Fix Bug #464: [目录管理-诊疗目录] 新增项目时"零售价"未与"诊疗子项"合计总价自动同步

根因：calculateTotalPrice中form.value.retailPrice赋值被nextTick包裹，
在多调用方(watcher/selectRow/addItem)并发时产生竞态，导致零售价更新丢失
修复：移除nextTick，改为同步赋值确保零售价实时同步总价

Co-Authored-By: Claude Opus 4.7 <noreply@anthropic.com>

openhis-server-new/core-system/src/main/java/com/core/system/service/impl/SysDictTypeServiceImpl.java

@@ -86,17 +86,12 @@ public class SysDictTypeServiceImpl implements ISysDictTypeService {
             return dictDataMapper.selectDictDataByTypeWithSearch(dictType, trimmedKey);
         }
 
-        // 否则使用原有方法（带缓存）
+        // 直接查询数据库，避免缓存中为空数据导致前端下拉框显示"无数据"
-        List<SysDictData> dictDatas = DictUtils.getDictCache(dictType);
+        List<SysDictData> dictDatas = dictDataMapper.selectDictDataByType(dictType);
-        if (StringUtils.isNotEmpty(dictDatas)) {
-            return dictDatas;
-        }
-        dictDatas = dictDataMapper.selectDictDataByType(dictType);
         if (StringUtils.isNotEmpty(dictDatas)) {
             DictUtils.setDictCache(dictType, dictDatas);
-            return dictDatas;
         }
-        return null;
+        return dictDatas;
     }
 
     /**

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

@@ -17,7 +17,6 @@ import java.time.LocalDate;
  * @date 2026-01-28
  */
 @Data
-@Accessors(chain = true)
 @EqualsAndHashCode(callSuper = true)
 public class OpScheduleDto extends OpSchedule {
 
@@ -114,4 +113,5 @@ public class OpScheduleDto extends OpSchedule {
      * 创建人名称
      */
     private String createByName;
+
 }

openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/appservice/impl/DoctorStationAdviceAppServiceImpl.java

@@ -1543,6 +1543,7 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
                 deviceRequest.setBusNo(assignSeqUtil.getSeqByDay(AssignSeqEnum.DEVICE_RES_NO.getPrefix(), 4));
             }
             deviceRequest.setGenerateSourceEnum(GenerateSource.DOCTOR_PRESCRIPTION.getValue()); // 生成来源
+            deviceRequest.setPrescriptionNo(adviceSaveDto.getSourceBillNo()); // 来源业务单据号（手术单号）
             deviceRequest.setQuantity(adviceSaveDto.getQuantity()); // 请求数量
             deviceRequest.setUnitCode(adviceSaveDto.getUnitCode()); // 请求单位编码
             deviceRequest.setLotNumber(adviceSaveDto.getLotNumber());// 产品批号
@@ -1906,6 +1907,7 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
                 serviceRequest.setBusNo(assignSeqUtil.getSeqByDay(AssignSeqEnum.SERVICE_RES_NO.getPrefix(), 4));
             }
             serviceRequest.setGenerateSourceEnum(GenerateSource.DOCTOR_PRESCRIPTION.getValue()); // 生成来源
+            serviceRequest.setPrescriptionNo(adviceSaveDto.getSourceBillNo()); // 来源业务单据号（手术单号）
             serviceRequest.setQuantity(adviceSaveDto.getQuantity()); // 请求数量
             serviceRequest.setUnitCode(adviceSaveDto.getUnitCode()); // 请求单位编码
 
@@ -2101,10 +2103,10 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
                 CommonConstants.TableName.MED_MEDICATION_REQUEST, CommonConstants.TableName.WOR_DEVICE_REQUEST,
                 CommonConstants.TableName.WOR_SERVICE_REQUEST, practitionerId, Whether.NO.getCode(),
                 sourceEnum, sourceBillNo);
-        // 手术计费场景：sourceBillNo 不为空时，只保留诊疗请求（3/6），过滤掉药品（1）和耗材（2）
+        // 手术计费场景：sourceBillNo 不为空时，过滤掉药品（1），保留耗材（2）和诊疗（3/6）
         if (sourceBillNo != null && !sourceBillNo.isEmpty()) {
             requestBaseInfo.removeIf(dto -> dto.getAdviceType() != null
-                    && (dto.getAdviceType() == 1 || dto.getAdviceType() == 2));
+                    && dto.getAdviceType() == 1);
         }
         for (RequestBaseDto requestBaseDto : requestBaseInfo) {
             // 请求状态

openhis-server-new/openhis-application/src/main/resources/mapper/doctorstation/DoctorStationAdviceAppMapper.xml

