506 门诊挂号：门诊诊前退号后，数据库多表状态值变更与 PRD 定义不符

CommonConstants.AppointmentOrderStatus 常量 → OrderStatus 枚举重构新增枚举：0=患者取消 / 1=有效 / 2=系统取消 / 3=已完成退号流程加乐观锁防并发，slot 状态改回待约，退号日志独立事务修复 XML 中 Integer 比较用字符串的问题 Bug #411 — 诊室过滤栏从科室下拉框改为诊室按钮组
2026-05-11 13:51:47 +08:00
parent f9ab4c5688
commit df6c5f3824
9 changed files with 259 additions and 172 deletions
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/appointmentmanage/appservice/impl/TicketAppServiceImpl.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/appointmentmanage/appservice/impl/TicketAppServiceImpl.java
@@ -10,7 +10,7 @@ import com.openhis.clinical.service.ITicketService;
 import com.openhis.web.appointmentmanage.appservice.ITicketAppService;
 import com.openhis.web.appointmentmanage.dto.TicketDto;
 import com.openhis.common.constant.CommonConstants.SlotStatus;
-import com.openhis.common.constant.CommonConstants.AppointmentOrderStatus;
+import com.openhis.common.enums.OrderStatus;
 import org.springframework.stereotype.Service;

 import javax.annotation.Resource;
@@ -198,10 +198,11 @@ public class TicketAppServiceImpl implements ITicketAppService {
                        if (SlotStatus.CHECKED_IN.equals(slotStatus)) {
                            dto.setStatus("已取号");
                        } else if (SlotStatus.BOOKED.equals(slotStatus)) {
-                            if (AppointmentOrderStatus.CHECKED_IN.equals(raw.getOrderStatus())) {
-                                dto.setStatus("已取号");
-                            } else if (AppointmentOrderStatus.RETURNED.equals(raw.getOrderStatus())) {
+                            // order_main.status: 0=患者取消(已退号) 2=系统取消 其余=已预约
+                            if (OrderStatus.PATIENT_CANCELLED.getValue().equals(raw.getOrderStatus())) {
                                dto.setStatus("已退号");
+                            } else if (OrderStatus.SYSTEM_CANCELLED.getValue().equals(raw.getOrderStatus())) {
+                                dto.setStatus("系统取消");
                            } else {
                                dto.setStatus("已预约");
                            }
@@ -372,10 +373,11 @@ public class TicketAppServiceImpl implements ITicketAppService {
                        if (SlotStatus.CHECKED_IN.equals(slotStatus)) {
                            dto.setStatus("已取号");
                        } else if (SlotStatus.BOOKED.equals(slotStatus)) {
-                            if (AppointmentOrderStatus.CHECKED_IN.equals(raw.getOrderStatus())) {
-                                dto.setStatus("已取号");
-                            } else if (AppointmentOrderStatus.RETURNED.equals(raw.getOrderStatus())) {
+                            // order_main.status: 0=患者取消(已退号) 2=系统取消 其余=已预约
+                            if (OrderStatus.PATIENT_CANCELLED.getValue().equals(raw.getOrderStatus())) {
                                dto.setStatus("已退号");
+                            } else if (OrderStatus.SYSTEM_CANCELLED.getValue().equals(raw.getOrderStatus())) {
+                                dto.setStatus("系统取消");
                            } else {
                                dto.setStatus("已预约");
                            }
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/chargemanage/appservice/impl/OutpatientRegistrationAppServiceImpl.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/chargemanage/appservice/impl/OutpatientRegistrationAppServiceImpl.java
@@ -2,6 +2,7 @@ package com.openhis.web.chargemanage.appservice.impl;

 import com.baomidou.mybatisplus.core.conditions.query.LambdaQueryWrapper;
 import com.baomidou.mybatisplus.core.conditions.query.QueryWrapper;
+import com.baomidou.mybatisplus.core.conditions.update.LambdaUpdateWrapper;
 import com.baomidou.mybatisplus.core.metadata.IPage;
 import com.baomidou.mybatisplus.extension.plugins.pagination.Page;
 import com.core.common.core.domain.R;
@@ -329,16 +330,14 @@ public class OutpatientRegistrationAppServiceImpl implements IOutpatientRegistra
            }
        }

