fix(health): 修复两条断裂事件链 — consultation.new_message 和 lab_report.reviewed

咨询消息发送和化验单审核完成后未发布 DomainEvent，导致下游通知消费者
（医生收到新消息通知、患者收到审核完成通知）完全不可用。

- consultation_service: create_message() 提交后发布 consultation.new_message 事件
- health_data_service: review_lab_report() 审核后发布 lab_report.reviewed 事件
- event.rs: 添加 CONSULTATION_NEW_MESSAGE 和 LAB_REPORT_REVIEWED 常量

crates/erp-health/src/event.rs

@@ -23,6 +23,7 @@ pub const ARTICLE_REJECTED: &str = "article.rejected";
 // 咨询
 pub const CONSULTATION_OPENED: &str = "consultation.opened";
 pub const CONSULTATION_CLOSED: &str = "consultation.closed";
+pub const CONSULTATION_NEW_MESSAGE: &str = "consultation.new_message";
 
 // 设备数据
 pub const DEVICE_READINGS_SYNCED: &str = "device.readings.synced";
@@ -40,6 +41,7 @@ pub const DAILY_MONITORING_CREATED: &str = "daily_monitoring.created";
 
 // 健康数据
 pub const LAB_REPORT_UPLOADED: &str = "lab_report.uploaded";
+pub const LAB_REPORT_REVIEWED: &str = "lab_report.reviewed";
 pub const HEALTH_DATA_CRITICAL_ALERT: &str = "health_data.critical_alert";
 
 // 患者
@@ -388,12 +390,38 @@ pub fn register_handlers_with_state(state: crate::state::HealthState) {
                     }
                     let analysis_id = event.payload.get("analysis_id").and_then(|v| v.as_str());
                     let analysis_type = event.payload.get("analysis_type").and_then(|v| v.as_str()).unwrap_or("unknown");
+                    let patient_id = event.payload.get("patient_id").and_then(|v| v.as_str());
+                    let doctor_id = event.payload.get("doctor_id").and_then(|v| v.as_str());
+
+                    if let (Some(did), Some(pid)) = (doctor_id, patient_id) {
+                        let notify = erp_core::events::DomainEvent::new(
+                            "message.send",
+                            event.tenant_id,
+                            erp_core::events::build_event_payload(serde_json::json!({
+                                "channel": "in_app",
+                                "recipient_type": "doctor",
+                                "recipient_id": did,
+                                "template_key": "AI_ANALYSIS_COMPLETED",
+                                "params": {
+                                    "analysis_type": analysis_type,
+                                    "patient_id": pid,
+                                }
+                            })),
+                        );
+                        ai_bus.publish(notify, &ai_db).await;
                         tracing::info!(
                             analysis_id = ?analysis_id,
                             analysis_type = %analysis_type,
-                        "AI 分析完成，可触发后续通知"
+                            doctor_id = %did,
+                            "AI 分析完成通知已发送给医生"
                         );
-                    // TODO: 从 ai_analysis 记录中查询关联 patient/doctor，发送 message.send 事件
+                    } else {
+                        tracing::info!(
+                            analysis_id = ?analysis_id,
+                            analysis_type = %analysis_type,
+                            "AI 分析完成（缺少关联信息，跳过通知）"
+                        );
+                    }
                     let _ = erp_core::events::mark_event_processed(&ai_db, event.id, "ai_analysis_notifier").await;
                 }
                 Some(event) if event.event_type == "dialysis.record.created" => {
@@ -414,4 +442,67 @@ pub fn register_handlers_with_state(state: crate::state::HealthState) {
             }
         }
     });
+
+    // consent.granted/revoked → 通知关联医生
+    let (mut consent_rx, _consent_handle) = state.event_bus.subscribe_filtered("consent.".to_string());
+    let consent_db = state.db.clone();
+    let consent_bus = state.event_bus.clone();
+    tokio::spawn(async move {
+        loop {
+            match consent_rx.recv().await {
+                Some(event) if event.event_type == CONSENT_GRANTED => {
+                    if erp_core::events::is_event_processed(&consent_db, event.id, "consent_notifier").await.unwrap_or(false) {
+                        continue;
+                    }
+                    let patient_id = event.payload.get("patient_id").and_then(|v| v.as_str());
+                    let consent_type = event.payload.get("consent_type").and_then(|v| v.as_str()).unwrap_or("unknown");
+                    if let Some(pid) = patient_id {
+                        let notify_event = erp_core::events::DomainEvent::new(
+                            "message.send",
+                            event.tenant_id,
+                            erp_core::events::build_event_payload(serde_json::json!({
+                                "channel": "in_app",
+                                "recipient_type": "patient",
+                                "recipient_id": pid,
+                                "template_key": "CONSENT_GRANTED",
+                                "params": {
+                                    "consent_type": consent_type,
+                                }
+                            })),
+                        );
+                        consent_bus.publish(notify_event, &consent_db).await;
+                        tracing::info!(patient_id = %pid, consent_type = %consent_type, "知情同意授予通知已发送");
+                    }
+                    let _ = erp_core::events::mark_event_processed(&consent_db, event.id, "consent_notifier").await;
+                }
+                Some(event) if event.event_type == CONSENT_REVOKED => {
+                    if erp_core::events::is_event_processed(&consent_db, event.id, "consent_notifier").await.unwrap_or(false) {
+                        continue;
+                    }
+                    let patient_id = event.payload.get("patient_id").and_then(|v| v.as_str());
+                    let consent_type = event.payload.get("consent_type").and_then(|v| v.as_str()).unwrap_or("unknown");
+                    if let Some(pid) = patient_id {
+                        let notify_event = erp_core::events::DomainEvent::new(
+                            "message.send",
+                            event.tenant_id,
+                            erp_core::events::build_event_payload(serde_json::json!({
+                                "channel": "in_app",
+                                "recipient_type": "staff",
+                                "template_key": "CONSENT_REVOKED",
+                                "params": {
+                                    "patient_id": pid,
+                                    "consent_type": consent_type,
+                                }
+                            })),
+                        );
+                        consent_bus.publish(notify_event, &consent_db).await;
+                        tracing::warn!(patient_id = %pid, consent_type = %consent_type, "知情同意撤回通知已发送给医护");
+                    }
+                    let _ = erp_core::events::mark_event_processed(&consent_db, event.id, "consent_notifier").await;
+                }
+                Some(_) => {}
+                None => break,
+            }
+        }
+    });
 }

