feat(health): 危急值告警消费者 — 幂等处理 + Handler + 路由

- event.rs: 消费 health_data.critical_alert 事件创建告警记录
- handler: list/get/acknowledge 三个端点
- 路由: /health/critical-alerts, /health/critical-alerts/{id}/acknowledge
- 权限: health.critical-alert.list / health.critical-alert.manage

crates/erp-health/src/event.rs

@@ -156,4 +156,62 @@ pub fn register_handlers_with_state(state: crate::state::HealthState) {
             }
         }
     });
+
+    // health_data.critical_alert → 创建危急值告警记录
+    let (mut critical_rx, _critical_handle) = state.event_bus.subscribe_filtered("health_data.".to_string());
+    let critical_state = state.clone();
+    tokio::spawn(async move {
+        loop {
+            match critical_rx.recv().await {
+                Some(event) if event.event_type == HEALTH_DATA_CRITICAL_ALERT => {
+                    // 幂等检查
+                    if erp_core::events::is_event_processed(&critical_state.db, event.id, "critical_alert_consumer").await.unwrap_or(false) {
+                        continue;
+                    }
+
+                    let patient_id = event.payload.get("patient_id")
+                        .and_then(|v| v.as_str())
+                        .and_then(|s| Uuid::parse_str(s).ok());
+                    let alert_type = event.payload.get("alert_type").and_then(|v| v.as_str()).unwrap_or("vital_sign");
+                    let metric_name = event.payload.get("metric_name").and_then(|v| v.as_str()).unwrap_or("unknown");
+                    let metric_value = event.payload.get("metric_value").and_then(|v| v.as_str()).unwrap_or("");
+                    let threshold_value = event.payload.get("threshold_value").and_then(|v| v.as_str()).unwrap_or("");
+
+                    if let Some(pid) = patient_id {
+                        match crate::service::critical_alert_service::handle_critical_alert_event(
+                            &critical_state,
+                            event.tenant_id,
+                            pid,
+                            alert_type,
+                            metric_name,
+                            metric_value,
+                            threshold_value,
+                            None,
+                        ).await {
+                            Ok(alert_id) => {
+                                tracing::info!(
+                                    event_id = %event.id,
+                                    alert_id = %alert_id,
+                                    patient_id = %pid,
+                                    metric = %metric_name,
+                                    "危急值告警已创建"
+                                );
+                                let _ = erp_core::events::mark_event_processed(&critical_state.db, event.id, "critical_alert_consumer").await;
+                            }
+                            Err(e) => {
+                                tracing::error!(
+                                    event_id = %event.id,
+                                    patient_id = %pid,
+                                    error = %e,
+                                    "危急值告警创建失败"
+                                );
+                            }
+                        }
+                    }
+                }
+                Some(_) => {}
+                None => break,
+            }
+        }
+    });
 }

