新增功能

admin/src/api/file.ts

@@ -26,6 +26,28 @@ export async function uploadImageBlob(file: Blob, filename = 'screenshot.jpg') {
   return json.data as { id: number; uri: string; url: string }
 }
 
+/** 本地上传视频（管理端 /upload/video），返回 data 含 uri 完整访问地址、url 相对路径 */
+export async function uploadVideoBlob(file: Blob, filename = 'recording.webm') {
+  const appStore = useAppStore()
+  const formData = new FormData()
+  formData.append('file', file, filename)
+  formData.append('cid', '0')
+  const url = `${config.baseUrl}${config.urlPrefix}/upload/video`
+  const res = await fetch(url, {
+    method: 'POST',
+    headers: {
+      token: getToken() || '',
+      version: appStore.config.version || ''
+    },
+    body: formData
+  })
+  const json = await res.json()
+  if (json.code !== RequestCodeEnum.SUCCESS) {
+    throw new Error(json.msg || '上传失败')
+  }
+  return json.data as { id: number; uri: string; url: string }
+}
+
 export function fileCateAdd(params: Record<string, any>) {
     return request.post({ url: '/file/addCate', params })
 }

admin/src/api/tcm.ts

@@ -89,9 +89,12 @@ export function getRecordsByPatient(params: any) {
 
 // ========== 音视频通话 ==========
 
-// 获取通话签名
+// 获取通话签名（忽略取消令牌，避免 open + 会话切换 watch 重复请求互斥取消）
 export function getCallSignature(params: any) {
-    return request.post({ url: '/tcm.diagnosis/getCallSignature', params })
+    return request.post(
+        { url: '/tcm.diagnosis/getCallSignature', params },
+        { ignoreCancelToken: true, isOpenRetry: false }
+    )
 }
 
 // 发起通话
@@ -99,9 +102,12 @@ export function startCall(params: any) {
     return request.post({ url: '/tcm.diagnosis/startCall', params })
 }
 
-// 结束通话
+// 结束通话（忽略取消令牌：idle / afterCalling 可能并发触发相同请求体）
 export function endCall(params: any) {
-    return request.post({ url: '/tcm.diagnosis/endCall', params })
+    return request.post(
+        { url: '/tcm.diagnosis/endCall', params },
+        { ignoreCancelToken: true, isOpenRetry: false }
+    )
 }
 
 // 获取通话记录
@@ -114,6 +120,24 @@ export function bindCallRoom(params: { diagnosis_id: number; room_id: string })
     return request.post({ url: '/tcm.diagnosis/bindCallRoom', params })
 }
 
+/** 医生接通并绑定房间后：发起腾讯云云端混流录制 */
+export function startCloudRecording(params: { diagnosis_id: number }) {
+    return request.post({ url: '/tcm.diagnosis/startCloudRecording', params })
+}
+
+/** 本地录制完成后，将已上传视频的访问地址写入通话记录（忽略取消令牌，避免与其它 POST 互斥取消） */
+export function attachLocalCallRecording(params: { diagnosis_id: number; file_url: string }) {
+    return request.post(
+        { url: '/tcm.diagnosis/attachLocalCallRecording', params },
+        { ignoreCancelToken: true, isOpenRetry: false }
+    )
+}
+
+/** 医助旁观当前进行中的视频通话（进房参数，Web TRTC 只拉流） */
+export function getAssistantWatchCallParams(params: { diagnosis_id: number }) {
+    return request.get({ url: '/tcm.diagnosis/watchCall', params })
+}
+
 // ========== 小程序分享 ==========
 
 // 生成小程序码

admin/src/components/chat-dialog/index.vue

@@ -66,7 +66,10 @@
           class="call-kit-drag-handle"
           @mousedown="onCallKitDragStart"
         >
-          <span class="drag-handle-text">视频通话</span>
+          <div class="call-kit-drag-handle-left">
+            <span class="drag-handle-text">视频通话</span>
+            <span v-if="localRecordingBadge" class="call-local-recording-hint">本地录制中</span>
+          </div>
          <div class="call-kit-drag-handle-actions">
              <el-button
               type="primary"
@@ -106,14 +109,17 @@
 <script setup lang="ts">
 import { ref, nextTick, watch, computed, onMounted, onUnmounted } from 'vue'
 import { Loading, Close, Rank, Camera } from '@element-plus/icons-vue'
-import { uploadImageBlob } from '@/api/file'
+import { uploadImageBlob, uploadVideoBlob } from '@/api/file'
 import {
+  attachLocalCallRecording,
   bindCallRoom,
+  endCall,
   getCallSignature,
   startCall,
   tcmDiagnosisDetail,
   tcmDiagnosisEdit
 } from '@/api/tcm'
+import { CallLocalRecorder } from '@/utils/call-local-recorder'
 import { captureVideoFrameFromElement } from '@/utils/call-video-screenshot'
 import feedback from '@/utils/feedback'
 import {
@@ -176,6 +182,68 @@ let bindRoomRetryAttempts = 0
 const BIND_ROOM_MAX_ATTEMPTS = 40
 const BIND_ROOM_RETRY_MS = 100
 
+const localCallRecorder = new CallLocalRecorder()
+const localRecordingBadge = ref(false)
+let localRecordingRound = 0
+let startLocalRecTimer: ReturnType<typeof setTimeout> | null = null
+let finalizeLocalRecordingPromise: Promise<void> | null = null
+/** 本次振铃/通话对应的 startCall 落库（beforeCalling 发起，bind/上传前须 await） */
+let pendingCallRecordStart: Promise<void> = Promise.resolve()
+/** 接通前快照诊单 ID，避免会话切换等导致上传阶段 diagnosisId 丢失 */
+let recordingDiagnosisIdSnapshot: number | null = null
+
+function clearLocalRecordingStartTimer() {
+  if (startLocalRecTimer) {
+    clearTimeout(startLocalRecTimer)
+    startLocalRecTimer = null
+  }
+}
+
+function finalizeLocalRecordingAndAttach(): Promise<void> {
+  if (finalizeLocalRecordingPromise) {
+    return finalizeLocalRecordingPromise
+  }
+  finalizeLocalRecordingPromise = (async () => {
+    clearLocalRecordingStartTimer()
+    localRecordingBadge.value = false
+    localCallRecorder.beginStopNow()
+    const id = recordingDiagnosisIdSnapshot ?? diagnosisId.value
+    try {
+      await pendingCallRecordStart
+    } catch {
+      //
+    }
+    const blob = await localCallRecorder.stop()
+    if (!blob) {
+      console.warn(
+        '[chat-dialog] 本地录制无有效文件（若通话较长仍出现，请换 Chrome 并看控制台是否有 MediaRecorder 报错）'
+      )
+      return
+    }
+    if (id == null) {
+      feedback.msgWarning('缺少诊单信息，本地录制无法保存到通话记录')
+      return
+    }
+    try {
+      const data = await uploadVideoBlob(blob, `call-rec-${id}-${Date.now()}.webm`)
+      const fileUrl = data.uri || data.url
+      if (!fileUrl) {
+        feedback.msgError('上传成功但未返回文件地址')
+        return
+      }
+      await attachLocalCallRecording({ diagnosis_id: id, file_url: fileUrl })
+      feedback.msgSuccess('本地录制已上传并关联到通话记录')
+    } catch (e: unknown) {
+      const msg = e instanceof Error ? e.message : String(e)
+      console.warn('[chat-dialog] 本地录制上传/关联失败', e)
+      feedback.msgError(msg || '本地录制上传失败')
+    }
+  })().finally(() => {
+    finalizeLocalRecordingPromise = null
+  })
+  return finalizeLocalRecordingPromise
+}
+
 /** 从 TUIStore 读取房间号；默认 0 表示尚未分配 */
 function readRoomIdFromStore(): string {
   const raw = TUIStore.getData(StoreName.CALL, NAME.ROOM_ID)
@@ -328,6 +396,50 @@ function installEngineRoomCapture() {
   wrap('groupCall')
 }
 