-        // 如果本次门诊挂号来自预约签到，同步把预约订单与号源槽位状态改为已退号
+        // 退费成功后，同步回滚预约订单状态及号源；同时移除分诊队列
+        Long refundOrderMainId = null;
        if (result != null && result.getCode() == 200) {
-            syncAppointmentReturnStatus(byId, cancelRegPaymentDto.getReason());
-
-            // 同步移除分诊队列中的记录
+            refundOrderMainId = syncAppointmentReturnStatus(byId, cancelRegPaymentDto.getReason());
            removeTriageQueueItem(byId.getId());
        }
-
-        // 记录退号日志
-        recordRefundLog(cancelRegPaymentDto, byId, result, paymentRecon);
+        // 退号日志独立事务写入，无论退费成功与否均记录
+        recordRefundLog(cancelRegPaymentDto, byId, result, paymentRecon, refundOrderMainId);

        // 2025/05/05 该处保存费用项后，会通过统一收费处理进行收费
        return R.ok(paymentRecon, MessageUtils.createMessage(PromptMsgConstant.Common.M00004, new Object[] {"退号"}));
@@ -435,8 +434,6 @@ public class OutpatientRegistrationAppServiceImpl implements IOutpatientRegistra
            // 通过患者、科室、日期查找关联的预约订单
            LambdaQueryWrapper<Order> queryWrapper = new LambdaQueryWrapper<Order>()
                .eq(Order::getPatientId, encounter.getPatientId())
-                .in(Order::getStatus, CommonConstants.AppointmentOrderStatus.BOOKED,
-                    CommonConstants.AppointmentOrderStatus.CHECKED_IN)
                .orderByDesc(Order::getUpdateTime)
                .orderByDesc(Order::getCreateTime)
                .last("LIMIT 1");
@@ -590,20 +587,25 @@ public class OutpatientRegistrationAppServiceImpl implements IOutpatientRegistra
    }

    /**
-     * 同步预约号源状态为已退号。
-     * 说明：
-     * 1) 门诊退号主流程不依赖该步骤成功与否，因此此方法内部异常仅记录日志，不向上抛出。
-     * 2) 通过患者、科室、日期以及状态筛选最近一条预约订单，尽量避免误匹配。
+     * 诊前退号：回滚预约订单、号源槽位、号源池统计。
+     *
+     * <p>处理四件事：
+     * <ol>
+     *   <li>order_main → status=0(患者取消), pay_status=3(已退费), 写入取消时间和原因</li>
+     *   <li>adm_schedule_slot → status=0(待约), order_id=NULL(释放号源)</li>
+     *   <li>adm_schedule_pool → 重算统计值 + version+1</li>
+     *   <li>返回 order_main.id 供 refund_log 关联</li>
+     * </ol>
+     *
+     * <p>异常仅记录日志不向上抛，不影响主流程返回成功。
     */
-    private void syncAppointmentReturnStatus(Encounter encounter, String reason) {
+    private Long syncAppointmentReturnStatus(Encounter encounter, String reason) {
        if (encounter == null || encounter.getPatientId() == null) {
-            return;
+            return null;
        }
        try {
            LambdaQueryWrapper<Order> queryWrapper = new LambdaQueryWrapper<Order>()
                .eq(Order::getPatientId, encounter.getPatientId())
-                .in(Order::getStatus, CommonConstants.AppointmentOrderStatus.BOOKED,
-                    CommonConstants.AppointmentOrderStatus.CHECKED_IN)
                .orderByDesc(Order::getUpdateTime)
                .orderByDesc(Order::getCreateTime)
                .last("LIMIT 1");
@@ -625,35 +627,55 @@ public class OutpatientRegistrationAppServiceImpl implements IOutpatientRegistra

            Order appointmentOrder = orderService.getOne(queryWrapper, false);
            if (appointmentOrder == null) {
-                return;
+                return null;
            }

-            Date now = new Date();
-            if (!CommonConstants.AppointmentOrderStatus.RETURNED.equals(appointmentOrder.getStatus())) {
-                Order updateOrder = new Order();
-                updateOrder.setId(appointmentOrder.getId());
-                updateOrder.setStatus(CommonConstants.AppointmentOrderStatus.RETURNED);
-                updateOrder.setPayStatus(0);
-                updateOrder.setCancelTime(now);
-                updateOrder.setCancelReason("门诊退号");
-                updateOrder.setUpdateTime(now);
-                orderService.updateById(updateOrder);
+            // 只有有效订单(1)才能退号
+            if (!OrderStatus.ACTIVE.getValue().equals(appointmentOrder.getStatus())) {
+                log.warn("退号跳过：订单状态非有效, orderId={}, status={}",
+                    appointmentOrder.getId(), appointmentOrder.getStatus());
+                return null;
+            }
+
+            // 乐观锁更新：WHERE version = 旧值，防并发重复退号
+            boolean updated = orderService.update(
+                new LambdaUpdateWrapper<Order>()
+                    .set(Order::getStatus, OrderStatus.PATIENT_CANCELLED.getValue())
+                    .set(Order::getPayStatus, PaymentStatus.REFUND_ALL.getValue())
+                    .set(Order::getCancelTime, new Date())
+                    .set(Order::getCancelReason,
+                        StringUtils.isNotEmpty(reason) ? reason : "诊前退号")
+                    .set(Order::getUpdateTime, new Date())
+                    .setSql("version = version + 1")
+                    .eq(Order::getId, appointmentOrder.getId())
+                    .eq(Order::getVersion, appointmentOrder.getVersion())
+            );
+            if (!updated) {
+                log.warn("退号乐观锁冲突，订单已被其他操作修改, orderId={}", appointmentOrder.getId());
+                return null;
            }

