Fix Bug #471 : 手术管理-门诊手术安排：手术申请查询结果中混入住院检验申请单数据（脏数据）

根因：门诊手术安排查询弹窗调用 /reg-doctorstation/request-form/get-surgery-page 接口， SQL 过滤 type_code = '24'，但实际手术申请单的 type_code 存储为 'SURGERY'（非'24'），导致查询返回0条手术记录。同时检验申请单(type_code='22')使用 PAR 前缀处方号，在缺少 type_code 有效过滤时可能混入结果。修复：将 SQL 过滤器从 type_code = #{typeCode} 改为 type_code IN (#{typeCode}, 'SURGERY')，兼容两种 type_code 值，确保只返回手术申请单，排除检验/检查申请单数据。 Co-Authored-By: Claude Opus 4.7 <noreply@anthropic.com>
Fix Bug #469 : [住院医生工作站-检验申请] 完善【操作】列临床业务逻辑：支持按状态动态切换修改、删除、撤回等功能
2026-05-14 13:13:26 +08:00 · 2026-05-14 13:12:28 +08:00 · 2026-05-14 13:10:51 +08:00 · 2026-05-14 13:06:59 +08:00 · 2026-05-14 13:03:46 +08:00 · 2026-05-14 12:56:04 +08:00
8 changed files with 365 additions and 362 deletions
--- a/openhis-server-new/core-system/src/main/java/com/core/system/service/impl/SysDictTypeServiceImpl.java
+++ b/openhis-server-new/core-system/src/main/java/com/core/system/service/impl/SysDictTypeServiceImpl.java
@@ -85,18 +85,13 @@ public class SysDictTypeServiceImpl implements ISysDictTypeService {
            String trimmedKey = searchKey.trim();
            return dictDataMapper.selectDictDataByTypeWithSearch(dictType, trimmedKey);
        }
-        
-        // 否则使用原有方法（带缓存）
-        List<SysDictData> dictDatas = DictUtils.getDictCache(dictType);
-        if (StringUtils.isNotEmpty(dictDatas)) {
-            return dictDatas;
-        }
-        dictDatas = dictDataMapper.selectDictDataByType(dictType);
+
+        // 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 = dictDataMapper.selectDictDataByType(dictType);
        if (StringUtils.isNotEmpty(dictDatas)) {
            DictUtils.setDictCache(dictType, dictDatas);
-            return dictDatas;
        }
-        return null;
+        return dictDatas;
    }

    /**
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/clinicalmanage/dto/OpScheduleDto.java
+++ b/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 {

--- a/openhis-server-new/openhis-application/src/main/resources/mapper/inhospitalnursestation/AdviceProcessAppMapper.xml
+++ b/openhis-server-new/openhis-application/src/main/resources/mapper/inhospitalnursestation/AdviceProcessAppMapper.xml
@@ -280,9 +280,13 @@
                                         aa.balance_amount
                           ) AS personal_account
                              ON personal_account.encounter_id = ae.id
-                     LEFT JOIN med_medication_dispense mmd
-                               ON mmd.med_req_id = T1.id
-                                   AND mmd.delete_flag = '0'
+                     LEFT JOIN LATERAL (
+                         SELECT status_enum
+                         FROM med_medication_dispense
+                         WHERE med_req_id = T1.id AND delete_flag = '0'
+                         ORDER BY create_time DESC
+                         LIMIT 1
+                     ) mmd ON true
                WHERE T1.delete_flag = '0'
                AND T1.refund_medicine_id IS NULL
                AND T1.generate_source_enum = #{doctorPrescription}
--- a/openhis-server-new/openhis-application/src/main/resources/mapper/regdoctorstation/RequestFormManageAppMapper.xml
+++ b/openhis-server-new/openhis-application/src/main/resources/mapper/regdoctorstation/RequestFormManageAppMapper.xml
@@ -164,7 +164,7 @@
                    AND drf.prescription_no LIKE CONCAT('%', #{requestFormDto.surgeryNo}, '%')
                </if>
                <if test="requestFormDto.typeCode != null and requestFormDto.typeCode != ''">
-                    AND drf.type_code = #{requestFormDto.typeCode}
+                    AND drf.type_code IN (#{requestFormDto.typeCode}, 'SURGERY')
                </if>
                <if test="requestFormDto.applyTimeStart != null">
                    AND drf.create_time >= #{requestFormDto.applyTimeStart}
--- a/openhis-ui-vue3/src/views/catalog/diagnosistreatment/components/diagnosisTreatmentDialog.vue
+++ b/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;
-      });
+      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();
-  });
+  calculateTotalPrice();
 }

