feat(lab): T7.1 室内质控Westgard规则 - AppService/Controller/前端质控图
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package com.healthlink.his.web.lab.appservice;
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import com.core.common.core.domain.R;
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import com.healthlink.his.lab.domain.LabInternalQc;
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import java.util.List;
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public interface ILabQcAppService {
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R<?> runWestgard(LabInternalQc qc);
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R<?> getQcResults(String qcItem, Boolean isPass, Integer pageNo, Integer pageSize);
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R<?> getQcStats();
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}
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package com.healthlink.his.web.lab.appservice.impl;
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import com.baomidou.mybatisplus.core.conditions.query.LambdaQueryWrapper;
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import com.baomidou.mybatisplus.extension.plugins.pagination.Page;
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import com.core.common.core.domain.R;
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import com.healthlink.his.lab.domain.LabInternalQc;
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import com.healthlink.his.lab.service.ILabInternalQcService;
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import com.healthlink.his.web.lab.appservice.ILabQcAppService;
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import lombok.extern.slf4j.Slf4j;
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import org.springframework.stereotype.Service;
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import org.springframework.util.StringUtils;
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import jakarta.annotation.Resource;
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import java.math.BigDecimal;
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import java.math.RoundingMode;
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import java.util.*;
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import java.util.stream.Collectors;
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@Service
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@Slf4j
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public class LabQcAppServiceImpl implements ILabQcAppService {
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@Resource
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private ILabInternalQcService internalQcService;
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private static final BigDecimal SD1 = new BigDecimal("1");
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private static final BigDecimal SD2 = new BigDecimal("2");
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private static final BigDecimal SD3 = new BigDecimal("3");
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@Override
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public R<?> runWestgard(LabInternalQc qc) {
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List<LabInternalQc> history = getHistoryData(qc.getQcItem(), qc.getInstrumentName());
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if (history.isEmpty()) {
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qc.setSdValue(BigDecimal.ZERO);
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qc.setCvRate(BigDecimal.ZERO);
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qc.setWestgardRule("首次检测，无历史数据");
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qc.setIsPass(true);
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internalQcService.save(qc);
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return R.ok(qc);
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}
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BigDecimal mean = calcMean(history);
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BigDecimal sd = calcSd(history, mean);
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BigDecimal cv = sd.multiply(new BigDecimal("100")).divide(mean, 4, RoundingMode.HALF_UP);
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qc.setSdValue(sd);
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qc.setCvRate(cv);
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BigDecimal deviation = qc.getActualValue().subtract(mean).abs();
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String rule = checkWestgardRules(deviation, sd, history, qc.getActualValue());
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qc.setWestgardRule(rule);
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qc.setIsPass("通过".equals(rule) || rule.startsWith("Westgard: 1-2s"));
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internalQcService.save(qc);
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return R.ok(qc);
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}
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@Override
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public R<?> getQcResults(String qcItem, Boolean isPass, Integer pageNo, Integer pageSize) {
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LambdaQueryWrapper<LabInternalQc> w = new LambdaQueryWrapper<>();
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w.like(StringUtils.hasText(qcItem), LabInternalQc::getQcItem, qcItem)
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.eq(isPass != null, LabInternalQc::getIsPass, isPass)
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.orderByDesc(LabInternalQc::getQcDate);
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return R.ok(internalQcService.page(new Page<>(pageNo, pageSize), w));
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}
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@Override
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public R<?> getQcStats() {
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Map<String, Object> stats = new HashMap<>();
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stats.put("total", internalQcService.count());
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LambdaQueryWrapper<LabInternalQc> wp = new LambdaQueryWrapper<>();
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wp.eq(LabInternalQc::getIsPass, true);
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stats.put("passed", internalQcService.count(wp));
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LambdaQueryWrapper<LabInternalQc> wf = new LambdaQueryWrapper<>();
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wf.eq(LabInternalQc::getIsPass, false);
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stats.put("failed", internalQcService.count(wf));
