import utils.jwtauth from flask import request, jsonify, Blueprint, make_response from sqlalchemy import distinct from models import db, Doctor, Office, DoctorOffice, DoctorHospital, Patient, Case, Image from datetime import datetime hospital_bp = Blueprint('hospital', __name__) @hospital_bp.route('/api/hospital/office', methods=['GET']) @utils.jwtauth.jwt_required def get_doctor_offices(): """ 获取当前登录医生在指定医院负责的所有科室列表。 如果医生负责的是一个父科室，则返回该科室及其所有子科室。 结果会自动去重。 请求参数: - hospital_id: 医院ID 返回: { "code": 200, "message": "获取科室列表成功", "data": [ { "id": 科室ID, "name": "科室名称", "parent_id": 父科室ID, "hospital_id": 医院ID, "created_at": "创建时间", "parent_path": [ { "id": 父科室ID, "name": "父科室名称", "parent_id": 上级父科室ID, "hospital_id": 医院ID, "created_at": "创建时间" }, ... ] }, ... ] } """ user_id = request.user_id hospital_id = request.args.get('hospital_id') if not hospital_id: return jsonify({ 'code': 400, 'message': '缺少必要参数: hospital_id' }), 400 try: hospital_id = int(hospital_id) except ValueError: return jsonify({ 'code': 400, 'message': 'hospital_id必须是整数' }), 400 # 验证医生是否属于该医院 doctor_hospital = DoctorHospital.query.filter_by( doc_id=user_id, hosp_id=hospital_id ).first() if not doctor_hospital: return jsonify({ 'code': 403, 'message': '您不属于该医院或该医院不存在' }), 403 # 1. 获取医生在该医院直接负责的所有科室 doctor_offices = db.session.query(Office).join( DoctorOffice, Office.id == DoctorOffice.off_id ).filter( DoctorOffice.doc_id == user_id, Office.hospital_id == hospital_id ).all() # 2. 收集所有相关科室（直接负责的 + 子科室），并去重 final_offices_map = {} # 使用字典去重, key: office.id, value: office object def get_all_descendants(office): # 递归函数，获取一个科室及其所有子孙科室 if office.id not in final_offices_map: final_offices_map[office.id] = office # office.children 来自于 models.py 中的 backref for child in office.children: get_all_descendants(child) for office in doctor_offices: get_all_descendants(office) # 3. 为每个科室构建完整的父科室路径 result = [] # 预先获取医院所有科室，以高效构建父路径，避免循环查库 all_hospital_offices = {o.id: o for o in Office.query.filter_by(hospital_id=hospital_id).all()} for office in final_offices_map.values(): office_data = office.to_dict() parent_path = [] current_parent_id = office.parent_id while current_parent_id: # 使用预先获取的字典来查找父科室 parent_office = all_hospital_offices.get(current_parent_id) if parent_office: parent_path.append(parent_office.to_dict()) current_parent_id = parent_office.parent_id else: break # 反转路径，使其从顶层父科室开始 parent_path.reverse() office_data['parent_path'] = parent_path result.append(office_data) return make_response(jsonify({ 'code': 200, 'message': '获取科室列表成功', 'data': result })) def get_all_child_offices(parent_office_id): """ 递归获取一个科室下的所有子科室ID """ # 使用集合以避免重复 all_office_ids = {int(parent_office_id)} # 待检查的科室ID队列 offices_to_check = [int(parent_office_id)] while offices_to_check: current_id = offices_to_check.pop(0) # 查询以当前科室为父科室的所有子科室 children = Office.query.filter_by(parent_id=current_id).all() for child in children: if child.id not in all_office_ids: all_office_ids.add(child.id) offices_to_check.append(child.id) return list(all_office_ids) @hospital_bp.route('/api/hospital/case', methods=['GET']) @utils.jwtauth.jwt_required def get_cases_by_office(): """ 根据科室ID获取所有病历（包括子科室），支持分页、病人姓名搜索和只看我的病历 """ user_id = request.user_id office_id = request.args.get('office_id') patient_name = request.args.get('patient_name') my_case = request.args.get('my_case') # 'true' or 'false' page = request.args.get('page', 1, type=int) per_page = request.args.get('per_page', 10, type=int) if not office_id: return jsonify({'code': 400, 'message': '缺少office_id参数'}), 400 try: office_id = int(office_id) except ValueError: return jsonify({'code': 400, 'message': 'office_id必须是整数'}), 400 # 检查科室是否存在 office = Office.query.get(office_id) if not office: return jsonify({'code': 404, 'message': '科室不存在'}), 404 # 获取该科室及其所有子科室的ID all_office_ids = get_all_child_offices(office_id) # 在这些科室中查询病历 cases_query = Case.query.filter(Case.office_id.in_(all_office_ids)) # 如果提供了病人姓名，则加入查询条件 if patient_name: cases_query = cases_query.join(Patient).filter(Patient.name.contains(patient_name)) # 如果勾选了"只显示我创建的" if my_case == 'true': cases_query = cases_query.filter(Case.doctor_id == user_id) # 按病历日期降序排序 cases_pagination = cases_query.order_by(Case.case_date.desc(), Case.created_at.desc()).paginate( page=page, per_page=per_page, error_out=False ) cases = cases_pagination.items # 优化：一次性获取所有相关影像及其预览图 images_by_case_id = {} case_ids = [c.id for c in cases] if case_ids: # 1. 获取所有病例关联的主影像 main_images = db.session.query(Image).filter( Image.case_id.in_(case_ids), Image.parent_image_id.is_(None) ).all() main_image_ids = [img.id for img in main_images] previews_by_parent_id = {} if main_image_ids: # 2. 为兼容旧版MySQL，采用两步查询法获取预览图 # 首先，获取所有主影像关联的子影像 all_child_images = db.session.query(Image).filter( Image.parent_image_id.in_(main_image_ids) ).order_by(Image.parent_image_id, Image.id.asc()).all() # 然后，在Python中处理，为每个父ID找到第一个子影像 for child in all_child_images: if child.parent_image_id not in previews_by_parent_id: previews_by_parent_id[child.parent_image_id] = child # 3. 构建影像信息并按case_id分组 base_url = "https://cdn.ember.ac.cn" for img in main_images: preview_url = f"{base_url}/{img.oss_key}" # 默认是源文件 if img.format in ['dicom', 'nii']: preview_image = previews_by_parent_id.get(img.id) if preview_image: preview_url = f"{base_url}/{preview_image.oss_key}" image_info = { 'image_id': img.id, 'name': img.name, 'preview_url': preview_url, 'dim': img.dim } if img.case_id not in images_by_case_id: images_by_case_id[img.case_id] = [] images_by_case_id[img.case_id].append(image_info) # 格式化返回数据 data = [] for case in cases: case_data = case.to_dict() case_data['patient_name'] = case.patient.name case_data['doctor_name'] = case.doctor.name case_data['office_name'] = case.office.name case_data['images'] = images_by_case_id.get(case.id, []) # 添加影像列表 data.append(case_data) return jsonify({ 'code': 200, 'message': '查询成功', 'data': data, 'pagination': { 'page': cases_pagination.page, 'per_page': cases_pagination.per_page, 'total_pages': cases_pagination.pages, 'total_items': cases_pagination.total } }) @hospital_bp.route('/api/hospital/add_patient', methods=['POST']) @utils.jwtauth.jwt_required def add_patient(): """ 添加新病人 """ data = request.get_json() if not data: return jsonify({'code': 400, 'message': '请求体不能为空'}), 400 name = data.get('name') gender = data.get('gender') birthday = data.get('birthday') # birthday是可选的 if not name or not gender: return jsonify({'code': 400, 'message': '缺少必要参数: name, gender'}), 400 if gender not in ['男', '女', '未知']: return jsonify({'code': 400, 'message': 'gender参数无效，应为 "男"、"女" 或 "未知"'}), 400 try: new_patient = Patient(name=name, gender=gender, birthday=birthday) db.session.add(new_patient) db.session.commit() except Exception as e: db.session.rollback() return jsonify({'code': 500, 'message': f'数据库错误: {str(e)}'}), 500 return jsonify({ 'code': 