            Long slotId = appointmentOrder.getSlotId();
            if (slotId == null) {
-                return;
+                return appointmentOrder.getId();
            }

-            int slotRows = scheduleSlotMapper.updateSlotStatus(slotId, CommonConstants.SlotStatus.RETURNED);
+            int slotRows = scheduleSlotMapper.updateSlotStatus(slotId, CommonConstants.SlotStatus.AVAILABLE);
            if (slotRows > 0) {
                Long poolId = scheduleSlotMapper.selectPoolIdBySlotId(slotId);
                if (poolId != null) {
                    schedulePoolMapper.refreshPoolStats(poolId);
+                    schedulePoolMapper.update(null,
+                        new LambdaUpdateWrapper<SchedulePool>()
+                            .setSql("version = version + 1")
+                            .set(SchedulePool::getUpdateTime, new Date())
+                            .eq(SchedulePool::getId, poolId));
                }
            }
+            return appointmentOrder.getId();
        } catch (Exception e) {
            log.warn("同步预约号源已退号状态失败, encounterId={}", encounter.getId(), e);
+            return null;
        }
    }

@@ -672,22 +694,29 @@ public class OutpatientRegistrationAppServiceImpl implements IOutpatientRegistra
    }

    /**
-     * 记录退号日志
+     * 记录退号日志（独立事务）。
+     *
+     * <p>REQUIRES_NEW 确保即使主事务回滚，退号审计日志也不丢失。
+     * orderMainId 优先使用 order_main.id，若退费失败则 fallback 到 encounterId。
     *
     * @param cancelRegPaymentDto 退号请求对象
     * @param encounter 就诊信息
     * @param result 退号结果
     * @param paymentRecon 支付对账信息
+     * @param orderMainId 预约订单主键（order_main.id），用于关联业务数据
     */
    @Transactional(propagation = Propagation.REQUIRES_NEW)
    public void recordRefundLog(CancelRegPaymentDto cancelRegPaymentDto,
                                Encounter encounter,
                                R<?> result,
-                                PaymentReconciliation paymentRecon) {
+                                PaymentReconciliation paymentRecon,
+                                Long orderMainId) {
        RefundLog refundLog = new RefundLog();
        try {
-            // 1. 订单ID（唯一）
-            String orderId = String.valueOf(cancelRegPaymentDto.getEncounterId());
+            // 1. 订单ID（关联 order_main.id）
+            String orderId = orderMainId != null
+                ? String.valueOf(orderMainId)
+                : String.valueOf(cancelRegPaymentDto.getEncounterId());
            refundLog.setOrderId(orderId);

