+         *
+         * @param summaryNoList 汇总单号
+         * @return 取消结果
+         */
+        @Override
+        public boolean cancelMedicationSummary(List<String> summaryNoList) {
+                int result = baseMapper.update(null,
+                                new LambdaUpdateWrapper<MedicationDispense>()
+                                                .set(MedicationDispense::getStatusEnum,
+                                                                DispenseStatus.PREPARATION.getValue())
+                                                .set(MedicationDispense::getSummaryNo, null)
+                                                .in(MedicationDispense::getSummaryNo, summaryNoList)
+                                                .eq(MedicationDispense::getDeleteFlag, DelFlag.NO.getCode()));
+                return result > 0;
+        }
+
+        /**
+         * 更新药品发放状态
+         *
+         * @param dispenseIdList 发放id列表
+         * @param dispenseStatus 发放状态
+         */
+        @Override
+        public void updateDispenseStatus(List<Long> dispenseIdList, Integer dispenseStatus) {
+                baseMapper.update(null,
+                                new LambdaUpdateWrapper<MedicationDispense>()
+                                                .set(MedicationDispense::getStatusEnum, dispenseStatus)
+                                                .set(MedicationDispense::getStatusChangedTime, DateUtils.getNowDate())
+                                                .in(MedicationDispense::getId, dispenseIdList)
+                                                .eq(MedicationDispense::getDeleteFlag, DelFlag.NO.getCode()));
+        }
+
+        /**
+         * 通过汇总单号获取药品发放信息
+         *
+         * @param summaryNoList 汇总单号列表
+         * @return 发放信息
+         */
+        @Override
+        public List<MedicationDispense> getMedDispenseBySummaryNo(List<String> summaryNoList) {
+                return baseMapper
+                                .selectList(new LambdaQueryWrapper<MedicationDispense>()
+                                                .in(MedicationDispense::getSummaryNo, summaryNoList)
+                                                .eq(MedicationDispense::getDeleteFlag, DelFlag.NO.getCode())
+                                                .eq(MedicationDispense::getStatusEnum,
+                                                                DispenseStatus.SUMMARIZED.getValue()));
+        }
 }
--- a/openhis-server-new/openhis-domain/src/main/java/com/openhis/workflow/service/impl/DeviceDispenseServiceImpl.java
+++ b/openhis-server-new/openhis-domain/src/main/java/com/openhis/workflow/service/impl/DeviceDispenseServiceImpl.java
@@ -77,6 +77,9 @@ public class DeviceDispenseServiceImpl extends ServiceImpl<DeviceDispenseMapper,
        deviceDispense.setDispenseQuantity(BigDecimal.ZERO);
        // 发药频次
        deviceDispense.setDispenseFrequencyCode(deviceRequest.getRateCode());
+        // 设置租户id
+        LoginUser loginUser = getLoginUser();
+        deviceDispense.setTenantId(loginUser.getTenantId());

        // 获取当前时间
        LocalDateTime now = LocalDateTime.now();
@@ -150,6 +153,9 @@ public class DeviceDispenseServiceImpl extends ServiceImpl<DeviceDispenseMapper,
        deviceDispense.setDispenseQuantity(BigDecimal.ZERO);
        // 发药频次
        deviceDispense.setDispenseFrequencyCode(deviceRequest.getRateCode());
+        // 设置租户id
+        LoginUser loginUser = getLoginUser();
+        deviceDispense.setTenantId(loginUser.getTenantId());

        // 获取当前时间
        LocalDateTime now = LocalDateTime.now();
@@ -230,6 +236,9 @@ public class DeviceDispenseServiceImpl extends ServiceImpl<DeviceDispenseMapper,
        deviceDispense.setDispenseTime(now);
        // id
        deviceDispense.setId(null);
+        // 设置租户id
+        LoginUser currentLoginUser = getLoginUser();
+        deviceDispense.setTenantId(currentLoginUser.getTenantId());
        // 新增器材发放
        baseMapper.insert(deviceDispense);

@@ -397,6 +406,8 @@ public class DeviceDispenseServiceImpl extends ServiceImpl<DeviceDispenseMapper,
        // todo 存疑,是否用请求人作为发药人
        LoginUser loginUser = getLoginUser();
        deviceDispense.setPerformerId(loginUser.getPractitionerId());
+        // 设置租户id
+        deviceDispense.setTenantId(loginUser.getTenantId());
        // 发放器材房
        deviceDispense.setLocationId(locationId);
        // 支持用药信息