Merge branch 'long-consultation-desk'

2026-04-30 12:19:12 +08:00
parent 1b6a981027 901629ac6e
commit d9175cada7
15 changed files with 675 additions and 272 deletions
@@ -16,8 +16,13 @@ export function notifyAssistant(params: { id: number }) {
    return request.post({ url: '/doctor.appointment/notifyAssistant', params })
 }

-// 医生备注 - 添加/追加（同一天追加 content + tongue_images）
-export function addDoctorNote(params: { diagnosis_id: number; content?: string; tongue_images?: string[] }) {
+// 医生备注 - 添加/追加（同一天追加 content + tongue_images + report_files）
+export function addDoctorNote(params: {
+    diagnosis_id: number
+    content?: string
+    tongue_images?: string[]
+    report_files?: string[]
+}) {
    return request.post({ url: '/doctor.appointment/addDoctorNote', params })
 }

@@ -25,3 +30,12 @@ export function addDoctorNote(params: { diagnosis_id: number; content?: string;
 export function getDoctorNotes(params: { diagnosis_id: number }) {
    return request.get({ url: '/doctor.appointment/doctorNotes', params })
 }
+
+// 医生备注 - 删除单张图片
+export function deleteDoctorNoteImage(params: {
+    note_id: number
+    image_type: 'tongue_images' | 'report_files'
+    image_path: string
+}) {
+    return request.post({ url: '/doctor.appointment/deleteDoctorNoteImage', params })
+}
@@ -135,16 +135,10 @@ import {
  bindCallRoom,
  endCall,
  getCallSignature,
-  startCall,
-  tcmDiagnosisDetail,
-  tcmDiagnosisEdit
+  startCall
 } from '@/api/tcm'
 import { CallLocalRecorder } from '@/utils/call-local-recorder'
 import { captureVideoFrameFromElement } from '@/utils/call-video-screenshot'
-import {
-    DIAGNOSIS_TONGUE_IMAGES_UPDATED,
-    type DiagnosisTongueImagesUpdatedDetail
-} from '@/utils/diagnosis-sync-events'
 import feedback from '@/utils/feedback'
 import {
  formatTUICallUserError,
@@ -1274,9 +1268,8 @@ const onCallKitDragEnd = () => {
  document.removeEventListener('mouseup', onCallKitDragEnd)
 }

-/** 截取当前视频画面并上传，同步到对应患者诊单的「舌苔照片」 */
+/** 截取当前视频画面并上传，保存到医生备注 */
 const handleCallKitScreenshot = async () => {
-  // 同步防重入：避免连点触发两次上传、诊单里出现两张图
  if (captureUploading.value) return
  captureUploading.value = true
  try {
@@ -1305,32 +1298,8 @@ const handleCallKitScreenshot = async () => {
      feedback.msgWarning('请先保存诊单后再从视频同步舌苔照片')
      return
    }
-    const detail = await tcmDiagnosisDetail({ id: diagnosisId.value })
-    if (Number(detail.patient_id) !== Number(patientId.value)) {
-      feedback.msgError('患者与当前诊单不匹配，无法同步')
-      return
-    }
-    const previous: string[] = [...((detail.tongue_images || []) as string[])]
-    // if (previous.length >= 9) {
-    //   feedback.msgWarning('舌苔照片已达上限 9 张')
-    //   return
-    // }
-    const next = [...previous, path]
-    const payload = JSON.parse(JSON.stringify(detail)) as Record<string, unknown>
-    payload.tongue_images = next
-    await tcmDiagnosisEdit(payload)
-    feedback.msgSuccess('舌苔照片已同步到诊单')
-    window.dispatchEvent(
-      new CustomEvent<DiagnosisTongueImagesUpdatedDetail>(DIAGNOSIS_TONGUE_IMAGES_UPDATED, {
-        detail: {
-          diagnosisId: diagnosisId.value,
-          tongue_images: next
-        }
-      })
-    )
-    try {
-      await addDoctorNote({ diagnosis_id: diagnosisId.value, tongue_images: [path] })
-    } catch { /* 写入备注表失败不阻塞主流程 */ }
+    await addDoctorNote({ diagnosis_id: diagnosisId.value, tongue_images: [path] })
+    feedback.msgSuccess('舌苔照片已保存')
  } catch (e: unknown) {
    const err = e as Error
    console.error(err)
@@ -1,9 +0,0 @@
-/**
- * 跨组件同步诊单数据（如视频截屏写入舌苔照后刷新编辑抽屉）
- */
-export const DIAGNOSIS_TONGUE_IMAGES_UPDATED = 'zyt:diagnosis-tongue-images-updated'
-
-export type DiagnosisTongueImagesUpdatedDetail = {
-    diagnosisId: number
-    tongue_images: string[]
-}
@@ -1,47 +1,108 @@
 <template>
-    <div v-if="notes.length" class="note-timeline">
-        <div v-for="note in notes" :key="note.id" class="timeline-node">
-            <div class="timeline-dot"></div>
-            <div class="timeline-date">{{ note.note_date }}</div>
-            <div class="timeline-body">
-                <div v-if="note.content" class="timeline-content">
-                    <div v-for="(line, idx) in splitLines(note.content)" :key="idx" class="content-line">
-                        {{ line }}
+    <div class="note-timeline-wrap">
+        <div v-if="!readonly && diagnosisId" class="timeline-actions">
+            <material-picker
+                v-model="tongueModel"
+                :limit="99"
+                type="image"
+                :exclude-domain="true"
+                @change="handleTongueChange"
+            >
+                <template #upload>
+                    <div class="upload-trigger">
+                        <icon :size="20" name="el-icon-Plus" />
+                        <span>舌苔照片</span>
+                    </div>
+                </template>
+            </material-picker>
+            <material-picker
+                v-model="reportModel"
+                :limit="99"
+                type="file"
+                :exclude-domain="true"
+                @change="handleReportChange"
+            >
+                <template #upload>
+                    <div class="upload-trigger">
+                        <icon :size="20" name="el-icon-Plus" />
+                        <span>检查报告</span>
+                    </div>
+                </template>
+            </material-picker>
+        </div>
+        <div v-if="notes.length" class="note-timeline">
+            <div v-for="note in notes" :key="note.id" class="timeline-node">
+                <div class="timeline-dot"></div>
+                <div class="timeline-date">{{ note.note_date }}</div>
+                <div class="timeline-body">
+                    <div v-if="note.content" class="timeline-content">
+                        <div v-for="(line, idx) in splitLines(note.content)" :key="idx" class="content-line">
+                            {{ line }}
+                        </div>
+                    </div>
+                    <div v-if="note.tongue_images?.length" class="timeline-images">
+                        <span class="images-label">舌苔照片</span>
+                        <div v-for="(url, idx) in note.tongue_images" :key="idx" class="thumb-wrap">
+                            <el-image
+                                :src="getImageUrl(url)"
+                                :preview-src-list="note.tongue_images.map(getImageUrl)"
+                                :initial-index="idx"
+                                fit="cover"
+                                class="timeline-thumb"
+                                preview-teleported
+                            />
+                            <el-icon
+                                v-if="!readonly"
+                                class="thumb-delete"
+                                @click.stop="handleDeleteImage(note.id, 'tongue_images', url)"
+                            ><CircleClose /></el-icon>
+                        </div>
+                    </div>
+                    <div v-if="note.report_files?.length" class="timeline-images">
+                        <span class="images-label">检查报告</span>
+                        <template v-for="(url, idx) in note.report_files" :key="idx">
+                            <div v-if="isImageFile(url)" class="thumb-wrap">
+                                <el-image
+                                    :src="getImageUrl(url)"
+                                    :preview-src-list="getImagePreviewList(note.report_files)"
+                                    :initial-index="getImagePreviewIndex(note.report_files, idx)"
+                                    fit="cover"
+                                    class="timeline-thumb"
+                                    preview-teleported
+                                />
+                                <el-icon
+                                    v-if="!readonly"
+                                    class="thumb-delete"
+                                    @click.stop="handleDeleteImage(note.id, 'report_files', url)"
+                                ><CircleClose /></el-icon>
+                            </div>
+                            <div v-else class="file-wrap">
+                                <a :href="getImageUrl(url)" target="_blank" class="file-link" :title="getFileName(url)">
+                                    <el-icon :size="20"><Document /></el-icon>
+                                    <span class="file-name">{{ getFileName(url) }}</span>
+                                </a>
+                                <el-icon
+                                    v-if="!readonly"
+                                    class="file-delete"
+                                    @click.stop="handleDeleteImage(note.id, 'report_files', url)"
+                                ><CircleClose /></el-icon>
+                            </div>
+                        </template>
                    </div>
-                </div>
-                <div v-if="note.tongue_images?.length" class="timeline-images">
-                    <span class="images-label">舌苔照片</span>
-                    <el-image
-                        v-for="(url, idx) in note.tongue_images"
-                        :key="idx"
-                        :src="getImageUrl(url)"
-                        :preview-src-list="note.tongue_images.map(getImageUrl)"
-                        :initial-index="idx"
-                        fit="cover"
-                        class="timeline-thumb"
-                        preview-teleported
-                    />
-                </div>
-                <div v-if="note.report_files?.length" class="timeline-images">
-                    <span class="images-label">检查报告</span>
-                    <el-image
-                        v-for="(url, idx) in note.report_files"
-                        :key="idx"
-                        :src="getImageUrl(url)"
-                        :preview-src-list="note.report_files.map(getImageUrl)"
-                        :initial-index="idx"
-                        fit="cover"
-                        class="timeline-thumb"
-                        preview-teleported
-                    />
                </div>
            </div>
        </div>
+        <el-empty v-if="!notes.length && readonly" description="暂无备注" :image-size="48" />
    </div>
 </template>