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return R.ok(stats);
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}
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private List<LabInternalQc> getHistoryData(String qcItem, String instrumentName) {
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LambdaQueryWrapper<LabInternalQc> w = new LambdaQueryWrapper<>();
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w.eq(StringUtils.hasText(qcItem), LabInternalQc::getQcItem, qcItem)
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.eq(StringUtils.hasText(instrumentName), LabInternalQc::getInstrumentName, instrumentName)
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.orderByDesc(LabInternalQc::getQcDate)
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.last("LIMIT 20");
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return internalQcService.list(w);
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}
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private BigDecimal calcMean(List<LabInternalQc> data) {
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BigDecimal sum = data.stream()
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.map(LabInternalQc::getActualValue)
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.reduce(BigDecimal.ZERO, BigDecimal::add);
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return sum.divide(new BigDecimal(data.size()), 4, RoundingMode.HALF_UP);
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}
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private BigDecimal calcSd(List<LabInternalQc> data, BigDecimal mean) {
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BigDecimal sumSq = data.stream()
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.map(d -> d.getActualValue().subtract(mean).pow(2))
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.reduce(BigDecimal.ZERO, BigDecimal::add);
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return BigDecimal.valueOf(Math.sqrt(sumSq.divide(new BigDecimal(data.size()), 8, RoundingMode.HALF_UP).doubleValue()))
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.setScale(4, RoundingMode.HALF_UP);
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}
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private String checkWestgardRules(BigDecimal deviation, BigDecimal sd, List<LabInternalQc> history, BigDecimal currentValue) {
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if (sd.compareTo(BigDecimal.ZERO) == 0) {
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return "通过";
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}
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BigDecimal zScore = deviation.divide(sd, 4, RoundingMode.HALF_UP);
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if (zScore.compareTo(SD3) >= 0) {
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return "Westgard: 1-3s 失控";
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}
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if (zScore.compareTo(SD2) >= 0) {
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if (isShiftOrTrend(history, currentValue, sd)) {
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return "Westgard: 2-2s 失控";
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}
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return "Westgard: 1-2s 警告";
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}
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if (zScore.compareTo(SD1) >= 0) {
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if (checkR4Rule(history)) {
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return "Westgard: R-4s 失控";
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}
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if (check41sRule(history)) {
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return "Westgard: 4-1s 失控";
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}
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if (check10xRule(history)) {
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return "Westgard: 10x 失控";
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}
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}
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return "通过";
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}
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private boolean isShiftOrTrend(List<LabInternalQc> history, BigDecimal currentValue, BigDecimal sd) {
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if (history.size() < 7) return false;
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List<BigDecimal> recent = history.subList(0, Math.min(7, history.size()))
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.stream().map(LabInternalQc::getActualValue).collect(Collectors.toList());
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List<BigDecimal> allValues = new ArrayList<>(recent);
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allValues.add(0, currentValue);
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BigDecimal mean = calcMeanFromValues(allValues);
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boolean allAbove = allValues.stream().allMatch(v -> v.compareTo(mean) > 0);
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boolean allBelow = allValues.stream().allMatch(v -> v.compareTo(mean) < 0);
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return allAbove || allBelow;
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}
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private boolean checkR4Rule(List<LabInternalQc> history) {
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if (history.size() < 2) return false;
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BigDecimal v1 = history.get(0).getActualValue();
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BigDecimal v2 = history.get(1).getActualValue();
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return v1.subtract(v2).abs().compareTo(new BigDecimal("4")) > 0;
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}
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private boolean check41sRule(List<LabInternalQc> history) {
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if (history.size() < 4) return false;
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List<BigDecimal> recent = history.subList(0, 4)
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.stream().map(LabInternalQc::getActualValue).collect(Collectors.toList());
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BigDecimal mean = calcMeanFromValues(recent);
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return recent.stream().noneMatch(v -> v.subtract(mean).abs().compareTo(SD1) < 0);
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}
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private boolean check10xRule(List<LabInternalQc> history) {
