新增校验，防止删除存在有效患者预约的医生排班。

更新 SurgeryDto，为计划手术时间添加 JSON 格式配置。

改进接诊确认逻辑，使医师确认流程更加健壮。

在 OrderMapper 中新增方法，用于统计患者在指定时间段内的有效预约订单数量。

增强 TicketServiceImpl，防止同一患者在相同科室与时间段内重复预约。

openhis-server-new/openhis-application/src/main/java/com/openhis/web/appointmentmanage/appservice/impl/DoctorScheduleAppServiceImpl.java

@@ -1,8 +1,10 @@
 package com.openhis.web.appointmentmanage.appservice.impl;
 
 import cn.hutool.core.util.ObjectUtil;
+import com.baomidou.mybatisplus.core.conditions.query.QueryWrapper;
 import com.core.common.core.domain.R;
 import com.core.common.utils.SecurityUtils;
+import com.openhis.common.constant.CommonConstants;
 import com.openhis.appointmentmanage.domain.DoctorSchedule;
 import com.openhis.appointmentmanage.domain.DoctorScheduleWithDateDto;
 import com.openhis.appointmentmanage.domain.SchedulePool;
@@ -497,6 +499,15 @@ public class DoctorScheduleAppServiceImpl implements IDoctorScheduleAppService {
         if (ObjectUtil.isNotEmpty(pools)) {
             List<Long> poolIds = pools.stream().map(SchedulePool::getId).collect(java.util.stream.Collectors.toList());
 
+            // 该排班下存在有效患者预约（号源槽：已预约/已锁定/已取号）则禁止删除；已退号、仅可用/已取消槽位不计入
+            long appointmentCount = scheduleSlotService.count(new QueryWrapper<ScheduleSlot>()
+                    .in("pool_id", poolIds)
+                    .in("status", CommonConstants.SlotStatus.BOOKED, CommonConstants.SlotStatus.LOCKED,
+                            CommonConstants.SlotStatus.CHECKED_IN));
+            if (appointmentCount > 0) {
+                return R.fail("该排班已有患者预约，禁止删除！如需取消请先处理患者退预约或使用'停诊'功能。");
+            }
+
             // 2. 根据号源池ID找到所有关联的号源槽
             List<ScheduleSlot> slots = scheduleSlotService.list(
                     new com.baomidou.mybatisplus.core.conditions.query.QueryWrapper<ScheduleSlot>()

openhis-server-new/openhis-application/src/main/java/com/openhis/web/clinicalmanage/dto/SurgeryDto.java

@@ -2,6 +2,7 @@ package com.openhis.web.clinicalmanage.dto;
 
 import com.fasterxml.jackson.databind.annotation.JsonSerialize;
 import com.fasterxml.jackson.databind.ser.std.ToStringSerializer;
+import com.fasterxml.jackson.annotation.JsonFormat;
 import com.openhis.common.annotation.Dict;
 import lombok.Data;
 import lombok.experimental.Accessors;
@@ -87,6 +88,7 @@ public class SurgeryDto {
     private String statusEnum_dictText;
 
     /** 计划手术时间 */
+    @JsonFormat(pattern = "yyyy-MM-dd'T'HH:mm:ss", timezone = "GMT+8")
     private Date plannedTime;
 
     /** 实际开始时间 */

openhis-server-new/openhis-application/src/main/java/com/openhis/web/consultation/appservice/impl/ConsultationAppServiceImpl.java

@@ -1365,10 +1365,13 @@ public class ConsultationAppServiceImpl implements IConsultationAppService {
             }
 
             // 4. 更新邀请记录（存储会诊意见）
-            // 格式：科室-医生：意见内容
+            // 格式：科室-会诊确认参加医师：意见内容
+            // 兼容：若前端未填写“会诊确认参加医师”，则回退为当前医生姓名
+            String confirmingPhysicianText =
+                StringUtils.hasText(dto.getConfirmingPhysician()) ? dto.getConfirmingPhysician().trim() : currentPhysicianName;
             String formattedOpinion = String.format("%s-%s：%s",
                 currentDeptName,
-                currentPhysicianName,
+                confirmingPhysicianText,
                 dto.getConsultationOpinion());
             
             invited.setInvitedStatus(ConsultationStatusEnum.CONFIRMED.getCode()); // 已确认

openhis-server-new/openhis-domain/src/main/java/com/openhis/clinical/mapper/OrderMapper.java

