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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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This commit is contained in:
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
View File

@@ -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

4
openhis-ui-vue3/src/api/surgicalschedule.js
View File

@@ -62,10 +62,10 @@ export function exportSurgerySchedule(query) {
}
//签名密码验证
export function checkPassword(params) {
export function checkPassword(data) {
return request({
url: '/clinical-manage/surgery-schedule/checkPassword',
method: 'POST',
params: params
data: data
})
}

8
openhis-ui-vue3/src/views/clinicmanagement/bargain/component/api.js
View File

@@ -24,11 +24,14 @@ export function getAdviceBaseInfo(queryParams) {
}
/**
* 保存处方(单条)
* @param {Object} data - 处方数据
* @param {String} adviceOpType - 医嘱操作类型：'0'=保存草稿，'1'=签发医嘱
*/
export function savePrescription(data) {
export function savePrescription(data, adviceOpType = '0') {
return request({
url: '/doctor-station/advice/save-advice',
method: 'post',
params: { adviceOpType },
data: data
})
}
@@ -56,8 +59,9 @@ export function singOut(data) {
* 获取患者本次就诊处方
*/
export function getPrescriptionList(encounterId) {
// Add timestamp to bypass browser caching and ensure fresh data is loaded
return request({
url: '/doctor-station/advice/request-base-info?encounterId=' + encounterId,
url: '/doctor-station/advice/request-base-info?encounterId=' + encounterId + '&t=' + Date.now(),
method: 'get',
})
}

467
openhis-ui-vue3/src/views/surgicalschedule/index.vue
View File

@@ -143,7 +143,7 @@
<!-- 弹窗头部操作按钮 -->
<div class="dialog-header-buttons" v-if="!isViewMode && !isEditMode">
<el-button @click="handleFindApply">查找</el-button>
<el-button @click="handleRefresh">刷新</el-button>
<el-button class="refresh-btn" @click="handleRefresh">刷新</el-button>
<el-button @click="cancel">返回</el-button>
<el-button type="primary" :disabled="isViewMode" @click="submitForm">保存</el-button>
</div>
@@ -837,21 +837,28 @@
</el-dialog>
<!-- 临时医嘱弹窗 -->
<el-dialog :title="temporaryMedicalTitle" v-model="showTemporaryMedical" width="80%" append-to-body :close-on-click-modal="false">
<el-dialog title="" v-model="showTemporaryMedical" width="80%" append-to-body :close-on-click-modal="false">
<!-- 🔧 新增：加载状态提示 -->
<div v-if="temporaryMedicalLoading" class="loading-container">
<el-icon class="is-loading"><loading /></el-icon>
<span>正在加载医嘱数据，请稍候...</span>
</div>
<temporary-medical
v-else
:patient-info="temporaryPatientInfo"
:billing-medicines="temporaryBillingMedicines"
v-model:temporary-advices="temporaryAdvices"
@submit="handleTemporaryMedicalSubmit"
@cancel="handleTemporaryMedicalCancel"
@delete-advice="handleDeleteTemporaryAdvice"
@refresh="handleTemporaryMedicalRefresh"
@quote-billing="handleQuoteBilling"
/>
</el-dialog>
</div>
</template>
<script setup name="SurgicalSchedule">
import { ref, reactive, onMounted, nextTick, computed } from 'vue'
import { ref, reactive, onMounted, nextTick, computed, watch } from 'vue'
import { getCurrentInstance } from 'vue'
import { parseTime } from '@/utils/openhis'
import { useDict } from '@/utils/dict'
@@ -859,6 +866,7 @@ import download from '@/plugins/download'
