更新

2026-06-13 15:00:43 +08:00
4 changed files with 208 additions and 25 deletions
@@ -67,17 +67,37 @@
                >
                <!-- 基本信息 -->
                <el-divider content-position="left">基本信息</el-divider>
+
+                <el-alert
+                    v-if="mode === 'edit' && patientBasicLocked && !canEditPatientBasicFields"
+                    type="warning"
+                    :closable="false"
+                    show-icon
+                    class="mb-3"
+                >
+                    <template v-if="latestPrescriptionOrder">
+                        最近业务订单 #{{ latestPrescriptionOrder.id }} 状态为「{{ latestPrescriptionOrder.fulfillment_status_text }}」，患者基本信息不可修改
+                    </template>
+                    <template v-else>
+                        存在未完成的业务订单，患者基本信息不可修改
+                    </template>
+                </el-alert>
                
                <el-form-item label="诊单ID">
                    <el-input v-model="formData.patient_id" disabled placeholder="系统自动生成" />
                </el-form-item>

+                <fieldset
+                    :disabled="!canEditPatientBasicFields"
+                    class="diagnosis-patient-basic-fieldset border-0 min-w-0 p-0 m-0"
+                >
                <el-row :gutter="20">
                    <el-col :span="12">
                        <el-form-item label="姓名" prop="patient_name">
                            <el-input
                                v-model="formData.patient_name"
                                placeholder="请输入姓名"
+                                :disabled="!canEditPatientBasicFields"
                            />
                        </el-form-item>
                    </el-col>
@@ -87,6 +107,7 @@
                                v-model="formData.id_card"
                                placeholder="请输入身份证号"
                                maxlength="18"
+                                :disabled="!canEditPatientBasicFields"
                                @focus="handleIdCardFocus"
                                @blur="handleIdCardBlur"
                            />
@@ -120,6 +141,7 @@
                                v-model="formData.phone"
                                placeholder="请输入手机号"
                                maxlength="11"
+                                :disabled="!canEditPatientBasicFields"
                                @focus="handlePhoneFocus"
                                @blur="handlePhoneBlur"
                            />
@@ -127,7 +149,7 @@
                    </el-col>
                    <el-col :span="12">
                        <el-form-item label="性别" prop="gender">
-                            <el-radio-group v-model="formData.gender">
+                            <el-radio-group v-model="formData.gender" :disabled="!canEditPatientBasicFields">
                                <el-radio :label="1">男</el-radio>
                                <el-radio :label="0">女</el-radio>
                            </el-radio-group>
@@ -144,11 +166,14 @@
                                :max="150"
                                placeholder="请输入年龄"
                                class="w-full"
+                                :disabled="!canEditPatientBasicFields"
+                                :controls="canEditPatientBasicFields"
                            />
                        </el-form-item>
                    </el-col>
                    
                </el-row>
+                </fieldset>

           
                <!-- 生命体征 -->
@@ -778,8 +803,24 @@ const submitting = ref(false)
 /** 拥有后手机号可正常编辑，失焦不再强制脱敏 */
 const hasPhonePlainPermission = computed(() => hasPermission(['tcm.diagnosis/phonePlain']))
 const hasDailyRecordPermission = computed(() => hasPermission(['tcm.diagnosis/dailyRecord']))
-/** 编辑且无明文权限：只读脱敏，点击切换查看完整号 */
-const showPhoneMaskedEdit = computed(() => mode.value === 'edit' && !hasPhonePlainPermission.value)
+const patientBasicLocked = ref(false)
+const canEditPatientBasicFromApi = ref(true)
+const latestPrescriptionOrder = ref<{
+    id: number
+    fulfillment_status: number
+    fulfillment_status_text: string
+} | null>(null)
+const canEditPatientBasicFields = computed(() => {
+    if (viewOnly.value) return false
+    if (mode.value === 'add') return true
+    return canEditPatientBasicFromApi.value
+})
+/** 编辑且无明文权限或基本信息锁定：只读脱敏，点击切换查看完整号 */
+const showPhoneMaskedEdit = computed(() => {
+    if (mode.value !== 'edit') return false
+    if (!canEditPatientBasicFields.value) return true
+    return !hasPhonePlainPermission.value
+})
 const phoneRevealUnlocked = ref(false)
 const activeTab = ref('basic')
 const drawerTitle = computed(() => {
@@ -1167,6 +1208,9 @@ async function loadDiagnosisDetailIntoForm(id: number): Promise<void> {

    originalPhone.value = data.phone || ''
    originalIdCard.value = data.id_card || ''
+    patientBasicLocked.value = !!data.patient_basic_locked
+    canEditPatientBasicFromApi.value = data.can_edit_patient_basic !== false
+    latestPrescriptionOrder.value = data.latest_prescription_order ?? null

    data.phone = hasPhonePlainPermission.value ? data.phone || '' : maskPhone(data.phone || '')
    data.id_card = maskIdCard(data.id_card || '')
@@ -1178,12 +1222,19 @@ async function loadDiagnosisDetailIntoForm(id: number): Promise<void> {
    formData.value.diabetes_discovery_year = y == null || y === '' ? '' : String(y)
 }

