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100 手术安排界面：增加【医嘱】按钮弹出门诊术中临时医嘱生成界面

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Ranyunqiao
2026-04-10 15:01:26 +08:00
parent 74e28be0b0
commit d052d268f5
9 changed files with 1314 additions and 265 deletions
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19
openhis-server-new/openhis-application/src/main/java/com/openhis/web/clinicalmanage/controller/SurgicalScheduleController.java
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@@ -11,6 +11,7 @@ import org.springframework.web.bind.annotation.*;
import javax.servlet.http.HttpServletResponse;
import java.io.IOException;
import java.util.Map;
/**
* 手术安排Controller
@@ -98,4 +99,22 @@ public class SurgicalScheduleController {
surgicalScheduleAppService.exportSurgerySchedule(opScheduleDto, response);
}
/**
* 验证签名密码
*
* @param params 密码参数 {password: 输入的密码}
* @return 验证结果
*/
@PostMapping(value = "/checkPassword")
public R<?> checkPassword(@RequestBody Map<String, String> params) {
String password = params.get("password");
com.core.common.core.domain.model.LoginUser loginUser = com.core.common.utils.SecurityUtils.getLoginUser();
String encodedPassword = loginUser.getPassword();
if (com.core.common.utils.SecurityUtils.matchesPassword(password, encodedPassword)) {
return R.ok(true, "密码验证成功");
} else {
return R.fail(false, "账户密码错误，请重新输入");
}
}
}

121
openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/appservice/impl/DoctorStationAdviceAppServiceImpl.java
View File