 <script setup lang="ts">
+import { ref, watch } from 'vue'
+import { CircleClose, Document } from '@element-plus/icons-vue'
+import { ElMessageBox } from 'element-plus'
 import useAppStore from '@/stores/modules/app'
+import { addDoctorNote, deleteDoctorNoteImage } from '@/api/patient'
+import feedback from '@/utils/feedback'

 export interface DoctorNoteItem {
    id: number
@@ -51,18 +112,129 @@ export interface DoctorNoteItem {
    report_files: string[]
 }

-defineProps<{ notes: DoctorNoteItem[] }>()
+const props = defineProps<{
+    notes: DoctorNoteItem[]
+    diagnosisId?: number
+    readonly?: boolean
+}>()
+
+const emit = defineEmits<{ refresh: [] }>()

 const appStore = useAppStore()
 const getImageUrl = (url: string) => appStore.getImageUrl(url)

+const tongueModel = ref<string[]>([])
+const reportModel = ref<string[]>([])
+const prevTongueCount = ref(0)
+const prevReportCount = ref(0)
+
+const IMAGE_EXTENSIONS = ['jpg', 'jpeg', 'png', 'gif', 'bmp', 'webp', 'svg']
+
+const isImageFile = (url: string): boolean => {
+    const ext = url.split('.').pop()?.toLowerCase().split('?')[0] || ''
+    return IMAGE_EXTENSIONS.includes(ext)
+}
+
+const getFileName = (url: string): string => {
+    const parts = url.split('/')
+    return decodeURIComponent(parts[parts.length - 1]?.split('?')[0] || '文件')
+}
+
+const getImagePreviewList = (files: string[]): string[] => {
+    return files.filter(isImageFile).map(getImageUrl)
+}
+
+const getImagePreviewIndex = (files: string[], currentIdx: number): number => {
+    const imageFiles = files.filter(isImageFile)
+    const currentUrl = files[currentIdx]
+    return imageFiles.indexOf(currentUrl)
+}
+
 const splitLines = (content: string | null): string[] => {
    if (!content) return []
    return content.split('\n').filter(Boolean)
 }
+
+const handleTongueChange = (val: string[]) => {
+    if (!props.diagnosisId) return
+    const newItems = Array.isArray(val) ? val : [val]
+    if (newItems.length <= prevTongueCount.value) {
+        prevTongueCount.value = newItems.length
+        return
+    }
+    const added = newItems.slice(prevTongueCount.value)
+    prevTongueCount.value = newItems.length
+    if (added.length > 0) {
+        addDoctorNote({ diagnosis_id: props.diagnosisId, tongue_images: added }).then(() => {
+            feedback.msgSuccess('舌苔照片已添加')
+            emit('refresh')
+        })
+    }
+}
+
+const handleReportChange = (val: string[]) => {
+    if (!props.diagnosisId) return
+    const newItems = Array.isArray(val) ? val : [val]
+    if (newItems.length <= prevReportCount.value) {
+        prevReportCount.value = newItems.length
+        return
+    }
+    const added = newItems.slice(prevReportCount.value)
+    prevReportCount.value = newItems.length
+    if (added.length > 0) {
+        addDoctorNote({ diagnosis_id: props.diagnosisId, report_files: added }).then(() => {
+            feedback.msgSuccess('检查报告已添加')
+            emit('refresh')
+        })
+    }
+}
+
+watch(() => props.notes, () => {
+    tongueModel.value = []
+    reportModel.value = []
+    prevTongueCount.value = 0
+    prevReportCount.value = 0
+})
+
+const handleDeleteImage = async (noteId: number, imageType: 'tongue_images' | 'report_files', imagePath: string) => {
+    try {
+        await ElMessageBox.confirm('确认删除？', '提示', { type: 'warning' })
+    } catch {
+        return
+    }
+    await deleteDoctorNoteImage({ note_id: noteId, image_type: imageType, image_path: imagePath })
+    feedback.msgSuccess('已删除')
+    emit('refresh')
+}
 </script>