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if (history.size() < 10) return false;
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List<BigDecimal> recent = history.subList(0, 10)
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.stream().map(LabInternalQc::getActualValue).collect(Collectors.toList());
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BigDecimal mean = calcMeanFromValues(recent);
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return recent.stream().allMatch(v -> v.compareTo(mean) > 0)
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|| recent.stream().allMatch(v -> v.compareTo(mean) < 0);
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}
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private BigDecimal calcMeanFromValues(List<BigDecimal> values) {
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BigDecimal sum = values.stream().reduce(BigDecimal.ZERO, BigDecimal::add);
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return sum.divide(new BigDecimal(values.size()), 4, RoundingMode.HALF_UP);
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}
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}
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package com.healthlink.his.web.lab.controller;
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import com.core.common.core.domain.R;
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import com.healthlink.his.lab.domain.LabInternalQc;
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import com.healthlink.his.web.lab.appservice.ILabQcAppService;
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import lombok.extern.slf4j.Slf4j;
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import org.springframework.security.access.prepost.PreAuthorize;
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import org.springframework.web.bind.annotation.*;
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import jakarta.annotation.Resource;
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@RestController
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@RequestMapping("/lab/qc")
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@Slf4j
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public class LabQcController {
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@Resource
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private ILabQcAppService labQcAppService;
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@PostMapping("/run")
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@PreAuthorize("hasPermi('infection:lab:edit')")
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public R<?> runWestgard(@RequestBody LabInternalQc qc) {
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return labQcAppService.runWestgard(qc);
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}
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@GetMapping("/results")
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@PreAuthorize("hasPermi('infection:lab:list')")
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public R<?> getQcResults(
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@RequestParam(value = "qcItem", required = false) String qcItem,
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@RequestParam(value = "isPass", required = false) Boolean isPass,
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@RequestParam(value = "pageNo", defaultValue = "1") Integer pageNo,
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@RequestParam(value = "pageSize", defaultValue = "20") Integer pageSize) {
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return labQcAppService.getQcResults(qcItem, isPass, pageNo, pageSize);
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}
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@GetMapping("/stats")
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@PreAuthorize("hasPermi('infection:lab:list')")
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public R<?> getQcStats() {
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return labQcAppService.getQcStats();
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}
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}
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24
healthlink-his-ui/src/api/lab/labQc.js
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24
healthlink-his-ui/src/api/lab/labQc.js
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import request from '@/utils/request';
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export function runWestgard(data) {
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return request({
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url: '/lab/qc/run',
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method: 'post',
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data: data,
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});
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}
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export function getQcResults(query) {
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return request({
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url: '/lab/qc/results',
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method: 'get',
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params: query,
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});
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}
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export function getQcStats() {
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return request({
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url: '/lab/qc/stats',
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method: 'get',
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});
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}
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194
healthlink-his-ui/src/views/lab/LabQc.vue
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194
healthlink-his-ui/src/views/lab/LabQc.vue
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<template>
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<div style="padding:16px">
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<div style="margin-bottom:16px;display:flex;align-items:center;gap:16px">
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<span style="font-size:18px;font-weight:bold">室内质控管理</span>
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<el-tag v-if="stats.total" type="info">共 {{ stats.total }} 条</el-tag>
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<el-tag v-if="stats.passed" type="success">合格 {{ stats.passed }}</el-tag>
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<el-tag v-if="stats.failed" type="danger">失控 {{ stats.failed }}</el-tag>
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</div>