import Prescriptionlist from '@/views/clinicmanagement/bargain/component/prescriptionlist.vue'
import useUserStore from '@/store/modules/user'
import { ElMessage } from 'element-plus'
import { Loading } from '@element-plus/icons-vue' // 🔧 新增：导入 Loading 图标
// 导入计费相关接口
import { getPrescriptionList } from '@/views/clinicmanagement/bargain/component/api'
@@ -1013,6 +1021,17 @@ const temporaryPatientInfo = ref({})
const temporaryBillingMedicines = ref([])
const temporaryAdvices = ref([])
// 🔧 新增：监听 temporaryAdvices 的变化，用于调试
watch(temporaryAdvices, (newVal, oldVal) => {
console.log('=== temporaryAdvices 变化 ===')
console.log('=== 新值 ===', newVal)
console.log('=== 新值[1]?.dosage ===', newVal[1]?.dosage)
console.log('=== 旧值 ===', oldVal)
console.log('=== 旧值[1]?.dosage ===', oldVal[1]?.dosage)
}, { deep: true })
const temporaryMedicalLoading = ref(false) // 🔧 新增：临时医嘱加载状态
// 下拉列表数据
const orgList = ref([])
const deptList = ref([])
@@ -1067,8 +1086,9 @@ const {
isolation_type: isolationTypeList,
surgery_type,
surgery_level,
surgery_nature: surgeryNatureList
} = useDict('surgical_site', 'anesthesia_type', 'incision_level', 'isolation_type', 'surgery_type', 'surgery_level', 'surgery_nature')
surgery_nature: surgeryNatureList,
method_code
} = useDict('surgical_site', 'anesthesia_type', 'incision_level', 'isolation_type', 'surgery_type', 'surgery_level', 'surgery_nature', 'method_code')
// 加载数据
onMounted(() => {
@@ -1370,6 +1390,9 @@ function closeChargeDialog() {
chargeSurgeryInfo.value = {}
}
// 🔧 新增：标志位，用于区分是"打开"还是"刷新"
const isRefreshAction = ref(false)
// 处理医嘱按钮点击事件
function handleMedicalAdvice(row) {
// 如果没有传入行数据，使用选中的行
@@ -1391,55 +1414,119 @@ function handleMedicalAdvice(row) {
roomCode: row.roomCode,
doctorName: userStore.nickName,
role: userStore.roles[0],
effectiveOrgId : row.effectiveOrgId,
orgId: userStore.orgId,
positionId: userStore.orgId
}
// 初始化临时医嘱列表
// 🔧 关键修复：如果已有提交的医嘱数据，并且是同一个患者的就诊，则使用保存的数据
// 这样可以保留 requestId，避免重复创建医嘱记录
console.log('=== 检查是否使用已保存的医嘱数据 ===')
console.log('=== temporaryAdvices.value.length ===', temporaryAdvices.value.length)
console.log('=== temporaryAdvices.value[0]?.originalMedicine?.encounterId ===', temporaryAdvices.value[0]?.originalMedicine?.encounterId)
console.log('=== row.visitId ===', row.visitId)
console.log('=== isRefreshAction.value ===', isRefreshAction.value)
const isSameEncounter = temporaryAdvices.value.length > 0 &&
temporaryAdvices.value[0]?.originalMedicine?.encounterId === row.visitId &&
!isRefreshAction.value
console.log('=== isSameEncounter ===', isSameEncounter)
if (isSameEncounter) {
console.log('=== 使用已保存的医嘱数据，避免重复创建 ===')
console.log('=== temporaryAdvices.value[0]?.originalMedicine?.requestId ===', temporaryAdvices.value[0]?.originalMedicine?.requestId)
// 直接打开弹窗，使用已保存的数据
showTemporaryMedical.value = true
temporaryMedicalLoading.value = false
isRefreshAction.value = false // 重置标志位
return
}
// 🔧 修复：每次打开临时医嘱时都重新加载数据，避免使用缓存数据导致数据重复
// 先清空旧数据
temporaryBillingMedicines.value = []
temporaryAdvices.value = []
temporaryMedicalLoading.value = true // 🔧 新增：开始加载
// 调用计费接口获取数据
getPrescriptionList(row.visitId).then((res) => {
console.log('=== 拉取计费数据返回结果 ===', res)
if (res.code === 200 && res.data) {
// 过滤数据，只保留 adviceType 值为 1 的药品
// 🔧 修复：显示所有药品请求数据，不管有没有计费项目