+/** hangup 时 SDK 会立刻 exitRoom；在 hangup 入口同步停录，避免轨道被掐断后无数据 */
+function installHangupPreStopHook() {
+  const w = window as unknown as Record<string, unknown>
+  if (w.__zytHangupPreStop__) return
+  const server = TUICallKitServer as unknown as Record<string, unknown> & {
+    hangup?: (...args: unknown[]) => unknown
+  }
+  const raw = server.hangup
+  if (typeof raw !== 'function') return
+  w.__zytHangupPreStop__ = true
+  server.hangup = function patchedHangup(this: unknown, ...args: unknown[]) {
+    localCallRecorder.beginStopNow()
+    return raw.apply(TUICallKitServer, args)
+  }
+}
+
+/**
+ * UI 挂断时往往先调 TRTC stopLocalVideo/stopLocalAudio，再 hangup；必须在它们之前停 MediaRecorder。
+ */
+function installTrtcCloudPreStopHook() {
+  const w = window as unknown as Record<string, unknown>
+  if (w.__zytTrtcPreStop__) return
+  const eng = TUICallKitServer.getTUICallEngineInstance?.() as
+    | { trtcCloud?: Record<string, unknown> }
+    | null
+    | undefined
+  const trtc = eng?.trtcCloud
+  if (!trtc || typeof trtc !== 'object') return
+  let patched = 0
+  const methods = ['stopLocalVideo', 'stopLocalAudio'] as const
+  for (const methodName of methods) {
+    const orig = trtc[methodName]
+    if (typeof orig !== 'function') continue
+    trtc[methodName] = function patchedTrtc(this: unknown, ...args: unknown[]) {
+      localCallRecorder.beginStopNow()
+      return (orig as (...a: unknown[]) => unknown).apply(trtc, args)
+    }
+    patched++
+  }
+  if (patched > 0) {
+    w.__zytTrtcPreStop__ = true
+  }
+}
+
 let engineRoomEventHandlers: Array<{ event: TUICallEvent; fn: (e: unknown) => void }> = []
 
 function bindEngineRoomEvents() {
@@ -348,6 +460,22 @@ function bindEngineRoomEvents() {
       }
       void tryBindRoomIfReady()
     }
+    const onEarlyStopRecording = () => {
+      console.log('[chat-dialog] 检测到通话结束事件，立即停止录制')
+      if (localCallRecorder.isRecording()) {
+        console.log('[chat-dialog] 录制进行中，触发 beginStopNow')
+        localCallRecorder.beginStopNow()
+      }
+    }
+    const earlyStopEvents = [
+      TUICallEvent.CALL_END,
+      TUICallEvent.USER_LEAVE,
+      TUICallEvent.ON_CALL_NOT_CONNECTED
+    ] as const
+    for (const event of earlyStopEvents) {
+      subscribe.call(eng, event, onEarlyStopRecording)
+      engineRoomEventHandlers.push({ event, fn: onEarlyStopRecording })
+    }
     const events = [TUICallEvent.USER_ENTER, TUICallEvent.ON_CALL_BEGIN] as const
     for (const event of events) {
       subscribe.call(eng, event, onRoomHint)
@@ -400,6 +528,11 @@ function installTUICallKitRoomHooks() {
 }
 
 async function doBindCallRoom(rid: string) {
+  try {
+    await pendingCallRecordStart
+  } catch {
+    //
+  }
   if (patientId.value == null || diagnosisId.value == null) return
   const key = `${diagnosisId.value}:${rid}`
   if (key === lastBoundRoomKey.value) {
@@ -449,17 +582,115 @@ async function ensureCallRecordStarted() {
   }
 }
 