            // 已存在则不重复插入（防止唯一约束异常）
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/paymentmanage/appservice/impl/PaymentRecServiceImpl.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/paymentmanage/appservice/impl/PaymentRecServiceImpl.java
@@ -1991,7 +1991,7 @@ public class PaymentRecServiceImpl implements IPaymentRecService {
            Order appointmentOrder = iOrderService.getOne(
                new LambdaQueryWrapper<Order>()
                    .eq(Order::getPatientId, encounterFormData.getPatientId())
-                    .eq(Order::getStatus, CommonConstants.AppointmentOrderStatus.CHECKED_IN)
+                    .eq(Order::getStatus, OrderStatus.ACTIVE.getValue()) // 有效订单(1)
                    .eq(Order::getDeleteFlag, "0")
                    .orderByDesc(Order::getCreateTime)
                    .last("LIMIT 1")
@@ -2114,11 +2114,11 @@ public class PaymentRecServiceImpl implements IPaymentRecService {
            Long queuePoolId = null;
            Long queueSlotId = null;
            try {
-                // 查询患者当天的待签到预约订单（status = 1 或 2 表示已预约或已取号）
+                // 查询患者当天有效订单(1)；已取消(0/2)和已完成(3)的不参与排队
                Order order = iOrderService.getOne(
                    new LambdaQueryWrapper<Order>()
                        .eq(Order::getPatientId, encounter.getPatientId())
-                        .in(Order::getStatus, 1, 2) // 1=BOOKED 已预约, 2=CHECKED_IN 已取号
+                        .eq(Order::getStatus, OrderStatus.ACTIVE.getValue()) // 有效(1)
                        .eq(Order::getDeleteFlag, "0")
                        .orderByDesc(Order::getCreateTime)
                        .last("LIMIT 1")
--- a/openhis-server-new/openhis-common/src/main/java/com/openhis/common/enums/OrderStatus.java
+++ b/openhis-server-new/openhis-common/src/main/java/com/openhis/common/enums/OrderStatus.java
@@ -0,0 +1,63 @@
+/*
+ * Copyright ©2023 CJB-CNIT Team. All rights reserved
+ */
+package com.openhis.common.enums;
+
+import lombok.AllArgsConstructor;
+import lombok.Getter;
+
+/**
+ * 订单状态 (order_main.status)
+ *
+ * <pre>
+ * 状态流转:
+ *   创建订单 → ACTIVE(1)
+ *   签到     → ACTIVE(1) 不变
+ *   患者退号 → PATIENT_CANCELLED(0)
+ *   系统取消 → SYSTEM_CANCELLED(2)
+ *   就诊完成 → COMPLETED(3)
+ * </pre>
+ *
+ * @author wangjian963
+ * @date 2026-05-09
+ */
+@Getter
+@AllArgsConstructor
+public enum OrderStatus implements HisEnumInterface {
+
+    /**
+     * 患者取消
+     */
+    PATIENT_CANCELLED(0, "0", "患者取消"),
+
+    /**
+     * 有效
+     */
+    ACTIVE(1, "1", "有效"),
+
+    /**
+     * 系统取消
+     */
+    SYSTEM_CANCELLED(2, "2", "系统取消"),
+
+    /**
+     * 已完成
+     */
+    COMPLETED(3, "3", "已完成");
+
+    private Integer value;
+    private String code;
+    private String info;
+
+    public static OrderStatus getByValue(Integer value) {
+        if (value == null) {
+            return null;
+        }
+        for (OrderStatus val : values()) {
+            if (val.getValue().equals(value)) {
+                return val;
+            }
+        }
+        return null;
+    }
+}
--- a/openhis-server-new/openhis-domain/src/main/java/com/openhis/clinical/service/impl/OrderServiceImpl.java
+++ b/openhis-server-new/openhis-domain/src/main/java/com/openhis/clinical/service/impl/OrderServiceImpl.java
@@ -6,8 +6,8 @@ import com.core.common.utils.AssignSeqUtil;
 import com.openhis.clinical.domain.Order;
 import com.openhis.clinical.mapper.OrderMapper;
 import com.openhis.clinical.service.IOrderService;
-import com.openhis.common.constant.CommonConstants.AppointmentOrderStatus;
 import com.openhis.common.enums.AssignSeqEnum;
+import com.openhis.common.enums.OrderStatus;
 import org.springframework.stereotype.Service;

 import javax.annotation.Resource;
@@ -124,7 +124,8 @@ public class OrderServiceImpl extends ServiceImpl<OrderMapper, Order> implements
                : new Date(); // 兜底：正常业务不应走到这里
        order.setAppointmentDate(appointmentDateTime);
        order.setAppointmentTime(appointmentDateTime);
-        order.setStatus(AppointmentOrderStatus.BOOKED);
+        // 订单状态: 0=患者取消 1=有效 2=系统取消 3=已完成
+        order.setStatus(OrderStatus.ACTIVE.getValue());
        order.setPayStatus(0);
        order.setVersion(0);

@@ -169,10 +170,13 @@ public class OrderServiceImpl extends ServiceImpl<OrderMapper, Order> implements
        if (order == null) {
            throw new RuntimeException("订单不存在");
        }
-        if (AppointmentOrderStatus.CANCELLED.equals(order.getStatus())) {
+        // 已取消（患者取消0 或 系统取消2）不可再次取消
+        if (OrderStatus.PATIENT_CANCELLED.getValue().equals(order.getStatus())
+                || OrderStatus.SYSTEM_CANCELLED.getValue().equals(order.getStatus())) {
            throw new RuntimeException("订单已取消");
        }
-        if (AppointmentOrderStatus.CHECKED_IN.equals(order.getStatus())) {
+        // 已完成(3)的订单不可取消
+        if (OrderStatus.COMPLETED.getValue().equals(order.getStatus())) {
            throw new RuntimeException("订单已完成，无法取消");
        }

