215 lines
7.4 KiB
Rust
215 lines
7.4 KiB
Rust
//! 15 条 Copilot 内置规则种子数据
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//!
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//! 覆盖 spec §3.1 的 5 大类：体征异常(4)、化验异常(4)、依从性(2)、透析质量(3)、综合(2)
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//! 所有规则 tenant_id = nil（系统级规则，适用于所有机构）
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use sea_orm_migration::prelude::*;
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#[derive(DeriveMigrationName)]
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pub struct Migration;
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#[async_trait::async_trait]
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impl MigrationTrait for Migration {
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async fn up(&self, manager: &SchemaManager) -> Result<(), DbErr> {
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let db = manager.get_connection();
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let nil_tenant = "00000000-0000-0000-0000-000000000000";
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// 15 条内置 Copilot 规则 (使用固定 UUID)
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// (id_suffix, name, category, condition_expr, score, severity, suggestion, sort_order)
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let rules: &[(i32, &str, &str, &str, i16, &str, &str, i32)] = &[
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// 体征异常
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(
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1,
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"血压持续偏高",
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"vital_signs",
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r#"{"and":[{"=": [{"var":"vital_signs.systolic_bp_morning.count_gte_140"}, 3]}]}"#,
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2,
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"warning",
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"建议增加血压监测频率并评估降压方案",
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1,
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),
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(
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2,
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"舒张压持续偏高",
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"vital_signs",
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r#"{"and":[{"=": [{"var":"vital_signs.diastolic_bp_morning.count_gte_90"}, 3]}]}"#,
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1,
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"info",
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"持续舒张压偏高，建议关注并记录血压变化",
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2,
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),
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(
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3,
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"体重周增幅过大",
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"vital_signs",
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r#"{">": [{"var":"vital_signs.weight.weekly_change_kg"}, 2]}"#,
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2,
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"warning",
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"体重周增幅超过2kg，建议评估水钠潴留情况",
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3,
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),
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(
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4,
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"心动过速",
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"vital_signs",
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r#"{">": [{"var":"vital_signs.heart_rate.latest"}, 100]}"#,
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1,
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"info",
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"心率超过100次/分，建议进一步评估原因",
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4,
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),
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// 化验异常
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(
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5,
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"eGFR下降",
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"lab",
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r#"{"<": [{"var":"lab_reports.egfr.latest"}, 60]}"#,
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3,
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"warning",
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"eGFR<60提示肾功能受损，建议调整透析方案",
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5,
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),
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(
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6,
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"高钾血症风险",
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"lab",
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r#"{">": [{"var":"lab_reports.potassium.latest"}, 5.5]}"#,
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4,
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"critical",
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"立即通知主治医生，评估紧急透析需求",
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6,
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),
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(
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7,
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"肌酐快速上升",
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"lab",
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r#"{">": [{"var":"lab_reports.creatinine.change_pct"}, 20]}"#,
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3,
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"warning",
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"肌酐环比增幅超过20%，建议评估急性肾损伤可能",
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7,
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),
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(
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8,
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"血磷偏高",
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"lab",
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r#"{">": [{"var":"lab_reports.phosphorus.latest"}, 1.5]}"#,
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2,
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"warning",
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"血磷>1.5mmol/L，建议调整磷结合剂用量",
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8,
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),
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// 依从性
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(
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9,
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"随访失约过多",
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"compliance",
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r#"{">": [{"var":"follow_up.missed_count"}, 2]}"#,
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1,
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"info",
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"近期随访失约超过2次，建议主动联系患者",
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9,
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),
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(
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10,
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"药物依从性不足",
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"compliance",
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r#"{"<": [{"var":"medication.adherence_rate"}, 80]}"#,
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2,
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"warning",
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"药物依从性低于80%，建议加强用药教育",
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10,
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),
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// 透析质量
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(
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11,
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"Kt/V不达标",
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"dialysis",
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r#"{"<": [{"var":"dialysis.kt_v.latest"}, 1.2]}"#,
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2,
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"warning",
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"Kt/V<1.2，建议评估透析充分性并调整透析参数",
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11,
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),
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(
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12,
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"透析间期体重增长过多",
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"dialysis",
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r#"{">": [{"var":"dialysis.interdialytic_weight_gain_pct"}, 5]}"#,
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3,
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"warning",
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"透析间期体重增长超过5%，建议加强液体管理教育",
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12,
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),
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(
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13,
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"透析前收缩压过高",
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"dialysis",
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r#"{">": [{"var":"dialysis.pre_systolic.latest"}, 180]}"#,
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3,
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"warning",
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"透析前收缩压>180mmHg，建议评估降压方案",
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13,
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),
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// 综合规则
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(
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14,
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"肾功能恶化伴高钾",
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"composite",
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r#"{"and":[{"<": [{"var":"lab_reports.egfr.latest"}, 60]},{">": [{"var":"lab_reports.potassium.latest"}, 5.5]}]}"#,
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5,
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"critical",
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"eGFR下降且高钾血症，建议紧急评估并考虑紧急透析",
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14,
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),
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(
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15,
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"血压急剧升高伴肾功能恶化",
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"composite",
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r#"{"and":[{">": [{"var":"vital_signs.systolic_bp_morning.latest"}, 160]},{">": [{"var":"lab_reports.creatinine.change_pct"}, 20]}]}"#,
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4,
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"critical",
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"血压急剧升高且肌酐快速上升，建议紧急评估并调整治疗方案",
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15,
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),
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];
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for &(idx, name, category, cond, score, severity, suggestion, sort) in rules {
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// 生成确定性 UUID: copilot-rule-XXXX 前缀
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let id = format!("c0000000-0000-0000-0000-{:012}", idx);
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let sql = format!(
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r#"INSERT INTO copilot_rules (id, tenant_id, name, category, condition_expr, score, severity, suggestion, enabled, sort_order, created_at, updated_at, version_lock)
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VALUES ('{}', '{}', $1, $2, $3::jsonb, $4, $5, $6, true, $7, NOW(), NOW(), 1)"#,
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id, nil_tenant
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);
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db.execute(sea_orm::Statement::from_sql_and_values(
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sea_orm::DatabaseBackend::Postgres,
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sql,
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[
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name.into(),
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category.into(),
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cond.into(),
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score.into(),
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severity.into(),
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suggestion.into(),
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sort.into(),
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],
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))
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.await?;
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}
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Ok(())
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}
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async fn down(&self, manager: &SchemaManager) -> Result<(), DbErr> {
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let db = manager.get_connection();
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db.execute(sea_orm::Statement::from_sql_and_values(
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sea_orm::DatabaseBackend::Postgres,
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"DELETE FROM copilot_rules WHERE tenant_id = '00000000-0000-0000-0000-000000000000'",
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[],
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))
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.await?;
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Ok(())
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}
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}
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