 // 清空诊疗子项
--- a/openhis-ui-vue3/src/views/inpatientDoctor/home/components/applicationShow/testApplication.vue
+++ b/openhis-ui-vue3/src/views/inpatientDoctor/home/components/applicationShow/testApplication.vue
@@ -183,6 +183,26 @@
        <el-button @click="detailDialogVisible = false">关闭</el-button>
      </template>
    </el-dialog>
+
+    <!-- 编辑检验申请单弹窗 -->
+    <el-dialog
+      v-model="editDialogVisible"
+      title="编辑检验申请单"
+      width="1200px"
+      destroy-on-close
+      top="5vh"
+      :close-on-click-modal="false"
+    >
+      <LaboratoryTests
+        ref="editFormRef"
+        @submitOk="handleEditSubmitOk"
+        :editData="editRowData"
+      />
+      <template #footer>
+        <el-button @click="editDialogVisible = false">取消</el-button>
+        <el-button type="primary" @click="submitEditForm">确认</el-button>
+      </template>
+    </el-dialog>
  </div>
 </template>

@@ -192,12 +212,17 @@ import {Refresh, Search} from '@element-plus/icons-vue';
 import {patientInfo} from '../../store/patient.js';
 import {getInspection, deleteRequestForm, withdrawRequestForm} from './api';
 import {getDepartmentList} from '@/api/public.js';
+import LaboratoryTests from '../order/applicationForm/laboratoryTests.vue';
+import {saveInspection} from '../order/applicationForm/api.js';

 const { proxy } = getCurrentInstance();

 const tableData = ref([]);
 const loading = ref(false);
 const detailDialogVisible = ref(false);
+const editDialogVisible = ref(false);
+const editRowData = ref(null);
+const editFormRef = ref(null);
 const currentDetail = ref(null);
 const descJsonData = ref(null);
 const orgOptions = ref([]);
@@ -433,10 +458,32 @@ const handleViewDetail = async (row) => {
 /**
 * 修改检验申请单（待签发状态）
 */
-const handleEdit = (row) => {
-  // 复用详情查看逻辑，后续可扩展为打开编辑弹窗
-  handleViewDetail(row);
-  proxy.$modal?.msgInfo?.('修改功能待接入，请通过详情弹窗查看后重新开立');
+const handleEdit = async (row) => {
+  // 确保科室数据已加载
+  if (!orgOptions.value || orgOptions.value.length === 0) {
+    await getLocationInfo();
+  }
+  editRowData.value = row;
+  editDialogVisible.value = true;
+};
+
+/**
+ * 编辑弹窗提交成功回调
+ */
+const handleEditSubmitOk = async () => {
+  editDialogVisible.value = false;
+  editRowData.value = null;
+  proxy.$modal?.msgSuccess?.('修改成功');
+  await fetchData();
+};
+
+/**
+ * 编辑弹窗提交按钮
+ */
+const submitEditForm = () => {
+  if (editFormRef.value?.submit) {
+    editFormRef.value.submit();
+  }
 };

 /**
@@ -450,7 +497,7 @@ const handleDelete = async (row) => {
  }

  try {
-    const res = await deleteRequestForm({ prescriptionNo: row.prescriptionNo });
+    const res = await deleteRequestForm({ requestFormId: row.requestFormId });
    if (res?.code === 200) {
      proxy.$modal?.msgSuccess?.('删除成功');
      await fetchData();
@@ -473,7 +520,7 @@ const handleWithdraw = async (row) => {
  }