// 根据用户需求：已引用计费药品（待生成医嘱）和临时医嘱预览（已生成）显示的数据应该相同
// 在提交医嘱之前状态应该是"待签发"，提交之后变为"已签发"
// 再次打开医嘱界面的时候能看到这两个状态的药品
const seenIds = new Set();
const filteredItems = res.data.filter(item => {
try {
// 尝试从 contentJson 中解析数据
const contentData = JSON.parse(item.contentJson)
const adviceType = Number(contentData.adviceType)
return adviceType === 1
} catch (e) {
// 如果解析失败，尝试使用顶层的 adviceType
const adviceType = Number(item.adviceType)
return adviceType === 1
}
// 匹配 encounterId
if (item.encounterId !== row.visitId) return false;
// 过滤掉名称为空的项目
const medicineName = item.adviceName || item.advice_name;
if (!medicineName || medicineName.trim() === '') return false;
// 根据药品请求ID去重，避免重复显示
const itemId = item.requestId || item.id;
if (itemId && seenIds.has(itemId)) return false;
if (itemId) seenIds.add(itemId);
return true;
})
// 将过滤后的数据转换为临时医嘱需要的格式
// 🔧 修复：限制返回数量，最多显示前100条，避免数据过多导致页面卡死
const maxItems = 100
if (filteredItems.length > maxItems) {
ElMessage.warning(`待签发医嘱数量过多(${filteredItems.length}条)，仅显示前${maxItems}条`)
filteredItems.length = maxItems
}
// 将过滤后的数据转换为临时医嘱需要的格式 - 兼容驼峰和下划线命名
// 对于从 adm_charge_item（计费项目表）查询来的项目，特殊处理
temporaryBillingMedicines.value = filteredItems.map(item => {
try {
// 从 contentJson 中解析详细数据
const contentData = JSON.parse(item.contentJson)
// 从 contentJson 或 content_json 中解析详细数据 - 兼容下划线和驼峰命名
const jsonContent = item.contentJson || item.content_json;
const contentData = jsonContent ? JSON.parse(jsonContent) : {};
return {
medicineName: contentData.adviceName || item.adviceName || '',
specification: contentData.volume || contentData.specification || '',
medicineName: contentData.adviceName || contentData.advice_name || item.adviceName || item.advice_name || '',
specification: contentData.volume || contentData.specification || item.volume || item.specification || '',
quantity: contentData.quantity || item.quantity || 0,
batchNumber: contentData.lotNumber || item.lotNumber || '',
unitPrice: contentData.unitPrice || item.unitPrice || 0,
subtotal: contentData.totalPrice || item.totalPrice || 0,
insuranceType: contentData.insuranceType === 1 ? '医保' : '自费'
}
batchNumber: contentData.lotNumber || contentData.lot_number || item.lotNumber || item.lot_number || '',
unitPrice: contentData.unitPrice || contentData.unit_price || item.unitPrice || item.unit_price || 0,
subtotal: contentData.totalPrice || contentData.total_price || item.totalPrice || item.total_price ||
(contentData.unitPrice || contentData.unit_price || item.unitPrice || item.unit_price || 0) *
(contentData.quantity || item.quantity || 0),
insuranceType: (contentData.insuranceType || contentData.insurance_type) === 1 ? '医保' : (item.insuranceType === 1 || item.insurance_type === 1) ? '医保' : '自费',
// 添加医嘱定义ID和表名，用于库存匹配
adviceDefinitionId: item.adviceDefinitionId || contentData.adviceDefinitionId || item.advice_definition_id || null,
adviceTableName: item.adviceTableName || contentData.adviceTableName || item.advice_table_name || null,
// 添加关键字段：医嘱类型、费用项目ID、定价ID，用于后端正确分类和保存
adviceType: item.adviceType || contentData.adviceType || item.advice_type || null,
chargeItemId: item.chargeItemId || contentData.chargeItemId || item.charge_item_id || null,
definitionId: item.definitionId || contentData.definitionId || item.definition_id || null,