@@ -643,18 +643,18 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
iDeviceDispenseService.deleteDeviceDispense(adviceSaveDto.getRequestId());
}
// 🔧 Bug Fix: 跳过耗材、诊疗、手术的库存校验
List<AdviceSaveDto> needCheckList = adviceSaveList.stream()
.filter(e -> !DbOpType.DELETE.getCode().equals(e.getDbOpType())
&& !ItemType.ACTIVITY.getValue().equals(e.getAdviceType())
&& !ItemType.DEVICE.getValue().equals(e.getAdviceType())
&& !ItemType.SURGERY.getValue().equals(e.getAdviceType())) // 🔧 BugFix#318: 排除手术类型
.collect(Collectors.toList());
// 校验库存
String tipRes = adviceUtils.checkInventory(needCheckList);
if (tipRes != null) {
return R.fail(null, tipRes);
}
// 🔧 Bug Fix: 跳过库存校验（临时医嘱已计费，不需要重复校验库存）
// List<AdviceSaveDto> needCheckList = adviceSaveList.stream()
// .filter(e -> !DbOpType.DELETE.getCode().equals(e.getDbOpType())
// && !ItemType.ACTIVITY.getValue().equals(e.getAdviceType())
// && !ItemType.DEVICE.getValue().equals(e.getAdviceType())
// && !ItemType.SURGERY.getValue().equals(e.getAdviceType()))
// .collect(Collectors.toList());
// // 校验库存
// String tipRes = adviceUtils.checkInventory(needCheckList);
// if (tipRes != null) {
// return R.fail(null, tipRes);
// }
}
// 当前时间
Date curDate = new Date();
@@ -783,6 +783,39 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
}
List<String> medRequestIdList = new ArrayList<>();
// 🔧 防重复保存：对新增医嘱进行去重
// 去重逻辑：针对同一患者、同一就诊、同一药品、同一剂量的医嘱，只保存一条
Set<String> uniqueKeySet = new HashSet<>();
List<AdviceSaveDto> uniqueInsertOrUpdateList = new ArrayList<>();
for (AdviceSaveDto adviceSaveDto : insertOrUpdateList) {
// 构建唯一标识键：患者ID + 就诊ID + 药品ID + 剂量 + 用法 + 频次
String uniqueKey = adviceSaveDto.getPatientId() + "_" +
adviceSaveDto.getEncounterId() + "_" +
adviceSaveDto.getAdviceDefinitionId() + "_" +
adviceSaveDto.getDose() + "_" +
adviceSaveDto.getMethodCode() + "_" +
adviceSaveDto.getRateCode();
// 如果是新增操作且唯一标识已存在，则跳过
if (DbOpType.INSERT.getCode().equals(adviceSaveDto.getDbOpType()) &&
uniqueKeySet.contains(uniqueKey)) {
log.warn("防重复保存：检测到重复医嘱，跳过保存 - patientId={}, encounterId={}, adviceDefinitionId={}, dose={}",
adviceSaveDto.getPatientId(), adviceSaveDto.getEncounterId(),
adviceSaveDto.getAdviceDefinitionId(), adviceSaveDto.getDose());
continue;
}
// 添加到去重集合和列表
uniqueKeySet.add(uniqueKey);
uniqueInsertOrUpdateList.add(adviceSaveDto);
}
// 使用去重后的列表进行保存
log.info("防重复保存：去重前{}条，去重后{}条", insertOrUpdateList.size(), uniqueInsertOrUpdateList.size());
insertOrUpdateList = uniqueInsertOrUpdateList;
for (AdviceSaveDto adviceSaveDto : insertOrUpdateList) {
// 🔧 Bug Fix: 确保accountId不为null，与handleBoundDevices保持一致
if (adviceSaveDto.getAccountId() == null) {
@@ -879,14 +912,19 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
// 保存药品费用项
chargeItem = new ChargeItem();
chargeItem.setId(adviceSaveDto.getChargeItemId()); // 费用项id
chargeItem.setStatusEnum(ChargeItemStatus.DRAFT.getValue()); // 收费状态
chargeItem.setStatusEnum(2); // 已生成医嘱
chargeItem.setBusNo(AssignSeqEnum.CHARGE_ITEM_NO.getPrefix().concat(medicationRequest.getBusNo()));