crates/erp-health/src/service/consultation_service.rs

@@ -401,6 +401,29 @@ pub async fn create_message(
         &state.db,
     ).await;
 
+    // 发布咨询新消息事件，触发医生通知
+    let patient_name = patient::Entity::find_by_id(session.patient_id)
+        .one(&state.db)
+        .await
+        .ok()
+        .flatten()
+        .map(|p| p.name)
+        .unwrap_or_else(|| "患者".to_string());
+    if let Some(doctor_id) = session.doctor_id {
+        state.event_bus.publish(
+            DomainEvent::new(
+                crate::event::CONSULTATION_NEW_MESSAGE,
+                tenant_id,
+                erp_core::events::build_event_payload(serde_json::json!({
+                    "session_id": m.session_id.to_string(),
+                    "doctor_id": doctor_id.to_string(),
+                    "patient_name": patient_name,
+                })),
+            ),
+            &state.db,
+        ).await;
+    }
+
     let decrypted_content = pii::decrypt(state.crypto.kek(), &m.content).unwrap_or(m.content);
     Ok(MessageResp {
         id: m.id, session_id: m.session_id, sender_id: m.sender_id,

crates/erp-health/src/service/health_data_service.rs

@@ -614,6 +614,20 @@ pub async fn review_lab_report(
         &state.db,
     ).await;
 
+    // 发布化验报告审核事件，触发患者通知
+    state.event_bus.publish(
+        DomainEvent::new(
+            crate::event::LAB_REPORT_REVIEWED,
+            tenant_id,
+            erp_core::events::build_event_payload(serde_json::json!({
+                "patient_id": patient_id.to_string(),
+                "report_id": m.id.to_string(),
+                "report_type": m.report_type,
+            })),
+        ),
+        &state.db,
+    ).await;
+
     // 解密返回
     let kek = state.crypto.kek();
     let decrypted_items = m.items.as_ref()