 <style scoped lang="scss">
+.timeline-actions {
+    display: flex;
+    gap: 12px;
+    margin-bottom: 12px;
+    padding-bottom: 12px;
+    border-bottom: 1px dashed #ebeef5;
+}
+.upload-trigger {
+    width: 90px;
+    height: 90px;
+    border: 1px dashed #dcdfe6;
+    border-radius: 6px;
+    display: flex;
+    flex-direction: column;
+    align-items: center;
+    justify-content: center;
+    gap: 4px;
+    cursor: pointer;
+    color: #909399;
+    font-size: 12px;
+    transition: border-color 0.2s;
+    &:hover {
+        border-color: #409eff;
+        color: #409eff;
+    }
+}
 .note-timeline {
    position: relative;
    padding-left: 22px;
@@ -128,6 +300,10 @@ const splitLines = (content: string | null): string[] => {
    color: #909399;
    flex-shrink: 0;
 }
+.thumb-wrap {
+    position: relative;
+    display: inline-block;
+}
 .timeline-thumb {
    width: 64px;
    height: 64px;
@@ -139,4 +315,59 @@ const splitLines = (content: string | null): string[] => {
 .timeline-thumb:hover {
    transform: scale(1.05);
 }
+.thumb-delete {
+    position: absolute;
+    top: -6px;
+    right: -6px;
+    font-size: 16px;
+    color: #f56c6c;
+    background: #fff;
+    border-radius: 50%;
+    cursor: pointer;
+    display: none;
+}
+.thumb-wrap:hover .thumb-delete {
+    display: block;
+}
+.file-wrap {
+    position: relative;
+    display: inline-flex;
+    align-items: center;
+}
+.file-link {
+    display: inline-flex;
+    align-items: center;
+    gap: 4px;
+    padding: 6px 10px;
+    border: 1px solid #ebeef5;
+    border-radius: 6px;
+    text-decoration: none;
+    color: #409eff;
+    font-size: 12px;
+    max-width: 180px;
+    transition: border-color 0.2s;
+    &:hover {
+        border-color: #409eff;
+    }
+}
+.file-name {
+    overflow: hidden;
+    text-overflow: ellipsis;
+    white-space: nowrap;
+    max-width: 120px;
+}
+.file-delete {
+    position: absolute;
+    top: -6px;
+    right: -6px;
+    font-size: 16px;
+    color: #f56c6c;
+    background: #fff;
+    border-radius: 50%;
+    cursor: pointer;
+    display: none;
+}
+.file-wrap:hover .file-delete {
+    display: block;
+}
 </style>
@@ -69,7 +69,7 @@
                                    <el-tag v-if="row.status === 4" size="small" type="warning" class="ml-1">已过号</el-tag>
                                </div>
                                <div class="time-line">
-                                    {{ row.appointment_time || '—' }} · 医助 {{ row.assistant_name || '—' }}
+                                    {{ formatTimeHM(row.appointment_time) }} · 医助 {{ row.assistant_name || '—' }}
                                </div>
                            </div>
                            <div class="row-actions" @click.stop>
@@ -246,9 +246,12 @@

                    <!-- 医生备注 & 舌苔照片 -->
                    <div class="card note-card">
-                        <div class="card-title">医生备注 & 舌苔照片</div>
-                        <NoteTimeline v-if="doctorNotes.length" :notes="doctorNotes" />
-                        <el-empty v-else description="暂无备注" :image-size="48" />
+                        <div class="card-title">医生备注 & 舌苔照片 & 检查报告</div>
+                        <NoteTimeline
+                            :notes="doctorNotes"
+                            :diagnosis-id="diag?.id"
+                            @refresh="refreshDetailSilently"
+                        />
                    </div>

                    <!-- 血糖血压记录 -->
@@ -478,6 +481,11 @@ const formatGenderAge = (row: QueueRow) => {
    return parts.filter((p) => p && p !== '—').join(' ')
 }

+const formatTimeHM = (time?: string) => {
+    if (!time) return '—'
+    return time.replace(/^(\d{2}:\d{2})(:\d{2})?$/, '$1')
+}
+
 const formatPeriod = (period?: string) => {
    if (period === 'morning') return '上午'
    if (period === 'afternoon') return '下午'
@@ -938,6 +946,7 @@ onUnmounted(() => {
    gap: 14px;
    flex: 1;
    min-height: 0;
+    align-items: flex-start;
 }
 .queue-col {
    width: 288px;
@@ -952,7 +961,6 @@ onUnmounted(() => {
    flex-direction: column;
    gap: 10px;
    height: calc(100vh - 260px);
-    min-height: 480px;
 }
 .queue-head {
    display: flex;
@@ -980,7 +988,7 @@ onUnmounted(() => {
 .queue-row {
    border: 1px solid var(--rx-line);
    border-radius: 8px;
-    padding: 10px;
+    padding: 12px 10px;
    display: flex;
    justify-content: space-between;
    align-items: center;
@@ -1011,6 +1019,7 @@ onUnmounted(() => {
    display: flex;
    align-items: baseline;
    gap: 6px;
+    flex-wrap: wrap;
 }
 .name-meta {
    font-size: 12px;
@@ -1018,7 +1027,7 @@ onUnmounted(() => {
    font-weight: 400;
 }
 .time-line {
-    margin-top: 2px;
+    margin-top: 4px;
    font-size: 12px;
    color: var(--rx-soft);
    font-family: var(--rx-font-data);
@@ -417,23 +417,6 @@
                <div class="form-section">
                    <div class="section-title">诊断详情</div>
                    