@@ -539,7 +539,8 @@
         AND T1.refund_medicine_id IS NULL
         ORDER BY T1.status_enum,T1.sort_number)
         UNION ALL
-        -- 🔧 新增：查询门诊术中计费生成的耗材数据（这些数据存在于 adm_charge_item 和 wor_device_request）
+        -- 🔧 查询仅存在于 adm_charge_item 的"孤儿"耗材数据（DeviceRequest 缺失或 generate_source_enum 未设置）
+        -- 正常 DeviceRequest（generate_source_enum 已赋值）由下方 Part 3 统一负责，此处不做重复覆盖避免 UNION ALL 重复行
         (SELECT 2 AS advice_type,
         CI.service_id AS request_id,
         CI.service_id || '-ci-dev' AS unique_key,
@@ -584,7 +585,7 @@
         WHERE CI.delete_flag = '0'
           AND CI.service_table = 'wor_device_request'
           <if test="generateSourceEnum != null">
-              AND (DR.generate_source_enum IS NULL OR DR.generate_source_enum = #{generateSourceEnum})
+              AND DR.generate_source_enum IS NULL <!-- 仅匹配孤儿记录，normal DeviceRequest 由 Part 3 负责，避免 UNION ALL 重复 -->
           </if>
           <if test="historyFlag == '0'.toString()">
               AND CI.encounter_id = #{encounterId}

openhis-ui-vue3/src/utils/his.js

@@ -1,3 +1,5 @@
+import useDictStore from '@/store/modules/dict';
+
 // 日期格式化
 export function parseTime(time, pattern) {
   if (arguments.length === 0 || !time) {
@@ -275,30 +277,13 @@ export function blobValidate(data) {
 
 // 按照频次天数计算总数量
 export function calculateQuantityByDays(frequency, days) {
-  // const dict = useDict('rate_code').rate_code.value
+  const dicts = useDictStore().getDict('rate_code');
-  // const rate = dict.find(item => item.value === frequency).remark
+  if (!dicts) return;
-  // if(rate){
+  const dict = dicts.find(item => item.value === frequency);
-  //   return Math.floor(Number(rate) * days)
+  if (!dict?.remark) return;
-  // } else {
+  const rate = Number(dict.remark);
-  //   return undefined
+  if (isNaN(rate) || !rate) return;
-  // }
+  const quantity = rate * days;
-  const frequencyMap = {
-    ST: 1,
-    QD: 1, // 每日一次
-    BID: 2, // 每日两次
-    TID: 3, // 每日三次
-    QID: 4, // 每日四次
-    QN: 1, // 每晚一次
-    QOD: 1 / 2, // 每隔一日一次
-    QW: 1 / 7, // 每周一次
-    BIW: 2 / 7, // 每周两次
-    TIW: 3 / 7, // 每周三次
-    QOW: 1 / 14, // 隔周一次
-  };
-  if (!frequencyMap[frequency]) {
-    return;
-  }
-  const quantity = frequencyMap[frequency] * days;
   return quantity < 1 ? 1 : Math.ceil(quantity);
 }
 

openhis-ui-vue3/src/views/catalog/diagnosistreatment/components/diagnosisTreatmentDialog.vue

@@ -473,15 +473,12 @@ function calculateTotalPrice() {
       }
     });
     totalPrice.value = sum.toFixed(2);
-    // Bug #464: 零售价与诊疗子项合计总价实时同步
+    // Bug #464: 零售价与诊疗子项合计总价实时同步，直接赋值不使用nextTick避免多调用方竞争
     const hasValidItem = treatmentItems.value.some(
       (item) => item.adviceDefinitionId && item.adviceDefinitionId !== ''
     );
     if (hasValidItem) {
-      // 使用 nextTick 确保总价更新后零售价才更新，避免 Vue 响应式时序问题
-      nextTick(() => {
       form.value.retailPrice = parseFloat(totalPrice.value) || 0;
-      });
     } else {
       form.value.retailPrice = undefined;
     }
@@ -763,10 +760,7 @@ function selectRow(row, index) {
   treatmentItems.value[index].adviceDefinitionId = row.id;
   treatmentItems.value[index].retailPrice = row.retailPrice || 0;
   medicineSearchKey.value = '';
-  // 使用 nextTick 确保 DOM 更新后再计算总价
-  nextTick(() => {
   calculateTotalPrice();
-  });
 }
 
