geng

2026-08-18 14:08:38 +08:00
parent 8b9df1154c
commit bc1228a310
77 changed files with 10763 additions and 1181 deletions
@@ -4,13 +4,12 @@ declare(strict_types=1);

 namespace app\adminapi\logic\tcm;

-use app\common\cache\AdminAuthCache;
-use app\common\logic\BaseLogic;
-use app\common\model\auth\AdminRole;
-use app\common\model\tcm\Diagnosis;
-use app\common\model\tcm\DiagnosisAiReport;
-use app\common\service\DataScope\DataScopeService;
-use app\common\service\DifyChatService;
+use app\common\cache\AdminAuthCache;
+use app\adminapi\logic\firstvisit\MyPatientLogic;
+use app\common\logic\BaseLogic;
+use app\common\model\tcm\Diagnosis;
+use app\common\model\tcm\DiagnosisAiReport;
+use app\common\service\DifyChatService;
 use think\facade\Db;
 use think\facade\Log;

@@ -201,6 +200,44 @@ class DiagnosisAiLogic extends BaseLogic
        string $prompt,
        int $adminId,
        array $adminInfo
+    ): ?array {
+        $prepared = self::prepareAssistant($diagnosisId, $task, $prompt, $adminId, $adminInfo);
+        if ($prepared === null) {
+            return null;
+        }
+
+        try {
+            $result = DifyChatService::chat(
+                $prepared['profile'],
+                $prepared['inputs'],
+                $prepared['query'],
+                $prepared['user']
+            );
+        } catch (\Throwable $e) {
+            self::logAssistantFailure($diagnosisId, $prepared['profile'], $adminId, $e);
+            self::setError('AI 助手暂时不可用，请稍后重试');
+            return null;
+        }
+
+        return self::formatAssistantResult($prepared, $result);
+    }
+
+    /**
+     * 在 SSE headers 发出前完成参数、权限、DataScope、病例和模型选择预检。
+     * 返回值只供同一请求内的流执行使用，绝不能直接序列化给客户端。
+     *
+     * @param array<string,mixed> $adminInfo
+     * @return array{
+     *     diagnosis_id:int,profile:string,model_name:string,model_label:string,task:string,
+     *     inputs:array<string,mixed>,query:string,user:string,admin_id:int
+     * }|null
+     */
+    public static function prepareAssistant(
+        int $diagnosisId,
+        string $task,
+        string $prompt,
+        int $adminId,
+        array $adminInfo
    ): ?array {
        $diagnosis = self::loadAuthorizedDiagnosis(
            $diagnosisId,
@@ -239,28 +276,63 @@ class DiagnosisAiLogic extends BaseLogic
            return null;
        }

+        return [
+            'diagnosis_id' => $diagnosisId,
+            'profile' => $profile,
+            'model_name' => $model,
+            'model_label' => $modelLabel,
+            'task' => $task,
+            'inputs' => self::buildUpstreamInputs(
+                $context,
+                '病例问诊助手',
+                self::ASSISTANT_PROMPT_VERSION
+            ),
+            'query' => self::buildAssistantPrompt($context, $task, $prompt),
+            'user' => 'admin-diagnosis-assistant-' . $adminId,
+            'admin_id' => $adminId,
+        ];
+    }
+
+    /**
+     * @param array<string,mixed> $prepared prepareAssistant() 的内部返回值
+     * @param callable(string):mixed $onDelta
+     * @param callable():bool|null $shouldAbort
+     * @return array{answer:string,model_key:string,model_label:string,model_name:string,task:string}|null
+     */
+    public static function streamPreparedAssistant(
+        array $prepared,
+        callable $onDelta,
+        ?callable $shouldAbort = null
+    ): ?array {
+        $diagnosisId = (int) ($prepared['diagnosis_id'] ?? 0);
+        $profile = (string) ($prepared['profile'] ?? '');
+        $adminId = (int) ($prepared['admin_id'] ?? 0);
+
        try {
-            $result = DifyChatService::chat(
+            $result = DifyChatService::streamChat(
                $profile,
-                self::buildUpstreamInputs(
-                    $context,
-                    '病例问诊助手',
-                    self::ASSISTANT_PROMPT_VERSION
-                ),
-                self::buildAssistantPrompt($context, $task, $prompt),
-                'admin-diagnosis-assistant-' . $adminId
+                is_array($prepared['inputs'] ?? null) ? $prepared['inputs'] : [],
+                (string) ($prepared['query'] ?? ''),
+                (string) ($prepared['user'] ?? ''),
+                $onDelta,
+                $shouldAbort
            );
        } catch (\Throwable $e) {
-            Log::warning('diagnosis ai assistant upstream call failed', [
-                'diagnosis_id' => $diagnosisId,
-                'profile' => $profile,
-                'admin_id' => $adminId,
-                'exception_class' => get_class($e),
-            ]);
+            self::logAssistantFailure($diagnosisId, $profile, $adminId, $e);
            self::setError('AI 助手暂时不可用，请稍后重试');
            return null;
        }

