feat(health+core+ai): 业务流程全面修复 Phase 4-6 + 集成测试修复

Phase 4 — Dead-letter 重试 + 内容推送 + 安全加固: - erp-core: retry_dead_letters() 定时重试 + PII payload 脱敏 - erp-core: audit_service 哈希链定时验证 + 写入失败告警 - erp-health: article.published 消费者匹配 patient_tag 推送消息 - erp-health: care_plan 事件消费者 (激活通知 + 完成积分) Phase 5 — 患者批量操作 + 咨询增强 + 护理事件: - patient: batch_import_patients + bind_by_phone + refer_patient - consultation: rate_session 满意度评价 (rating + feedback) - consent: patient_sign_consent 患者端签署 - validation: source 枚举 (7值) + relationship 枚举 (7值) + 12 单元测试 Phase 6 — 咨询文件上传 + AI 引用标注: - consultation_message: media_id 附件上传端点 - ai_suggestion: references JSONB + [ref:id] 格式引用标注 - AI system prompt 增加引用指令 + output_parser 提取逻辑迁移: 000161 (media_id + references) + 000162 (rating + feedback) 集成测试: consultation/follow_up/pii_encryption 新字段同步修复讨论文档: 2026-05-20-business-process-brainstorm.md (10域审核报告)
2026-05-21 01:34:20 +08:00
parent 9033ec8ca2
commit 41a865cf68
37 changed files with 1929 additions and 14 deletions
--- a/crates/erp-health/src/handler/consent_handler.rs
+++ b/crates/erp-health/src/handler/consent_handler.rs
@@ -4,6 +4,7 @@ use erp_core::error::AppError;
 use erp_core::rbac::require_permission;
 use erp_core::types::{ApiResponse, PaginatedResponse, TenantContext};
 use serde::Deserialize;
+use validator::Validate;

 use crate::dto::consent_dto::*;
 use crate::service::consent_service;
@@ -89,3 +90,35 @@ where
            .await?;
    Ok(Json(ApiResponse::ok(result)))
 }
+
+/// 患者端签署知情同意 — 验证 consent 归属当前患者后更新状态为 granted
+#[utoipa::path(
+    post,
+    path = "/health/consents/{consent_id}/patient-sign",
+    request_body = PatientSignConsentReq,
+    responses(
+        (status = 200, description = "签署成功"),
+        (status = 400, description = "状态不允许签署或不属于该患者"),
+        (status = 404, description = "知情同意记录不存在"),
+    ),
+    tag = "知情同意",
+    security(("bearer_auth" = [])),
+)]
+pub async fn patient_sign_consent<S>(
+    State(state): State<HealthState>,
+    Extension(ctx): Extension<TenantContext>,
+    Path(consent_id): Path<uuid::Uuid>,
+    Json(req): Json<crate::dto::consent_dto::PatientSignConsentReq>,
+) -> Result<Json<ApiResponse<crate::dto::consent_dto::ConsentResp>>, AppError>
+where
+    HealthState: FromRef<S>,
+    S: Clone + Send + Sync + 'static,
+{
+    // 患者自己签署，只需认证，不需要特殊权限
+    req.validate()
+        .map_err(|e| AppError::Validation(e.to_string()))?;
+    let result =
+        consent_service::patient_sign_consent(&state, ctx.tenant_id, ctx.user_id, consent_id, req)
+            .await?;
+    Ok(Json(ApiResponse::ok(result)))
+}
--- a/crates/erp-health/src/handler/consultation_handler.rs
+++ b/crates/erp-health/src/handler/consultation_handler.rs
@@ -1,9 +1,10 @@
 use axum::Extension;
-use axum::extract::{FromRef, Json, Path, Query, State};
+use axum::extract::{FromRef, Json, Multipart, Path, Query, State};
 use sea_orm::{ColumnTrait, EntityTrait, QueryFilter};
 use serde::Deserialize;
 use utoipa::IntoParams;
 use uuid::Uuid;
+use validator::Validate;

 use erp_core::error::AppError;
 use erp_core::rbac::require_permission;
@@ -206,6 +207,7 @@ where
        session_id: req.session_id,
        content_type: req.content_type,
        content: req.content,
+        media_id: None,
    };
    msg_req.sanitize();
    let result = consultation_service::create_message(
@@ -372,3 +374,133 @@ where
    .await?;
    Ok(Json(ApiResponse::ok(result)))
 }
+
+/// 咨询消息附件上传 — 接收 multipart 文件，调用媒体库上传，返回 media_id。
+/// 前端先调用此端点上传文件获得 media_id，再通过 create_message 发送消息。
+#[utoipa::path(
+    post,
+    path = "/consultation-messages/attachment",
+    responses(
+        (status = 200, description = "附件上传成功"),