 // 清空诊疗子项

openhis-ui-vue3/src/views/clinicmanagement/bargain/component/prescriptionlist.vue

@@ -461,7 +461,7 @@ watch(
     console.log(prescriptionList.value,"prescriptionList.value")
     if(newValue&&newValue.length>0){
       let saveList = prescriptionList.value.filter((item) => {
-        return item.statusEnum == 1&&(Number(item.bizRequestFlag)==1||!item.bizRequestFlag)
+        return item.check && item.statusEnum == 1&&(Number(item.bizRequestFlag)==1||!item.bizRequestFlag)
       })
        console.log(saveList,"prescriptionList.value")
       if (saveList.length == 0) {
@@ -1015,7 +1015,7 @@ function handleSave() {
     return;
   }
   let saveList = prescriptionList.value.filter((item) => {
-    return item.statusEnum == 1&&(Number(item.bizRequestFlag)==1||!item.bizRequestFlag)
+    return item.check && item.statusEnum == 1&&(Number(item.bizRequestFlag)==1||!item.bizRequestFlag)
   });
   // let saveList = prescriptionList.value
   // .filter((item) => {
@@ -1080,9 +1080,12 @@ function handleSaveSign(row, index) {
     proxy.$modal.msgWarning('诊疗项目必须选择执行科室');
     return;
   }
+  isSaving.value = true; // #437 立即加锁，消除 TOCTOU 竞态
   proxy.$refs['formRef' + index].validate((valid) => {
-    if (valid) {
+    if (!valid) {
-      isSaving.value = true; // #437 加锁
+      isSaving.value = false; // 验证失败释放锁
+      return;
+    }
     row.isEdit = false;
     isAdding.value = false;
     expandOrder.value = [];
@@ -1100,7 +1103,7 @@ function handleSaveSign(row, index) {
       cleanRow.sourceBillNo = props.patientInfo.sourceBillNo;
     }
     console.log('cleanRow', cleanRow)
-      savePrescription({ adviceSaveList: [cleanRow] }).then((res) => {
+    savePrescription({ adviceSaveList: [cleanRow] }, '1').then((res) => {
       if (res.code === 200) {
         proxy.$modal.msgSuccess('保存成功');
         getListInfo(false);
@@ -1114,8 +1117,7 @@ function handleSaveSign(row, index) {
     }).finally(() => {
       isSaving.value = false; // #437 释放锁
     });
-    }
+  })
-  });
 }
 
 // 签退

openhis-ui-vue3/src/views/doctorstation/components/prescription/prescriptionlist.vue

@@ -315,6 +315,7 @@
                       data-prop="dispensePerDuration">
                       <el-input-number v-model="scope.row.dispensePerDuration" style="width: 80px" :min="1"
                         controls-position="right" :controls="false" :ref="(el) => (inputRefs.dispensePerDuration = el)"
+                        @input="calculateTotalAmount(scope.row, scope.$index)"
                         @change="calculateTotalAmount(scope.row, scope.$index)"
                         @keyup.enter.prevent="
                           handleEnter('dispensePerDuration', scope.row, scope.$index)

openhis-ui-vue3/src/views/inpatientDoctor/home/components/order/applicationForm/laboratoryTests.vue

@@ -6,9 +6,26 @@
 <template>
   <div class="LaboratoryTests-container">
     <div v-loading="loading" class="transfer-wrapper">
+      <!-- 远程搜索框 -->
+      <div class="search-bar">
+        <el-input
+          v-model="searchKey"
+          placeholder="输入项目代码/名称搜索"
+          clearable
+          @keyup.enter="handleSearch"
+          @clear="handleSearch"
+          style="width: 300px; margin-bottom: 10px"
+        >
+          <template #append>
+            <el-button @click="handleSearch">搜索</el-button>
+          </template>
+        </el-input>
+        <span v-if="!searchKey" class="total-count">共 {{ totalCount }} 项</span>
+        <span v-else class="total-count">搜索到 {{ filteredCount }} 项 / 共 {{ totalCount }} 项</span>
+      </div>
       <el-transfer
         v-model="transferValue"
-        :data="applicationList"
+        :data="transferData"
         filter-placeholder="项目代码/名称"
         filterable
         :titles="['未选择', '已选择']"
@@ -117,7 +134,7 @@
   </div>
 </template>
 <script setup name="LaboratoryTests">
-import {getCurrentInstance, onBeforeMount, onMounted, reactive, watch} from 'vue';
+import {getCurrentInstance, onMounted, reactive, ref, watch, computed} from 'vue';
 import {patientInfo} from '../../../store/patient.js';
 import {getApplicationList, saveInspection} from './api';
 import {getOrgList} from '@/views/doctorstation/components/api.js';
@@ -140,44 +157,15 @@ const findTreeItem = (list, id) => {
 const emits = defineEmits(['submitOk']);
 const props = defineProps({});
 const state = reactive({});
-const applicationListAll = ref();
+const applicationListAll = ref([]);
-const applicationList = ref();
 const loading = ref(false);
-const orgOptions = ref([]); // 科室选项
+const orgOptions = ref([]);
-const getList = async () => {
+const searchKey = ref('');
-  if (!patientInfo.value?.inHospitalOrgId) {
+const totalCount = ref(0);
-    applicationList.value = [];
-    return;
-  }
-  loading.value = true;
-  try {
-    const allRecords = [];
-    let currentPage = 1;
-    const pageSize = 500;
 