+        return self::formatAssistantResult($prepared, $result);
+    }
+
+    /**
+     * @param array<string,mixed> $prepared
+     * @param array<string,mixed> $result
+     * @return array{answer:string,model_key:string,model_label:string,model_name:string,task:string}|null
+     */
+    private static function formatAssistantResult(array $prepared, array $result): ?array
+    {
        if (empty($result['ok'])) {
            self::setError((string) ($result['error'] ?? 'AI 助手暂时不可用，请稍后重试'));
            return null;
@@ -273,13 +345,27 @@ class DiagnosisAiLogic extends BaseLogic

        return [
            'answer' => $content,
-            'model_key' => $profile,
-            'model_label' => $modelLabel,
-            'model_name' => $model,
-            'task' => $task,
+            'model_key' => (string) ($prepared['profile'] ?? ''),
+            'model_label' => (string) ($prepared['model_label'] ?? ''),
+            'model_name' => (string) ($prepared['model_name'] ?? ''),
+            'task' => (string) ($prepared['task'] ?? ''),
        ];
    }

+    private static function logAssistantFailure(
+        int $diagnosisId,
+        string $profile,
+        int $adminId,
+        \Throwable $exception
+    ): void {
+        Log::warning('diagnosis ai assistant upstream call failed', [
+            'diagnosis_id' => $diagnosisId,
+            'profile' => $profile,
+            'admin_id' => $adminId,
+            'exception_class' => get_class($exception),
+        ]);
+    }
+
    /**
     * 接诊台结构化 AI 智能分析。每次只调用客户端白名单键对应的服务端模型，
     * 上游失败或响应不符合契约时直接失败，不构造本地伪分析。
@@ -604,28 +690,10 @@ class DiagnosisAiLogic extends BaseLogic
            return null;
        }

-        $accessQuery = Diagnosis::where('id', $id)->whereNull('delete_time');
-        $isRoot = !empty($adminInfo['root']) && (int) $adminInfo['root'] === 1;
-        if (!$isRoot) {
-            $roleIds = array_map('intval', AdminRole::where('admin_id', $adminId)->column('role_id'));
-            if (in_array(2, $roleIds, true)) {
-                $accessQuery->where('assistant_id', $adminId);
-            }
-            if (DataScopeService::isEnabled()) {
-                $visibleIds = DataScopeService::getVisibleAdminIds($adminId, $adminInfo);
-                if ($visibleIds === []) {
-                    self::setError('诊单不存在或无权访问');
-                    return null;
-                }
-                if (is_array($visibleIds)) {
-                    $accessQuery->whereIn('assistant_id', $visibleIds);
-                }
-            }
+        if (!MyPatientLogic::canAccessDiagnosis($id, $adminId, $adminInfo)) {
+            self::setError('诊单不存在或无权访问');
+            return null;
        }
-        if (!$accessQuery->find()) {
-            self::setError('诊单不存在或无权访问');
-            return null;
-        }

