Fix Bug #489: 【医嘱闭环】医生站签发单条长期药品医嘱，护士校对界面生成重复（两条）待校对记录

在住院医生站签发流程的 handMedication() 方法中增加去重逻辑，
与门诊医生站保持一致，使用 patientId+encounterId+adviceDefinitionId+dose+methodCode+rateCode
作为唯一键，防止前端重复提交导致数据库产生重复医嘱记录。

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

openhis-server-new/openhis-application/src/main/java/com/openhis/web/regdoctorstation/appservice/impl/AdviceManageAppServiceImpl.java

@@ -341,6 +341,28 @@ public class AdviceManageAppServiceImpl implements IAdviceManageAppService {
                 && (DbOpType.INSERT.getCode().equals(e.getDbOpType()) || DbOpType.UPDATE.getCode().equals(e.getDbOpType())))
                 .collect(Collectors.toList());
 
+        // 防重复保存：对新增医嘱进行去重，避免签发单条长期医嘱时产生重复记录
+        Set<String> longUniqueKeySet = new HashSet<>();
+        List<RegAdviceSaveDto> longUniqueList = new ArrayList<>();
+        for (RegAdviceSaveDto adviceSaveDto : longInsertOrUpdateList) {
+            String uniqueKey = adviceSaveDto.getPatientId() + "_"
+                    + adviceSaveDto.getEncounterId() + "_"
+                    + adviceSaveDto.getAdviceDefinitionId() + "_"
+                    + adviceSaveDto.getDose() + "_"
+                    + adviceSaveDto.getMethodCode() + "_"
+                    + adviceSaveDto.getRateCode();
+            if (DbOpType.INSERT.getCode().equals(adviceSaveDto.getDbOpType()) && longUniqueKeySet.contains(uniqueKey)) {
+                log.warn("防重复保存：检测到重复长期医嘱，跳过保存 - patientId={}, encounterId={}, adviceDefinitionId={}, dose={}",
+                        adviceSaveDto.getPatientId(), adviceSaveDto.getEncounterId(),
+                        adviceSaveDto.getAdviceDefinitionId(), adviceSaveDto.getDose());
+                continue;
+            }
+            longUniqueKeySet.add(uniqueKey);
+            longUniqueList.add(adviceSaveDto);
+        }
+        log.info("防重复保存（长期）：去重前{}条，去重后{}条", longInsertOrUpdateList.size(), longUniqueList.size());
+        longInsertOrUpdateList = longUniqueList;
+
         for (RegAdviceSaveDto regAdviceSaveDto : longInsertOrUpdateList) {
             boolean firstTimeSave = false;// 第一次保存
             longMedicationRequest = new MedicationRequest();
@@ -406,6 +428,29 @@ public class AdviceManageAppServiceImpl implements IAdviceManageAppService {
                 .getValue().equals(e.getTherapyEnum())
                 && (DbOpType.INSERT.getCode().equals(e.getDbOpType()) || DbOpType.UPDATE.getCode().equals(e.getDbOpType())))
                 .collect(Collectors.toList());
+
+        // 防重复保存：对新增医嘱进行去重
+        Set<String> tempUniqueKeySet = new HashSet<>();
+        List<RegAdviceSaveDto> tempUniqueList = new ArrayList<>();
+        for (RegAdviceSaveDto adviceSaveDto : tempInsertOrUpdateList) {
+            String uniqueKey = adviceSaveDto.getPatientId() + "_"
+                    + adviceSaveDto.getEncounterId() + "_"
+                    + adviceSaveDto.getAdviceDefinitionId() + "_"
+                    + adviceSaveDto.getDose() + "_"
+                    + adviceSaveDto.getMethodCode() + "_"
+                    + adviceSaveDto.getRateCode();
+            if (DbOpType.INSERT.getCode().equals(adviceSaveDto.getDbOpType()) && tempUniqueKeySet.contains(uniqueKey)) {
+                log.warn("防重复保存：检测到重复临时医嘱，跳过保存 - patientId={}, encounterId={}, adviceDefinitionId={}, dose={}",
+                        adviceSaveDto.getPatientId(), adviceSaveDto.getEncounterId(),
+                        adviceSaveDto.getAdviceDefinitionId(), adviceSaveDto.getDose());
+                continue;
+            }
+            tempUniqueKeySet.add(uniqueKey);
+            tempUniqueList.add(adviceSaveDto);
+        }
+        log.info("防重复保存（临时）：去重前{}条，去重后{}条", tempInsertOrUpdateList.size(), tempUniqueList.size());
+        tempInsertOrUpdateList = tempUniqueList;
+
         for (RegAdviceSaveDto regAdviceSaveDto : tempInsertOrUpdateList) {
             boolean firstTimeSave = false;// 第一次保存
             tempMedicationRequest = new MedicationRequest();