+/** 将 tcm_call_record 中本条进行中的记录置为已结束（挂断、对端挂断、异常断线、关窗等） */
+async function reportCallEnded() {
+  if (diagnosisId.value == null) return
+  try {
+    await endCall({ diagnosis_id: diagnosisId.value })
+    console.log('[chat-dialog] endCall 已同步')
+  } catch (e) {
+    console.warn('[chat-dialog] endCall 失败', e)
+  }
+}
+
 function setupCallRoomBinding() {
   tearDownCallRoomBinding?.()
+  let previousCallStatus =
+    (TUIStore.getData(StoreName.CALL, NAME.CALL_STATUS) as string | undefined) ?? CALL_STATUS_IDLE
+
   const onCallStatus = (newData?: string) => {
-    if (newData === CALL_STATUS_IDLE) {
+    const next = (newData as string | undefined) ?? CALL_STATUS_IDLE
+    if (next === CALL_STATUS_IDLE) {
+      if (previousCallStatus === CALL_STATUS_CALLING || previousCallStatus === CALL_STATUS_CONNECTED) {
+        localCallRecorder.beginStopNow()
+      }
+      clearLocalRecordingStartTimer()
+      localRecordingBadge.value = false
+      if (previousCallStatus === CALL_STATUS_CALLING || previousCallStatus === CALL_STATUS_CONNECTED) {
+        void (async () => {
+          await finalizeLocalRecordingAndAttach()
+          showCallKitWindow.value = false
+          await reportCallEnded()
+        })()
+      }
       clearBindRoomRetry()
       lastBoundRoomKey.value = ''
+      previousCallStatus = next
       return
     }
-    if (newData === CALL_STATUS_CONNECTED) {
+    if (next === CALL_STATUS_CONNECTED) {
       void tryBindRoomIfReady()
+      clearLocalRecordingStartTimer()
+      const roundAtSchedule = localRecordingRound
+      
+      // 立即尝试启动录制，不要等待 1200ms
+      const attemptStartRecording = (retryCount = 0) => {
+        if (roundAtSchedule !== localRecordingRound) {
+          console.log('[chat-dialog] 录制轮次已变化，取消启动')
+          return
+        }
+        
+        const root = callKitContentRef.value
+        const st = TUIStore.getData(StoreName.CALL, NAME.CALL_STATUS) as string | undefined
+        if (!root || st !== CALL_STATUS_CONNECTED) {
+          console.warn('[chat-dialog] 录制启动条件不满足', { root: !!root, status: st })
+          return
+        }
+        
+        console.log(`[chat-dialog] 尝试启动本地录制（第 ${retryCount + 1} 次）`)
+        
+        // 检查视频元素
+        let videos = Array.from(root.querySelectorAll('video')) as HTMLVideoElement[]
+        
+        // 如果容器内没有，检查 body（TUICallKit Teleport）
+        if (videos.length === 0) {
+          const bodyVideos = Array.from(document.body.querySelectorAll('video')) as HTMLVideoElement[]
+          videos = bodyVideos.filter(v => {
+            const so = v.srcObject
+            if (!(so instanceof MediaStream)) return false
+            return so.getVideoTracks().some(t => t.readyState === 'live')
+          })
+          console.log('[chat-dialog] 在 body 中找到活跃视频:', videos.length)
+        }
+        
+        if (videos.length === 0) {
+          if (retryCount < 10) {
+            console.warn('[chat-dialog] 未找到视频元素，300ms 后重试')
+            startLocalRecTimer = setTimeout(() => attemptStartRecording(retryCount + 1), 300)
+          } else {
+            console.error('[chat-dialog] 重试 10 次后仍未找到视频元素，放弃录制')
+          }
+          return
+        }
+        
+        // 检查视频是否有有效数据
+        const hasReadyVideo = videos.some(v => v.readyState >= HTMLMediaElement.HAVE_CURRENT_DATA)
+        if (!hasReadyVideo) {
+          if (retryCount < 10) {
+            console.warn('[chat-dialog] 视频元素未就绪，300ms 后重试')
+            startLocalRecTimer = setTimeout(() => attemptStartRecording(retryCount + 1), 300)
+          } else {
+            console.error('[chat-dialog] 重试 10 次后视频仍未就绪，放弃录制')
+          }
+          return
+        }
+        
+        console.log('[chat-dialog] 视频元素已就绪，立即启动录制')
+        const ok = localCallRecorder.start(root)
+        localRecordingBadge.value = ok
+        if (!ok) {
+          console.error('[chat-dialog] 本地录制启动失败（MediaRecorder 或画布初始化失败）')
+        } else {
+          console.log('[chat-dialog] ✅ 本地录制已成功启动')
+        }
+      }
+      
+      // 延迟 500ms 后开始尝试（给视频元素一点加载时间）
+      startLocalRecTimer = setTimeout(() => attemptStartRecording(0), 500)
+    } else {
+      clearLocalRecordingStartTimer()
     }
+    previousCallStatus = next
   }
   const onRoomId = () => {
     void tryBindRoomIfReady()
@@ -595,6 +826,8 @@ onMounted(() => {
 })
 
 onUnmounted(() => {
+  clearLocalRecordingStartTimer()
+  localCallRecorder.reset()
   tearDownCallRoomBinding?.()
   unbindEngineRoomEvents()
   unhookConsoleErrorForPackageHint()
@@ -733,18 +966,33 @@ const open = async (data: { patientId: number; patientName: string; diagnosisId?
     }
     isCallReady.value = !!(window as any).__TUICallKitInited__
     if (isCallReady.value) {
-      // 仅在通话时显示视频窗口，无通话时隐藏；发起通话前落库、接通后绑定房间号（云端录制）
+      // 仅在通话时显示视频窗口；发起通话前落库、接通后绑定房间号（自动云端录制 + 浏览器本地录制）
       TUICallKitServer.setCallback({
         beforeCalling: () => {
+          installTrtcCloudPreStopHook()
+          clearLocalRecordingStartTimer()
+          localCallRecorder.reset()
+          localRecordingBadge.value = false
+          localRecordingRound++
+          recordingDiagnosisIdSnapshot = diagnosisId.value
           showCallKitWindow.value = true
-          void ensureCallRecordStarted()
+          pendingCallRecordStart = ensureCallRecordStarted()
+          void pendingCallRecordStart
         },
+        // 同步停录须早于 SDK 内部退房；再 finalize 上传并关窗
         afterCalling: () => {
-          showCallKitWindow.value = false
+          localCallRecorder.beginStopNow()
+          void (async () => {
+            await finalizeLocalRecordingAndAttach()
+            showCallKitWindow.value = false
+            await reportCallEnded()
+          })()
         }
       })
       installTUICallKitRoomHooks()
       installEngineRoomCapture()
+      installHangupPreStopHook()
+      installTrtcCloudPreStopHook()
       bindEngineRoomEvents()
       setupCallRoomBinding()
       bindEnginePackageErrorListener()
@@ -945,6 +1193,8 @@ const handleCallKitScreenshot = async () => {
 const handleCallKitClose = async () => {
   if (isCallReady.value) {
     try {
+      localCallRecorder.beginStopNow()
+      await finalizeLocalRecordingAndAttach()
       await TUICallKitServer.hangup()
     } catch (err) {
       console.warn('关闭视频窗口时挂断失败:', err)
@@ -982,14 +1232,22 @@ const onHeaderMouseUp = () => {
 }
 
 const handleClose = async () => {
-  // 关闭时如有通话中/拨通中，自动挂断
-  if (isCallReady.value && showCallKitWindow.value) {
-    try {
-      await TUICallKitServer.hangup()
-    } catch (err) {
-      console.warn('挂断通话时出错:', err)
+  // 关闭时如有通话中/拨通中，先结束本地录制再挂断（不依赖悬浮窗是否显示）
+  if (isCallReady.value) {
+    const st = TUIStore.getData(StoreName.CALL, NAME.CALL_STATUS)
+    if (st === CALL_STATUS_CALLING || st === CALL_STATUS_CONNECTED) {
+      try {
+        localCallRecorder.beginStopNow()
+        await finalizeLocalRecordingAndAttach()
+        await TUICallKitServer.hangup()
+      } catch (err) {
+        console.warn('挂断通话时出错:', err)
+      }
     }
   }
+  if (diagnosisId.value != null) {
+    await reportCallEnded()
+  }
   try {
     // 登出 Chat
    // await logout()
@@ -1139,11 +1397,24 @@ defineExpose({ open })
   user-select: none;
   flex-shrink: 0;
 
+  .call-kit-drag-handle-left {
+    display: flex;
+    align-items: center;
+    gap: 8px;
+    min-width: 0;
+  }
+
   .drag-handle-text {
     font-size: 13px;
     color: #fff;
   }
 