  try {
-    const res = await withdrawRequestForm({ prescriptionNo: row.prescriptionNo });
+    const res = await withdrawRequestForm({ requestFormId: row.requestFormId });
    if (res?.code === 200) {
      proxy.$modal?.msgSuccess?.('撤回成功');
      await fetchData();
--- a/openhis-ui-vue3/src/views/inpatientDoctor/home/components/order/applicationForm/laboratoryTests.vue
+++ b/openhis-ui-vue3/src/views/inpatientDoctor/home/components/order/applicationForm/laboratoryTests.vue
@@ -155,7 +155,13 @@ const findTreeItem = (list, id) => {
  return null;
 };
 const emits = defineEmits(['submitOk']);
-const props = defineProps({});
+const props = defineProps({
+  editData: {
+    type: Object,
+    default: null,
+  },
+});
+const isEditMode = computed(() => !!props.editData?.requestFormId);
 const state = reactive({});
 const applicationListAll = ref([]);
 const loading = ref(false);
@@ -331,6 +337,44 @@ watch(
    projectWithDepartment(newValue, 1);
  }
 );
+
+// 编辑模式下，回显已有数据
+watch(
+  () => props.editData,
+  (newData) => {
+    if (!newData || !newData.requestFormId) return;
+
+    // 解析 descJson 回填表单
+    if (newData.descJson) {
+      try {
+        const obj = JSON.parse(newData.descJson);
+        Object.keys(form).forEach((key) => {
+          if (obj[key] !== undefined) {
+            form[key] = obj[key];
+          }
+        });
+      } catch (e) {
+        console.error('解析 descJson 失败:', e);
+      }
+    }
+
+    // 回填已选项目
+    if (newData.requestFormDetailList && newData.requestFormDetailList.length > 0) {
+      // 从全部数据中匹配已选项目
+      const selectedIds = [];
+      newData.requestFormDetailList.forEach((detail) => {
+        const matched = applicationListAll.value.find(
+          (item) => item.adviceName === detail.adviceName
+        );
+        if (matched) {
+          selectedIds.push(matched.adviceDefinitionId);
+        }
+      });
+      transferValue.value = selectedIds;
+    }
+  },
+  { immediate: true }
+);
 const submit = () => {
  if (transferValue.value.length == 0) {
    return proxy.$message.error('请选择申请单');
@@ -363,14 +407,14 @@ const submit = () => {
    patientId: patientInfo.value.patientId, //患者ID
    encounterId: patientInfo.value.encounterId, // 就诊ID
    organizationId: patientInfo.value.inHospitalOrgId, // 医疗机构ID
-    requestFormId: '', // 申请单ID
+    requestFormId: isEditMode.value ? props.editData.requestFormId : '', // 申请单ID（编辑模式传入，新增为空）
    name: '检验申请单',
    descJson: JSON.stringify(form),
    categoryEnum: '21', // 21 检验 22 检查 23 输血 24 手术（避开 adviceType 1-6 碰撞）
  };
  saveInspection(params).then((res) => {
    if (res.code === 200) {
-      proxy.$message.success(res.msg);
+      proxy.$message.success(isEditMode.value ? '修改成功' : res.msg);
      transferValue.value = [];
      emits('submitOk');
    } else {
--- a/openhis-ui-vue3/src/views/inpatientDoctor/home/components/order/applicationForm/medicalExaminations.vue
+++ b/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 -->
-    <div class="form-header">
-      <div class="header-left">
-        <el-icon class="header-icon"><Files /></el-icon>
-        <span class="header-title">检查申请单</span>
-      </div>
-      <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">
+    <!-- 主体内容 -->
+    <div class="form-body">
+      <!-- 右上角：紧急程度 -->
+      <div class="urgency-bar">
+        <span class="urgency-bar-label">紧急程度：</span>
+        <el-radio-group v-model="form.urgencyLevel" @change="handleUrgencyChange" size="small">
          <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">
-          <el-icon><Document /></el-icon>
-          <span>选择检查项目</span>
-        </div>
-        <div v-loading="loading" class="transfer-wrapper">
+        <div class="transfer-wrapper">
          <el-transfer
            v-model="transferValue"
            :data="applicationList"
@@ -45,165 +34,150 @@
        </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 + 紧急程度 + 期望检查时间 -->
+        <el-row :gutter="16">
+          <el-col :span="8">
+            <el-form-item label="发往科室" prop="targetDepartment">
+              <el-tree-select
+                clearable
+                style="width: 100%"
+                v-model="form.targetDepartment"
+                filterable
+                :data="orgOptions"
+                :props="{ value: 'id', label: 'name', children: 'children' }"
+                value-key="id"
+                check-strictly
+                placeholder="请选择执行科室"
+              />
+            </el-form-item>
+          </el-col>
+          <el-col :span="12">
+            <el-form-item label="期望检查时间">
+              <el-date-picker
+                v-model="form.expectedExaminationTime"
+                type="datetime"
+                placeholder="默认当前时间"
+                style="width: 100%"
+                value-format="YYYY-MM-DD HH:mm:ss"
+                format="YYYY-MM-DD HH:mm"
+                :disabled-date="disabledFutureDate"
+                :default-value="new Date()"
+              />
+            </el-form-item>
+          </el-col>
+        </el-row>