+        (status = 400, description = "文件无效"),
+    ),
+    tag = "咨询管理",
+)]
+pub async fn upload_message_attachment<S>(
+    State(state): State<HealthState>,
+    Extension(ctx): Extension<TenantContext>,
+    mut multipart: Multipart,
+) -> Result<Json<ApiResponse<serde_json::Value>>, AppError>
+where
+    HealthState: FromRef<S>,
+    S: Clone + Send + Sync + 'static,
+{
+    require_permission(&ctx, "health.consultation.list")?;
+
+    // 文件大小限制: 10MB
+    const MAX_UPLOAD_SIZE: usize = 10 * 1024 * 1024;
+
+    // 允许的 MIME 类型（咨询场景）
+    const ALLOWED_CONSULTATION_MIME_TYPES: &[&str] = &[
+        "image/jpeg",
+        "image/png",
+        "image/gif",
+        "image/webp",
+        "application/pdf",
+        "audio/mpeg",
+        "audio/wav",
+        "audio/ogg",
+        "audio/webm",
+    ];
+
+    let mut file_data = None;
+    let mut original_name = String::new();
+    let mut content_type = String::new();
+
+    while let Some(field) = multipart
+        .next_field()
+        .await
+        .map_err(|e| AppError::Validation(format!("读取上传数据失败: {}", e)))?
+    {
+        if field.name().unwrap_or("") == "file" {
+            original_name = field.file_name().unwrap_or("file").to_string();
+            content_type = field
+                .content_type()
+                .unwrap_or("application/octet-stream")
+                .to_string();
+            // MIME 类型白名单校验
+            if !ALLOWED_CONSULTATION_MIME_TYPES.contains(&content_type.as_str()) {
+                return Err(AppError::Validation(format!(
+                    "不支持的文件类型: {}（允许: {}）",
+                    content_type,
+                    ALLOWED_CONSULTATION_MIME_TYPES.join(", ")
+                )));
+            }
+            let data = field
+                .bytes()
+                .await
+                .map_err(|e| AppError::Validation(format!("读取文件数据失败: {}", e)))?;
+            if data.len() > MAX_UPLOAD_SIZE {
+                return Err(AppError::Validation(format!(
+                    "文件大小超过限制 (最大 {}MB)",
+                    MAX_UPLOAD_SIZE / 1024 / 1024
+                )));
+            }
+            file_data = Some(data);
+        }
+    }
+
+    let data = file_data.ok_or_else(|| AppError::Validation("未找到上传文件".to_string()))?;
+    let upload_dir = std::env::var("UPLOAD_DIR").unwrap_or_else(|_| "./uploads".to_string());
+
+    let result = crate::service::media_service::upload_media(
+        &state,
+        ctx.tenant_id,
+        Some(ctx.user_id),
+        &data,
+        &original_name,
+        &content_type,
+        None,  // 不指定文件夹
+        false, // 咨询附件默认不公开
+        &upload_dir,
+    )
+    .await?;
+
+    Ok(Json(ApiResponse::ok(serde_json::json!({
+        "media_id": result.id,
+        "filename": result.filename,
+        "content_type": result.content_type,
+        "file_size": result.file_size,
+    }))))
+}
+
+/// 咨询满意度评价 — 只有已关闭会话的患者可以评价
+#[utoipa::path(
+    post,
+    path = "/consultation-sessions/{id}/rate",
+    request_body = RateSessionReq,
+    responses(
+        (status = 200, description = "评价成功"),
+        (status = 400, description = "会话未关闭或不属于该患者"),
+        (status = 404, description = "会话不存在"),
+    ),
+    tag = "咨询管理",
+    security(("bearer_auth" = [])),
+)]
+pub async fn rate_session<S>(
+    State(state): State<HealthState>,
+    Extension(ctx): Extension<TenantContext>,
+    Path(id): Path<Uuid>,
+    Json(req): Json<RateSessionReq>,
+) -> Result<Json<ApiResponse<SessionResp>>, AppError>
+where
+    HealthState: FromRef<S>,
+    S: Clone + Send + Sync + 'static,
+{
+    require_permission(&ctx, "health.consultation.list")?;
+    req.validate()
