"1. 新增系统字典与全局植入目录相关表结构及迁移

2. 扩展患者手术与材料模型，更新种子数据
3. 新增字典模块，增强设备植入目录管理能力
4. 重构患者后台服务与表单链路，统一权限与参数校验
5. 管理台新增字典页面并改造患者/设备页面与路由权限
6. 补充字典及相关领域 e2e 测试并更新文档"

docs/devices.md

@@ -2,17 +2,52 @@
 
 ## 1. 目标
 
-- 提供 B 端设备 CRUD。
+- 提供“全局植入物目录”管理，供患者手术表单选择。
-- 管理设备与患者的归属关系。
+- 维护患者手术下的植入实例记录。
-- 支持管理员按医院、患者、状态和关键词分页查询设备。
+- 支持为可调压器械配置挡位列表。
+- 支持管理员按医院、患者、状态和关键词分页查询患者植入实例。
 
-## 2. 权限
+## 2. 设备实例
 
-- `SYSTEM_ADMIN`：可跨院查询和维护设备。
+`Device` 现在表示“患者某次手术下的植入设备实例”，不是独立库存主数据。
-- `HOSPITAL_ADMIN`：仅可操作本院患者名下设备。
-- 其他角色：默认拒绝。
 
-## 3. 接口
+核心字段：
+
+- `snCode`：设备唯一标识
+- `patientId`：归属患者
+- `surgeryId`：归属手术，可为空
+- `implantCatalogId`：型号字典 ID，可为空
+- `implantModel` / `implantManufacturer` / `implantName`：历史快照
+- `isPressureAdjustable`：是否可调压
+- `isAbandoned`：是否弃用
+- `currentPressure`：当前压力
+- `status`：设备状态
+
+补充：
+
+- `currentPressure` 不允许在创建/编辑设备实例时手工指定。
+- 新植入设备默认以 `initialPressure`（或系统默认值）作为当前压力起点，后续只允许在调压任务完成时更新。
+
+## 3. 植入物目录
+
+新增 `ImplantCatalog`：
+
+- `modelCode`：型号编码，唯一
+- `manufacturer`：厂商
+- `name`：名称
+- `pressureLevels`：可调压器械的挡位列表
+- `isPressureAdjustable`：是否可调压
+- `notes`：目录备注
+
+可见性：
+
+- 全部已登录 B 端角色都可读取，用于患者手术录入
+- 仅 `SYSTEM_ADMIN` 可做目录 CRUD
+- 目录是全局共享的，不按医院隔离
+
+## 4. 接口
+
+设备实例：
 
 - `GET /b/devices`：分页查询设备列表
 - `GET /b/devices/:id`：查询设备详情
@@ -20,8 +55,19 @@
 - `PATCH /b/devices/:id`：更新设备
 - `DELETE /b/devices/:id`：删除设备
 
-## 4. 约束
+型号字典：
+
+- `GET /b/devices/catalogs`：查询植入物型号字典
+- `POST /b/devices/catalogs`：新增植入物目录
+- `PATCH /b/devices/catalogs/:id`：更新植入物目录
+- `DELETE /b/devices/catalogs/:id`：删除植入物目录
+
+## 5. 约束
 
 - 设备必须绑定到一个患者。
 - 设备 SN 在全库唯一，服务端会统一转成大写后再校验。
 - 删除已被任务明细引用的设备会返回 `409`。
+- 删除已被患者手术引用的植入物目录会返回 `409`。
+- 可调压植入物若配置了 `pressureLevels`，患者手术录入和任务调压时的压力值必须命中该挡位列表。
+- 调压任务仅允许针对 `ACTIVE + isPressureAdjustable=true + isAbandoned=false` 的设备发布。
+- `Device.currentPressure` 只允许由调压任务完成时更新，患者手术录入和设备实例编辑都不开放手工写入。

docs/dictionaries.md

@@ -0,0 +1,42 @@
+# 系统字典说明（`src/dictionaries`）
+
+## 1. 目标
+
+- 将患者手术表单中的固定选项沉淀为系统级字典。
+- 仅允许 `SYSTEM_ADMIN` 做 CRUD。
+- 业务角色仅可读取启用中的字典项，用于患者录入表单。
+
+## 2. 当前字典类型
+
+- `PRIMARY_DISEASE`：原发病
+- `HYDROCEPHALUS_TYPE`：脑积水类型
+- `SHUNT_MODE`：分流方式
+- `PROXIMAL_PUNCTURE_AREA`：近端穿刺区域
+- `VALVE_PLACEMENT_SITE`：阀门植入部位
+- `DISTAL_SHUNT_DIRECTION`：远端分流方向
+
+## 3. 数据结构
+
+新增 `DictionaryItem`：
+
+- `type`：字典类型枚举
+- `label`：字典项显示值
+- `sortOrder`：排序值，越小越靠前
+- `enabled`：是否启用
+
+约束：
+
+- 同一 `type` 下 `label` 唯一。
+- 非系统管理员读取时只返回 `enabled=true` 的字典项。
+
+## 4. 接口
+
+- `GET /b/dictionaries`：查询字典项
+- `POST /b/dictionaries`：创建字典项（仅系统管理员）
+- `PATCH /b/dictionaries/:id`：更新字典项（仅系统管理员）
+- `DELETE /b/dictionaries/:id`：删除字典项（仅系统管理员）
+
+说明：
+
+- `GET /b/dictionaries?includeDisabled=true` 仅系统管理员生效。
+- 患者手术表单现在从该接口动态读取选项，不再使用前端硬编码数组。