-                    <el-form-item label="舌苔照片">
-                        <material-picker
-                            v-model="formData.tongue_images"
-                            :limit="9"
-                            type="image"
-                        />
-                        <div class="form-tips">支持上传多张舌苔照片，最多9张</div>
-                    </el-form-item>
-
-                    <el-form-item label="检查报告">
-                        <material-picker
-                            v-model="formData.report_files"
-                            :limit="10"
-                            type="image"
-                        />
-                        <div class="form-tips">支持上传检查报告、病历、彩超等影像科检查图片，最多10个文件</div>
-                    </el-form-item>

                    <el-form-item label="舌苔" prop="tongue_coating">
                        <el-input v-model="formData.tongue_coating" placeholder="请输入舌苔情况" />
@@ -549,8 +532,6 @@ const formData = ref({
    allergy_history: 0,
    family_history: 0,
    pregnancy_history: 0,
-    tongue_images: [],
-    report_files: [],
    symptoms: '',
    tongue_coating: '',
    pulse: '',
@@ -493,25 +493,6 @@
                <!-- 诊断信息 -->
                <el-divider content-position="left">诊断信息</el-divider>

-                <el-form-item label="舌苔照片">
-                    <material-picker
-                        v-model="formData.tongue_images"
-                        :limit="9"
-                        type="image"
-                        :exclude-domain="true"
-                    />
-                    <div class="form-tips">支持上传多张舌苔照片，最多9张</div>
-                </el-form-item>
-
-                <el-form-item label="检查报告">
-                    <material-picker
-                        v-model="formData.report_files"
-                        :limit="10"
-                        type="image"
-                        :exclude-domain="true"
-                    />
-                    <div class="form-tips">支持上传检查报告、病历、彩超等影像科检查图片，最多10个文件</div>
-                </el-form-item>


               
@@ -529,8 +510,11 @@
                </el-tab-pane>
                <el-tab-pane label="医生备注" name="doctorNote" :disabled="!formData.id" lazy>
                    <div v-if="formData.id" class="p-4">
-                        <NoteTimeline v-if="diagNotes.length" :notes="diagNotes" />
-                        <el-empty v-else description="暂无备注记录" :image-size="48" />
+                        <NoteTimeline
+                            :notes="diagNotes"
+                            :diagnosis-id="Number(formData.id)"
+                            @refresh="fetchDiagNotes"
+                        />
                    </div>
                    <el-empty v-else description="请先保存诊单后查看" />
                </el-tab-pane>
@@ -567,40 +551,6 @@
                <!-- 病历记录标签页（开方后自动显示） -->
                <el-tab-pane label="处方" name="bingli" :disabled="!formData.id"  v-if="hasPermission(['tcm.diagnosis/chufang'])">
                    <div v-if="formData.id" class="bingli-tab-content">
-                        <!-- 诊断信息：舌苔照片、检查报告 -->
-                        <div class="bingli-diagnosis-section">
-                            <el-divider content-position="left">诊断信息</el-divider>
-                            <el-row :gutter="24">
-                                <el-col :span="12">
-                                    <div class="bingli-label">舌苔照片</div>
-                                    <div v-if="formData.tongue_images?.length" class="bingli-images">
-                                        <el-image
-                                            v-for="(img, idx) in formData.tongue_images"
-                                            :key="idx"
-                                            :src="getImageUrl(img)"
-                                            :preview-src-list="(formData.tongue_images || []).map((u: string) => getImageUrl(u))"
-                                            class="bingli-img"
-                                            fit="cover"
-                                        />
-                                    </div>
-                                    <span v-else class="bingli-empty">暂无</span>
-                                </el-col>
-                                <el-col :span="12">
-                                    <div class="bingli-label">检查报告</div>
-                                    <div v-if="formData.report_files?.length" class="bingli-images">
-                                        <el-image
-                                            v-for="(file, idx) in formData.report_files"
-                                            :key="idx"
-                                            :src="getImageUrl(file)"
-                                            :preview-src-list="(formData.report_files || []).map((u: string) => getImageUrl(u))"
-                                            class="bingli-img"
-                                            fit="cover"
-                                        />
-                                    </div>
-                                    <span v-else class="bingli-empty">暂无</span>
-                                </el-col>
-                            </el-row>
-                        </div>
                        <!-- 病历记录列表 -->
                        <case-record-list
                            ref="caseRecordListRef"
@@ -712,10 +662,6 @@ import AppointmentRecordPanel from './components/AppointmentRecordPanel.vue'
 import NoteTimeline from '@/views/patient/reception/components/NoteTimeline.vue'
 import TcmPrescription from '@/components/tcm-prescription/index.vue'
 import { getDoctorNotes } from '@/api/patient'
-import {
-    DIAGNOSIS_TONGUE_IMAGES_UPDATED,
-    type DiagnosisTongueImagesUpdatedDetail
-} from '@/utils/diagnosis-sync-events'

 const emit = defineEmits(['success'])
 const appStore = useAppStore()
@@ -744,11 +690,16 @@ const drawerTitle = computed(() => {

 const diagNotes = ref<any[]>([])

+const fetchDiagNotes = async () => {
+    if (!formData.value.id) return
+    try {
+        diagNotes.value = await getDoctorNotes({ diagnosis_id: Number(formData.value.id) }) || []
+    } catch { diagNotes.value = [] }
+}
+
 watch(() => activeTab.value, async (tab) => {
    if (tab === 'doctorNote' && formData.value.id) {
-        try {
-            diagNotes.value = await getDoctorNotes({ diagnosis_id: Number(formData.value.id) }) || []
-        } catch { diagNotes.value = [] }
+        await fetchDiagNotes()
    }
 })

@@ -772,21 +723,6 @@ watch([visible, activeTab], () => {
    }
 })