+  .call-local-recording-hint {
+    font-size: 11px;
+    color: #f89898;
+    white-space: nowrap;
+  }
+
   .call-kit-drag-handle-actions {
     display: flex;
     align-items: center;

admin/src/utils/call-local-recorder.ts

@@ -0,0 +1,480 @@
+/**
+ * 浏览器端本地录制：将通话区域内多路 video 合成到 canvas 后 MediaRecorder
+ * 音频从各 video 的 srcObject 汇入 Web Audio 混音；Chrome 下 canvas 2D 的 captureStream 需每帧 requestFrame 才会稳定产出编码数据
+ */
+
+function pickRecorderMime(): string {
+  const candidates = [
+    'video/webm;codecs=vp9,opus',
+    'video/webm;codecs=vp8,opus',
+    'video/webm;codecs=vp9',
+    'video/webm;codecs=vp8',
+    'video/webm'
+  ]
+  for (const m of candidates) {
+    if (MediaRecorder.isTypeSupported(m)) return m
+  }
+  return ''
+}
+
+function getAudioContextCtor(): (typeof AudioContext) | null {
+  const w = window as unknown as {
+    AudioContext?: typeof AudioContext
+    webkitAudioContext?: typeof AudioContext
+  }
+  return w.AudioContext || w.webkitAudioContext || null
+}
+
+/** 2D canvas 的 captureStream 视频轨，需每帧 requestFrame（否则 Chrome 可能整段无编码数据） */
+type CanvasCaptureVideoTrack = MediaStreamTrack & { requestFrame?: () => void }
+
+function drawCover(
+  ctx: CanvasRenderingContext2D,
+  v: HTMLVideoElement,
+  x: number,
+  y: number,
+  w: number,
+  h: number
+) {
+  const vw = v.videoWidth || v.clientWidth || 1
+  const vh = v.videoHeight || v.clientHeight || 1
+  const scale = Math.max(w / vw, h / vh)
+  const dw = vw * scale
+  const dh = vh * scale
+  const dx = x + (w - dw) / 2
+  const dy = y + (h - dh) / 2
+  try {
+    ctx.drawImage(v, dx, dy, dw, dh)
+  } catch {
+    /* 部分浏览器安全策略 */
+  }
+}
+
+function drawVideosGrid(
+  ctx: CanvasRenderingContext2D,
+  videos: HTMLVideoElement[],
+  cw: number,
+  ch: number
+) {
+  ctx.fillStyle = '#0b0b0b'
+  ctx.fillRect(0, 0, cw, ch)
+  const list = videos.filter((v) => v.readyState >= HTMLMediaElement.HAVE_CURRENT_DATA)
+  if (list.length === 0) return
+  if (list.length === 1) {
+    drawCover(ctx, list[0], 0, 0, cw, ch)
+    return
+  }
+  const cols = Math.ceil(Math.sqrt(list.length))
+  const rows = Math.ceil(list.length / cols)
+  const cellW = cw / cols
+  const cellH = ch / rows
+  list.forEach((v, i) => {
+    const c = i % cols
+    const r = Math.floor(i / cols)
+    drawCover(ctx, v, c * cellW, r * cellH, cellW, cellH)
+  })
+}
+
+function collectAudioTracksFromVideos(videos: HTMLVideoElement[]): MediaStreamTrack[] {
+  const seen = new Set<string>()
+  const out: MediaStreamTrack[] = []
+  for (const v of videos) {
+    const so = v.srcObject
+    if (!(so instanceof MediaStream)) continue
+    for (const t of so.getAudioTracks()) {
+      if (t.kind !== 'audio' || t.readyState === 'ended' || !t.enabled) continue
+      if (seen.has(t.id)) continue
+      seen.add(t.id)
+      out.push(t)
+    }
+  }
+  return out
+}
+
+function collectAudioTracksFromCaptureStream(videos: HTMLVideoElement[]): MediaStreamTrack[] {
+  const seen = new Set<string>()
+  const out: MediaStreamTrack[] = []
+  for (const v of videos) {
+    if (v.readyState < HTMLMediaElement.HAVE_CURRENT_DATA) continue
+    const cap = (v as HTMLVideoElement & { captureStream?: () => MediaStream }).captureStream?.()
+    if (!cap) continue
+    for (const t of cap.getAudioTracks()) {
+      if (t.kind !== 'audio' || t.readyState === 'ended' || !t.enabled) continue
+      if (seen.has(t.id)) continue
+      seen.add(t.id)
+      out.push(t)
+    }
+  }
+  return out
+}
+
+/** TRTC 等可能用独立 <audio> 播远端，不挂在 video 的 srcObject 上 */
+function collectAudioTracksFromAudioElements(root?: HTMLElement | null): MediaStreamTrack[] {
+  const seen = new Set<string>()
+  const out: MediaStreamTrack[] = []
+  const lists: HTMLAudioElement[] = [
+    ...document.body.querySelectorAll('audio')
+  ] as HTMLAudioElement[]
+  if (root) lists.push(...(root.querySelectorAll('audio') as unknown as HTMLAudioElement[]))
+  const kit = document.getElementById('tuicallkit-id')
+  if (kit) lists.push(...(kit.querySelectorAll('audio') as unknown as HTMLAudioElement[]))
+  const dedupEl = new Set<Element>()
+  for (const a of lists) {
+    if (dedupEl.has(a)) continue
+    dedupEl.add(a)
+    const so = a.srcObject
+    if (!(so instanceof MediaStream)) continue
+    for (const t of so.getAudioTracks()) {
+      if (t.kind !== 'audio' || t.readyState === 'ended' || !t.enabled) continue
+      if (seen.has(t.id)) continue
+      seen.add(t.id)
+      out.push(t)
+    }
+  }
+  return out
+}
+
+function resolveRecordingVideos(preferred: HTMLElement): HTMLVideoElement[] {
+  const seen = new Set<Element>()
+  const uniq = (list: HTMLVideoElement[]) => {
+    const out: HTMLVideoElement[] = []
+    for (const v of list) {
+      if (seen.has(v)) continue
+      seen.add(v)
+      out.push(v)
+    }
+    return out
+  }
+
+  const fromPreferred = [...preferred.querySelectorAll('video')] as HTMLVideoElement[]
+  if (fromPreferred.length > 0) return uniq(fromPreferred)
+
+  const kit = document.getElementById('tuicallkit-id')
+  if (kit) {
+    const fromKit = [...kit.querySelectorAll('video')] as HTMLVideoElement[]
+    if (fromKit.length > 0) return uniq(fromKit)
+  }
+
+  const bodyVideos = [...document.body.querySelectorAll('video')] as HTMLVideoElement[]
+  const withLiveVideo = bodyVideos.filter((v) => {
+    const so = v.srcObject
+    if (!(so instanceof MediaStream)) return false
+    return so.getVideoTracks().some((t) => t.readyState === 'live')
+  })
+  return uniq(withLiveVideo)
+}
+
+export class CallLocalRecorder {
+  private canvas: HTMLCanvasElement | null = null
+  private ctx: CanvasRenderingContext2D | null = null
+  private rafId = 0
+  private container: HTMLElement | null = null
+  private mediaRecorder: MediaRecorder | null = null
+  private chunks: Blob[] = []
+  private mimeType = ''
+  private audioCtx: AudioContext | null = null
+  private audioDestination: MediaStreamAudioDestinationNode | null = null
+  private wiredTrackIds = new Set<string>()
+  private canvasVideoTrack: CanvasCaptureVideoTrack | null = null
+  private silentOsc: OscillatorNode | null = null
+  private silentGain: GainNode | null = null
+  /** 本机麦克风：TRTC 常不把本地麦混进远端画面用的 MediaStream，需单独拉一路混音 */
+  private micStream: MediaStream | null = null
+  private stopResultPromise: Promise<Blob | null> | null = null
+
+  isRecording(): boolean {
+    return this.mediaRecorder !== null && this.mediaRecorder.state === 'recording'
+  }
+
+  beginStopNow(): void {
+    if (this.stopResultPromise) return
+
+    cancelAnimationFrame(this.rafId)
+    this.rafId = 0
+
+    const mr = this.mediaRecorder
+    const mimeFallback = this.mimeType
+
+    if (!mr || mr.state === 'inactive') {
+      return
+    }
+
+    this.stopResultPromise = new Promise((resolve) => {
+      mr.onstop = () => {
+        this.teardownAudioGraph()
+        const type = mr.mimeType || mimeFallback || 'video/webm'
+        const blob =
+          this.chunks.length > 0 ? new Blob(this.chunks, { type }) : null
+        this.chunks = []
+        this.mediaRecorder = null
+        this.container = null
+        this.canvas = null
+        this.ctx = null
+        this.canvasVideoTrack = null
+        resolve(blob && blob.size > 0 ? blob : null)
+      }
+      try {
+        const m = mr as MediaRecorder & { requestData?: () => void }
+        m.requestData?.()
+        mr.stop()
+      } catch {
+        this.teardownAudioGraph()
+        this.chunks = []
+        this.mediaRecorder = null
+        this.container = null
+        this.canvas = null
+        this.ctx = null