definitionDetailId: item.definitionDetailId || contentData.definitionDetailId || item.definition_detail_id || null
};
} catch (e) {
// 如果解析失败，使用顶层数据
// 如果解析失败，使用顶层数据 - 兼容 snake_case 和 camelCase 以及后端不同字段名
return {
medicineName: item.adviceName || '',
specification: item.specification || '',
quantity: item.quantity || 0,
batchNumber: item.lotNumber || '',
unitPrice: item.unitPrice || 0,
subtotal: item.totalPrice || 0,
insuranceType: item.insuranceType === 1 ? '医保' : '自费'
medicineName: item.adviceName || item.advice_name || item.chargeName || '',
specification: item.specification || item.specification || item.volume || '',
quantity: item.quantity || item.quantity_value || item.quantityValue || 0,
batchNumber: item.lotNumber || item.lot_number || '',
unitPrice: item.unitPrice || item.unit_price || 0,
subtotal: item.totalPrice || item.total_price ||
(item.unitPrice || item.unit_price || 0) *
(item.quantity || item.quantity_value || item.quantityValue || 0),
insuranceType: (item.insuranceType || item.insurance_type) === 1 ? '医保' : '自费',
// 添加医嘱定义ID和表名，用于库存匹配
adviceDefinitionId: item.adviceDefinitionId || item.advice_definition_id || null,
adviceTableName: item.adviceTableName || item.advice_table_name || null,
// 添加关键字段：医嘱类型、费用项目ID、定价ID，用于后端正确分类和保存
adviceType: item.adviceType || item.advice_type || null,
chargeItemId: item.chargeItemId || item.charge_item_id || null,
definitionId: item.definitionId || item.definition_id || null,
definitionDetailId: item.definitionDetailId || item.definition_detail_id || null
};
}
}
})
});
} else {
// 如果没有数据或接口调用失败，初始化空列表
temporaryBillingMedicines.value = []
@@ -1455,14 +1542,36 @@ function handleMedicalAdvice(row) {
// 计算剂量 = 规格数值 × 数量
const dosage = specValue * (medicine.quantity || 1)
// 根据药品名称判断用法
let usage = '静脉注射'
// 🔧 修复：优先从 contentJson 中读取已有的用法，如果没有则根据药品名称判断
let usageCode = 'iv' // 默认静脉注射编码
let usageLabel = '静脉注射' // 默认显示名称
// 尝试从 contentJson 中读取用法
try {
const jsonContent = medicine.contentJson || medicine.content_json;
if (jsonContent) {
const contentData = JSON.parse(jsonContent);
if (contentData.methodCode) {
usageCode = contentData.methodCode;
usageLabel = getUsageLabel(contentData.methodCode);
}
}
} catch (e) {
// 解析失败，继续使用默认值
}
// 如果没有从 contentJson 中读取到用法，根据药品名称判断
if (!usageCode || usageCode === 'iv') {
if (medicine.medicineName && medicine.medicineName.includes('注射液')) {
usage = '静脉注射'
usageCode = 'iv'
usageLabel = '静脉注射'
} else if (medicine.medicineName && medicine.medicineName.includes('片')) {
usage = '口服'
usageCode = 'po'
usageLabel = '口服'
} else if (medicine.medicineName && medicine.medicineName.includes('胶囊')) {
usage = '口服'
usageCode = 'po'
usageLabel = '口服'
}
}
return {
@@ -1470,46 +1579,274 @@ function handleMedicalAdvice(row) {
adviceName: medicine.medicineName || '',
dosage: dosage,
unit: specUnit,
usage: usage,
usage: usageCode, // 🔧 修复：保存的是编码
usageLabel: usageLabel, // 🔧 新增：保存显示名称
frequency: '临时',
executeTime: new Date().toLocaleString('zh-CN'),
originalMedicine: medicine
// 🔧 关键修复：确保 originalMedicine 中包含 encounterId，以便后续判断是否为同一患者
originalMedicine: {
...medicine,
encounterId: row.visitId // 添加 encounterId 字段
}
}
})
// 打开临时医嘱弹窗
showTemporaryMedical.value = true
}).catch(() => {