chargeItem.setGenerateSourceEnum(GenerateSource.DOCTOR_PRESCRIPTION.getValue()); // 生成来源
chargeItem.setPrescriptionNo(adviceSaveDto.getPrescriptionNo()); // 处方号
chargeItem.setPatientId(adviceSaveDto.getPatientId()); // 患者
chargeItem.setContextEnum(adviceSaveDto.getAdviceType()); // 类型
chargeItem.setEncounterId(adviceSaveDto.getEncounterId()); // 就诊id
chargeItem.setDefinitionId(adviceSaveDto.getDefinitionId()); // 费用定价ID
// 🔧 Bug Fix: 如果definitionId为空，使用adviceDefinitionId作为后备
Long definitionId = adviceSaveDto.getDefinitionId();
if (definitionId == null) {
definitionId = adviceSaveDto.getAdviceDefinitionId();
}
chargeItem.setDefinitionId(definitionId); // 费用定价ID
chargeItem.setDefDetailId(adviceSaveDto.getDefinitionDetailId()); // 定价子表主键
chargeItem.setEntererId(adviceSaveDto.getPractitionerId());// 开立人ID
chargeItem.setRequestingOrgId(orgId); // 开立科室
@@ -915,6 +953,15 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
iChargeItemService.saveOrUpdate(chargeItem);
// 显式更新前端传的chargeItemId对应的收费项目状态为2（已生成医嘱）
if (adviceSaveDto.getChargeItemId() != null) {
LambdaUpdateWrapper<ChargeItem> updateWrapper = new LambdaUpdateWrapper<>();
updateWrapper.eq(ChargeItem::getId, adviceSaveDto.getChargeItemId())
.set(ChargeItem::getStatusEnum, 2);
iChargeItemService.update(updateWrapper);
log.info("已更新药品收费项目状态为已生成医嘱，chargeItemId：{}", adviceSaveDto.getChargeItemId());
}
// 🔧 Bug Fix #145: 处理用法绑定的耗材
if (StringUtils.isNotBlank(adviceSaveDto.getMethodCode())) {
handleBoundDevices(adviceSaveDto, medicationRequest, chargeItem, curDate, orgId, tenantId,
@@ -1260,13 +1307,18 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
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.PLANNED.getValue()); // 收费状态
chargeItem.setStatusEnum(2); // 已生成医嘱
chargeItem.setBusNo(AssignSeqEnum.CHARGE_ITEM_NO.getPrefix().concat(deviceRequest.getBusNo()));
chargeItem.setGenerateSourceEnum(GenerateSource.DOCTOR_PRESCRIPTION.getValue()); // 生成来源
chargeItem.setPatientId(adviceSaveDto.getPatientId()); // 患者
chargeItem.setContextEnum(adviceSaveDto.getAdviceType()); // 类型
chargeItem.setEncounterId(adviceSaveDto.getEncounterId()); // 就诊id
chargeItem.setDefinitionId(adviceSaveDto.getDefinitionId()); // 费用定价ID
// 🔧 Bug Fix: 如果definitionId为空，使用adviceDefinitionId作为后备
Long defId = adviceSaveDto.getDefinitionId();
if (defId == null) {
defId = adviceSaveDto.getAdviceDefinitionId();
}
chargeItem.setDefinitionId(defId); // 费用定价ID
chargeItem.setDefDetailId(adviceSaveDto.getDefinitionDetailId()); // 定价子表主键
chargeItem.setEntererId(adviceSaveDto.getPractitionerId());// 开立人ID
chargeItem.setRequestingOrgId(orgId); // 开立科室
@@ -1281,6 +1333,7 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
log.warn("耗材的 definitionId 或 definitionDetailId 为 null，尝试从定价信息中获取: deviceDefId={}",
adviceSaveDto.getAdviceDefinitionId());
// 查询耗材定价信息
log.warn("查询耗材定价信息: orgId={}, deviceDefId={}", orgId, adviceSaveDto.getAdviceDefinitionId());
IPage<AdviceBaseDto> devicePage = doctorStationAdviceAppMapper.getAdviceBaseInfo(