+        this.canvasVideoTrack = null
+        resolve(null)
+      }
+    })
+  }
+
+  private teardownAudioGraph(): void {
+    try {
+      this.silentOsc?.stop()
+    } catch {
+      /* */
+    }
+    this.silentOsc = null
+    this.silentGain = null
+    if (this.micStream) {
+      for (const t of this.micStream.getTracks()) {
+        try {
+          t.stop()
+        } catch {
+          /* */
+        }
+      }
+      this.micStream = null
+    }
+    this.wiredTrackIds.clear()
+    this.audioDestination = null
+    if (this.audioCtx) {
+      void this.audioCtx.close().catch(() => {})
+      this.audioCtx = null
+    }
+  }
+
+  private connectTrackToMixer(track: MediaStreamTrack): void {
+    if (track.kind !== 'audio' || track.readyState === 'ended' || !track.enabled) return
+    if (!this.audioCtx || !this.audioDestination) return
+    if (this.wiredTrackIds.has(track.id)) return
+    try {
+      const src = this.audioCtx.createMediaStreamSource(new MediaStream([track]))
+      const gain = this.audioCtx.createGain()
+      gain.gain.value = 1.25
+      src.connect(gain)
+      gain.connect(this.audioDestination)
+      this.wiredTrackIds.add(track.id)
+    } catch {
+      /* */
+    }
+  }
+
+  /** 接通后单独混本机麦（与画面里的远端轨并存，避免「只有画面没医生声音」） */
+  private attachMicForMixer(): void {
+    if (!this.audioCtx || !this.audioDestination) return
+    const md = navigator.mediaDevices
+    if (!md?.getUserMedia) return
+    void md.getUserMedia({ audio: true, video: false }).then((stream) => {
+      if (!this.audioDestination || !this.audioCtx) {
+        stream.getTracks().forEach((t) => t.stop())
+        return
+      }
+      if (this.micStream) {
+        stream.getTracks().forEach((t) => t.stop())
+        return
+      }
+      this.micStream = stream
+      for (const t of stream.getAudioTracks()) {
+        this.connectTrackToMixer(t)
+      }
+    }).catch(() => {
+      /* 无权限或已占用时仅录远端 */
+    })
+  }
+
+  private wireIncomingAudio(): void {
+    if (!this.audioCtx || !this.audioDestination || !this.container) return
+    if (this.audioCtx.state === 'suspended') {
+      void this.audioCtx.resume().catch(() => {})
+    }
+    const videos = resolveRecordingVideos(this.container)
+    const kit = document.getElementById('tuicallkit-id')
+    const audioTags = [
+      ...document.body.querySelectorAll('audio'),
+      ...this.container.querySelectorAll('audio'),
+      ...(kit ? kit.querySelectorAll('audio') : [])
+    ] as HTMLAudioElement[]
+
+    const seenEl = new Set<Element>()
+    const mediaEls: HTMLMediaElement[] = []
+    for (const v of videos) {
+      if (!seenEl.has(v)) {
+        seenEl.add(v)
+        mediaEls.push(v)
+      }
+    }
+    for (const a of audioTags) {
+      if (!seenEl.has(a)) {
+        seenEl.add(a)
+        mediaEls.push(a)
+      }
+    }
+
+    for (const el of mediaEls) {
+      const so = el.srcObject
+      if (so instanceof MediaStream) {
+        for (const t of so.getAudioTracks()) {
+          this.connectTrackToMixer(t)
+        }
+      }
+      if (el instanceof HTMLVideoElement) {
+        if (el.readyState >= HTMLMediaElement.HAVE_CURRENT_DATA) {
+          const cap = el.captureStream?.()
+          if (cap) {
+            for (const t of cap.getAudioTracks()) {
+              this.connectTrackToMixer(t)
+            }
+          }
+        }
+      }
+    }
+  }
+
+  reset(): void {
+    cancelAnimationFrame(this.rafId)
+    this.rafId = 0
+    this.stopResultPromise = null
+    this.canvasVideoTrack = null
+    if (this.mediaRecorder && this.mediaRecorder.state !== 'inactive') {
+      try {
+        this.mediaRecorder.stop()
+      } catch {
+        /* */
+      }
+    }
+    this.mediaRecorder = null
+    this.chunks = []
+    this.canvas = null
+    this.ctx = null
+    this.container = null
+    this.mimeType = ''
+    this.teardownAudioGraph()
+  }
+
+  start(container: HTMLElement): boolean {
+    if (typeof MediaRecorder === 'undefined') return false
+    this.reset()
+    this.container = container
+    const mime = pickRecorderMime()
+    this.mimeType = mime || 'video/webm'
+
+    this.canvas = document.createElement('canvas')
+    this.canvas.width = 1280
+    this.canvas.height = 720
+    this.ctx = this.canvas.getContext('2d', { alpha: false })
+    if (!this.ctx) return false
+
+    const canvasVideoStream = this.canvas.captureStream(30)
+    const videoTracks = canvasVideoStream.getVideoTracks()
+    this.canvasVideoTrack = (videoTracks[0] as CanvasCaptureVideoTrack) ?? null
+
+    const videos = resolveRecordingVideos(container)
+    const AudioCtxCtor = getAudioContextCtor()
+    let outStream: MediaStream
+
+    if (AudioCtxCtor) {
+      try {
+        this.audioCtx = new AudioCtxCtor()
+        this.audioDestination = this.audioCtx.createMediaStreamDestination()
+        void this.audioCtx.resume().catch(() => {})
+        this.wireIncomingAudio()
+        this.attachMicForMixer()
+        const mixed = this.audioDestination.stream.getAudioTracks()
+        // 极低电平直流激励，避免「仅 WebRTC 音轨 + suspended/间歇」时 mux 无输出
+        const osc = this.audioCtx.createOscillator()
+        const gain = this.audioCtx.createGain()
+        gain.gain.value = 1e-5
+        osc.frequency.value = 20
+        osc.connect(gain)
+        gain.connect(this.audioDestination)
+        osc.start()
+        this.silentOsc = osc
+        this.silentGain = gain
+        outStream = new MediaStream([...videoTracks, ...mixed])
+      } catch {
+        this.teardownAudioGraph()
+        outStream = this.buildStreamWithoutMixer(videoTracks, videos)
+      }
+    } else {
+      outStream = this.buildStreamWithoutMixer(videoTracks, videos)
+    }
+
+    try {
+      this.mediaRecorder = mime
+        ? new MediaRecorder(outStream, { mimeType: mime })
+        : new MediaRecorder(outStream)
+    } catch {
+      try {
+        this.mediaRecorder = new MediaRecorder(outStream)
+      } catch {
+        this.reset()
+        return false
+      }
+    }
+
+    this.chunks = []
+    this.mediaRecorder.ondataavailable = (e) => {
+      if (e.data && e.data.size > 0) this.chunks.push(e.data)
+    }
+    this.mediaRecorder.onerror = (ev) => {
+      console.error('[call-local-recorder] MediaRecorder 错误', ev)
+    }
+
+    const tick = () => {
+      if (!this.ctx || !this.canvas || !this.container) return
+      this.wireIncomingAudio()
+      const vids = resolveRecordingVideos(this.container)
+      drawVideosGrid(this.ctx, vids, this.canvas.width, this.canvas.height)
+      this.canvasVideoTrack?.requestFrame?.()
+      this.rafId = requestAnimationFrame(tick)
+    }
+    this.rafId = requestAnimationFrame(tick)
+
+    try {
+      this.mediaRecorder.start(250)
+    } catch {
+      this.reset()
+      return false
+    }
+    return true
+  }
+
+  private buildStreamWithoutMixer(
+    videoTracks: MediaStreamTrack[],
+    videos: HTMLVideoElement[]
+  ): MediaStream {
+    const seen = new Set<string>()
+    const audio: MediaStreamTrack[] = []
+    const push = (tracks: MediaStreamTrack[]) => {
+      for (const t of tracks) {
+        if (seen.has(t.id)) continue
+        seen.add(t.id)
+        audio.push(t)
+      }
+    }
+    push(collectAudioTracksFromVideos(videos))
+    push(collectAudioTracksFromCaptureStream(videos))
+    push(collectAudioTracksFromAudioElements(this.container))
+    return new MediaStream([...videoTracks, ...audio])
+  }
+
+  async stop(): Promise<Blob | null> {
+    this.beginStopNow()
+    const p = this.stopResultPromise
+    if (!p) return null
+    return p
+  }
+}

