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

openhis-server-new/openhis-application/src/main/java/com/openhis/web/clinicalmanage/controller/SurgicalScheduleController.java

@@ -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");
+        }
+    }
+
 }

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

@@ -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

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

@@ -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());
     }

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

@@ -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
      */