fix(database): 修复数据库字典重复和表结构缺失问题

- 删除手术状态下拉框的重复字典数据，保留每组中dict_code最小的记录
- 修复HisBaseEntity列缺失问题，为多个表添加create_by、update_by、update_time等基础字段
- 为adm_patient表添加邮政编码、户籍地址、监护人信息、患者来源等缺失字段
- 添加文化程度字典类型和相关字典数据，补充3919到3914等10个学历级别选项
- 为adm_patient_identifier表创建tenant_id和patient_id的联合索引以提升查询性能
- 修复prescription_intercept_log和clinical_pathway_execution表的基础实体字段缺失
- 为wor_device_request表增加医嘱退回相关的back_reason、performer_check_id等字段
- 创建EMPI核心表empi_person和empi_person_id_mapping用于全局患者主

healthlink-his-server/healthlink-his-application/src/main/java/com/healthlink/his/web/quality/appservice/IEmrQualityAppService.java

@@ -8,4 +8,6 @@ public interface IEmrQualityAppService {
     List<Map<String, Object>> getDefects(Long encounterId);
     Map<String, Object> getDefectStatistics(String startDate, String endDate);
     Map<String, Object> getCompletionRate(String startDate, String endDate);
+    Map<String, Object> startDefectRectify(Long defectId);
+    Map<String, Object> completeDefectRectify(Long defectId);
 }

healthlink-his-server/healthlink-his-application/src/main/java/com/healthlink/his/web/quality/appservice/impl/EmrQualityAppServiceImpl.java

@@ -7,6 +7,7 @@ import com.baomidou.mybatisplus.core.conditions.query.LambdaQueryWrapper;
 import org.springframework.beans.factory.annotation.Autowired;
 import org.springframework.stereotype.Service;
 import java.util.*;
+import java.util.Date;
 @Service
 public class EmrQualityAppServiceImpl implements IEmrQualityAppService {
     @Autowired private EmrQualityScoreMapper scoreMapper;
@@ -80,4 +81,37 @@ public class EmrQualityAppServiceImpl implements IEmrQualityAppService {
         result.put("totalEncounters", 0); result.put("completedEmr", 0); result.put("overdueEmr", 0); result.put("completionRate", 100);
         return result;
     }
+
+    @Override
+    public Map<String, Object> startDefectRectify(Long defectId) {
+        Map<String, Object> result = new HashMap<>();
+        EmrDefect defect = defectMapper.selectById(defectId);
+        if (defect != null) {
+            defect.setRectifyStatus("RECTIFYING");
+            defectMapper.updateById(defect);
+            result.put("success", true);
+            result.put("message", "开始整改");
+        } else {
+            result.put("success", false);
+            result.put("message", "缺陷记录不存在");
+        }
+        return result;
+    }
+
+    @Override
+    public Map<String, Object> completeDefectRectify(Long defectId) {
+        Map<String, Object> result = new HashMap<>();
+        EmrDefect defect = defectMapper.selectById(defectId);
+        if (defect != null) {
+            defect.setRectifyStatus("RECTIFIED");
+            defect.setRectifyTime(new Date());
+            defectMapper.updateById(defect);
+            result.put("success", true);
+            result.put("message", "整改完成");
+        } else {
+            result.put("success", false);
+            result.put("message", "缺陷记录不存在");
+        }
+        return result;
+    }
 }

healthlink-his-server/healthlink-his-application/src/main/java/com/healthlink/his/web/quality/controller/EmrQualityController.java

@@ -30,4 +30,12 @@ public class EmrQualityController {
     @Operation(summary = "完成率") @GetMapping("/completion-rate")
     public AjaxResult completionRate(@RequestParam(required = false) String startDate, @RequestParam(required = false) String endDate) {
         return AjaxResult.success(emrQualityAppService.getCompletionRate(startDate, endDate)); }
+
+    @Operation(summary = "开始整改缺陷") @PostMapping("/defect/rectify/{defectId}")
+    public AjaxResult startDefectRectify(@PathVariable Long defectId) {
+        return AjaxResult.success(emrQualityAppService.startDefectRectify(defectId)); }
+
+    @Operation(summary = "完成整改缺陷") @PostMapping("/defect/complete/{defectId}")
+    public AjaxResult completeDefectRectify(@PathVariable Long defectId) {
+        return AjaxResult.success(emrQualityAppService.completeDefectRectify(defectId)); }
 }