201, 'message': '添加病人成功', 'data': new_patient.to_dict() }), 201 @hospital_bp.route('/api/hospital/case', methods=['POST']) @utils.jwtauth.jwt_required def add_case(): """ 创建新病历 """ doctor_id = request.user_id data = request.get_json() if not data: return jsonify({'code': 400, 'message': '请求体不能为空'}), 400 patient_id = data.get('patient_id') office_id = data.get('office_id') case_date_str = data.get('case_date') if not all([patient_id, office_id, case_date_str]): return jsonify({'code': 400, 'message': '缺少必要参数: patient_id, office_id, case_date'}), 400 # 验证数据 if not Patient.query.get(patient_id): return jsonify({'code': 404, 'message': '病人不存在'}), 404 office = Office.query.get(office_id) if not office: return jsonify({'code': 404, 'message': '科室不存在'}), 404 # 验证医生是否属于该科室所在的医院 if not DoctorHospital.query.filter_by(doc_id=doctor_id, hosp_id=office.hospital_id).first(): return jsonify({'code': 403, 'message': '您不属于该科室所在的医院，无法创建病历'}), 403 try: case_date = datetime.strptime(case_date_str, '%Y-%m-%d').date() except ValueError: return jsonify({'code': 400, 'message': 'case_date格式不正确，应为YYYY-MM-DD'}), 400 # 创建新病历 new_case = Case( doctor_id=doctor_id, patient_id=patient_id, office_id=office_id, case_date=case_date, chief_complaint=data.get('chief_complaint'), present_illness_history=data.get('present_illness_history'), past_medical_history=data.get('past_medical_history'), personal_history=data.get('personal_history'), family_history=data.get('family_history'), physical_examination=data.get('physical_examination'), diagnosis=data.get('diagnosis'), treatment_plan=data.get('treatment_plan'), medication_details=data.get('medication_details'), notes=data.get('notes') ) try: db.session.add(new_case) db.session.commit() except Exception as e: db.session.rollback() return jsonify({'code': 500, 'message': f'数据库错误: {str(e)}'}), 500 return jsonify({'code': 201, 'message': '病历创建成功', 'data': new_case.to_dict()}), 201 @hospital_bp.route('/api/hospital/case', methods=['PUT']) @utils.jwtauth.jwt_required def update_case(): """ 更新病历信息 """ data = request.get_json() if not data: return jsonify({'code': 400, 'message': '请求体不能为空'}), 400 case_id = data.get('id') if not case_id: return jsonify({'code': 400, 'message': '缺少病历ID (id)'}), 400 case = Case.query.get(case_id) if not case: return jsonify({'code': 404, 'message': '病历不存在'}), 404 # 任何医生都可以编辑病历，也可以添加权限控制 # if case.doctor_id != request.user_id: # return jsonify({'code': 403, 'message': '您无权编辑此病历'}), 403 # 更新字段 for key, value in data.items(): # id和创建时间不能被修改 if key not in ['id', 'created_at', 'doctor_id', 'patient_id'] and hasattr(case, key): if key == 'case_date': try: setattr(case, key, datetime.strptime(value, '%Y-%m-%d').date()) except (ValueError, TypeError): # 如果日期格式错误，可以忽略或返回错误 pass else: setattr(case, key, value) try: db.session.commit() except Exception as e: db.session.rollback() return jsonify({'code': 500, 'message': f'数据库错误: {str(e)}'}), 500 return jsonify({'code': 200, 'message': '病历更新成功', 'data': case.to_dict()}) # 根据姓名搜索病人 @hospital_bp.route('/api/hospital/patient', methods=['GET']) @utils.jwtauth.jwt_required def search_patient(): """ 根据姓名搜索病人 """ name = request.args.get('name') if not name: return jsonify({'code': 400, 'message': '缺少必要参数: name'}), 400 patients = Patient.query.filter(Patient.name.contains(name)).all() return jsonify({ 'code': 200, 'message': '搜索成功', 'data': [patient.to_dict() for patient in patients] })