@@ -42,4 +42,20 @@ public interface OrderMapper extends BaseMapper<Order> {
      * @return 结果
      */
     int updatePayStatus(@Param("orderId") Long orderId, @Param("payStatus") Integer payStatus, @Param("payTime") Date payTime);
+
+    /**
+     * 统计同一患者在同一科室、同一时段（上午/下午）内的有效预约订单数量
+     *
+     * @param patientId 患者ID
+     * @param departmentId 科室ID
+     * @param startTime 时段起始时间（含）
+     * @param endTime 时段结束时间（不含）
+     * @param statuses 订单状态集合（如 1=已预约,2=已取号）
+     * @return 数量
+     */
+    int countPatientDeptOrdersInPeriod(@Param("patientId") Long patientId,
+        @Param("departmentId") Long departmentId,
+        @Param("startTime") Date startTime,
+        @Param("endTime") Date endTime,
+        @Param("statuses") List<Integer> statuses);
 }

openhis-server-new/openhis-domain/src/main/java/com/openhis/clinical/service/impl/TicketServiceImpl.java

@@ -28,6 +28,7 @@ import java.time.LocalTime;
 import java.time.ZoneId;
 import java.time.temporal.TemporalAdjusters;
 import java.util.Date;
+import java.util.Arrays;
 import java.util.List;
 import java.util.Map;
 
@@ -182,6 +183,28 @@ public class TicketServiceImpl extends ServiceImpl<TicketMapper, Ticket> impleme
             throw new RuntimeException("该排班医生已停诊");
         }
 
+        // 2.1 同一患者同一天/同一科室/同一时段（上午/下午）不可重复预约
+        if (dto.getPatientId() != null && slot.getDepartmentId() != null && slot.getScheduleDate() != null && slot.getExpectTime() != null) {
+            boolean isMorning = slot.getExpectTime().isBefore(LocalTime.NOON);
+            LocalDate scheduleDateForCheck = slot.getScheduleDate();
+            LocalDateTime periodStart = isMorning
+                ? LocalDateTime.of(scheduleDateForCheck, LocalTime.MIN)
+                : LocalDateTime.of(scheduleDateForCheck, LocalTime.NOON);
+            LocalDateTime periodEnd = isMorning
+                ? LocalDateTime.of(scheduleDateForCheck, LocalTime.NOON)
+                : LocalDateTime.of(scheduleDateForCheck.plusDays(1), LocalTime.MIN);
+
+            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);
+            int exists = orderMapper.countPatientDeptOrdersInPeriod(dto.getPatientId(), slot.getDepartmentId(), startTime, endTime, effectiveOrderStatuses);
+            if (exists > 0) {
+                throw new RuntimeException("该患者已在当前科室该时段存在预约记录，不可重复预约");
+            }
+        }
+
         // 原子抢占：避免并发下同一槽位被重复预约
         int lockRows = scheduleSlotMapper.lockSlotForBooking(slotId);
         if (lockRows <= 0) {
@@ -264,9 +287,6 @@ public class TicketServiceImpl extends ServiceImpl<TicketMapper, Ticket> impleme
             throw new RuntimeException("当前号源没有可取消的预约订单");
         }
 
-        // 获取订单信息
-        Order latestOrder = orders.get(0);
-
         // 直接执行取消，不再检查取消限制
         // 根据需求，取消限制应在预约挂号时检查，而非取消预约时
         for (Order order : orders) {

openhis-server-new/openhis-domain/src/main/resources/mapper/clinical/OrderMapper.xml

@@ -217,6 +217,23 @@
         where id = #{id}
     </update>
 
+    <select id="countPatientDeptOrdersInPeriod" resultType="int">
+        select count(*)
+        from order_main
+        <where>
+            and patient_id = #{patientId}
+            and department_id = #{departmentId}
+            and appointment_time &gt;= #{startTime}
+            and appointment_time &lt; #{endTime}
+            <if test="statuses != null and statuses.size() &gt; 0">
+                and status in
+                <foreach item="s" collection="statuses" open="(" separator="," close=")">
+                    #{s}
+                </foreach>
+            </if>
+        </where>
+    </select>
+
     <update id="updateOrderStatusById">
         update order_main set status = #{status} where id = #{id}
     </update>

openhis-ui-vue3/src/views/consultationmanagement/consultationconfirmation/index.vue

@@ -352,7 +352,20 @@ const applyRowToForm = (row) => {
 
     if (myOpinion) {
       // 如果当前医生已确认，回显其信息
+      // 回显“会诊确认参加医师”：优先从 opinion 前缀解析（格式：科室-参加医师：意见）
+      // 兼容旧数据（格式：科室-医生：意见）以及异常格式
+      if (myOpinion.opinion) {
+        const opinionText = myOpinion.opinion
+        const colonIndex = opinionText.indexOf('：')
+        const dashIndex = opinionText.indexOf('-')
+        if (dashIndex >= 0 && colonIndex > dashIndex) {
+          formData.value.confirmingPhysician = opinionText.substring(dashIndex + 1, colonIndex).trim()
+        } else {
           formData.value.confirmingPhysician = myOpinion.physicianName || ''
+        }
+      } else {
+        formData.value.confirmingPhysician = myOpinion.physicianName || ''
+      }
       formData.value.confirmingPhysicianName = myOpinion.physicianName
       formData.value.confirmingDeptName = myOpinion.deptName