admin/src/views/tcm/diagnosis/components/AssistantWatchCallDialog.vue

@@ -0,0 +1,285 @@
+<template>
+    <el-dialog
+        v-model="visible"
+        :title="dialogTitle"
+        width="760px"
+        destroy-on-close
+        append-to-body
+        :close-on-click-modal="false"
+        class="assistant-watch-call-dialog"
+        @closed="onClosed"
+    >
+        <div v-if="loading" class="watch-state">正在连接房间…</div>
+        <div v-else-if="errorMsg" class="watch-state watch-error">{{ errorMsg }}</div>
+        <div v-show="!loading && !errorMsg" ref="gridRef" class="watch-grid" />
+        <template #footer>
+            <span class="watch-hint">仅观看，不会开启摄像头与麦克风</span>
+            <el-button type="primary" @click="visible = false">离开</el-button>
+        </template>
+    </el-dialog>
+</template>
+
+<script setup lang="ts">
+import { computed, ref, watch } from 'vue'
+import TRTC from 'trtc-sdk-v5'
+import type { TRTCStreamType } from 'trtc-sdk-v5'
+import { getAssistantWatchCallParams } from '@/api/tcm'
+
+const props = defineProps<{
+    modelValue: boolean
+    diagnosisId: number
+}>()
+
+const emit = defineEmits<{
+    'update:modelValue': [boolean]
+    closed: []
+}>()
+
+const visible = computed({
+    get: () => props.modelValue,
+    set: (v: boolean) => emit('update:modelValue', v)
+})
+
+const gridRef = ref<HTMLElement | null>(null)
+const loading = ref(false)
+const errorMsg = ref('')
+const dialogTitle = ref('旁观视频通话')
+
+type TileEntry = { wrap: HTMLElement; userId: string; streamType: TRTCStreamType }
+const tiles = new Map<string, TileEntry>()
+
+let trtc: ReturnType<typeof TRTC.create> | null = null
+let joinSession = 0
+
+function tileKey(userId: string, streamType: TRTCStreamType) {
+    return `${userId}\u0000${String(streamType)}`
+}
+
+function remoteLabel(userId: string) {
+    if (userId.startsWith('patient_')) return '患者'
+    if (userId.startsWith('doctor_')) return '医护'
+    return userId
+}
+
+async function onRemoteVideoAvailable(event: { userId: string; streamType: TRTCStreamType }) {
+    if (!trtc || !gridRef.value) return
+    if (event.streamType !== TRTC.TYPE.STREAM_TYPE_MAIN) return
+
+    const key = tileKey(event.userId, event.streamType)
+    if (tiles.has(key)) return
+
+    const wrap = document.createElement('div')
+    wrap.className = 'watch-tile'
+    const cap = document.createElement('div')
+    cap.className = 'watch-tile-cap'
+    cap.textContent = remoteLabel(event.userId)
+    const view = document.createElement('div')
+    view.className = 'watch-tile-view'
+    wrap.appendChild(cap)
+    wrap.appendChild(view)
+    gridRef.value.appendChild(wrap)
+    tiles.set(key, { wrap, userId: event.userId, streamType: event.streamType })
+
+    try {
+        await trtc.startRemoteVideo({
+            userId: event.userId,
+            streamType: event.streamType,
+            view
+        })
+    } catch (e) {
+        console.warn('[AssistantWatchCall] startRemoteVideo', e)
+    }
+}
+
+async function onRemoteVideoUnavailable(event: { userId: string; streamType: TRTCStreamType }) {
+    if (!trtc) return
+    const key = tileKey(event.userId, event.streamType)
+    const t = tiles.get(key)
+    if (!t) return
+    try {
+        await trtc.stopRemoteVideo({ userId: event.userId, streamType: event.streamType })
+    } catch {
+        /* ignore */
+    }
+    t.wrap.remove()
+    tiles.delete(key)
+}
+
+function bindTrtcEvents() {
+    if (!trtc) return
+    trtc.on(TRTC.EVENT.REMOTE_VIDEO_AVAILABLE, onRemoteVideoAvailable)
+    trtc.on(TRTC.EVENT.REMOTE_VIDEO_UNAVAILABLE, onRemoteVideoUnavailable)
+}
+
+function unbindTrtcEvents() {
+    if (!trtc) return
+    trtc.off(TRTC.EVENT.REMOTE_VIDEO_AVAILABLE, onRemoteVideoAvailable)
+    trtc.off(TRTC.EVENT.REMOTE_VIDEO_UNAVAILABLE, onRemoteVideoUnavailable)
+}
+
+async function cleanup() {
+    unbindTrtcEvents()
+    if (trtc) {
+        for (const [, t] of tiles) {
+            try {
+                await trtc.stopRemoteVideo({ userId: t.userId, streamType: t.streamType })
+            } catch {
+                /* ignore */
+            }
+            t.wrap.remove()
+        }
+        tiles.clear()
+        if (gridRef.value) gridRef.value.innerHTML = ''
+        try {
+            await trtc.exitRoom()
+        } catch {
+            /* ignore */
+        }
+        try {
+            trtc.destroy()
+        } catch {
+            /* ignore */
+        }
+        trtc = null
+    } else {
+        tiles.clear()
+        if (gridRef.value) gridRef.value.innerHTML = ''
+    }
+}
+
+async function joinRoom() {
+    const session = ++joinSession