temporaryMedicalLoading.value = false // 🔧 新增：加载完成
}).catch((error) => {
temporaryBillingMedicines.value = []
temporaryAdvices.value = []
temporaryMedicalLoading.value = false // 🔧 新增：加载完成（即使失败也要关闭加载状态）
proxy.$modal.msgError('刷新数据失败，请重试')
console.error('Failed to refresh prescription list', error)
showTemporaryMedical.value = true
})
}
// 关闭临时医嘱弹窗
// 🔧 修复：清空数据，避免下次打开时使用缓存数据导致数据重复
function closeTemporaryMedical() {
showTemporaryMedical.value = false
temporaryPatientInfo.value = {}
temporaryBillingMedicines.value = []
temporaryAdvices.value = []
// 🔧 修复：关闭弹窗时不清空数据，保留用户可能已经修改过的数据
// 只有当用户点击"取消"按钮时才应该清空数据
}
// 处理临时医嘱提交
// 🔧 修复：提交成功后，更新 temporaryAdvices 中的 requestId，以便下次提交时执行更新操作
function handleTemporaryMedicalSubmit(data) {
// 这里可以调用后端API保存临时医嘱数据
proxy.$modal.msgSuccess('临时医嘱提交成功')
closeTemporaryMedical()
console.log('=== handleTemporaryMedicalSubmit 被调用 ===')
console.log('=== data ===', data)
console.log('=== data.temporaryAdvices ===', data.temporaryAdvices)
console.log('=== data.temporaryAdvices[1]?.dosage ===', data.temporaryAdvices[1]?.dosage)
// 🔧 修复：使用用户修改后的数据，而不是重新加载数据
// 这样可以确保用户修改的内容（如剂量）在保存后仍然正确显示
if (data.temporaryAdvices && data.temporaryAdvices.length > 0) {
// 🔧 关键修复：更新 temporaryAdvices 中的数据，保留用户的修改
// 但是需要从后端返回的数据中获取 requestId，以便下次提交时执行更新操作
// 如果后端返回了医嘱ID（requestId），我们需要更新到 temporaryAdvices 中
temporaryAdvices.value = data.temporaryAdvices.map((advice, index) => {
const originalMedicine = advice.originalMedicine || {}
// 🔧 关键修复：从后端返回的数据中获取 requestId（如果有）
// 后端返回的医嘱ID可能需要通过某个字段获取，这里暂时假设后端会返回
// 如果后端返回的 response 中包含医嘱ID，需要更新到 originalMedicine 中
// 这里暂时保留原逻辑，等待用户提供后端返回的具体数据结构
return {
...advice,
// 确保 originalMedicine 包含所有必要字段
originalMedicine: {
...originalMedicine,
// 保留用户的修改
contentJson: originalMedicine.contentJson || JSON.stringify({
dose: advice.dosage,
methodCode: advice.usage,
rateCode: advice.frequency,
quantity: advice.quantity,
totalPrice: advice.totalPrice
})
}
}
})
// 同步更新计费药品列表，保持数据一致性
temporaryBillingMedicines.value = data.billingMedicines || []
console.log('=== 使用用户修改后的临时医嘱数据 ===', temporaryAdvices.value)
console.log('=== temporaryAdvices.value[1]?.dosage ===', temporaryAdvices.value[1]?.dosage)
} else {
// 如果没有传递数据，则清空
temporaryAdvices.value = []
temporaryBillingMedicines.value = []
}
// 关闭弹窗
showTemporaryMedical.value = false
}
// 处理临时医嘱取消
function handleTemporaryMedicalCancel() {
// 🔧 修复：用户点击取消时才清空数据，因为用户可能要放弃修改
temporaryPatientInfo.value = {}
temporaryBillingMedicines.value = []
temporaryAdvices.value = []
closeTemporaryMedical()
}
// 处理删除临时医嘱
// 处理删除临时医嘱 - 将删除的医嘱放回已引用计费药品列表
function handleDeleteTemporaryAdvice(index) {
const deletedAdvice = temporaryAdvices.value[index]
// 如果有原始药品数据，放回到计费药品列表
if (deletedAdvice.originalMedicine) {
temporaryBillingMedicines.value.push(deletedAdvice.originalMedicine)
}
temporaryAdvices.value.splice(index, 1)
proxy.$modal.msgSuccess('临时医嘱已删除')
proxy.$modal.msgSuccess('临时医嘱已删除，已放回待生成列表')
}
// 处理刷新按钮点击
function handleTemporaryMedicalRefresh() {
// 重新拉取计费药品数据
if (temporaryPatientInfo.value.visitId) {
handleMedicalAdvice(temporaryPatientInfo.value)
} else {
proxy.$modal.msgWarning('患者信息不完整，请关闭弹窗重新打开')
}
}
// 处理引用计费按钮点击
function handleQuoteBilling() {
// 重新拉取计费药品数据
if (temporaryPatientInfo.value.visitId) {