@@ -189,6 +193,7 @@ public class OrderServiceImpl extends ServiceImpl<OrderMapper, Order> implements
                .eq(Order::getPatientId, patientId)
                .eq(Order::getTenantId, tenantId)
                .ge(Order::getCancelTime, startTime)
-                .eq(Order::getStatus, AppointmentOrderStatus.CANCELLED));
+                // 只统计患者主动取消(0)，不含系统取消(2)
+                .eq(Order::getStatus, OrderStatus.PATIENT_CANCELLED.getValue()));
    }
 }
--- a/openhis-server-new/openhis-domain/src/main/java/com/openhis/clinical/service/impl/TicketServiceImpl.java
+++ b/openhis-server-new/openhis-domain/src/main/java/com/openhis/clinical/service/impl/TicketServiceImpl.java
@@ -13,8 +13,8 @@ import com.openhis.clinical.domain.Ticket;
 import com.openhis.clinical.mapper.TicketMapper;
 import com.openhis.clinical.service.IOrderService;
 import com.openhis.clinical.service.ITicketService;
-import com.openhis.common.constant.CommonConstants.AppointmentOrderStatus;
 import com.openhis.common.constant.CommonConstants.SlotStatus;
+import com.openhis.common.enums.OrderStatus;
 import org.slf4j.Logger;
 import org.slf4j.LoggerFactory;
 import org.springframework.stereotype.Service;
@@ -195,8 +195,8 @@ public class TicketServiceImpl extends ServiceImpl<TicketMapper, Ticket> impleme
            Date startTime = Date.from(periodStart.atZone(ZoneId.systemDefault()).toInstant());
            Date endTime = Date.from(periodEnd.atZone(ZoneId.systemDefault()).toInstant());

-            // 预约去重以订单为准（order_main），因为预约成功会先落订单；clinical_ticket 不一定在此链路写入
-            List<Integer> effectiveOrderStatuses = Arrays.asList(AppointmentOrderStatus.BOOKED, AppointmentOrderStatus.CHECKED_IN);
+            // 预约去重以订单为准（order_main），有效订单(1)才参与去重
+            List<Integer> effectiveOrderStatuses = Arrays.asList(OrderStatus.ACTIVE.getValue());
            int exists = orderMapper.countPatientDeptOrdersInPeriod(dto.getPatientId(), slot.getDepartmentId(), slot.getDepartmentName(),
                startTime, endTime, effectiveOrderStatuses);
            if (exists > 0) {
@@ -314,9 +314,8 @@ public class TicketServiceImpl extends ServiceImpl<TicketMapper, Ticket> impleme
        }
        Order latestOrder = orders.get(0);

-        // 1. 更新订单状态为已取号，并更新支付状态和支付时间
-        orderService.updateOrderStatusById(latestOrder.getId(), AppointmentOrderStatus.CHECKED_IN);
-        // 更新支付状态为已支付，记录支付时间
+        // 1. 签到不改变订单状态(仍为有效1)，更新支付状态为已支付并记录支付时间
+        orderService.updateOrderStatusById(latestOrder.getId(), OrderStatus.ACTIVE.getValue());
        orderMapper.updatePayStatus(latestOrder.getId(), 1, new Date());

        // 2. 查询号源槽位信息
--- a/openhis-server-new/openhis-domain/src/main/resources/mapper/administration/ScheduleSlotMapper.xml
+++ b/openhis-server-new/openhis-domain/src/main/resources/mapper/administration/ScheduleSlotMapper.xml
@@ -160,11 +160,12 @@
            AND delete_flag = '0'
    </update>

+    <!-- status=0(待约)时清空order_id，释放号源，使退号后号源可再被预约 -->
    <update id="updateSlotStatus">
        UPDATE adm_schedule_slot
        SET
            status = #{status},
-        <if test="status != null and '0'.equals(status.toString())">
+        <if test="status != null and status == 0">
            order_id = NULL,
        </if>
        update_time = now()
--- a/openhis-server-new/openhis-domain/src/main/resources/mapper/clinical/OrderMapper.xml
+++ b/openhis-server-new/openhis-domain/src/main/resources/mapper/clinical/OrderMapper.xml
@@ -117,12 +117,14 @@
        </where>
    </select>