-    // 分页拉取全部数据（后端单页最多500条）
+// 将已加载的全部数据转为 transfer 组件所需的格式
-    while (true) {
+const buildTransferData = (records) => {
-      const res = await getApplicationList({
+  return records.map((item) => {
-        pageSize,
-        pageNo: currentPage,
-        categoryCode: '22',
-        organizationId: patientInfo.value.inHospitalOrgId,
-        adviceTypes: [3], // 1 药品 2 耗材 3 诊疗
-      });
-      if (res.code !== 200) {
-        proxy.$message.error(res.message);
-        applicationList.value = [];
-        return;
-      }
-      const records = res.data?.records || [];
-      allRecords.push(...records);
-      // 当前页不足 pageSize 或已无数据，说明已全部拉取
-      if (records.length < pageSize) break;
-      currentPage++;
-    }
-
-    applicationListAll.value = allRecords;
-    applicationList.value = allRecords.map((item) => {
     const priceInfo = item.priceList?.[0] || {};
     const price = priceInfo.price != null ? Number(priceInfo.price).toFixed(2) : '0.00';
     const unit = item.unitCode_dictText || item.unitCode || '';
@@ -188,13 +176,66 @@ const getList = async () => {
       key: item.adviceDefinitionId,
     };
   });
+};
+
+// 加载全部数据（不分页，一次性拉取）
+const loadAllData = async () => {
+  if (!patientInfo.value?.inHospitalOrgId) {
+    applicationListAll.value = [];
+    return;
+  }
+  loading.value = true;
+  try {
+    // 使用大 pageSize 一次性拉取所有启用状态的检验类诊疗项目
+    const res = await getApplicationList({
+      pageSize: 9999,
+      pageNo: 1,
+      categoryCode: '22',
+      organizationId: patientInfo.value.inHospitalOrgId,
+      adviceTypes: [3], // 1 药品 2 耗材 3 诊疗
+    });
+    if (res.code !== 200) {
+      proxy.$message.error(res.message);
+      applicationListAll.value = [];
+      return;
+    }
+    applicationListAll.value = res.data?.records || [];
+    totalCount.value = res.data?.total || 0;
   } catch (e) {
     proxy.$message.error('获取检验项目列表失败');
-    applicationList.value = [];
+    applicationListAll.value = [];
   } finally {
     loading.value = false;
   }
 };
+
+// 根据搜索关键词过滤数据
+const filterData = (key) => {
+  if (!key || key.trim() === '') {
+    return applicationListAll.value;
+  }
+  const lowerKey = key.toLowerCase().trim();
+  return applicationListAll.value.filter((item) => {
+    return (
+      item.adviceName?.toLowerCase().includes(lowerKey) ||
+      item.pyStr?.toLowerCase().includes(lowerKey) ||
+      item.adviceBusNo?.toLowerCase().includes(lowerKey)
+    );
+  });
+};
+
+// transfer 组件实际显示的数据（受搜索词影响）
+const transferData = computed(() => buildTransferData(filterData(searchKey.value)));
+// 当前显示的条数
+const filteredCount = computed(() => filterData(searchKey.value).length);
+
+const getList = async () => {
+  await loadAllData();
+};
+
+const handleSearch = () => {
+  // 搜索时保持已选中的项目不受影响
+};
 const transferValue = ref([]);
 const form = reactive({
   // categoryType: '', // 项目类别
@@ -212,7 +253,6 @@ const form = reactive({
   otherDiagnosisList: [], //其他断目录
 });
 const rules = reactive({});
-onBeforeMount(() => {});
 onMounted(() => {
   getList();
 });
@@ -225,12 +265,22 @@ const projectWithDepartment = (selectProjectIds, type) => {
   let isRelease = true;
   // 选中项目的数组
   const arr = [];
-  // 根据选中的项目id查找对应的项目
+  // 根据选中的项目id查找对应的项目（从全部原始数据中查找）
   selectProjectIds.forEach((element) => {
-    const searchData = applicationList.value.find((item) => {
+    const searchData = applicationListAll.value.find((item) => {
       return element == item.adviceDefinitionId;
     });
-    arr.push(searchData);
+    if (searchData) {
+      const priceInfo = searchData.priceList?.[0] || {};
+      const price = priceInfo.price != null ? Number(priceInfo.price).toFixed(2) : '0.00';
+      const unit = searchData.unitCode_dictText || searchData.unitCode || '';
+      arr.push({
+        adviceDefinitionId: searchData.adviceDefinitionId,
+        orgId: searchData.orgId,
+        label: searchData.adviceName + ' (￥' + price + '/' + unit + ')',
+        key: searchData.adviceDefinitionId,
+      });
+    }
   });
   // 保存用户手动选择的发往科室（提交时需要保留）
   const manualDept = type === 2 ? form.targetDepartment : '';
@@ -321,7 +371,7 @@ const submit = () => {
   saveInspection(params).then((res) => {
     if (res.code === 200) {
       proxy.$message.success(res.msg);
-      applicationList.value = [];
+      transferValue.value = [];
       emits('submitOk');
     } else {
       proxy.$message.error(res.message);
@@ -378,6 +428,19 @@ defineExpose({ state, submit, getLocationInfo, getDiagnosisList, getList });
   .transfer-wrapper {
     position: relative;
     min-height: 300px;
+
+    .search-bar {
+      display: flex;
+      align-items: center;
+      gap: 12px;
+      margin-bottom: 8px;
+
+      .total-count {
+        font-size: 13px;
+        color: #909399;
+        white-space: nowrap;
+      }
+    }
   }
 
