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Fix Bug #489: 【医嘱闭环】医生站签发单条长期药品医嘱，护士校对界面生成重复（两条）待校对记录

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根因分析：
1. SQL查询JOIN倍增：selectInpatientAdvicePage 中多个LEFT JOIN（如adm_encounter_location、
   adm_encounter_participant、med_medication）可能产生重复行，外层查询无DISTINCT去重
2. 防重复逻辑缺陷：handMedication() 中仅对 DbOpType.INSERT 进行去重，若同一请求中包含
   INSERT 和 UPDATE（编辑后签发的医嘱），两者uniqueKey相同但UPDATE不受去重限制，
   导致 UPDATE 修改旧记录 + INSERT 创建新记录 = 两条数据

修复方案：
1. 在AdviceProcessAppMapper.xml的UNION两侧子查询中添加SELECT DISTINCT，防止JOIN倍增
2. 在AdviceManageAppServiceImpl.java中移除dbOpType限制，对所有医嘱（INSERT+UPDATE）
   统一按uniqueKey去重，确保同一业务医嘱只处理一次

Co-Authored-By: Claude Opus 4.7 <noreply@anthropic.com>
This commit is contained in:
赵云
2026-05-13 19:19:03 +08:00
parent 5bf1e4151c
commit dc9f47c534
2 changed files with 10 additions and 10 deletions
Download Patch File Download Diff File Expand all files Collapse all files

16
openhis-server-new/openhis-application/src/main/java/com/openhis/web/regdoctorstation/appservice/impl/AdviceManageAppServiceImpl.java
View File

@@ -341,7 +341,7 @@ public class AdviceManageAppServiceImpl implements IAdviceManageAppService {
&& (DbOpType.INSERT.getCode().equals(e.getDbOpType()) || DbOpType.UPDATE.getCode().equals(e.getDbOpType())))
.collect(Collectors.toList());
// 防重复保存：对新增医嘱进行去重，避免签发单条长期医嘱时产生重复记录
// 防重复保存：对所有医嘱进行去重（包括 INSERT 和 UPDATE 混合场景），避免签发单条医嘱时产生重复记录
Set<String> longUniqueKeySet = new HashSet<>();
List<RegAdviceSaveDto> longUniqueList = new ArrayList<>();
for (RegAdviceSaveDto adviceSaveDto : longInsertOrUpdateList) {
@@ -351,10 +351,10 @@ public class AdviceManageAppServiceImpl implements IAdviceManageAppService {
+ adviceSaveDto.getDose() + "_"
+ adviceSaveDto.getMethodCode() + "_"
+ adviceSaveDto.getRateCode();
if (DbOpType.INSERT.getCode().equals(adviceSaveDto.getDbOpType()) && longUniqueKeySet.contains(uniqueKey)) {
log.warn("防重复保存：检测到重复长期医嘱，跳过保存 - patientId={}, encounterId={}, adviceDefinitionId={}, dose={}",
if (longUniqueKeySet.contains(uniqueKey)) {
log.warn("防重复保存：检测到重复长期医嘱（跨操作类型），跳过 - patientId={}, encounterId={}, adviceDefinitionId={}, dbOpType={}",
adviceSaveDto.getPatientId(), adviceSaveDto.getEncounterId(),
adviceSaveDto.getAdviceDefinitionId(), adviceSaveDto.getDose());
adviceSaveDto.getAdviceDefinitionId(), adviceSaveDto.getDbOpType());
continue;
}
longUniqueKeySet.add(uniqueKey);
@@ -429,7 +429,7 @@ public class AdviceManageAppServiceImpl implements IAdviceManageAppService {
&& (DbOpType.INSERT.getCode().equals(e.getDbOpType()) || DbOpType.UPDATE.getCode().equals(e.getDbOpType())))
.collect(Collectors.toList());
// 防重复保存：对新增医嘱进行去重
// 防重复保存：对所有医嘱进行去重（包括 INSERT 和 UPDATE 混合场景），避免签发时产生重复记录
Set<String> tempUniqueKeySet = new HashSet<>();
List<RegAdviceSaveDto> tempUniqueList = new ArrayList<>();
for (RegAdviceSaveDto adviceSaveDto : tempInsertOrUpdateList) {
@@ -439,10 +439,10 @@ public class AdviceManageAppServiceImpl implements IAdviceManageAppService {
+ adviceSaveDto.getDose() + "_"
+ adviceSaveDto.getMethodCode() + "_"
+ adviceSaveDto.getRateCode();
if (DbOpType.INSERT.getCode().equals(adviceSaveDto.getDbOpType()) && tempUniqueKeySet.contains(uniqueKey)) {
log.warn("防重复保存：检测到重复临时医嘱，跳过保存 - patientId={}, encounterId={}, adviceDefinitionId={}, dose={}",
if (tempUniqueKeySet.contains(uniqueKey)) {
log.warn("防重复保存：检测到重复临时医嘱（跨操作类型），跳过 - patientId={}, encounterId={}, adviceDefinitionId={}, dbOpType={}",
adviceSaveDto.getPatientId(), adviceSaveDto.getEncounterId(),
adviceSaveDto.getAdviceDefinitionId(), adviceSaveDto.getDose());
adviceSaveDto.getAdviceDefinitionId(), adviceSaveDto.getDbOpType());
continue;
}
tempUniqueKeySet.add(uniqueKey);

4
openhis-server-new/openhis-application/src/main/resources/mapper/inhospitalnursestation/AdviceProcessAppMapper.xml
View File

@@ -155,7 +155,7 @@
ii.performer_check_id,
ii.category_code,
ii.dispense_status
FROM (( SELECT T1.encounter_id,
FROM (( SELECT DISTINCT T1.encounter_id,
T1.tenant_id,
#{medMedicationRequest} AS advice_table,
T1.id AS request_id,
@@ -293,7 +293,7 @@
T1.sort_number,
T1.group_id )
UNION
( SELECT T1.encounter_id,
( SELECT DISTINCT T1.encounter_id,
T1.tenant_id,
#{worServiceRequest} AS advice_table,
T1.id AS request_id,