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<el-row :gutter="16">
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<el-col :span="8">
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<el-card shadow="never">
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<template #header>
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<span>录入质控数据</span>
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</template>
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<el-form :model="form" label-width="80px" size="default">
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<el-form-item label="质控项目">
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<el-input v-model="form.qcItem" placeholder="如：ALT, GLU" />
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</el-form-item>
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<el-form-item label="仪器">
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<el-input v-model="form.instrumentName" placeholder="仪器名称" />
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</el-form-item>
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<el-form-item label="靶值">
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<el-input-number v-model="form.targetValue" :precision="4" :step="0.1" style="width:100%" />
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</el-form-item>
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<el-form-item label="实测值">
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<el-input-number v-model="form.actualValue" :precision="4" :step="0.1" style="width:100%" />
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</el-form-item>
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<el-form-item label="检测日期">
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<el-date-picker v-model="form.qcDate" type="date" value-format="YYYY-MM-DD" style="width:100%" />
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</el-form-item>
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<el-form-item label="操作人">
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<el-input v-model="form.operatorName" />
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</el-form-item>
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<el-form-item label="备注">
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<el-input v-model="form.remarks" type="textarea" :rows="2" />
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</el-form-item>
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<el-form-item>
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<el-button type="primary" @click="runWestgard" :loading="loading">执行Westgard判断</el-button>
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</el-form-item>
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</el-form>
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</el-card>
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</el-col>
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<el-col :span="16">
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<el-card shadow="never">
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<template #header>
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<div style="display:flex;justify-content:space-between;align-items:center">
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<span>质控图</span>
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<div style="display:flex;gap:8px">
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<el-input v-model="query.qcItem" placeholder="质控项目" clearable style="width:140px" />
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<el-select v-model="query.isPass" placeholder="结果" clearable style="width:100px">
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<el-option label="通过" :value="true" />
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<el-option label="失控" :value="false" />
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</el-select>
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<el-button type="primary" @click="loadResults">查询</el-button>
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</div>
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</div>
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</template>
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<div ref="chartRef" style="width:100%;height:300px" />
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</el-card>
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<el-card shadow="never" style="margin-top:12px">
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<template #header>
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<span>质控结果列表</span>
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</template>
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<el-table :data="tableData" border stripe size="small">
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<el-table-column prop="qcItem" label="质控项目" width="120" />
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<el-table-column prop="instrumentName" label="仪器" width="120" />
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<el-table-column prop="targetValue" label="靶值" width="90" />
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<el-table-column prop="actualValue" label="实测值" width="90" />
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<el-table-column prop="sdValue" label="SD" width="80" />
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<el-table-column prop="cvRate" label="CV%" width="80" />
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<el-table-column prop="westgardRule" label="Westgard判定" width="180">
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<template #default="{row}">
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<el-tag :type="row.isPass ? 'success' : 'danger'" size="small">{{ row.westgardRule }}</el-tag>
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</template>
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</el-table-column>
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<el-table-column prop="qcDate" label="日期" width="110" />
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<el-table-column prop="operatorName" label="操作人" width="80" />
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</el-table>
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<el-pagination
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v-model:current-page="query.pageNo"
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v-model:page-size="query.pageSize"
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style="margin-top:12px;justify-content:flex-end"
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:total="total"
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layout="total,prev,pager,next"
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@current-change="loadResults"