+const resetPatientBasicLockState = () => {
+    patientBasicLocked.value = false
+    canEditPatientBasicFromApi.value = true
+    latestPrescriptionOrder.value = null
+}
+
 const open = async (type: string, id?: number) => {
    viewOnly.value = false
    mode.value = type
    visible.value = true
    activeTab.value = 'basic' // 重置到基本信息标签页
    phoneRevealUnlocked.value = false
+    resetPatientBasicLockState()

    // 加载字典数据
    await getDictOptions()
@@ -1206,6 +1257,7 @@ const openViewOnly = async (id: number) => {
    visible.value = true
    activeTab.value = 'basic'
    phoneRevealUnlocked.value = false
+    resetPatientBasicLockState()
    await getDictOptions()
    await loadDiagnosisDetailIntoForm(id)
 }
@@ -1370,6 +1422,19 @@ defineExpose({
        }
    }

+    .diagnosis-patient-basic-fieldset:disabled {
+        opacity: 1;
+        :deep(.el-input__wrapper),
+        :deep(.el-input-number),
+        :deep(.el-input-number__decrease),
+        :deep(.el-input-number__increase),
+        :deep(.el-radio),
+        :deep(.el-radio__input) {
+            cursor: not-allowed;
+            pointer-events: none;
+        }
+    }
+
    :deep(.el-form) {
        padding-bottom: 20px;
        font-size: 12px;
@@ -87,7 +87,7 @@ class DiagnosisController extends BaseAdminController
    public function edit()
    {
        $params = (new DiagnosisValidate())->post()->goCheck('edit');
-        $result = DiagnosisLogic::edit($params);
+        $result = DiagnosisLogic::edit($params, $this->adminInfo);
        if ($result) {
            return $this->success('编辑成功', [], 1, 1);
        }
@@ -116,7 +116,7 @@ class DiagnosisController extends BaseAdminController
    {

        $params = (new DiagnosisValidate())->goCheck('id');
-        $result = DiagnosisLogic::detail($params);
+        $result = DiagnosisLogic::detail($params, $this->adminInfo);
        DiagnosisLogic::markAssignRead((int) ($params['id'] ?? 0), $this->adminId);
        return $this->data($result);
    }
@@ -28,6 +28,7 @@ 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;
@@ -73,8 +74,8 @@ class DiagnosisLogic extends BaseLogic
                }
            }
            
-            // 生成患者ID
-            $params['patient_id'] = self::generatePatientId();
+            // 新患者先占位 0，写入后 patient_id 与自增 id 对齐
+            $params['patient_id'] = 0;
            
            // 处理既往史数组
            if (isset($params['past_history']) && is_array($params['past_history'])) {
@@ -119,6 +120,7 @@ class DiagnosisLogic extends BaseLogic
            }

            $model = Diagnosis::create($params);
+            $model = self::syncPatientIdWithDiagnosisId($model);

            // 图片写入 doctor_note 表
            if (!empty($newTongueImages) || !empty($newReportFiles)) {
@@ -130,7 +132,7 @@ class DiagnosisLogic extends BaseLogic
            }

            // 自动为患者创建 TRTC 账号
-            self::createPatientTrtcAccount($model->id);
+            self::createPatientTrtcAccount($model->patient_id);

            return $model->id;
        } catch (\Exception $e) {
@@ -140,16 +142,20 @@ class DiagnosisLogic extends BaseLogic
    }

    /**
-     * @notes 生成患者ID
-     * @return int
+     * @notes 新患者首张诊单：patient_id 与自增 id 对齐
+     * @param Diagnosis $model
+     * @return Diagnosis
     */
-    private static function generatePatientId(): int
+    private static function syncPatientIdWithDiagnosisId(Diagnosis $model): Diagnosis
    {
-        // 获取当前最大的患者ID
-        $maxPatientId = Diagnosis::max('id') ?? 10000000;
-        
-        // 返回下一个患者ID
-        return $maxPatientId + 1;
+        if ((int) $model->patient_id === (int) $model->id) {
+            return $model;
+        }
+
+        Diagnosis::where('id', $model->id)->update(['patient_id' => $model->id]);
+        $model->patient_id = (int) $model->id;
+
+        return $model;
    }