+    <!-- status=1: 只查有效订单(0=患者取消 1=有效 2=系统取消 3=已完成) -->
    <select id="selectOrderById" resultMap="OrderResult">
        select * from order_main where id = #{id}
        and status = 1
        order by create_time desc
    </select>

+    <!-- status=1: 只查有效订单 -->
    <select id="selectOrderBySlotId" resultMap="OrderResult">
        select * from order_main where slot_id = #{slotId} and status = 1
    </select>
@@ -248,8 +250,9 @@
        update order_main set status = #{status} where id = #{id}
    </update>

+    <!-- status=0: 患者取消 (OrderStatus.PATIENT_CANCELLED) -->
    <update id="updateOrderCancelInfoById">
-        update order_main set status = 3, cancel_time = #{cancelTime}, cancel_reason = #{cancelReason} where id = #{id}
+        update order_main set status = 0, cancel_time = #{cancelTime}, cancel_reason = #{cancelReason} where id = #{id}
    </update>

    <update id="updatePayStatus">
--- a/openhis-ui-vue3/src/views/triageandqueuemanage/cardiology/index.vue
+++ b/openhis-ui-vue3/src/views/triageandqueuemanage/cardiology/index.vue
@@ -198,53 +198,52 @@
              ↓
            </el-button>
          </div>
-          <div class="queue-actions-right">
-            <el-button 
-              :type="showOnlyWaiting ? 'primary' : ''" 
-              size="small"
-              @click="showOnlyWaiting = true"
-            >
-              只显示等待
-            </el-button>
-            <el-button 
-              :type="!showOnlyWaiting ? 'primary' : ''" 
-              size="small"
-              @click="showOnlyWaiting = false"
-            >
-              显示全部状态
-            </el-button>
-          </div>
        </div>
      </div>
    </div>

    <!-- 底部控制面板 -->
    <div class="footer-section">
-      <!-- 诊室快速过滤栏 -->
+      <!-- Bug #411：诊室快速过滤栏，筛选维度从科室改为诊室 -->
      <div class="filter-section">
-        <div class="filter-label">
-          ③ 诊室快速过滤栏
-        </div>
-        <div class="filter-select-wrapper">
-          <el-select
-            v-model="selectedClinicRoom"
-            placeholder="请选择诊室"
-            clearable
-            filterable
-            style="width: 100%"
-            size="default"
-          >
-            <el-option
-              label="全部"
-              value="all"
-            />
-            <el-option
-              v-for="room in clinicRoomList"
+        <div class="filter-left">
+          <div class="filter-label">
+            ③ 诊室快速过滤栏
+          </div>
+          <div class="filter-button-wrapper">
+            <el-button
+              :type="selectedRoom === 'all' ? 'primary' : ''"
+              size="small"
+              @click="selectedRoom = 'all'"
+            >
+              全部
+            </el-button>
+            <el-button
+              v-for="room in uniqueRooms"
              :key="room"
-              :label="room"
-              :value="room"
-            />
-          </el-select>
+              :type="selectedRoom === room ? 'primary' : ''"
+              size="small"
+              @click="selectedRoom = room"
+            >
+              {{ room }}
+            </el-button>
+          </div>
+        </div>
+        <div class="filter-right">
+          <el-button
+            :type="showOnlyWaiting ? 'primary' : ''"
+            size="small"
+            @click="showOnlyWaiting = true"
+          >
+            只显示等待
+          </el-button>
+          <el-button
+            :type="!showOnlyWaiting ? 'primary' : ''"
+            size="small"
+            @click="showOnlyWaiting = false"
+          >
+            显示全部状态
+          </el-button>
        </div>
      </div>

@@ -680,10 +679,8 @@ const selectedCandidates = ref([])
 // 显示选项
 const showOnlyWaiting = ref(false)

-// 诊室过滤（按诊室维度筛选）
-const selectedClinicRoom = ref('all')
-// 诊室列表（从数据中动态提取）
-const clinicRoomList = ref([])
+// Bug #411：诊室过滤，替代原来的科室下拉框（selectedDept/departmentList 已移除）
+const selectedRoom = ref('all')