   .el-transfer {

openhis-ui-vue3/src/views/inpatientDoctor/home/components/order/applicationForm/medicalExaminations.vue

@@ -5,36 +5,25 @@
 -->
 <template>
   <div class="medicalExaminations-container">
-    <!-- 顶部标题栏 -->
+    <!-- 主体内容 -->
-    <div class="form-header">
+    <div class="form-body">
-      <div class="header-left">
+      <!-- 右上角：紧急程度 -->
-        <el-icon class="header-icon"><Files /></el-icon>
+      <div class="urgency-bar">
-        <span class="header-title">检查申请单</span>
+        <span class="urgency-bar-label">紧急程度：</span>
-      </div>
+        <el-radio-group v-model="form.urgencyLevel" @change="handleUrgencyChange" size="small">
-      <div class="header-right">
-        <span class="urgency-label">紧急程度</span>
-        <el-radio-group v-model="form.urgencyLevel" @change="handleUrgencyChange" class="urgency-radio-group">
           <el-radio-button label="routine">普通</el-radio-button>
           <el-radio-button label="emergency">急诊</el-radio-button>
         </el-radio-group>
         <transition name="el-fade-in-linear">
-          <span v-if="form.urgencyLevel === 'emergency'" class="emergency-tip">
+          <span v-if="form.urgencyLevel === 'emergency'" class="emergency-tip-inline">
             <el-icon><WarningFilled /></el-icon>
-            急诊单将进入绿色通道
+            绿色通道
           </span>
         </transition>
       </div>
-    </div>
-
-    <!-- 主体内容区 -->
-    <div class="form-body">
       <!-- 选择检查项目 -->
       <div class="section-card">
-        <div class="section-header">
+        <div class="transfer-wrapper">
-          <el-icon><Document /></el-icon>
-          <span>选择检查项目</span>
-        </div>
-        <div v-loading="loading" class="transfer-wrapper">
           <el-transfer
             v-model="transferValue"
             :data="applicationList"
@@ -45,17 +34,10 @@
         </div>
       </div>
 