-function onTongueImagesSyncedFromCall(e: Event) {
-    if (!visible.value) return
-    const d = (e as CustomEvent<DiagnosisTongueImagesUpdatedDetail>).detail
-    if (!d?.diagnosisId || !Array.isArray(d.tongue_images)) return
-    if (Number(formData.value.id) !== Number(d.diagnosisId)) return
-    formData.value.tongue_images = [...d.tongue_images]
-}
-
-onMounted(() => {
-    window.addEventListener(DIAGNOSIS_TONGUE_IMAGES_UPDATED, onTongueImagesSyncedFromCall as EventListener)
-})
-
-onUnmounted(() => {
-    window.removeEventListener(DIAGNOSIS_TONGUE_IMAGES_UPDATED, onTongueImagesSyncedFromCall as EventListener)
-})

 const formData = ref({
    id: '',
@@ -831,8 +767,6 @@ const formData = ref({
    family_history: 0,
    pregnancy_history: 0,
    assistant_id: undefined as number | undefined,
-    tongue_images: [] as string[],
-    report_files: [],
    symptoms: '',
    tongue_coating: '',
    pulse: '',
@@ -1263,8 +1197,6 @@ const handleClose = () => {
        family_history: 0,
        pregnancy_history: 0,
        assistant_id: undefined as number | undefined,
-        tongue_images: [] as string[],
-        report_files: [],
        symptoms: '',
        tongue_coating: '',
        pulse: '',
@@ -147,4 +147,18 @@ class AppointmentController extends BaseAdminController
        $params = (new AppointmentValidate())->goCheck('doctorNotes');
        return $this->data(DoctorNoteLogic::getByDiagnosis((int) $params['diagnosis_id']));
    }
+
+    public function deleteDoctorNoteImage()
+    {
+        $params = (new AppointmentValidate())->post()->goCheck('deleteDoctorNoteImage');
+        $result = DoctorNoteLogic::deleteImage(
+            (int) $params['note_id'],
+            $params['image_type'],
+            $params['image_path']
+        );
+        if ($result === false) {
+            return $this->fail(DoctorNoteLogic::getError());
+        }
+        return $this->success('删除成功');
+    }
 }
@@ -25,8 +25,8 @@ class DoctorNoteLogic extends BaseLogic
                ->find();

            $newContent = trim($params['content'] ?? '');
-            $newImages  = self::parseJsonArray($params['tongue_images'] ?? []);
-            $newReports = self::parseJsonArray($params['report_files'] ?? []);
+            $newImages  = array_map([self::class, 'toRelativePath'], self::parseJsonArray($params['tongue_images'] ?? []));
+            $newReports = array_map([self::class, 'toRelativePath'], self::parseJsonArray($params['report_files'] ?? []));

            if ($existing) {
                $data = [];
@@ -108,6 +108,91 @@ class DoctorNoteLogic extends BaseLogic
        }
    }

+    /**
+     * 删除备注中的单张图片
+     */
+    public static function deleteImage(int $noteId, string $imageType, string $imagePath): bool
+    {
+        try {
+            $note = DoctorNote::where('id', $noteId)->whereNull('delete_time')->find();
+            if (!$note) {
+                self::setError('记录不存在');
+                return false;
+            }
+            if (!in_array($imageType, ['tongue_images', 'report_files'])) {
+                self::setError('类型无效');
+                return false;
+            }
+            $images = self::parseJsonArray($note->$imageType);
+            // 统一转为相对路径再匹配
+            $targetPath = self::toRelativePath($imagePath);
+            $images = array_values(array_filter($images, fn($url) => self::toRelativePath($url) !== $targetPath));
+            $note->$imageType = empty($images) ? null : json_encode($images, JSON_UNESCAPED_UNICODE);
+            $note->save();
+            return true;
+        } catch (\Exception $e) {
+            self::setError($e->getMessage());
+            return false;
+        }
+    }
+
+    /**
+     * 聚合某诊单所有备注中的图片（供 DiagnosisLogic::detail 使用）
+     */
+    public static function getAggregatedImages(int $diagnosisId): array
+    {
+        $records = DoctorNote::where('diagnosis_id', $diagnosisId)
+            ->whereNull('delete_time')
+            ->select();
+
+        $tongueImages = [];
+        $reportFiles = [];
+        foreach ($records as $r) {
+            $tongueImages = array_merge($tongueImages, self::parseJsonArray($r->tongue_images));
+            $reportFiles = array_merge($reportFiles, self::parseJsonArray($r->report_files));
+        }
+
+        return [
+            'tongue_images' => array_map(
+                fn($u) => empty($u) ? $u : FileService::getFileUrl($u),
+                array_values(array_unique($tongueImages))
+            ),
+            'report_files' => array_map(
+                fn($u) => empty($u) ? $u : FileService::getFileUrl($u),
+                array_values(array_unique($reportFiles))
+            ),
+        ];
+    }
+
+    /**
+     * 如果 URL 的域名是当前配置的存储域名则去掉，否则原样保留
+     */
+    private static function toRelativePath(string $url): string
+    {
+        if (empty($url)) return $url;
+        if (stripos($url, 'http://') !== 0 && stripos($url, 'https://') !== 0) {
+            return $url;
+        }
+        // 获取当前存储域名
+        $domain = self::getStorageDomain();
+        if ($domain && stripos($url, rtrim($domain, '/')) === 0) {
+            $relative = substr($url, strlen(rtrim($domain, '/')));
+            return ltrim($relative, '/');
+        }
+        // 非当前存储域名，保留完整 URL
+        return $url;
+    }
+
+    private static function getStorageDomain(): string
+    {
+        $default = \app\common\service\ConfigService::get('storage', 'default', 'local');
+        if ($default === 'local') {
+            return request()->domain() . '/';
+        }
+        $storage = \app\common\service\ConfigService::get('storage', $default);
+        return $storage ? ($storage['domain'] ?? '') : '';
+    }
+
    private static function parseJsonArray($value): array
    {
        if (is_array($value)) return $value;
@@ -80,15 +80,12 @@ class DiagnosisLogic extends BaseLogic
                }
            }
            
-            // 处理舌苔照片（JSON数组）
-            if (isset($params['tongue_images']) && is_array($params['tongue_images'])) {
-                $params['tongue_images'] = json_encode($params['tongue_images'], JSON_UNESCAPED_UNICODE);
-            }
-            
-            // 处理检查报告（JSON数组）
-            if (isset($params['report_files']) && is_array($params['report_files'])) {
-                $params['report_files'] = json_encode($params['report_files'], JSON_UNESCAPED_UNICODE);
-            }
+            // 图片字段迁移至 doctor_note，从 params 中提取后再写入备注表
+            $newTongueImages = isset($params['tongue_images']) && is_array($params['tongue_images'])
+                ? $params['tongue_images'] : [];
+            $newReportFiles = isset($params['report_files']) && is_array($params['report_files'])
+                ? $params['report_files'] : [];
+            unset($params['tongue_images'], $params['report_files']);