    /**
@@ -157,9 +163,23 @@ class DiagnosisLogic extends BaseLogic
     * @param array $params
     * @return bool
     */
-    public static function edit(array $params): bool
+    /** 诊单编辑：患者基本信息字段（姓名/身份证/手机/性别/年龄） */
+    private const PATIENT_BASIC_FIELDS = ['patient_name', 'id_card', 'phone', 'gender', 'age'];
+
+    public static function edit(array $params, array $adminInfo = []): bool
    {
        try {
+            if (!empty($params['id']) && $adminInfo !== []) {
+                $existing = Diagnosis::find((int) $params['id']);
+                if ($existing && !self::canEditPatientBasicInfo((int) $params['id'], $adminInfo)) {
+                    if (self::patientBasicFieldsChanged($existing, $params)) {
+                        self::setError('最近业务订单未完成，无法修改患者基本信息');
+
+                        return false;
+                    }
+                }
+            }
+
            // 检查手机号是否重复（排除当前记录）
            if (!empty($params['phone'])) {
                $exists = Diagnosis::where('phone', $params['phone'])
@@ -250,7 +270,7 @@ class DiagnosisLogic extends BaseLogic
     * @param $params
     * @return array
     */
-    public static function detail($params): array
+    public static function detail($params, array $adminInfo = []): array
    {
        $diagnosis = Diagnosis::findOrEmpty($params['id'])->toArray();
        
@@ -317,7 +337,17 @@ class DiagnosisLogic extends BaseLogic
            $diagnosis['local_hospital_visit_date'] = $diagnosis['diagnosis_date'];
        }
        $diagnosis['is_view'] =DiagnosisViewRecord::where(['diagnosis_id'=> $diagnosis['id'], 'user_id' =>$params['user_id']??0])->find() ? 1 : 0;
-       
+
+        $latestPo = self::getLatestPrescriptionOrderRowForDiagnosis((int) ($diagnosis['id'] ?? 0));
+        $patientBasicLocked = $latestPo !== null && (int) ($latestPo['fulfillment_status'] ?? 0) !== 3;
+        $diagnosis['patient_basic_locked'] = $patientBasicLocked;
+        $diagnosis['can_edit_patient_basic'] = self::canEditPatientBasicInfo((int) ($diagnosis['id'] ?? 0), $adminInfo);
+        $diagnosis['latest_prescription_order'] = $latestPo !== null ? [
+            'id'                     => (int) ($latestPo['id'] ?? 0),
+            'fulfillment_status'     => (int) ($latestPo['fulfillment_status'] ?? 0),
+            'fulfillment_status_text'=> PrescriptionOrderLogic::fulfillmentStatusLabel((int) ($latestPo['fulfillment_status'] ?? 0)),
+        ] : null;
+
        return $diagnosis;
    }
    
@@ -486,11 +516,11 @@ class DiagnosisLogic extends BaseLogic
    }

    /**
-     * 诊单下用于指派日志快照的「最新」业务单：按 create_time 最新，其次 id（避免误用更早下单但 id 更大的记录）。
+     * 诊单下「最新」业务单：按 create_time 最新，其次 id（避免误用更早下单但 id 更大的记录）。
     *
-     * @return array{creator_id: int, create_time: int}|null
+     * @return array<string, mixed>|null
     */
-    private static function getLatestPrescriptionOrderSnapshotForDiagnosis(int $diagnosisId): ?array
+    private static function getLatestPrescriptionOrderRowForDiagnosis(int $diagnosisId): ?array
    {
        if ($diagnosisId <= 0) {
            return null;
@@ -500,19 +530,88 @@ class DiagnosisLogic extends BaseLogic
            ->whereNull('delete_time')
            ->order('create_time', 'desc')
            ->order('id', 'desc')
-            ->field(['creator_id', 'create_time'])
+            ->field(['id', 'creator_id', 'create_time', 'fulfillment_status'])
            ->find();

        if ($row === null || $row === []) {
            return null;
        }

+        return $row;
+    }
+
+    /**
+     * 诊单下用于指派日志快照的「最新」业务单：按 create_time 最新，其次 id（避免误用更早下单但 id 更大的记录）。
+     *
+     * @return array{creator_id: int, create_time: int}|null
+     */
+    private static function getLatestPrescriptionOrderSnapshotForDiagnosis(int $diagnosisId): ?array
+    {
+        $row = self::getLatestPrescriptionOrderRowForDiagnosis($diagnosisId);
+        if ($row === null) {
+            return null;
+        }
+
        return [
            'creator_id'   => (int) ($row['creator_id'] ?? 0),
            'create_time' => (int) ($row['create_time'] ?? 0),
        ];
    }