        $diagnosis = DiagnosisLogic::detail(['id' => $id], $adminInfo);
        if ($diagnosis === [] || empty($diagnosis['id'])) {
@@ -28,10 +28,11 @@ use app\common\model\DiagnosisViewRecord;
 use app\common\model\doctor\Appointment;
 use app\common\model\auth\Admin;
 use app\common\model\auth\AdminRole;
-use app\adminapi\logic\auth\AuthLogic;
-use app\adminapi\logic\doctor\DoctorNoteLogic;
-use app\adminapi\logic\doctor\AppointmentLogic;
-use app\adminapi\logic\tcm\TrackingNoteLogic;
+use app\adminapi\logic\auth\AuthLogic;
+use app\adminapi\logic\doctor\DoctorNoteLogic;
+use app\adminapi\logic\doctor\AppointmentLogic;
+use app\adminapi\logic\firstvisit\MyPatientLogic;
+use app\adminapi\logic\tcm\TrackingNoteLogic;
 use app\common\service\ConfigService;
 use app\common\service\FileService;
 use app\common\service\DataScope\DataScopeService;
@@ -4182,32 +4183,10 @@ class DiagnosisLogic extends BaseLogic
            return [];
        }

-        // 1) 数据权限闸 — 不通过则返回「不存在或无权访问」
-        $accessQuery = Diagnosis::where('id', $diagnosisId)->whereNull('delete_time');
-
-        $roleIds = array_map('intval', AdminRole::where('admin_id', $adminId)->column('role_id'));
-        if (in_array(2, $roleIds, true)) {
-            // 医助仅看自己被指派的
-            $accessQuery->where('assistant_id', $adminId);
-        }
-
-        if (DataScopeService::isEnabled()) {
-            $visibleIds = DataScopeService::getVisibleAdminIds($adminId, $adminInfo);
-            if ($visibleIds === []) {
-                self::setError('诊单不存在或无权访问');
-
-                return [];
-            }
-            if (is_array($visibleIds)) {
-                $accessQuery->whereIn('assistant_id', $visibleIds);
-            }
-        }
-
-        if (!$accessQuery->find()) {
-            self::setError('诊单不存在或无权访问');
-
-            return [];
-        }
+        // 1) 数据权限闸 — 不通过则返回「不存在或无权访问」
+        if (!self::canViewReadonlyDiagnosis($diagnosisId, $adminId, $adminInfo)) {
+            return [];
+        }

        // 2) 诊单详情（含图片聚合等）+ 字典翻译
        $diagnosis = self::detail(['id' => $diagnosisId]);
@@ -4238,24 +4217,43 @@ class DiagnosisLogic extends BaseLogic
        $unservedDays      = $maxRecordTs > 0 ? max(0, (int) floor((time() - $maxRecordTs) / 86400)) : null;
        $lastBloodRecordAt = $maxRecordTs > 0 ? date('Y-m-d', $maxRecordTs) : null;