            // 处理诊断日期
            if (isset($params['diagnosis_date'])) {
@@ -96,7 +93,6 @@ class DiagnosisLogic extends BaseLogic
            }

            // 表未增加 admin_id 列时勿写入，避免 SQL 报错（见 sql/1.9.20260421/add_tcm_diagnosis_admin_id.sql）
-            // 注意：Model::getConnection() 在 think-orm 中返回连接名（string），须用 Db 查询对象取字段
            if (array_key_exists('admin_id', $params)) {
                $fieldNames = Db::name('tcm_diagnosis')->getTableFields();
                if (! is_array($fieldNames) || ! in_array('admin_id', $fieldNames, true)) {
@@ -106,6 +102,15 @@ class DiagnosisLogic extends BaseLogic

            $model = Diagnosis::create($params);

+            // 图片写入 doctor_note 表
+            if (!empty($newTongueImages) || !empty($newReportFiles)) {
+                DoctorNoteLogic::addOrAppend([
+                    'diagnosis_id' => (int) $model->id,
+                    'tongue_images' => $newTongueImages,
+                    'report_files' => $newReportFiles,
+                ]);
+            }
+
            // 自动为患者创建 TRTC 账号
            self::createPatientTrtcAccount($model->id);

@@ -179,46 +184,16 @@ class DiagnosisLogic extends BaseLogic
                }
            }
            
-            // 处理舌苔照片（JSON数组）
-            if (isset($params['tongue_images']) && is_array($params['tongue_images'])) {
-                $params['tongue_images'] = json_encode($params['tongue_images'], JSON_UNESCAPED_UNICODE);
-            }
-
-            // 处理检查报告（JSON数组）
-            if (isset($params['report_files']) && is_array($params['report_files'])) {
-                $params['report_files'] = json_encode($params['report_files'], JSON_UNESCAPED_UNICODE);
-            }
+            // 图片字段已迁移至 doctor_note 表管理，不再写入 tcm_diagnosis
+            unset($params['tongue_images'], $params['report_files']);

            // 处理诊断日期
            if (isset($params['diagnosis_date'])) {
                $params['diagnosis_date'] = strtotime($params['diagnosis_date']);
            }

-            // 保存前记录旧的检查报告，用于对比新增
-            $oldReportFiles = [];
-            if (isset($params['report_files'])) {
-                $old = Diagnosis::where('id', $params['id'])->value('report_files');
-                if ($old) {
-                    $oldReportFiles = is_string($old) ? (json_decode($old, true) ?: []) : (array) $old;
-                }
-            }
-
            Diagnosis::update($params);

-            // 检查报告有新增时同步到医生备注
-            if (isset($params['report_files'])) {
-                $newReportFiles = is_string($params['report_files'])
-                    ? (json_decode($params['report_files'], true) ?: [])
-                    : (array) $params['report_files'];
-                $added = array_values(array_diff($newReportFiles, $oldReportFiles));
-                if (!empty($added)) {
-                    DoctorNoteLogic::addOrAppend([
-                        'diagnosis_id' => (int) $params['id'],
-                        'report_files' => $added,
-                    ]);
-                }
-            }
-
            // 如果是编辑，也确保患者有 TRTC 账号
            $diagnosis = Diagnosis::find($params['id']);
            if ($diagnosis) {
@@ -280,33 +255,36 @@ class DiagnosisLogic extends BaseLogic
        }
        
 
-        if (!empty($diagnosis['tongue_images'])) {
-            $files = json_decode($diagnosis['tongue_images'], true);
-            if (is_array($files)) {
-                $diagnosis['tongue_images'] = $files;
-            } else {
-                $diagnosis['tongue_images'] = array_filter(explode(',', $diagnosis['tongue_images'])) ?: [];
-            }
-            $diagnosis['tongue_images'] = array_map(function($url) {
-                return empty($url) ? $url : FileService::getFileUrl($url);
-            }, $diagnosis['tongue_images']);
+        // 从 doctor_note 聚合图片（已迁移至备注表统一管理）
+        $noteImages = DoctorNoteLogic::getAggregatedImages((int) $diagnosis['id']);
+        if (!empty($noteImages['tongue_images']) || !empty($noteImages['report_files'])) {
+            $diagnosis['tongue_images'] = $noteImages['tongue_images'];
+            $diagnosis['report_files'] = $noteImages['report_files'];
        } else {
-            $diagnosis['tongue_images'] = [];
+            // Fallback: 未迁移的旧数据仍从 tcm_diagnosis 读取
+            if (!empty($diagnosis['tongue_images'])) {
+                $files = json_decode($diagnosis['tongue_images'], true);
+                if (!is_array($files)) {
+                    $files = array_filter(explode(',', $diagnosis['tongue_images'])) ?: [];
+                }
+                $diagnosis['tongue_images'] = array_map(function($url) {
+                    return empty($url) ? $url : FileService::getFileUrl($url);
+                }, $files);
+            } else {
+                $diagnosis['tongue_images'] = [];
+            }
+            if (!empty($diagnosis['report_files'])) {
+                $files = json_decode($diagnosis['report_files'], true);
+                if (!is_array($files)) {
+                    $files = array_filter(explode(',', $diagnosis['report_files'])) ?: [];
+                }
+                $diagnosis['report_files'] = array_map(function($url) {
+                    return empty($url) ? $url : FileService::getFileUrl($url);
+                }, $files);
+            } else {
+                $diagnosis['report_files'] = [];
+            }
        }
-        
-        if (!empty($diagnosis['report_files'])) {
-            $files = json_decode($diagnosis['report_files'], true);
-            if (is_array($files)) {
-                $diagnosis['report_files'] = $files;
-            } else {
-                $diagnosis['report_files'] = array_filter(explode(',', $diagnosis['report_files'])) ?: [];
-            }
-            $diagnosis['report_files'] = array_map(function($url) {
-                return empty($url) ? $url : FileService::getFileUrl($url);
-            }, $diagnosis['report_files']);
-        } else {
-    $diagnosis['report_files'] = [];
-}
        // 处理诊断日期格式
        if (!empty($diagnosis['diagnosis_date'])) {
            $diagnosis['diagnosis_date'] = date('Y-m-d', $diagnosis['diagnosis_date']);
@@ -2788,12 +2766,13 @@ class DiagnosisLogic extends BaseLogic
                    $params[$field] = implode(',', $params[$field]);
                }
            }
-            if (isset($params['tongue_images']) && is_array($params['tongue_images'])) {
-                $params['tongue_images'] = json_encode($params['tongue_images'], JSON_UNESCAPED_UNICODE);
-            }
-            if (isset($params['report_files']) && is_array($params['report_files'])) {
-                $params['report_files'] = json_encode($params['report_files'], JSON_UNESCAPED_UNICODE);
-            }
+            // 图片字段迁移至 doctor_note 表
+            $cardTongueImages = isset($params['tongue_images']) && is_array($params['tongue_images'])
+                ? $params['tongue_images'] : [];
+            $cardReportFiles = isset($params['report_files']) && is_array($params['report_files'])
+                ? $params['report_files'] : [];
+            unset($params['tongue_images'], $params['report_files']);
+
            if (isset($params['diagnosis_date'])) {
                $params['diagnosis_date'] = is_numeric($params['diagnosis_date']) ? $params['diagnosis_date'] : strtotime($params['diagnosis_date']);
            }
@@ -2801,6 +2780,15 @@ class DiagnosisLogic extends BaseLogic
            $model = Diagnosis::create($params);
            self::createPatientTrtcAccount($model->patient_id);