+    await cleanup()
+    if (!props.diagnosisId) {
+        errorMsg.value = '诊单无效'
+        return
+    }
+
+    loading.value = true
+    errorMsg.value = ''
+    dialogTitle.value = '旁观视频通话'
+
+    try {
+        const data = (await getAssistantWatchCallParams({
+            diagnosis_id: props.diagnosisId
+        })) as {
+            sdkAppId: number
+            userId: string
+            userSig: string
+            roomId?: number
+            strRoomId?: string
+            patientName?: string
+        }
+
+        if (session !== joinSession) {
+            return
+        }
+
+        if (data.patientName) {
+            dialogTitle.value = `旁观视频通话 · ${data.patientName}`
+        }
+
+        trtc = TRTC.create()
+        bindTrtcEvents()
+
+        const roomCfg = {
+            sdkAppId: data.sdkAppId,
+            userId: data.userId,
+            userSig: data.userSig,
+            autoReceiveAudio: true,
+            autoReceiveVideo: true,
+            ...(data.roomId != null && data.roomId > 0
+                ? { roomId: data.roomId }
+                : { strRoomId: data.strRoomId as string })
+        }
+        if (!(data.roomId != null && data.roomId > 0) && !data.strRoomId) {
+            throw new Error('缺少房间号')
+        }
+
+        await trtc.enterRoom(roomCfg)
+        if (session !== joinSession) {
+            await cleanup()
+            return
+        }
+        loading.value = false
+    } catch (e: unknown) {
+        loading.value = false
+        let msg = '进入房间失败'
+        if (typeof e === 'string') msg = e
+        else if (e && typeof e === 'object') {
+            const o = e as { msg?: string; message?: string }
+            if (o.msg) msg = String(o.msg)
+            else if (o.message) msg = String(o.message)
+        }
+        errorMsg.value = msg
+        await cleanup()
+    }
+}
+
+function onClosed() {
+    void cleanup()
+    loading.value = false
+    errorMsg.value = ''
+    dialogTitle.value = '旁观视频通话'
+    emit('closed')
+}
+
+watch(
+    () => [props.modelValue, props.diagnosisId] as const,
+    ([open, id]) => {
+        if (!open) {
+            joinSession++
+            void cleanup()
+            return
+        }
+        if (id > 0) {
+            void joinRoom()
+        }
+    }
+)
+</script>
+
+<style scoped>
+.watch-state {
+    min-height: 200px;
+    display: flex;
+    align-items: center;
+    justify-content: center;
+    color: var(--el-text-color-secondary);
+    font-size: 14px;
+}
+.watch-error {
+    color: var(--el-color-danger);
+}
+.watch-grid {
+    display: grid;
+    grid-template-columns: repeat(auto-fill, minmax(280px, 1fr));
+    gap: 12px;
+    min-height: 220px;
+}
+.watch-tile {
+    background: #0f0f0f;
+    border-radius: 8px;
+    overflow: hidden;
+    aspect-ratio: 16 / 10;
+    display: flex;
+    flex-direction: column;
+}
+.watch-tile-cap {
+    padding: 6px 10px;
+    font-size: 12px;
+    color: #e5e5e5;
+    background: rgba(0, 0, 0, 0.55);
+}
+.watch-tile-view {
+    flex: 1;
+    min-height: 0;
+    position: relative;
+}
+.watch-hint {
+    float: left;
+    line-height: 32px;
+    font-size: 12px;
+    color: var(--el-text-color-secondary);
+}
+</style>

admin/src/views/tcm/diagnosis/components/CallRecordPanel.vue

@@ -5,11 +5,10 @@
             show-icon
             :closable="false"
             class="mb-4"
-            title="视频通话与云端录制"
+            title="视频通话与录制回放"
         >
             <p class="call-record-tip">
-                下列为与本诊单关联的通话记录。若在腾讯云 TRTC
-                控制台开启了云端录制并填写回调地址，录制生成后会自动写入「录制回放」。
+                下列为与本诊单关联的通话记录。医生接通并同步房间号后，服务端会尝试自动发起「云端混流录制」（需配置 CAM 密钥与云点播等）；录制完成后由腾讯云回调写入回放地址。同时，管理端浏览器会进行「本地录制」，挂断后自动上传并合并到本条记录。
             </p>
             <p class="call-record-tip muted">
                 回调 URL 示例：<code>{{ callbackHint }}</code>

admin/src/views/tcm/diagnosis/components/ImChatRecordPanel.vue

@@ -2,8 +2,8 @@
     <div class="im-chat-record-panel">
         <el-alert type="info" show-icon :closable="false" class="mb-4" title="说明">
             <p class="panel-tip">
-                展示腾讯云 IM 单聊记录：已合并患者 <code>{{ patientImHint }}</code> 与
-                <strong>所有医生 / 医助账号</strong>（<code>doctor_*</code>）分别产生的会话，按时间排序。
+                展示腾讯云 IM 单聊记录：已合并患者  与
+                <strong>所有医生 / 医助账号</strong>分别产生的会话，按时间排序。
                 数据来自 IM 漫游；若未开通漫游或某账号与该患者无会话，对应侧无消息。
             </p>
         </el-alert>

admin/src/views/tcm/diagnosis/edit.vue

@@ -587,13 +587,19 @@
                     <el-empty v-else description="请先保存诊单，开方后病历将在此显示" />
                 </el-tab-pane>
 