temporaryMedicalLoading.value = true // 🔧 新增：开始加载
getPrescriptionList(temporaryPatientInfo.value.visitId).then((res) => {
if (res.code === 200 && res.data) {
// 🔧 修复：先清空旧数据，避免数据累积
temporaryBillingMedicines.value = []
temporaryAdvices.value = []
// 🔧 修复：显示所有药品请求数据，不管有没有计费项目
const filteredItems = res.data.filter(item => {
// 匹配 encounterId
if (item.encounterId !== temporaryPatientInfo.value.visitId) return false;
// 过滤掉名称为空的项目
const medicineName = item.adviceName || item.advice_name;
return medicineName && medicineName.trim() !== '';
})
// 🔧 修复：限制返回数量，最多显示前100条，避免数据过多导致页面卡死
const maxItems = 100
if (filteredItems.length > maxItems) {
ElMessage.warning(`待签发医嘱数量过多(${filteredItems.length}条)，仅显示前${maxItems}条`)
filteredItems.length = maxItems
}
// 将过滤后的数据转换为临时医嘱需要的格式
temporaryBillingMedicines.value = filteredItems.map(item => {
try {
// 从 contentJson 或 content_json 中解析详细数据 - 兼容下划线和驼峰命名
const jsonContent = item.contentJson || item.content_json;
const contentData = jsonContent ? JSON.parse(jsonContent) : {};
return {
medicineName: contentData.adviceName || contentData.advice_name || item.adviceName || item.advice_name || item.chargeName || '',
specification: contentData.volume || contentData.specification || item.volume || item.specification || '',
quantity: contentData.quantity || item.quantity || item.quantity_value || item.quantityValue || 0,
batchNumber: contentData.lotNumber || contentData.lot_number || item.lotNumber || item.lot_number || '',
unitPrice: contentData.unitPrice || contentData.unit_price || item.unitPrice || item.unit_price || 0,
subtotal: contentData.totalPrice || contentData.total_price || item.totalPrice || item.total_price ||
(contentData.unitPrice || contentData.unit_price || item.unitPrice || item.unit_price || 0) *
(contentData.quantity || item.quantity || item.quantity_value || item.quantityValue || 0),
insuranceType: (contentData.insuranceType || contentData.insurance_type) === 1 ? '医保' : (item.insuranceType === 1 || item.insurance_type === 1) ? '医保' : '自费',
orgId: contentData.orgId || item.orgId || contentData.positionId || item.positionId || userStore.orgId,
positionId: contentData.positionId || item.positionId || userStore.orgId,
definitionId: contentData.definitionId || item.definitionId,
definitionDetailId: contentData.definitionDetailId || item.definitionDetailId
}
} catch (e) {
// 如果解析失败，使用顶层数据 - 兼容 snake_case 和 camelCase
return {
medicineName: item.adviceName || item.advice_name || '',
specification: item.specification || item.specification || item.volume || '',
quantity: item.quantity || item.quantity_value || 0,
batchNumber: item.lotNumber || item.lot_number || '',
unitPrice: item.unitPrice || item.unit_price || 0,
subtotal: item.totalPrice || item.total_price ||
(item.unitPrice || item.unit_price || 0) *
(item.quantity || item.quantity_value || 0),
insuranceType: (item.insuranceType || item.insurance_type) === 1 ? '医保' : '自费',
orgId: item.orgId || item.positionId || userStore.orgId,
positionId: item.positionId || userStore.orgId,
definitionId: item.definitionId,
definitionDetailId: item.definitionDetailId
}
}
})
// 将计费药品转换为临时医嘱数据
temporaryAdvices.value = temporaryBillingMedicines.value.map((medicine, index) => {
// 解析规格中的数值和单位