+            // 图片写入 doctor_note
+            if (!empty($cardTongueImages) || !empty($cardReportFiles)) {
+                DoctorNoteLogic::addOrAppend([
+                    'diagnosis_id' => (int) $model->id,
+                    'tongue_images' => $cardTongueImages,
+                    'report_files' => $cardReportFiles,
+                ]);
+            }
+
            // 关联 diagnosis_view_records，便于用户通过 User::with('diagnosis') 获取就诊卡
            if ($userId) {
                $now = time();
@@ -2906,8 +2894,6 @@ class DiagnosisLogic extends BaseLogic
                // 临床信息
                'symptoms' => $params['symptoms'] ?? '',
                'tongue_coating' => $params['tongue_coating'] ?? '',
-                'tongue_images' => $params['tongue_images'] ?? '',
-                'report_files' => $params['report_files'] ?? '',
                'pulse' => $params['pulse'] ?? '',
                'treatment_principle' => $params['treatment_principle'] ?? '',
                'prescription' => $params['prescription'] ?? '',
@@ -2920,14 +2906,25 @@ class DiagnosisLogic extends BaseLogic
            if (!empty($params['diagnosis_date'])) {
                $updateData['diagnosis_date'] = strtotime($params['diagnosis_date']);
            } elseif (!empty($params['local_hospital_visit_date'])) {
-                // 如果没有diagnosis_date但有local_hospital_visit_date，则使用local_hospital_visit_date
                $updateData['diagnosis_date'] = strtotime($params['local_hospital_visit_date']);
            }

-           
            // 执行更新
            $diagnosis->save($updateData);

+            // 图片写入 doctor_note 表
+            $cardTongueImages = isset($params['tongue_images']) && is_array($params['tongue_images'])
+                ? $params['tongue_images'] : [];
+            $cardReportFiles = isset($params['report_files']) && is_array($params['report_files'])
+                ? $params['report_files'] : [];
+            if (!empty($cardTongueImages) || !empty($cardReportFiles)) {
+                DoctorNoteLogic::addOrAppend([
+                    'diagnosis_id' => (int) $diagnosisId,
+                    'tongue_images' => $cardTongueImages,
+                    'report_files' => $cardReportFiles,
+                ]);
+            }
+
            \think\facade\Log::info('诊单更新成功 - diagnosis_id: ' . $diagnosisId . ', patient_id: ' . $patientId);

            return true;
@@ -25,6 +25,9 @@ class AppointmentValidate extends BaseValidate
        'appointment_time' => 'require',
        'appointment_type' => 'in:video,text,phone',
        'channel_source' => 'require',
+        'note_id' => 'require|integer',
+        'image_type' => 'require|in:tongue_images,report_files',
+        'image_path' => 'require',
    ];

    /**
@@ -115,4 +118,9 @@ class AppointmentValidate extends BaseValidate
    {
        return $this->only(['diagnosis_id']);
    }
+
+    public function sceneDeleteDoctorNoteImage()
+    {
+        return $this->only(['note_id', 'image_type', 'image_path']);
+    }
 }
@@ -64,7 +64,7 @@ class DiagnosisValidate extends BaseValidate

    public function sceneEdit()
    {
-        return $this->only(['id', 'patient_name', 'id_card', 'phone', 'gender', 'age', 'diagnosis_date', 'diagnosis_type', 'syndrome_type', 'marital_status', 'height', 'weight', 'region', 'systolic_pressure', 'diastolic_pressure', 'fasting_blood_sugar', 'diabetes_discovery_year', 'local_hospital_diagnosis', 'local_hospital_name', 'past_history', 'symptoms', 'tongue_coating', 'pulse', 'treatment_principle', 'prescription', 'doctor_advice', 'remark', 'current_medications', 'status', 'tongue_images', 'report_files']);
+        return $this->only(['id', 'patient_name', 'id_card', 'phone', 'gender', 'age', 'diagnosis_date', 'diagnosis_type', 'syndrome_type', 'marital_status', 'height', 'weight', 'region', 'systolic_pressure', 'diastolic_pressure', 'fasting_blood_sugar', 'diabetes_discovery_year', 'local_hospital_diagnosis', 'local_hospital_name', 'past_history', 'symptoms', 'tongue_coating', 'pulse', 'treatment_principle', 'prescription', 'doctor_advice', 'remark', 'current_medications', 'status']);
    }