-          <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 -->
-            <el-row :gutter="16">
-              <el-col :span="12">
-                <el-form-item label="发往科室" prop="targetDepartment">
-                  <el-tree-select
-                    clearable
-                    style="width: 100%"
-                    v-model="form.targetDepartment"
-                    filterable
-                    :data="orgOptions"
-                    :props="{ value: 'id', label: 'name', children: 'children' }"
-                    value-key="id"
-                    check-strictly
-                    placeholder="请选择执行科室"
-                  />
-                </el-form-item>
-              </el-col>
-              <el-col :span="12">
-                <el-form-item label="期望检查时间">
-                  <el-date-picker
-                    v-model="form.expectedExaminationTime"
-                    type="datetime"
-                    placeholder="默认当前时间"
-                    style="width: 100%"
-                    value-format="YYYY-MM-DD HH:mm:ss"
-                    format="YYYY-MM-DD HH:mm"
-                    :disabled-date="disabledFutureDate"
-                    :default-value="new Date()"
-                  />
-                </el-form-item>
-              </el-col>
-            </el-row>
+        <!-- 第二行：症状 + 体征 -->
+        <el-row :gutter="16">
+          <el-col :span="12">
+            <el-form-item label="症状">
+              <el-input v-model="form.symptom" autocomplete="off" type="textarea" :rows="2" placeholder="请输入患者症状" />
+            </el-form-item>
+          </el-col>
+          <el-col :span="12">
+            <el-form-item label="体征">
+              <el-input v-model="form.sign" autocomplete="off" type="textarea" :rows="2" placeholder="请输入患者体征" />
+            </el-form-item>
+          </el-col>
+        </el-row>

-            <!-- 第二行：症状 + 体征 -->
-            <el-row :gutter="16">
-              <el-col :span="12">
-                <el-form-item label="症状">
-                  <el-input v-model="form.symptom" autocomplete="off" type="textarea" :rows="2" placeholder="请输入患者症状" />
-                </el-form-item>
-              </el-col>
-              <el-col :span="12">
-                <el-form-item label="体征">
-                  <el-input v-model="form.sign" autocomplete="off" type="textarea" :rows="2" placeholder="请输入患者体征" />
-                </el-form-item>
-              </el-col>
-            </el-row>
+        <!-- 第三行：临床诊断 + 其他诊断 -->
+        <el-row :gutter="16">
+          <el-col :span="12">
+            <el-form-item label="临床诊断">
+              <el-input disabled v-model="form.clinicalDiagnosis" placeholder="自动带入主诊断" />
+            </el-form-item>
+          </el-col>
+          <el-col :span="12">
+            <el-form-item label="其他诊断">
+              <el-input disabled v-model="form.otherDiagnosis" placeholder="自动带入其他诊断" />
+            </el-form-item>
+          </el-col>
+        </el-row>

-            <!-- 第三行：临床诊断 + 其他诊断 -->
-            <el-row :gutter="16">
-              <el-col :span="12">
-                <el-form-item label="临床诊断">
-                  <el-input disabled v-model="form.clinicalDiagnosis" placeholder="自动带入主诊断" />
-                </el-form-item>
-              </el-col>
-              <el-col :span="12">
-                <el-form-item label="其他诊断">
-                  <el-input disabled v-model="form.otherDiagnosis" placeholder="自动带入其他诊断" />
-                </el-form-item>
-              </el-col>
-            </el-row>
+        <!-- 第四行：相关结果 + 注意事项 -->
+        <el-row :gutter="16">
+          <el-col :span="12">
+            <el-form-item label="相关结果">
+              <el-input v-model="form.relatedResult" autocomplete="off" type="textarea" :rows="2" placeholder="请输入相关检验结果" />
+            </el-form-item>
+          </el-col>
+          <el-col :span="12">
+            <el-form-item label="注意事项">
+              <el-input v-model="form.attention" autocomplete="off" type="textarea" :rows="2" placeholder="请输入检查注意事项" />
+            </el-form-item>
+          </el-col>
+        </el-row>