+    /**
+     * 菜单权限 tcm.diagnosis/editPatientBasic：最近业务订单未完成时仍可改患者基本信息
+     */
+    public static function hasEditPatientBasicPermission(array $adminInfo): bool
+    {
+        if (!empty($adminInfo['root']) && (int) $adminInfo['root'] === 1) {
+            return true;
+        }
+        $perms = AuthLogic::getAuthByAdminId((int) ($adminInfo['admin_id'] ?? 0));
+
+        return in_array('tcm.diagnosis/editPatientBasic', $perms, true);
+    }
+
+    /**
+     * 是否允许编辑诊单患者基本信息（无业务单 / 最近一单已完成 / 具备 editPatientBasic 权限）
+     */
+    public static function canEditPatientBasicInfo(int $diagnosisId, array $adminInfo): bool
+    {
+        $latest = self::getLatestPrescriptionOrderRowForDiagnosis($diagnosisId);
+        if ($latest === null) {
+            return true;
+        }
+        if ((int) ($latest['fulfillment_status'] ?? 0) === 3) {
+            return true;
+        }
+
+        return self::hasEditPatientBasicPermission($adminInfo);
+    }
+
+    /**
+     * @param Diagnosis $existing
+     */
+    private static function patientBasicFieldsChanged($existing, array $params): bool
+    {
+        foreach (self::PATIENT_BASIC_FIELDS as $field) {
+            if (!array_key_exists($field, $params)) {
+                continue;
+            }
+            $old = $existing->{$field};
+            $new = $params[$field];
+            if ($field === 'age' || $field === 'gender') {
+                if ((int) $old !== (int) $new) {
+                    return true;
+                }
+                continue;
+            }
+            if ((string) $old !== (string) $new) {
+                return true;
+            }
+        }
+
+        return false;
+    }
+
    /**
     * 诊单 current assistant_id 为 0 时，从最近一条指派日志推断「原医助」（如发货释放后：上一条多为 from=X、to=0）。
     * - 最近一条 to_assistant_id > 0：视为上一任持有人（库未同步时的兜底）
@@ -3092,8 +3191,9 @@ class DiagnosisLogic extends BaseLogic
            unset($params['user_id']); // 诊单表无此字段，仅用于创建 view_record

            $patientId = $params['patient_id'] ?? 0;
-            if (!$patientId) {
-                $params['patient_id'] = self::generatePatientId();
+            $isNewPatient = !$patientId;
+            if ($isNewPatient) {
+                $params['patient_id'] = 0;
            }
            $params['status'] = 1;

@@ -3123,6 +3223,9 @@ class DiagnosisLogic extends BaseLogic
            }

            $model = Diagnosis::create($params);
+            if ($isNewPatient) {
+                $model = self::syncPatientIdWithDiagnosisId($model);
+            }
            self::createPatientTrtcAccount($model->patient_id);

            // 图片写入 doctor_note
@@ -0,0 +1,15 @@
+-- 诊单编辑页：最近业务订单未完成时仍可修改患者基本信息（姓名/身份证/手机/性别/年龄）
+-- 接口：tcm.diagnosis/edit（后端校验）；前端 edit.vue 同 perms 控制表单可编辑
+SET @diag_menu_id := (SELECT id FROM zyt_system_menu WHERE perms = 'tcm.diagnosis/lists' LIMIT 1);
+
+INSERT INTO zyt_system_menu (
+    pid, type, name, icon, sort, perms, paths, component,
+    selected, params, is_cache, is_show, is_disable, create_time, update_time
+)
+SELECT
+    @diag_menu_id, 'A', '未完成订单改患者信息', '', 22,
+    'tcm.diagnosis/editPatientBasic', '', '',
+    '', '', 0, 1, 0, UNIX_TIMESTAMP(), UNIX_TIMESTAMP()
+FROM DUAL
+WHERE @diag_menu_id IS NOT NULL
+  AND NOT EXISTS (SELECT 1 FROM zyt_system_menu WHERE perms = 'tcm.diagnosis/editPatientBasic');