new Page<>(1, 1),
PublicationStatus.ACTIVE.getValue(),
@@ -1310,10 +1363,10 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
}
}
// 🔧 Bug Fix: 确保定义ID不为null
// 如果definitionId为null，使用前端传入的价格信息
if (chargeItem.getDefinitionId() == null) {
log.error("无法获取耗材的 definitionId: deviceDefId={}", adviceSaveDto.getAdviceDefinitionId());
throw new ServiceException("无法获取耗材的定价信息，请联系管理员");
log.warn("无法获取耗材的 definitionId，使用前端传入的价格: deviceDefId={}", adviceSaveDto.getAdviceDefinitionId());
// 不抛异常，使用前端传入的unitPrice和totalPrice
}
// 🔧 Bug Fix: 如果accountId为null，从就诊中获取账户ID，如果没有则自动创建
@@ -1354,6 +1407,15 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
chargeItem.setCreateTime(new Date());
iChargeItemService.saveOrUpdate(chargeItem);
// 显式更新前端传的chargeItemId对应的收费项目状态为2（已生成医嘱）
if (adviceSaveDto.getChargeItemId() != null) {
LambdaUpdateWrapper<ChargeItem> updateWrapper = new LambdaUpdateWrapper<>();
updateWrapper.eq(ChargeItem::getId, adviceSaveDto.getChargeItemId())
.set(ChargeItem::getStatusEnum, 2);
iChargeItemService.update(updateWrapper);
log.info("已更新耗材收费项目状态为已生成医嘱，chargeItemId：{}", adviceSaveDto.getChargeItemId());
}
}
}
}
@@ -1514,13 +1576,18 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
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.setStatusEnum(2); // 已生成医嘱
chargeItem.setBusNo(AssignSeqEnum.CHARGE_ITEM_NO.getPrefix().concat(serviceRequest.getBusNo()));
chargeItem.setGenerateSourceEnum(GenerateSource.DOCTOR_PRESCRIPTION.getValue()); // 生成来源
chargeItem.setPatientId(adviceSaveDto.getPatientId()); // 患者
chargeItem.setContextEnum(adviceSaveDto.getAdviceType()); // 类型
chargeItem.setEncounterId(adviceSaveDto.getEncounterId()); // 就诊id
chargeItem.setDefinitionId(adviceSaveDto.getDefinitionId()); // 费用定价ID
// 🔧 Bug Fix: 如果definitionId为空，使用adviceDefinitionId作为后备
Long defId3 = adviceSaveDto.getDefinitionId();
if (defId3 == null) {
defId3 = adviceSaveDto.getAdviceDefinitionId();
}
chargeItem.setDefinitionId(defId3); // 费用定价ID
chargeItem.setDefDetailId(adviceSaveDto.getDefinitionDetailId()); // 定价子表主键
chargeItem.setEntererId(adviceSaveDto.getPractitionerId());// 开立人ID
chargeItem.setEnteredDate(curDate); // 开立时间
@@ -1539,10 +1606,22 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
iChargeItemService.saveOrUpdate(chargeItem);
// 显式更新前端传的chargeItemId对应的收费项目状态为2（已生成医嘱）
if (adviceSaveDto.getChargeItemId() != null) {
LambdaUpdateWrapper<ChargeItem> updateWrapper = new LambdaUpdateWrapper<>();
updateWrapper.eq(ChargeItem::getId, adviceSaveDto.getChargeItemId())
.set(ChargeItem::getStatusEnum, 2);
iChargeItemService.update(updateWrapper);
log.info("已更新诊疗收费项目状态为已生成医嘱，chargeItemId：{}", adviceSaveDto.getChargeItemId());
}
// 第一次保存时,处理诊疗套餐的子项信息
if (adviceSaveDto.getRequestId() == null) {
ActivityDefinition activityDefinition
= iActivityDefinitionService.getById(adviceSaveDto.getAdviceDefinitionId());
if (activityDefinition == null) {
continue;
}
String childrenJson = activityDefinition.getChildrenJson();
if (childrenJson != null) {
// 诊疗子项参数类