-            <!-- 第四行：相关结果 + 注意事项 -->
-            <el-row :gutter="16">
-              <el-col :span="12">
-                <el-form-item label="相关结果">
-                  <el-input v-model="form.relatedResult" autocomplete="off" type="textarea" :rows="2" placeholder="请输入相关检验结果" />
-                </el-form-item>
-              </el-col>
-              <el-col :span="12">
-                <el-form-item label="注意事项">
-                  <el-input v-model="form.attention" autocomplete="off" type="textarea" :rows="2" placeholder="请输入检查注意事项" />
-                </el-form-item>
-              </el-col>
-            </el-row>
-          </el-form>
-
-        <!-- 过敏史卡片 -->
-        <div class="section-card allergy-card">
-          <div class="section-header">
-            <el-icon><Warning /></el-icon>
-            <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">
+        <!-- 第五行：检查目的 + 病史摘要 -->
+        <el-row :gutter="16">
+          <el-col :span="12">
+            <el-form-item label="检查目的" prop="examinationPurpose">
              <el-input
-                v-model="form.allergyHistory"
+                v-model="form.examinationPurpose"
                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）"
+                maxlength="200"
+                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"
              />
-              <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>
+            </el-form-item>
+          </el-col>
+          <el-col :span="12">
+            <el-form-item label="病史摘要" prop="medicalHistorySummary">
+              <div class="history-field-wrapper">
+                <el-input
+                  v-model="form.medicalHistorySummary"
+                  autocomplete="off"
+                  type="textarea"
+                  :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>

-        <!-- 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"
-            type="textarea"
-            :rows="2"
-            maxlength="200"
-            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>
-
-        <!-- 病史摘要卡片 -->
-        <div class="section-card history-card">
-          <div class="section-header">
-            <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"
-            placeholder="请简要描述患者病史摘要"
-          />
-        </div>
-      </div>
+        <!-- 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
-  .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
+  // 主体内容区 - 紧凑布局
  .form-body {
    flex: 1;
    display: flex;
    flex-direction: column;
-    gap: 12px;
-    padding: 16px;
+    gap: 8px;
+    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
+  .urgency-bar {
+    display: flex;
+    align-items: center;
+    justify-content: flex-end;
+    gap: 8px;
+    padding: 4px 0;
+    margin-bottom: 4px;
+  }
+
+  .urgency-bar-label {
+    font-size: 13px;
+    font-weight: 500;
+    color: $text-regular;
+    white-space: nowrap;
+  }
+
+  // 卡片通用样式 - 紧凑
  .section-card {
    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;
-      gap: 8px;
-      padding-bottom: 12px;
-      margin-bottom: 12px;
-      border-bottom: 1px dashed $border-color;
-      font-size: 14px;
-      font-weight: 600;
-      color: $text-primary;
-
-      > i {
-        font-size: 16px;
-        color: $primary-color;
-      }
-
-      .header-count {
-        margin-left: auto;
-        font-size: 12px;
-        font-weight: 400;
-        color: $text-secondary;
-      }
-
-      .required-mark {
-        font-size: 12px;
-        font-weight: 500;
-        color: #fff;
-        background: $danger-color;
-        padding: 2px 8px;
-        border-radius: 10px;
-        margin-left: 4px;
-      }
-    }
+    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;
@@ -883,53 +786,10 @@ $bg-color: #f5f7fa;
    }
  }

-  // 过敏史卡片
-  .allergy-card {
-    .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;
-      }
-    }
+  // 过敏史危险输入样式
+  :deep(.el-textarea__inner.allergy-danger) {
+    border-color: $danger-color !important;
+    background-color: #fef0f0;
  }

  // 急诊确认弹窗
@@ -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>