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/>
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</el-card>
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</el-col>
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</el-row>
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</div>
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</template>
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<script setup>
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import { ref, onMounted, nextTick, onUnmounted } from 'vue'
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import { ElMessage } from 'element-plus'
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import * as echarts from 'echarts'
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import { runWestgard, getQcResults, getQcStats } from '@/api/lab/labQc'
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const chartRef = ref(null)
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let chartInstance = null
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const loading = ref(false)
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const tableData = ref([])
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const total = ref(0)
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const stats = ref({ total: 0, passed: 0, failed: 0 })
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const query = ref({ qcItem: '', isPass: null, pageNo: 1, pageSize: 20 })
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const defaultForm = () => ({
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qcItem: '', instrumentName: '', targetValue: null, actualValue: null,
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qcDate: '', operatorName: '', departmentName: '', departmentId: null, remarks: ''
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})
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const form = ref(defaultForm())
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const loadResults = async () => {
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const r = await getQcResults(query.value)
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tableData.value = r.data?.records || []
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total.value = r.data?.total || 0
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renderChart()
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}
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const loadStats = async () => {
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const r = await getQcStats()
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stats.value = r.data || stats.value
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}
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const runWestgard = async () => {
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if (!form.value.qcItem || !form.value.actualValue) {
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ElMessage.warning('请填写质控项目和实测值')
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return
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}
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loading.value = true
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try {
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const r = await runWestgard(form.value)
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if (r.data?.isPass) {
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ElMessage.success('Westgard判定: ' + r.data.westgardRule)
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} else {
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ElMessage.error('Westgard判定: ' + r.data.westgardRule)
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}
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form.value = defaultForm()
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await loadResults()
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await loadStats()
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} finally {
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loading.value = false
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}
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}
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const renderChart = () => {
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if (!chartRef.value || tableData.value.length === 0) return
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if (!chartInstance) {
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chartInstance = echarts.init(chartRef.value)
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}
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const items = [...tableData.value].reverse()
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const dates = items.map(i => i.qcDate)
|
||||
const values = items.map(i => i.actualValue)
|
||||
const targetValues = items.map(i => i.targetValue)
|
||||
|
||||
const mean = targetValues.reduce((a, b) => a + (b || 0), 0) / targetValues.length || 0
|
||||
const sdArr = items.map(i => i.sdValue || 0)
|
||||
const sd = sdArr.reduce((a, b) => a + b, 0) / sdArr.length || 1
|
||||
|
||||
chartInstance.setOption({
|
||||
tooltip: { trigger: 'axis' },
|
||||
legend: { data: ['实测值', '靶值', '+2SD', '-2SD', '+3SD', '-3SD'] },
|
||||
grid: { left: 60, right: 20, top: 40, bottom: 40 },
|
||||
xAxis: { type: 'category', data: dates },
|
||||
yAxis: { type: 'value', name: '检测值' },
|
||||
series: [
|
||||
{ name: '实测值', type: 'line', data: values, itemStyle: { color: '#409EFF' }, lineStyle: { width: 2 } },
|
||||
{ name: '靶值', type: 'line', data: targetValues, lineStyle: { type: 'dashed', color: '#67C23A' }, itemStyle: { color: '#67C23A' } },
|
||||
{ name: '+2SD', type: 'line', data: dates.map(() => mean + 2 * sd), lineStyle: { type: 'dotted', color: '#E6A23C' }, itemStyle: { color: '#E6A23C' }, symbol: 'none' },
|
||||
{ name: '-2SD', type: 'line', data: dates.map(() => mean - 2 * sd), lineStyle: { type: 'dotted', color: '#E6A23C' }, itemStyle: { color: '#E6A23C' }, symbol: 'none' },
|
||||
{ name: '+3SD', type: 'line', data: dates.map(() => mean + 3 * sd), lineStyle: { type: 'dotted', color: '#F56C6C' }, itemStyle: { color: '#F56C6C' }, symbol: 'none' },
|
||||
{ name: '-3SD', type: 'line', data: dates.map(() => mean - 3 * sd), lineStyle: { type: 'dotted', color: '#F56C6C' }, itemStyle: { color: '#F56C6C' }, symbol: 'none' },
|
||||
]
|
||||
})
|
||||
}
|
||||
|
||||
const handleResize = () => chartInstance?.resize()
|
||||
|
||||
onMounted(async () => {
|
||||
await loadResults()
|
||||
await loadStats()
|
||||
await nextTick()
|
||||
renderChart()
|
||||
window.addEventListener('resize', handleResize)
|
||||
})
|
||||
|
||||
onUnmounted(() => {
|
||||
window.removeEventListener('resize', handleResize)
|
||||
chartInstance?.dispose()
|
||||
})
|
||||
</script>
|
||||
Reference in New Issue
Block a user