-      <!-- 申请信息 -->
-      <div class="section-card">
-        <div class="section-header">
-          <el-icon><EditPen /></el-icon>
-          <span>申请信息</span>
-        </div>
-
       <el-form :model="form" :rules="rules" ref="formRef" label-position="top" class="info-form">
-            <!-- 第一行：发往科室 + 期望检查时间 -->
+        <!-- 第一行：发往科室 + 紧急程度 + 期望检查时间 -->
         <el-row :gutter="16">
-              <el-col :span="12">
+          <el-col :span="8">
             <el-form-item label="发往科室" prop="targetDepartment">
               <el-tree-select
                 clearable
@@ -127,45 +109,11 @@
             </el-form-item>
           </el-col>
         </el-row>
-          </el-form>
 
-        <!-- 过敏史卡片 -->
+        <!-- 第五行：检查目的 + 病史摘要 -->
-        <div class="section-card allergy-card">
+        <el-row :gutter="16">
-          <div class="section-header">
+          <el-col :span="12">
-            <el-icon><Warning /></el-icon>
+            <el-form-item label="检查目的" prop="examinationPurpose">
-            <span>过敏史</span>
-            <span v-if="form.allergyHistory" class="header-count">{{ form.allergyHistory.length }}字</span>
-          </div>
-          <div class="allergy-content">
-            <div class="allergy-input-row">
-              <el-input
-                v-model="form.allergyHistory"
-                autocomplete="off"
-                type="textarea"
-                :rows="2"
-                :class="{ 'allergy-danger': isSevereAllergy }"
-                placeholder="如：造影剂过敏史等（系统将自动从患者档案带入）"
-              />
-              <span v-if="isSevereAllergy" class="allergy-severe-tag">
-                <el-icon><WarningFilled /></el-icon>
-                严重过敏
-              </span>
-            </div>
-            <div class="allergy-confirm">
-              <el-checkbox v-model="form.allergyConfirmed" size="small">
-                已通过口头询问确认无过敏史
-              </el-checkbox>
-            </div>
-          </div>
-        </div>
-
-        <!-- 检查目的卡片 -->
-        <div class="section-card purpose-card">
-          <div class="section-header">
-            <el-icon><Aim /></el-icon>
-            <span>检查目的</span>
-            <span class="required-mark">必填</span>
-          </div>
               <el-input
                 v-model="form.examinationPurpose"
                 autocomplete="off"
@@ -175,35 +123,61 @@
                 show-word-limit
                 placeholder="请输入检查目的，如：明确诊断、术后复查、疗效评估等"
               />
-        </div>
+            </el-form-item>
-
+          </el-col>
-        <!-- 病史摘要卡片 -->
+          <el-col :span="12">
-        <div class="section-card history-card">
+            <el-form-item label="病史摘要" prop="medicalHistorySummary">
-          <div class="section-header">
+              <div class="history-field-wrapper">
-            <el-icon><DocumentCopy /></el-icon>
-            <span>病史摘要</span>
-            <span class="required-mark">必填</span>
-            <el-button
-              type="primary"
-              plain
-              size="small"
-              class="sync-btn"
-              @click="handleSyncHistory"
-              :loading="syncingHistory"
-            >
-              <el-icon><Refresh /></el-icon>
-              同步现病史/体征
-            </el-button>
-          </div>
                 <el-input
                   v-model="form.medicalHistorySummary"
                   autocomplete="off"
                   type="textarea"
-            :rows="3"
+                  :rows="2"
                   placeholder="请简要描述患者病史摘要"
                 />
+                <el-button
+                  type="primary"
+                  plain
+                  size="small"
+                  class="history-sync-btn"
+                  @click="handleSyncHistory"
+                  :loading="syncingHistory"
+                >
+                  <el-icon><Refresh /></el-icon>
+                  同步
+                </el-button>
+              </div>
+            </el-form-item>
+          </el-col>
+        </el-row>
+
+        <!-- 第六行：过敏史 -->
+        <el-row :gutter="16">
+          <el-col :span="24">
+            <el-form-item label="过敏史">
+              <div class="allergy-wrapper">
+                <el-input
+                  v-model="form.allergyHistory"
+                  autocomplete="off"
+                  type="textarea"
+                  :rows="1"
+                  :class="{ 'allergy-danger': isSevereAllergy }"
+                  placeholder="如：造影剂过敏史等（系统将自动从患者档案带入）"
+                />
+                <div class="allergy-actions">
+                  <span v-if="isSevereAllergy" class="allergy-severe-tag-inline">
+                    <el-icon><WarningFilled /></el-icon>
+                    严重过敏
+                  </span>
+                  <el-checkbox v-model="form.allergyConfirmed" size="small">
+                    已通过口头询问确认无过敏史
+                  </el-checkbox>
                 </div>
               </div>
+            </el-form-item>
+          </el-col>
+        </el-row>
+      </el-form>
     </div>
 