    public function sceneId()
@@ -0,0 +1,164 @@
+<?php
+
+declare(strict_types=1);
+
+namespace app\command;
+
+use think\console\Command;
+use think\console\Input;
+use think\console\Output;
+use think\facade\Db;
+
+/**
+ * 将 tcm_diagnosis 中的 tongue_images / report_files 迁移到 zyt_doctor_note 表
+ *
+ * 使用方法：
+ * php think migrate:images-to-doctor-note
+ * php think migrate:images-to-doctor-note --dry-run   # 仅统计不实际写入
+ */
+class MigrateImagesToDoctorNote extends Command
+{
+    protected function configure()
+    {
+        $this->setName('migrate:images-to-doctor-note')
+            ->addOption('dry-run', null, \think\console\input\Option::VALUE_NONE, '仅统计，不实际写入')
+            ->setDescription('迁移诊单舌苔照片/检查报告到医生备注表');
+    }
+
+    protected function execute(Input $input, Output $output)
+    {
+        $dryRun = $input->getOption('dry-run');
+
+        $output->writeln('开始扫描 tcm_diagnosis 中有图片数据的记录...');
+
+        $query = Db::name('tcm_diagnosis')
+            ->whereNull('delete_time')
+            ->where(function ($q) {
+                $q->whereRaw("tongue_images IS NOT NULL AND tongue_images != '' AND tongue_images != '[]'")
+                  ->whereOr(function ($q2) {
+                      $q2->whereRaw("report_files IS NOT NULL AND report_files != '' AND report_files != '[]'");
+                  });
+            })
+            ->field('id, patient_id, create_time, tongue_images, report_files');
+
+        $total = $query->count();
+        $output->writeln("找到 {$total} 条需要迁移的诊单记录");
+
+        if ($total === 0) {
+            $output->writeln('<info>无需迁移</info>');
+            return;
+        }
+
+        if ($dryRun) {
+            $output->writeln('<comment>[dry-run] 不执行实际写入</comment>');
+            return;
+        }
+
+        $migrated = 0;
+        $skipped = 0;
+        $errors = 0;
+
+        $query->chunk(100, function ($rows) use ($output, &$migrated, &$skipped, &$errors) {
+            foreach ($rows as $row) {
+                try {
+                    $diagnosisId = (int) $row['id'];
+                    $noteDate = $row['create_time'] > 0
+                        ? date('Y-m-d', (int) $row['create_time'])
+                        : date('Y-m-d');
+
+                    $tongueImages = array_map([$this, 'toRelativePath'], $this->parseJson($row['tongue_images']));
+                    $reportFiles = array_map([$this, 'toRelativePath'], $this->parseJson($row['report_files']));
+                    $tongueImages = array_values(array_filter($tongueImages));
+                    $reportFiles = array_values(array_filter($reportFiles));
+
+                    if (empty($tongueImages) && empty($reportFiles)) {
+                        $skipped++;
+                        continue;
+                    }
+
+                    $existing = Db::name('doctor_note')
+                        ->where('diagnosis_id', $diagnosisId)
+                        ->where('note_date', $noteDate)
+                        ->whereNull('delete_time')
+                        ->find();
+
+                    if ($existing) {
+                        $data = [];
+                        if (!empty($tongueImages)) {
+                            $prev = $this->parseJson($existing['tongue_images']);
+                            $merged = array_values(array_unique(array_merge($prev, $tongueImages)));
+                            $data['tongue_images'] = json_encode($merged, JSON_UNESCAPED_UNICODE);
+                        }
+                        if (!empty($reportFiles)) {
+                            $prev = $this->parseJson($existing['report_files']);
+                            $merged = array_values(array_unique(array_merge($prev, $reportFiles)));
+                            $data['report_files'] = json_encode($merged, JSON_UNESCAPED_UNICODE);
+                        }
+                        if (!empty($data)) {
+                            $data['update_time'] = time();
+                            Db::name('doctor_note')->where('id', $existing['id'])->update($data);
+                        }
+                    } else {
+                        Db::name('doctor_note')->insert([
+                            'diagnosis_id' => $diagnosisId,
+                            'doctor_id' => 0,
+                            'note_date' => $noteDate,
+                            'content' => null,
+                            'tongue_images' => !empty($tongueImages)
+                                ? json_encode($tongueImages, JSON_UNESCAPED_UNICODE)
+                                : null,
+                            'report_files' => !empty($reportFiles)
+                                ? json_encode($reportFiles, JSON_UNESCAPED_UNICODE)
+                                : null,
+                            'create_time' => (int) $row['create_time'],
+                            'update_time' => time(),
+                        ]);
+                    }
+
+                    $migrated++;
+                } catch (\Exception $e) {
+                    $errors++;
+                    $output->writeln("<error>诊单 ID={$row['id']} 迁移失败: {$e->getMessage()}</error>");
+                }
+            }
+        });
+
+        $output->writeln('');
+        $output->writeln('<info>迁移完成</info>');
+        $output->writeln("  成功: {$migrated}");
+        $output->writeln("  跳过(空数据): {$skipped}");
+        $output->writeln("  失败: {$errors}");
+    }
+
+    private function parseJson($value): array
+    {
+        if (empty($value)) return [];
+        if (is_array($value)) return $value;
+        if (is_string($value)) {
+            $decoded = json_decode($value, true);
+            return is_array($decoded) ? $decoded : [];
+        }
+        return [];
+    }
+
+    private function toRelativePath(string $url): string
+    {
+        if (empty($url)) return $url;
+        if (stripos($url, 'http://') !== 0 && stripos($url, 'https://') !== 0) {
+            return $url;
+        }
+        // 只去掉当前配置的存储域名，其他域名保留完整 URL
+        $default = \app\common\service\ConfigService::get('storage', 'default', 'local');
+        if ($default === 'local') {
+            $domain = request()->domain() . '/';
+        } else {
+            $storage = \app\common\service\ConfigService::get('storage', $default);
+            $domain = $storage ? ($storage['domain'] ?? '') : '';
+        }
+        if ($domain && stripos($url, rtrim($domain, '/')) === 0) {
+            $relative = substr($url, strlen(rtrim($domain, '/')));
+            return ltrim($relative, '/');
+        }
+        return $url;
+    }
+}
@@ -32,5 +32,7 @@ return [
        'qywx:sync-msg-archive' => 'app\\command\\QywxSyncMsgArchive',
        // 甘草订单物流路由同步（GET_TASK_ROUTE_LIST）
        'gancao:sync-logistics' => 'app\\command\\GancaoSyncLogisticsRoute',
+        // 迁移诊单图片到医生备注表
+        'migrate:images-to-doctor-note' => 'app\\command\\MigrateImagesToDoctorNote',
    ],
 ];
@@ -0,0 +1,6 @@
+-- 新增「删除备注图片」按钮权限
+
+SET @reception_menu_id = (SELECT id FROM system_menu WHERE perms = 'doctor.appointment/reception' LIMIT 1);
+
+INSERT INTO system_menu (pid, type, name, icon, sort, perms, paths, component, selected, params, is_cache, is_show, is_disable, create_time, update_time, delete_time)
+VALUES (@reception_menu_id, 'A', '删除备注图片', '', 5, 'doctor.appointment/deleteDoctorNoteImage', '', '', '', '', 0, 1, 0, UNIX_TIMESTAMP(), UNIX_TIMESTAMP(), NULL);