 // 修复【#397】：动态获取当前科室名称
 const currentDeptName = computed(() => {
@@ -906,11 +903,12 @@ const mapFrontendStatusToBackend = (status) => {
 // 从数据库加载队列
 const loadQueueFromDb = async () => {
  try {
-    // 使用当前登录人的科室
+    // Bug #411：不再按科室选筛加载，后端默认按当前登录人科室查询
+    const organizationId = undefined
+    // 只查询今天的患者
    const today = new Date()
    const todayStr = `${today.getFullYear()}-${String(today.getMonth() + 1).padStart(2, '0')}-${String(today.getDate()).padStart(2, '0')}`
-    console.log('【心内科】loadQueueFromDb 开始：date=', todayStr)
-    const res = await getTriageQueueList({ date: todayStr }).catch((err) => {
+    const res = await getTriageQueueList({ organizationId, date: todayStr }).catch((err) => {
      console.error('【心内科】loadQueueFromDb 请求异常：', err)
      return { code: 500, msg: err?.message || '请求失败', data: null }
    })
@@ -1138,8 +1136,6 @@ const loadDataFromApi = async () => {

    // 同步当前呼叫（队列从 DB 加载后已同步；这里再兜底一次）
    syncCurrentCallFromQueue()
-    // 提取诊室列表供过滤栏使用
-    extractClinicRooms()
    console.log('【心内科】数据加载完成：候选池', originalCandidatePoolList.value.length, '条，队列', originalQueueList.value.length, '条')
    ElMessage.success('【心内科】已从门诊挂号接口加载数据')
  } catch (e) {
@@ -1151,42 +1147,35 @@ const loadDataFromApi = async () => {
    totalSignedIn.value = originalCandidatePoolList.value.length
    totalInQueue.value = originalQueueList.value.length
    syncCurrentCallFromQueue()
-    extractClinicRooms()
  }
 }

 // 原始数据存储（用于过滤）
 const originalCandidatePoolList = ref(getInitialCandidatePoolList())

-// 提取诊室列表（从队列和候选池数据中动态获取）
-const extractClinicRooms = () => {
-  const roomSet = new Set()
-  // 从队列中提取
-  originalQueueList.value.forEach(item => {
-    if (item.room && item.room !== '-') {
-      roomSet.add(item.room)
-    }
-  })
-  // 从候选池中提取
-  originalCandidatePoolList.value.forEach(item => {
-    if (item.room && item.room !== '-') {
-      roomSet.add(item.room)
-    }
-  })
-  clinicRoomList.value = Array.from(roomSet).sort()
-}
-
-// 过滤后的智能候选池数据
+// 过滤后的智能候选池数据（按诊室过滤）
 const filteredCandidatePoolList = computed(() => {
-  if (selectedClinicRoom.value === 'all') {
+  if (selectedRoom.value === 'all') {
    return originalCandidatePoolList.value
  }
-  return originalCandidatePoolList.value.filter(item => item.room === selectedClinicRoom.value)
+  return originalCandidatePoolList.value.filter(item => item.room === selectedRoom.value)
 })

 // 原始队列数据存储（用于过滤）
 const originalQueueList = ref(getInitialQueueList())

+// 动态计算已加载数据中的唯一诊室列表（依赖上方两个 ref，确保声明顺序正确）
+const uniqueRooms = computed(() => {
+  const rooms = new Set()
+  originalCandidatePoolList.value.forEach(item => {
+    if (item.room && item.room !== '-') rooms.add(item.room)
+  })
+  originalQueueList.value.forEach(item => {
+    if (item.room && item.room !== '-') rooms.add(item.room)
+  })
+  return Array.from(rooms).sort()
+})
+
 const parseMmSsToSeconds = (mmss) => {
  if (!mmss || typeof mmss !== 'string') return 0
  const [mm, ss] = mmss.split(':')
@@ -1203,7 +1192,7 @@ const formatSecondsToMmSs = (totalSeconds) => {
  return `${mm}:${ss}`
 }

-// 过滤后的智能队列数据（同时考虑诊室过滤和状态过滤）
+// 过滤后的智能队列数据（Bug #411：诊室过滤 + 状态过滤）
 const filteredQueueList = computed(() => {
  let filtered = originalQueueList.value

@@ -1211,8 +1200,8 @@ const filteredQueueList = computed(() => {
  filtered = filtered.filter(item => item.status !== '已完成')

  // 再按诊室过滤
-  if (selectedClinicRoom.value !== 'all') {
-    filtered = filtered.filter(item => item.room === selectedClinicRoom.value)
+  if (selectedRoom.value !== 'all') {
+    filtered = filtered.filter(item => item.room === selectedRoom.value)
  }