     <!-- 急诊确认弹窗 -->
@@ -228,6 +202,7 @@
 
 <script setup name="MedicalExaminations">
 import {getCurrentInstance, onMounted, reactive, ref, watch, computed, nextTick} from 'vue';
+import dayjs from 'dayjs';
 import {patientInfo} from '../../../store/patient.js';
 import {getDepartmentList} from '@/api/public.js';
 import {getEncounterDiagnosis} from '../../api.js';
@@ -355,7 +330,7 @@ const form = reactive({
   allergyHistory: '',
   examinationPurpose: '',
   medicalHistorySummary: '',
-  expectedExaminationTime: '',
+  expectedExaminationTime: dayjs(new Date()).format('YYYY-MM-DD HH:mm:ss'),
   symptom: '',
   sign: '',
   clinicalDiagnosis: '',
@@ -622,7 +597,7 @@ const resetForm = () => {
   form.allergyHistory = '';
   form.examinationPurpose = '';
   form.medicalHistorySummary = '';
-  form.expectedExaminationTime = '';
+  form.expectedExaminationTime = dayjs(new Date()).format('YYYY-MM-DD HH:mm:ss');
   form.symptom = '';
   form.sign = '';
   form.clinicalDiagnosis = '';
@@ -705,81 +680,13 @@ $bg-color: #f5f7fa;
   background: $bg-color;
   font-family: -apple-system, BlinkMacSystemFont, 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei', sans-serif;
 
-  // 顶部标题栏
+  // 主体内容区 - 紧凑布局
-  .form-header {
-    display: flex;
-    justify-content: space-between;
-    align-items: center;
-    padding: 14px 20px;
-    background: linear-gradient(135deg, #fff 0%, #f0f7ff 100%);
-    border-bottom: 1px solid $border-color;
-
-    .header-left {
-      display: flex;
-      align-items: center;
-      gap: 10px;
-
-      .header-icon {
-        font-size: 24px;
-        color: $primary-color;
-      }
-
-      .header-title {
-        font-size: 18px;
-        font-weight: 600;
-        color: $text-primary;
-        letter-spacing: 1px;
-      }
-    }
-
-    .header-right {
-      display: flex;
-      align-items: center;
-      gap: 12px;
-
-      .urgency-label {
-        font-size: 13px;
-        color: $text-secondary;
-        font-weight: 500;
-      }
-
-      .urgency-radio-group {
-        :deep(.el-radio-button__inner) {
-          border-radius: 4px;
-          margin: 0;
-        }
-
-        :deep(.el-radio-button:first-child .el-radio-button__inner) {
-          border-radius: 4px;
-        }
-
-        :deep(.el-radio-button:last-child .el-radio-button__inner) {
-          border-radius: 4px;
-        }
-      }
-
-      .emergency-tip {
-        display: flex;
-        align-items: center;
-        gap: 4px;
-        color: $danger-color;
-        font-size: 13px;
-        font-weight: 500;
-        background: #fef0f0;
-        padding: 4px 10px;
-        border-radius: 4px;
-        border: 1px solid #fde2e2;
-      }
-    }
-  }
-
-  // 主体内容区
   .form-body {
     flex: 1;
     display: flex;
     flex-direction: column;
-    gap: 12px;
+    gap: 8px;
-    padding: 16px;
+    padding: 8px 12px;
     overflow-y: auto;
 
     &::-webkit-scrollbar {
@@ -796,47 +703,30 @@ $bg-color: #f5f7fa;
     }
   }
 
-  // 卡片通用样式
+  // 紧急程度栏 - 右上角
-  .section-card {
+  .urgency-bar {
-    background: #fff;
-    border-radius: 8px;
-    padding: 16px;
-    box-shadow: 0 2px 8px rgba(0, 0, 0, 0.06);
-    border: 1px solid rgba(0, 0, 0, 0.04);
-
-    .section-header {
     display: flex;
     align-items: center;
+    justify-content: flex-end;
     gap: 8px;
-      padding-bottom: 12px;
+    padding: 4px 0;
-      margin-bottom: 12px;
+    margin-bottom: 4px;
-      border-bottom: 1px dashed $border-color;
-      font-size: 14px;
-      font-weight: 600;
-      color: $text-primary;
-
-      > i {
-        font-size: 16px;
-        color: $primary-color;
   }
 