const specMatch = medicine.specification ? medicine.specification.match(/(\d+)(\D+)/) : null
const specValue = specMatch ? parseInt(specMatch[1]) : 1
const specUnit = specMatch ? specMatch[2] : 'ml'
// 计算剂量 = 规格数值 × 数量
const dosage = specValue * (medicine.quantity || 1)
// 🔧 修复：优先从 contentJson 中读取已有的用法，如果没有则根据药品名称判断
let usageCode = 'iv' // 默认静脉注射编码
let usageLabel = '静脉注射' // 默认显示名称
// 尝试从 contentJson 中读取用法
try {
const jsonContent = medicine.contentJson || medicine.content_json;
if (jsonContent) {
const contentData = JSON.parse(jsonContent);
if (contentData.methodCode) {
usageCode = contentData.methodCode;
usageLabel = getUsageLabel(contentData.methodCode);
}
}
} catch (e) {
// 解析失败，继续使用默认值
}
// 如果没有从 contentJson 中读取到用法，根据药品名称判断
if (!usageCode || usageCode === 'iv') {
if (medicine.medicineName && medicine.medicineName.includes('注射液')) {
usageCode = 'iv'
usageLabel = '静脉注射'
} else if (medicine.medicineName && medicine.medicineName.includes('片')) {
usageCode = 'po'
usageLabel = '口服'
} else if (medicine.medicineName && medicine.medicineName.includes('胶囊')) {
usageCode = 'po'
usageLabel = '口服'
}
}
return {
id: index + 1,
adviceName: medicine.medicineName || '',
dosage: dosage,
unit: specUnit,
usage: usageCode, // 🔧 修复：保存的是编码
usageLabel: usageLabel, // 🔧 新增：保存显示名称
frequency: '临时',
executeTime: new Date().toLocaleString('zh-CN'),
// 🔧 关键修复：确保 originalMedicine 中包含 encounterId，以便后续判断是否为同一患者
originalMedicine: {
...medicine,
encounterId: temporaryPatientInfo.value.visitId // 添加 encounterId 字段
}
}
})
temporaryMedicalLoading.value = false // 🔧 新增：加载完成
ElMessage.success('已成功引用最新计费药品信息！')
} else {
// 如果没有数据或接口调用失败，初始化空列表
temporaryBillingMedicines.value = []
temporaryAdvices.value = []
temporaryMedicalLoading.value = false // 🔧 新增：加载完成（即使失败也要关闭加载状态）
ElMessage.error('获取计费数据失败，请重试')
}
}).catch(() => {
temporaryBillingMedicines.value = []
temporaryAdvices.value = []
temporaryMedicalLoading.value = false // 🔧 新增：加载完成（即使失败也要关闭加载状态）
ElMessage.error('获取计费数据失败，请重试')
})
} else {
proxy.$modal.msgWarning('患者信息不完整，请关闭弹窗重新打开')
}
}
// 🔧 新增：根据用法编码获取对应的显示名称
function getUsageLabel(usageCode) {
if (!usageCode) return '-'
const dictItem = method_code.value?.find(item => item.value === usageCode)
return dictItem ? dictItem.label : usageCode
}
// 格式化计费弹窗中的日期
@@ -1591,7 +1928,7 @@ function resetForm() {
function submitForm() {
proxy.$refs['surgeryRef'].validate((valid) => {
if (valid) {
const submitData = { ...form }
const submitData = { ...form, orgId: userStore.orgId }
if (!form.scheduleId) {
// 新增手术安排
addSurgerySchedule(submitData).then((res) => {
@@ -1827,6 +2164,25 @@ function getRowClassName({ row, rowIndex }) {
</script>
<style scoped>
/* 🔧 新增：临时医嘱加载状态样式 */
.loading-container {
display: flex;
flex-direction: column;
align-items: center;
justify-content: center;
padding: 100px 0;
color: #409eff;
font-size: 16px;
}
.loading-container .el-icon {
font-size: 32px;
margin-bottom: 16px;
}
.loading-container span {
font-weight: 500;
}
.app-container {
padding: 20px;
}
@@ -1875,4 +2231,5 @@ function getRowClassName({ row, rowIndex }) {
:deep(.el-table .selected-row > td) {
border-bottom: 1px solid #d9ecff !important;
}
</style>

801
openhis-ui-vue3/src/views/surgicalschedule/temporaryMedical.vue
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