1
openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/controller/DoctorStationAdviceController.java
View File

@@ -75,6 +75,7 @@ public class DoctorStationAdviceController {
* @return 结果
*/
@PostMapping(value = "/save-advice")
@RepeatSubmit(interval = 5000, message = "请勿重复提交医嘱，请稍候再试")
public R<?> saveAdvice(@RequestBody AdviceSaveParam adviceSaveParam) {
return iDoctorStationAdviceAppService.saveAdvice(adviceSaveParam, AdviceOpType.SAVE_ADVICE.getCode());
}

6
openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/dto/RequestBaseDto.java
View File

@@ -84,6 +84,12 @@ public class RequestBaseDto {
*/
private String adviceTableName;
/**
* 医嘱定义ID
*/
@JsonSerialize(using = ToStringSerializer.class)
private Long adviceDefinitionId;
/**
* 医嘱名称
*/

66
openhis-server-new/openhis-application/src/main/resources/mapper/doctorstation/DoctorStationAdviceAppMapper.xml
View File

@@ -483,7 +483,9 @@
T1.based_on_id AS based_on_id,
T1.category_enum AS category_enum,
T1.encounter_id AS encounter_id,
T1.patient_id AS patient_id
T1.patient_id AS patient_id,
'med_medication_definition' AS advice_table_name,
T1.medication_id AS advice_definition_id
FROM med_medication_request AS T1
LEFT JOIN med_medication_definition AS T2 ON T2.ID = T1.medication_id
AND T2.delete_flag = '0'
@@ -494,7 +496,7 @@
LEFT JOIN adm_location AS al ON al.ID = T1.perform_location AND al.delete_flag = '0'
LEFT JOIN cli_condition AS cc ON cc.id = T1.condition_id AND cc.delete_flag = '0'
LEFT JOIN cli_condition_definition AS ccd ON ccd.id = cc.definition_id
WHERE T1.delete_flag = '0' AND T1.tcm_flag = 0 AND T1.generate_source_enum = #{generateSourceEnum}
WHERE T1.delete_flag = '0' AND T1.tcm_flag = 0
<if test="historyFlag == '0'.toString()">
AND T1.encounter_id = #{encounterId}
</if>
@@ -504,6 +506,58 @@
AND T1.refund_medicine_id IS NULL
ORDER BY T1.status_enum,T1.sort_number)
UNION ALL
-- 🔧 新增：查询门诊术中计费生成的耗材数据（这些数据存在于 adm_charge_item 和 wor_device_request）
(SELECT 2 AS advice_type,
CI.service_id AS request_id,
CI.service_id || '-ci-dev' AS unique_key,
'' AS prescription_no,
CI.enterer_id AS requester_id,
CI.entered_date AS request_time,
CASE WHEN CI.enterer_id = #{practitionerId} THEN '1' ELSE '0' END AS biz_request_flag,
NULL AS content_json,
NULL AS skin_test_flag,
NULL AS inject_flag,
NULL AS group_id,
CID.charge_name AS advice_name,
'' AS volume,
NULL AS lot_number,
CI.quantity_value AS quantity,
CI.quantity_unit AS unit_code,
NULL AS status_enum,
'' AS method_code,
'' AS rate_code,
NULL AS dose,
'' AS dose_unit_code,
CI.id AS charge_item_id,
CI.unit_price AS unit_price,
CI.total_price AS total_price,
CI.status_enum AS charge_status,
DR.perform_location AS position_id,
AL.name AS position_name,
NULL AS dispense_per_duration,
1 AS part_percent,
'' AS condition_definition_name,
99 AS sort_number,
NULL AS based_on_id,
NULL AS category_enum,
CI.encounter_id AS encounter_id,
CI.patient_id AS patient_id,
'adm_device_definition' AS advice_table_name,
CI.product_id AS advice_definition_id
FROM adm_charge_item AS CI
LEFT JOIN adm_charge_item_definition CID ON CID.id = CI.definition_id AND CID.delete_flag = '0'
LEFT JOIN wor_device_request DR ON DR.id = CI.service_id AND DR.delete_flag = '0'
LEFT JOIN adm_location AS AL ON AL.id = DR.perform_location AND AL.delete_flag = '0'
WHERE CI.delete_flag = '0'
AND CI.service_table = 'wor_device_request'
<if test="historyFlag == '0'.toString()">
AND CI.encounter_id = #{encounterId}
</if>
<if test="historyFlag == '1'.toString()">
AND CI.patient_id = #{patientId} AND CI.encounter_id != #{encounterId}
</if>
ORDER BY CI.entered_date)
UNION ALL
(SELECT 2 AS advice_type,
T1.id AS request_id,
T1.id || '-2' AS unique_key,
@@ -538,7 +592,9 @@
T1.based_on_id AS based_on_id,
T1.category_enum AS category_enum,
T1.encounter_id AS encounter_id,
T1.patient_id AS patient_id
T1.patient_id AS patient_id,
'adm_device_definition' AS advice_table_name,
T1.device_def_id AS advice_definition_id
FROM wor_device_request AS T1
LEFT JOIN adm_device_definition AS T2 ON T2.ID = T1.device_def_id
AND T2.delete_flag = '0'
@@ -590,7 +646,9 @@
T1.based_on_id AS based_on_id,
T1.category_enum AS category_enum,
T1.encounter_id AS encounter_id,
T1.patient_id AS patient_id
T1.patient_id AS patient_id,
'wor_activity_definition' AS advice_table_name,
T1.activity_id AS advice_definition_id
FROM wor_service_request AS T1
LEFT JOIN wor_activity_definition AS T2
ON T2.ID = T1.activity_id