+        .map_err(|e| AppError::Validation(e.to_string()))?;
+    let result =
+        consultation_service::rate_session(&state, ctx.tenant_id, id, ctx.user_id, req).await?;
+    Ok(Json(ApiResponse::ok(result)))
+}
--- a/crates/erp-health/src/handler/patient_handler.rs
+++ b/crates/erp-health/src/handler/patient_handler.rs
@@ -11,8 +11,9 @@ use erp_core::types::{ApiResponse, PaginatedResponse, TenantContext};

 use crate::dto::DeleteWithVersion;
 use crate::dto::patient_dto::{
-    CreatePatientReq, FamilyMemberReq, FamilyMemberResp, ManageTagsReq, PatientResp,
-    UpdatePatientReq,
+    BatchImportPatientReq, BatchResultResp, BindByPhoneReq, BindResultResp, CreatePatientReq,
+    FamilyMemberReq, FamilyMemberResp, ManageTagsReq, PatientResp, ReferPatientReq,
+    ReferResultResp, UpdatePatientReq,
 };
 use crate::service::patient_service;
 use crate::state::HealthState;
@@ -448,3 +449,90 @@ where
    patient_service::delete_tag(&state, ctx.tenant_id, id, Some(ctx.user_id), req.version).await?;
    Ok(Json(ApiResponse::ok(())))
 }
+
+/// 批量导入患者
+#[utoipa::path(
+    post,
+    path = "/health/patients/import",
+    request_body = BatchImportPatientReq,
+    responses(
+        (status = 200, description = "批量导入结果"),
+    ),
+    tag = "患者管理",
+    security(("bearer_auth" = [])),
+)]
+pub async fn batch_import_patients<S>(
+    State(state): State<HealthState>,
+    Extension(ctx): Extension<TenantContext>,
+    Json(req): Json<BatchImportPatientReq>,
+) -> Result<Json<ApiResponse<BatchResultResp>>, AppError>
+where
+    HealthState: FromRef<S>,
+    S: Clone + Send + Sync + 'static,
+{
+    require_permission(&ctx, "health.patient.manage")?;
+    req.validate()
+        .map_err(|e| AppError::Validation(e.to_string()))?;
+    let result =
+        patient_service::batch_import_patients(&state, ctx.tenant_id, Some(ctx.user_id), req)
+            .await?;
+    Ok(Json(ApiResponse::ok(result)))
+}
+
+/// 患者通过手机号自助绑定
+#[utoipa::path(
+    post,
+    path = "/health/patients/bind-by-phone",
+    request_body = BindByPhoneReq,
+    responses(
+        (status = 200, description = "绑定成功"),
+        (status = 404, description = "未找到匹配患者"),
+    ),
+    tag = "患者管理",
+    security(("bearer_auth" = [])),
+)]
+pub async fn bind_by_phone<S>(
+    State(state): State<HealthState>,
+    Extension(ctx): Extension<TenantContext>,
+    Json(req): Json<BindByPhoneReq>,
+) -> Result<Json<ApiResponse<BindResultResp>>, AppError>
+where
+    HealthState: FromRef<S>,
+    S: Clone + Send + Sync + 'static,
+{
+    // 患者自己绑定，只需认证，不需要特殊权限
+    req.validate()
+        .map_err(|e| AppError::Validation(e.to_string()))?;
+    let result = patient_service::bind_by_phone(&state, ctx.tenant_id, ctx.user_id, req).await?;
+    Ok(Json(ApiResponse::ok(result)))
+}
+
+/// 患者转诊
+#[utoipa::path(
+    post,
+    path = "/health/patients/{id}/refer",
+    request_body = ReferPatientReq,
+    responses(
+        (status = 200, description = "转诊成功"),
+        (status = 404, description = "患者或医生不存在"),
+    ),
+    tag = "患者管理",
+    security(("bearer_auth" = [])),
+)]
+pub async fn refer_patient<S>(
+    State(state): State<HealthState>,
+    Extension(ctx): Extension<TenantContext>,
+    Path(id): Path<Uuid>,
+    Json(req): Json<ReferPatientReq>,
+) -> Result<Json<ApiResponse<ReferResultResp>>, AppError>
+where
+    HealthState: FromRef<S>,
+    S: Clone + Send + Sync + 'static,
+{
+    require_permission(&ctx, "health.patient.manage")?;
+    req.validate()
+        .map_err(|e| AppError::Validation(e.to_string()))?;
+    let result =
+        patient_service::refer_patient(&state, ctx.tenant_id, id, req, Some(ctx.user_id)).await?;
+    Ok(Json(ApiResponse::ok(result)))
+}