  // 再按状态过滤（只显示等待）
@@ -1723,16 +1712,12 @@ const handleNextPatient = async () => {
      reqData.id = selectedQueueRow.value.id
      reqData.organizationId = selectedQueueRow.value.organizationId
    } else {
-      // 如果没有选中患者，使用查询条件（兼容旧逻辑）
-      // 全科模式：优先用"当前叫号中/第一个等待"所在科室
-      let orgId = null
-      {
-        const calling = originalQueueList.value.find((i) => i.status === '叫号中')
-        const waiting = originalQueueList.value.find((i) => i.status === '等待')
-        console.log('【心内科】handleNextPatient 查找：叫号中=', calling?.patientName, '等待=', waiting?.patientName)
-        orgId = calling?.organizationId ?? waiting?.organizationId
-        console.log('【心内科】handleNextPatient 确定的 orgId=', orgId)
-      }
+      // Bug #411：已移除 selectedDept，改为从队列数据中动态获取科室
+      const calling = originalQueueList.value.find((i) => i.status === '叫号中')
+      const waiting = originalQueueList.value.find((i) => i.status === '等待')
+      console.log('【心内科】handleNextPatient 查找：叫号中=', calling?.patientName, '等待=', waiting?.patientName)
+      const orgId = calling?.organizationId ?? waiting?.organizationId
+      console.log('【心内科】handleNextPatient 确定的 orgId=', orgId)
      if (orgId != null) {
        reqData.organizationId = orgId
      }
@@ -1761,13 +1746,9 @@ const handleSkip = async () => {
      reqData.id = selectedQueueRow.value.id
      reqData.organizationId = selectedQueueRow.value.organizationId
    } else {
-      // 如果没有选中患者，使用查询条件（兼容旧逻辑）
-      // 全科模式：优先用”当前叫号中”所在科室
-      let orgId = null
-      {
-        const calling = originalQueueList.value.find((i) => i.status === '叫号中')
-        orgId = calling?.organizationId
-      }
+      // 如果没有选中患者，使用当前叫号中的科室
+      const calling = originalQueueList.value.find((i) => i.status === '叫号中')
+      const orgId = calling?.organizationId
      if (orgId != null) {
        reqData.organizationId = orgId
      }
@@ -1795,13 +1776,9 @@ const handleComplete = async () => {
      reqData.id = selectedQueueRow.value.id
      reqData.organizationId = selectedQueueRow.value.organizationId
    } else {
-      // 如果没有选中患者，使用查询条件（兼容旧逻辑）
-      // 全科模式：优先用”当前叫号中”所在科室
-      let orgId = null
-      {
-        const calling = originalQueueList.value.find((i) => i.status === '叫号中')
-        orgId = calling?.organizationId
-      }
+      // 如果没有选中患者，使用当前叫号中的科室
+      const calling = originalQueueList.value.find((i) => i.status === '叫号中')
+      const orgId = calling?.organizationId
      if (orgId != null) {
        reqData.organizationId = orgId
      }
@@ -1829,13 +1806,9 @@ const handleRequeue = async () => {
      reqData.id = selectedQueueRow.value.id
      reqData.organizationId = selectedQueueRow.value.organizationId
    } else {
-      // 如果没有选中患者，使用查询条件（兼容旧逻辑）
-      // 全科模式：优先用”当前叫号中”所在科室
-      let orgId = null
-      {
-        const calling = originalQueueList.value.find((i) => i.status === '叫号中')
-        orgId = calling?.organizationId
-      }
+      // 如果没有选中患者，使用当前叫号中的科室
+      const calling = originalQueueList.value.find((i) => i.status === '叫号中')
+      const orgId = calling?.organizationId
      if (orgId != null) {
        reqData.organizationId = orgId
      }
@@ -2219,10 +2192,6 @@ onUnmounted(() => {
          gap: 10px;
        }

-        .queue-actions-right {
-          display: flex;
-          gap: 10px;
-        }
      }

      .candidate-actions {
@@ -2244,16 +2213,32 @@ onUnmounted(() => {

    .filter-section {
      margin-bottom: 20px;
+      display: flex;
+      align-items: flex-start;
+      justify-content: space-between;

-      .filter-label {
-        font-size: 14px;
-        font-weight: bold;
-        color: #333;
-        margin-bottom: 10px;
+      .filter-left {
+        flex: 1;
+
+        .filter-label {
+          font-size: 14px;
+          font-weight: bold;
+          color: #333;
+          margin-bottom: 10px;
+        }
+
+        .filter-button-wrapper {
+          display: flex;
+          flex-wrap: wrap;
+          gap: 8px;
+        }
      }

-      .filter-select-wrapper {
-        width: 100%;
+      .filter-right {
+        display: flex;
+        gap: 8px;
+        flex-shrink: 0;
+        align-self: flex-end;
      }
    }