更新

2026-08-14 14:37:30 +08:00
parent 21790e35f4
commit 18c15d1262
117 changed files with 28157 additions and 8080 deletions
@@ -0,0 +1,107 @@
+-- 患者级 AI 诊断报告：不可变生成快照 + 两个独立接口权限。
+-- 重要：本表故意不设置 (patient_id, model_key) 唯一键；每次生成必须 INSERT，历史绝不覆盖。
+
+CREATE TABLE IF NOT EXISTS `zyt_patient_ai_report` (
+  `id` bigint unsigned NOT NULL AUTO_INCREMENT COMMENT '患者AI报告快照ID',
+  `patient_id` int unsigned NOT NULL COMMENT '稳定患者ID(tcm_diagnosis.patient_id)',
+  `diagnosis_id` int unsigned DEFAULT NULL COMMENT '生成时数据域内最新诊单ID',
+  `model_key` varchar(32) NOT NULL COMMENT '服务端模型配置键(qwen/openai)',
+  `model_name` varchar(100) NOT NULL DEFAULT '' COMMENT '生成时实际模型名称快照',
+  `model_label` varchar(50) NOT NULL DEFAULT '' COMMENT '模型展示名快照',
+  `report_json` longtext NOT NULL COMMENT '结构化报告JSON',
+  `diagnosis` mediumtext NOT NULL COMMENT '结构化诊断分析',
+  `risk_assessment_json` text NOT NULL COMMENT '风险评估JSON数组',
+  `treatment_advice` mediumtext NOT NULL COMMENT '治疗与复核建议',
+  `disclaimer` varchar(255) NOT NULL DEFAULT '' COMMENT '固定医疗免责声明',
+  `source_snapshot` longtext NOT NULL COMMENT '生成时结构化来源快照JSON，仅服务端保存',
+  `source_summary_json` text NOT NULL COMMENT '用于历史列表的非原文来源计数摘要JSON',
+  `source_diagnosis_ids_json` text NOT NULL COMMENT '生成时全部来源诊单ID集合，用于历史行级权限复核',
+  `source_hash` char(64) NOT NULL COMMENT '规范化来源快照SHA-256',
+  `prompt_version` varchar(64) NOT NULL DEFAULT '' COMMENT '服务端提示词版本',
+  `message_id` varchar(191) NOT NULL DEFAULT '' COMMENT '上游消息ID，仅用于服务端审计',
+  `generated_at` int unsigned NOT NULL COMMENT '模型生成Unix时间',
+  `admin_id` int unsigned NOT NULL DEFAULT 0 COMMENT '发起生成的管理员ID',
+  `department_id` int unsigned NOT NULL DEFAULT 0 COMMENT '生成时首个所属部门ID快照',
+  `department_name` varchar(100) NOT NULL DEFAULT '' COMMENT '生成时首个所属部门名称快照',
+  `department_snapshot_json` text NOT NULL COMMENT '生成时全部所属部门JSON快照',
+  `created_at` int unsigned NOT NULL COMMENT '记录创建Unix时间',
+  PRIMARY KEY (`id`),
+  KEY `idx_patient_generated` (`patient_id`, `generated_at`, `id`),
+  KEY `idx_patient_model_generated` (`patient_id`, `model_key`, `generated_at`, `id`),
+  KEY `idx_diagnosis` (`diagnosis_id`),
+  KEY `idx_admin_generated` (`admin_id`, `generated_at`),
+  KEY `idx_department_generated` (`department_id`, `generated_at`),
+  KEY `idx_source_hash` (`source_hash`)
+) ENGINE=InnoDB DEFAULT CHARSET=utf8mb4 COLLATE=utf8mb4_unicode_ci COMMENT='患者级AI诊断报告不可变快照';
+
+SET @patient_ai_parent_id := (
+    SELECT `id`
+    FROM `zyt_system_menu`
+    WHERE `type` = 'C'
+      AND `perms` IN ('tcm.diagnosis/lists', 'doctor.appointment/lists')
+    ORDER BY FIELD(`perms`, 'tcm.diagnosis/lists', 'doctor.appointment/lists'), `id`
+    LIMIT 1
+);
+
+INSERT INTO `zyt_system_menu` (
+    `pid`, `type`, `name`, `icon`, `sort`, `perms`, `paths`, `component`,
+    `selected`, `params`, `is_cache`, `is_show`, `is_disable`, `create_time`, `update_time`
+)
+SELECT
+    COALESCE(@patient_ai_parent_id, 0), 'A', '查看患者AI诊断报告', '', 66,
+    'tcm.diagnosis/patientAiReports', '', '', '', '', 0, 1, 0,
+    UNIX_TIMESTAMP(), UNIX_TIMESTAMP()
+FROM DUAL
+WHERE NOT EXISTS (
+    SELECT 1 FROM `zyt_system_menu`
+    WHERE `perms` = 'tcm.diagnosis/patientAiReports'
+);
+
+INSERT INTO `zyt_system_menu` (
+    `pid`, `type`, `name`, `icon`, `sort`, `perms`, `paths`, `component`,
+    `selected`, `params`, `is_cache`, `is_show`, `is_disable`, `create_time`, `update_time`
+)
+SELECT
+    COALESCE(@patient_ai_parent_id, 0), 'A', '生成患者AI诊断报告', '', 67,
+    'tcm.diagnosis/generatePatientAiReport', '', '', '', '', 0, 1, 0,
+    UNIX_TIMESTAMP(), UNIX_TIMESTAMP()
+FROM DUAL
+WHERE NOT EXISTS (
+    SELECT 1 FROM `zyt_system_menu`
+    WHERE `perms` = 'tcm.diagnosis/generatePatientAiReport'
+);
+
+SET @patient_ai_read_id := (
+    SELECT `id` FROM `zyt_system_menu`
+    WHERE `perms` = 'tcm.diagnosis/patientAiReports'
+    ORDER BY `id` LIMIT 1
+);
+SET @patient_ai_generate_id := (
+    SELECT `id` FROM `zyt_system_menu`
+    WHERE `perms` = 'tcm.diagnosis/generatePatientAiReport'
+    ORDER BY `id` LIMIT 1
+);
+
+-- 已能查看诊单/旧诊单AI报告的角色继承患者报告读取权限；之后仍可在角色菜单中单独撤销。
+INSERT IGNORE INTO `zyt_system_role_menu` (`role_id`, `menu_id`)
+SELECT DISTINCT `rm`.`role_id`, @patient_ai_read_id
+FROM `zyt_system_role_menu` AS `rm`
+INNER JOIN `zyt_system_menu` AS `m` ON `m`.`id` = `rm`.`menu_id`
+WHERE @patient_ai_read_id IS NOT NULL
+  AND `m`.`perms` IN (
+      'tcm.diagnosis/lists',
+      'tcm.diagnosis/detail',
+      'tcm.diagnosis/readonlyDetail',
+      'tcm.diagnosis/aiReports'
+  );
+
+-- 生成是独立能力，只从原有AI生成/结构化分析能力继承，不因能查看诊单而自动开放。
+INSERT IGNORE INTO `zyt_system_role_menu` (`role_id`, `menu_id`)
+SELECT DISTINCT `rm`.`role_id`, @patient_ai_generate_id
+FROM `zyt_system_role_menu` AS `rm`
+INNER JOIN `zyt_system_menu` AS `m` ON `m`.`id` = `rm`.`menu_id`
+WHERE @patient_ai_generate_id IS NOT NULL
+  AND `m`.`perms` IN (
+      'tcm.diagnosis/generateAiReports',
+      'tcm.diagnosis/aiAnalysis'
+  );