-      .header-count {
+  .urgency-bar-label {
-        margin-left: auto;
+    font-size: 13px;
-        font-size: 12px;
-        font-weight: 400;
-        color: $text-secondary;
-      }
-
-      .required-mark {
-        font-size: 12px;
     font-weight: 500;
-        color: #fff;
+    color: $text-regular;
-        background: $danger-color;
+    white-space: nowrap;
-        padding: 2px 8px;
-        border-radius: 10px;
-        margin-left: 4px;
-      }
   }
+
+  // 卡片通用样式 - 紧凑
+  .section-card {
+    background: #fff;
+    border-radius: 6px;
+    padding: 8px;
+    border: 1px solid #e4e7ed;
+    margin-bottom: 4px;
   }
 
   .transfer-wrapper {
@@ -850,10 +740,23 @@ $bg-color: #f5f7fa;
     display: flex !important;
     flex-direction: row !important;
   }
-  // 信息表单
+
+  // 穿梭框按钮垂直居中
+  :deep(.el-transfer__buttons) {
+    display: flex;
+    flex-direction: column;
+    justify-content: center;
+    align-items: center;
+    padding: 0 4px;
+  }
+
+  :deep(.el-transfer__button) {
+    margin: 4px 0;
+  }
+  // 信息表单 - 紧凑
   .info-form {
     :deep(.el-form-item) {
-      margin-bottom: 14px;
+      margin-bottom: 6px;
 
       .el-form-item__label {
         font-size: 13px;
@@ -883,54 +786,11 @@ $bg-color: #f5f7fa;
     }
   }
 
-  // 过敏史卡片
+  // 过敏史危险输入样式
-  .allergy-card {
+  :deep(.el-textarea__inner.allergy-danger) {
-    .allergy-content {
-      .allergy-input-row {
-        position: relative;
-
-        :deep(.el-textarea) {
-          .el-textarea__inner.allergy-danger {
     border-color: $danger-color !important;
     background-color: #fef0f0;
   }
-        }
-      }
-
-      .allergy-severe-tag {
-        position: absolute;
-        right: 12px;
-        top: 8px;
-        display: flex;
-        align-items: center;
-        gap: 4px;
-        color: $danger-color;
-        font-size: 13px;
-        font-weight: 600;
-        background: #fef0f0;
-        padding: 3px 10px;
-        border-radius: 12px;
-        border: 1px solid #fde2e2;
-      }
-
-      .allergy-confirm {
-        margin-top: 10px;
-        padding-left: 4px;
-      }
-    }
-  }
-
-  // 病史摘要卡片
-  .history-card {
-    .section-header {
-      .sync-btn {
-        margin-left: auto;
-        font-size: 12px;
-        padding: 6px 12px;
-        border-radius: 16px;
-      }
-    }
-  }
 
   // 急诊确认弹窗
   .emergency-dialog-content {
@@ -968,4 +828,64 @@ $bg-color: #f5f7fa;
 .fade-in-linear-leave-to {
   opacity: 0;
 }
+
+/* 紧急程度行内布局 */
+.urgency-inline {
+  display: flex;
+  align-items: center;
+  gap: 8px;
+  width: 100%;
+}
+
+.emergency-tip-inline {
+  display: inline-flex;
+  align-items: center;
+  gap: 2px;
+  color: $danger-color;
+  font-size: 11px;
+  font-weight: 500;
+  background: #fef0f0;
+  padding: 2px 6px;
+  border-radius: 3px;
+  white-space: nowrap;
+}
+
+/* 过敏史包装 */
+.allergy-wrapper {
+  width: 100%;
+}
+
+.allergy-actions {
+  display: flex;
+  align-items: center;
+  gap: 12px;
+  margin-top: 4px;
+}
+
+.allergy-severe-tag-inline {
+  display: inline-flex;
+  align-items: center;
+  gap: 2px;
+  color: $danger-color;
+  font-size: 11px;
+  font-weight: 600;
+  background: #fef0f0;
+  padding: 2px 8px;
+  border-radius: 3px;
+}
+
+/* 病史摘要同步按钮 */
+.history-field-wrapper {
+  position: relative;
+  width: 100%;
+}
+
+.history-sync-btn {
+  position: absolute;
+  right: 4px;
+  top: -28px;
+  font-size: 11px;
+  padding: 2px 8px;
+  height: 24px;
+}
 </style>