-        return [
+        return [
            'appointment'           => $appointment,
            'diagnosis'             => $diagnosis,
            'doctor_notes'          => $doctorNotes,
            'tracking_notes'        => $trackingNotes,
            'unserved_days'         => $unservedDays,
            'last_blood_record_at'  => $lastBloodRecordAt,
-        ];
-    }
-
-    /**
+        ];
+    }
+
+    /**
+     * 与 readonlyDetail 共用的诊单行级可见性入口。
+     *
+     * 复用“我的患者”统一行权策略：医生按有效接诊关系，医助按归属关系，
+     * 团队管理角色才使用 DataScope。不存在与越权使用同一错误避免枚举。
+     */
+    public static function canViewReadonlyDiagnosis(int $diagnosisId, int $adminId, array $adminInfo): bool
+    {
+        self::$error = '';
+        if (!MyPatientLogic::canAccessDiagnosis($diagnosisId, $adminId, $adminInfo)) {
+            self::setError('诊单不存在或无权访问');
+
+            return false;
+        }
+
+        return true;
+    }
+
+    /**
     * 取指定日期区间内的三类跟踪记录（血糖血压 / 饮食 / 运动），供 readonlyDetail 与
     * 医生接诊台 reception 通过独立接口 lazy load。
     *
     * 区间语义：闭区间 [startDate, endDate]（Y-m-d），均不传则不限。
     *
     * @return array{
-     *   blood_records: array<int,array<string,mixed>>,
+     *   diagnosis_id: int,
+     *   blood_records: array<int,array<string,mixed>>,
     *   diet_records: array<int,array<string,mixed>>,
     *   exercise_records: array<int,array<string,mixed>>,
     *   start_date: string,
@@ -4267,10 +4265,11 @@ class DiagnosisLogic extends BaseLogic
        $sinceTs = $startDate !== '' ? (int) strtotime($startDate . ' 00:00:00') : 0;
        $untilTs = $endDate !== '' ? (int) strtotime($endDate . ' 23:59:59') : 0;
        $sinceTs = $sinceTs > 0 ? $sinceTs : 0;
-        $untilTs = $untilTs > 0 ? $untilTs : 0;
-
-        return [
-            'blood_records'    => self::fetchBloodRecordsForReadonly($diagnosisId, $sinceTs, $untilTs),
+        $untilTs = $untilTs > 0 ? $untilTs : 0;
+
+        return [
+            'diagnosis_id'     => $diagnosisId,
+            'blood_records'    => self::fetchBloodRecordsForReadonly($diagnosisId, $sinceTs, $untilTs),
            'diet_records'     => self::fetchDietRecordsForReadonly($diagnosisId, $sinceTs, $untilTs),
            'exercise_records' => self::fetchExerciseRecordsForReadonly($diagnosisId, $sinceTs, $untilTs),
            'start_date'       => $startDate,
@@ -2,9 +2,10 @@

 declare(strict_types=1);

-namespace app\adminapi\logic\tcm;
-
-use app\common\model\auth\Admin;
+namespace app\adminapi\logic\tcm;
+
+use app\adminapi\logic\firstvisit\MyPatientLogic;
+use app\common\model\auth\Admin;
 use app\common\model\doctor\Appointment;
 use app\common\model\doctor\Medicine as DoctorMedicine;
 use app\common\model\tcm\Prescription;
@@ -934,14 +935,35 @@ class PrescriptionLogic
    /**
     * 根据诊单ID获取处方列表
     */
-    public static function listByDiagnosis(int $diagnosisId): array
-    {
-        return Prescription::where('diagnosis_id', $diagnosisId)
-            ->whereNull('delete_time')
-            ->order('id', 'desc')
-            ->select()
-            ->toArray();
-    }
+    public static function listByDiagnosis(int $diagnosisId, int $viewerAdminId, array $viewerAdminInfo): array
+    {
+        self::$error = '';
+        if (!MyPatientLogic::canAccessDiagnosis($diagnosisId, $viewerAdminId, $viewerAdminInfo)) {
+            self::setError('诊单不存在或无权访问');
+
+            return [];
+        }
+
+        $rows = Prescription::where('diagnosis_id', $diagnosisId)
+            ->whereNull('delete_time')
+            ->order('id', 'desc')
+            ->select()
+            ->toArray();
+
+        return self::filterViewablePrescriptions($rows, $viewerAdminId, $viewerAdminInfo);
+    }
+
+    /**
+     * @param array<int, array<string,mixed>> $rows
+     * @return array<int, array<string,mixed>>
+     */
+    private static function filterViewablePrescriptions(array $rows, int $viewerAdminId, array $viewerAdminInfo): array
+    {
+        return array_values(array_filter(
+            $rows,
+            static fn (array $row): bool => self::canViewPrescription($row, $viewerAdminId, $viewerAdminInfo)
+        ));
+    }

    /**
     * 根据预约ID获取处方（带权限检查）