-                <el-tab-pane label="回访记录" name="visit" :disabled="!formData.id" v-perms="['tcm.diagnosis/huifang']"  v-if="hasPermission(['tcm.diagnosis/huifang'])">
+                <el-tab-pane
+                    v-if="hasPermission(['tcm.diagnosis/huifang'])"
+                    label="视频录制回放记录"
+                    name="visit"
+                    :disabled="!formData.id"
+                    lazy
+                >
                     <call-record-panel
                         v-if="formData.id"
                         ref="callRecordPanelRef"
                         :diagnosis-id="Number(formData.id)"
                     />
-                    <el-empty v-else description="请先保存诊单后再查看回访记录" />
+                    <el-empty v-else description="请先保存诊单后再查看视频录制回放记录" />
                 </el-tab-pane>
                 <el-tab-pane
                     v-if="hasPermission(['tcm.diagnosis/chat'])"
@@ -642,6 +648,7 @@ import { ElMessage } from 'element-plus'
 import { QuestionFilled } from '@element-plus/icons-vue'
 import BloodRecordList from './components/BloodRecordList.vue'
 import CaseRecordList from './components/CaseRecordList.vue'
+import CallRecordPanel from './components/CallRecordPanel.vue'
 import ImChatRecordPanel from './components/ImChatRecordPanel.vue'
 import TcmPrescription from '@/components/tcm-prescription/index.vue'
 
@@ -660,7 +667,11 @@ const activeTab = ref('basic')
 const drawerTitle = computed(() => (mode.value === 'add' ? '新增诊单' : '编辑诊单'))
 
 watch([visible, activeTab], () => {
-    if (visible.value && activeTab.value === 'chat' && !hasPermission(['tcm.diagnosis/chat'])) {
+    if (!visible.value) return
+    if (activeTab.value === 'chat' && !hasPermission(['tcm.diagnosis/chat'])) {
+        activeTab.value = 'basic'
+    }
+    if (activeTab.value === 'visit' && !hasPermission(['tcm.diagnosis/huifang'])) {
         activeTab.value = 'basic'
     }
 })

admin/src/views/tcm/diagnosis/index.vue

@@ -136,6 +136,30 @@
                         <span v-else class="status-unprescribed">未开方</span>
                     </template>
                 </el-table-column>
+                <el-table-column label="视频旁观" width="120" fixed="right" align="center">
+                    <template #default="{ row }">
+                        <div class="video-watch-col">
+                            <template v-if="canWatchCallEntry(row)">
+                                <template v-if="watchCallShowEnterButton(row)">
+                                    <el-tooltip :content="watchCallEnterTooltip(row)" placement="top">
+                                        <span class="video-watch-trigger">
+                                            <el-button
+                                                type="primary"
+                                                link
+                                                size="small"
+                                                @click="onWatchCallEntryClick(row)"
+                                            >
+                                                进入旁观
+                                            </el-button>
+                                        </span>
+                                    </el-tooltip>
+                                </template>
+                                <span v-else class="video-watch-muted">{{ watchCallAssistantIdleText(row) }}</span>
+                            </template>
+                            <span v-else class="video-watch-muted">{{ watchCallPublicStatus(row) }}</span>
+                        </div>
+                    </template>
+                </el-table-column>
                 <el-table-column label="操作" width="260" fixed="right" align="left">
                     <template #default="{ row }">
                         <div class="action-cell">
@@ -180,6 +204,11 @@
         <edit-popup ref="editRef" @success="getLists" />
         <detail-popup ref="detailRef" />
         <appointment-popup ref="appointmentRef" @success="getLists" />
+        <assistant-watch-call-dialog
+            v-model="watchCallVisible"
+            :diagnosis-id="watchCallDiagnosisId"
+            @closed="getLists"
+        />
         
         <!-- 小程序二维码弹窗 -->
         <el-dialog
@@ -465,6 +494,7 @@ import { Loading, Warning, List, CircleCheck, Clock, ArrowDown, RefreshRight, Pi
 import EditPopup from './edit.vue'
 import DetailPopup from './detail.vue'
 import AppointmentPopup from './appointment.vue'
+import AssistantWatchCallDialog from './components/AssistantWatchCallDialog.vue'
 import useUserStore from '@/stores/modules/user'
 import { useRoute } from 'vue-router'
 import { nextTick } from 'vue'
@@ -681,6 +711,77 @@ const detailRef = ref()
 const appointmentRef = ref()
 const userStore = useUserStore()
 
+const watchCallVisible = ref(false)
+const watchCallDiagnosisId = ref(0)
+
+const isAssignedAssistant = (row: any) => {
+    const aid = row.assistant_id ?? row.assistant
+    if (aid === null || aid === undefined || aid === '') return false
+    return Number(aid) === Number(userStore.userInfo?.id)
+}
+
+const openWatchCall = (row: any) => {
+    watchCallDiagnosisId.value = Number(row.id) || 0
+    watchCallVisible.value = true
+}
+
+type VideoCallHint = {
+    state: string
+    label: string
+    start_time?: number
+    end_time?: number
+}
+
+const canWatchCallEntry = (row: any) =>
+    isAssignedAssistant(row) && hasPermission(['tcm.diagnosis/watchCall'])
+
+const watchCallState = (row: any) => (row.video_call_hint?.state as string) || 'none'
+
+const watchCallLiveTooltip = (row: any) => {
+    const h = row.video_call_hint as VideoCallHint | undefined
+    const base = '点击进入实时房间（仅观看，不推流、不上麦）'
+    if (h?.start_time) {
+        return `${base}。开始时间：${formatDateTime(h.start_time)}`
+    }
+    return base
+}
+
+/** 通话进行中或已发起待同步房间时，都显示「进入旁观」入口（避免仅 live 才有按钮导致看不见） */
+const watchCallShowEnterButton = (row: any) => {
+    const st = watchCallState(row)
+    return st === 'live' || st === 'pending_room'
+}
+
+const watchCallEnterTooltip = (row: any) => {
+    if (watchCallState(row) === 'pending_room') {
+        return '医生尚未接通或未同步房间号，接通后再点此进入'
+    }
+    return watchCallLiveTooltip(row)
+}
+
+const onWatchCallEntryClick = (row: any) => {
+    if (watchCallState(row) !== 'live') {
+        feedback.msgWarning('医生尚未接通或未同步房间号，请稍后再试')
+        return
+    }
+    openWatchCall(row)
+}
+
+const watchCallAssistantIdleText = (row: any) => {
+    const h = row.video_call_hint as VideoCallHint | undefined
+    if (h?.label) return h.label
+    return '暂无可旁观通话'
+}
+
+const watchCallPublicStatus = (row: any) => {
+    const st = watchCallState(row)
+    if (st === 'none') return '—'
+    if (st === 'live') return '通话中'
+    if (st === 'pending_room') return '接通中'
+    const h = row.video_call_hint as VideoCallHint | undefined
+    return h?.label || '—'
+}
+
 // 创建订单相关
 const createOrderVisible = ref(false)
 const orderFormRef = ref()
@@ -1443,6 +1544,22 @@ onMounted(async () => {
     flex-wrap: wrap;
 }
 
+.video-watch-col {
+    font-size: 12px;
+    line-height: 1.4;
+    padding: 0 2px;
+}
+
+/* el-tooltip 单个子节点为行内按钮时，包一层避免触发区域为 0 或错位 */
+.video-watch-trigger {
+    display: inline-block;
+    vertical-align: middle;
+}
+
+.video-watch-muted {
+    color: var(--el-text-color-secondary);
+}
+
 .text-danger {
     color: var(--el-color-danger);
 }