crates/erp-health/src/handler/critical_alert_handler.rs

@@ -0,0 +1,87 @@
+use axum::extract::{FromRef, Path, Query, State};
+use axum::response::IntoResponse;
+use axum::Extension;
+use serde::Deserialize;
+use utoipa::IntoParams;
+use uuid::Uuid;
+
+use erp_core::error::AppError;
+use erp_core::rbac::require_permission;
+use erp_core::types::{ApiResponse, PaginatedResponse, TenantContext};
+
+use crate::service::critical_alert_service;
+use crate::state::HealthState;
+
+#[derive(Debug, Deserialize, IntoParams)]
+pub struct CriticalAlertListQuery {
+    pub page: Option<u64>,
+    pub page_size: Option<u64>,
+}
+
+pub async fn list_critical_alerts<S>(
+    State(state): State<HealthState>,
+    Extension(ctx): Extension<TenantContext>,
+    Query(query): Query<CriticalAlertListQuery>,
+) -> Result<impl IntoResponse, AppError>
+where
+    HealthState: FromRef<S>,
+    S: Clone + Send + Sync + 'static,
+{
+    require_permission(&ctx, "health.critical-alert.list")?;
+    let page = query.page.unwrap_or(1);
+    let page_size = query.page_size.unwrap_or(20);
+
+    let (items, total) = critical_alert_service::list_pending_alerts(
+        &state, ctx.tenant_id, page, page_size,
+    )
+    .await?;
+
+    Ok(axum::Json(ApiResponse::ok(PaginatedResponse {
+        data: items,
+        total,
+        page,
+        page_size,
+        total_pages: total.div_ceil(page_size.max(1)),
+    })))
+}
+
+pub async fn get_critical_alert<S>(
+    State(state): State<HealthState>,
+    Extension(ctx): Extension<TenantContext>,
+    Path(id): Path<Uuid>,
+) -> Result<impl IntoResponse, AppError>
+where
+    HealthState: FromRef<S>,
+    S: Clone + Send + Sync + 'static,
+{
+    require_permission(&ctx, "health.critical-alert.list")?;
+    let alert = critical_alert_service::get_alert(&state, ctx.tenant_id, id).await?;
+    Ok(axum::Json(ApiResponse::ok(alert)))
+}
+
+#[derive(Debug, serde::Deserialize, utoipa::ToSchema)]
+pub struct AcknowledgeCriticalAlertRequest {
+    pub notes: Option<String>,
+}
+
+pub async fn acknowledge_critical_alert<S>(
+    State(state): State<HealthState>,
+    Extension(ctx): Extension<TenantContext>,
+    Path(id): Path<Uuid>,
+    axum::Json(body): axum::Json<AcknowledgeCriticalAlertRequest>,
+) -> Result<impl IntoResponse, AppError>
+where
+    HealthState: FromRef<S>,
+    S: Clone + Send + Sync + 'static,
+{
+    require_permission(&ctx, "health.critical-alert.manage")?;
+    critical_alert_service::acknowledge_alert(
+        &state,
+        ctx.tenant_id,
+        id,
+        ctx.user_id,
+        body.notes,
+    )
+    .await?;
+    Ok(axum::Json(ApiResponse::ok(serde_json::json!({"message": "告警已确认"}))))
+}

crates/erp-health/src/handler/mod.rs

@@ -6,6 +6,7 @@ pub mod article_handler;
 pub mod article_tag_handler;
 pub mod consultation_handler;
 pub mod consent_handler;
+pub mod critical_alert_handler;
 pub mod critical_value_threshold_handler;
 pub mod daily_monitoring_handler;
 pub mod device_reading_handler;

crates/erp-health/src/module.rs

@@ -7,7 +7,7 @@ use erp_core::module::{ErpModule, PermissionDescriptor};
 
 use crate::handler::{
     alert_handler, alert_rule_handler,
-    appointment_handler, article_category_handler, article_handler, article_tag_handler, consultation_handler, consent_handler, critical_value_threshold_handler, daily_monitoring_handler, device_reading_handler, diagnosis_handler, dialysis_handler, dialysis_prescription_handler, doctor_handler, follow_up_handler, follow_up_template_handler,
+    appointment_handler, article_category_handler, article_handler, article_tag_handler, consultation_handler, consent_handler, critical_alert_handler, critical_value_threshold_handler, daily_monitoring_handler, device_reading_handler, diagnosis_handler, dialysis_handler, dialysis_prescription_handler, doctor_handler, follow_up_handler, follow_up_template_handler,
     health_data_handler, medication_record_handler, patient_handler, points_handler, stats_handler,
 };
 
@@ -635,6 +635,19 @@ impl HealthModule {
                 "/health/alerts/{id}/resolve",
                 axum::routing::put(alert_handler::resolve),
             )
+            // 危急值告警路由
+            .route(
+                "/health/critical-alerts",
+                axum::routing::get(critical_alert_handler::list_critical_alerts),
+            )
+            .route(
+                "/health/critical-alerts/{id}",
+                axum::routing::get(critical_alert_handler::get_critical_alert),
+            )
+            .route(
+                "/health/critical-alerts/{id}/acknowledge",
+                axum::routing::post(critical_alert_handler::acknowledge_critical_alert),
+            )
             .route(
                 "/health/alert-rules",
                 axum::routing::get(alert_rule_handler::list_rules)