docs/patients.md

@@ -2,33 +2,99 @@
 
 ## 1. 目标
 
-- B 端：按组织与角色范围查询患者（强依赖 `hospitalId`）。
+- B 端：按组织与角色范围查询患者，并维护患者基础档案。
-- C 端：按 `phone + idCard` 做跨院聚合查询。
+- B 端：支持患者首术录入、二次手术追加、旧设备弃用标记。
-- 患者档案直接保存身份证号原文，不再做哈希转换。
+- 数据关系升级为 `Patient -> PatientSurgery -> Device -> TaskItem -> Task`。
-- 服务端只做轻量格式整理：去空格、统一末尾 `x/X` 为大写。
+- C 端：按 `phone + idCard` 做跨院生命周期聚合，返回手术事件与调压事件。
 
-## 2. B 端可见性
+## 2. 患者基础档案
+
+患者表新增以下字段：
+
+- `inpatientNo`：住院号
+- `projectName`：项目名称
+- `phone`：联系电话
+- `idCard`：身份证号原文
+- `doctorId`：患者归属人员（医生/主任/组长）
+
+说明：
+
+- `name` 仍然保留为患者姓名必填字段。
+- `doctorId + hospitalId` 仍然是患者的组织归属来源，不直接绑定小组/科室。
+- 手术表单中的 `原发病 / 脑积水类型 / 分流方式 / 近端穿刺区域 / 阀门植入部位 / 远端分流方向` 改为读取系统字典，不再前端硬编码。
+
+## 3. 手术档案
+
+新增 `PatientSurgery` 表，每次手术保存：
+
+- `surgeryDate`：手术日期
+- `surgeryName`：手术名称
+- `surgeonName`：主刀医生
+- `preOpPressure`：术前测压，可为空
+- `primaryDisease`：原发病
+- `hydrocephalusTypes`：脑积水类型，多选
+- `previousShuntSurgeryDate`：上次分流手术时间，可为空
+- `preOpMaterials`：术前 CT 影像/资料，保存为附件元数据数组
+- `notes`：手术备注，可为空
+
+返回时会自动补充：
+
+- `shuntSurgeryCount`：当前这台手术是该患者第几次分流手术
+- `activeDeviceCount`：本次手术仍在用设备数
+- `abandonedDeviceCount`：本次手术已弃用设备数
+
+## 4. 植入设备
+
+设备表仍沿用 `Device`，但语义改为“患者手术下植入的设备实例”。
+
+新增/使用字段：
+
+- `implantCatalogId`：植入物型号字典 ID
+- `implantModel` / `implantManufacturer` / `implantName`：型号快照
+- `isPressureAdjustable`：是否可调压
+- `isAbandoned`：是否已弃用
+- `shuntMode`：分流方式
+- `proximalPunctureAreas`：近端穿刺区域，最多 2 个
+- `valvePlacementSites`：阀门植入部位，最多 2 个
+- `distalShuntDirection`：远端分流方向
+- `initialPressure`：初始压力，可为空
+- `implantNotes`：植入物备注，可为空
+- `labelImageUrl`：植入物标签图片地址，可为空
+
+说明：
+
+- 患者手术里选择的是“全局植入物目录”，不是按医院单独维护的设备库。
+- 同一个植入物目录可被多个患者手术重复绑定，患者侧保存的是目录快照。
+- 旧设备弃用后，`TaskItem` 历史不会删除。
+- 任务发布只允许选择 `ACTIVE + isPressureAdjustable=true + isAbandoned=false` 的设备。
+- 同一患者一次手术可录入多个设备，因此支持“两个可调压仪器同时佩戴”。
+- 如果植入物目录配置了挡位，`initialPressure` 必须取挡位中的值。
+- 手术创建时不允许手工录入 `currentPressure`，设备当前压力默认继承 `initialPressure`，后续仅能由调压任务完成后更新。
+
+## 5. B 端可见性
 
 - `DOCTOR`：仅可查自己名下患者
-- `LEADER`：可查本组医生名下患者（按医生当前 `groupId` 反查）
+- `LEADER`：可查本组医生名下患者
-- `DIRECTOR`：可查本科室医生名下患者（按医生当前 `departmentId` 反查）
+- `DIRECTOR`：可查本科室医生名下患者
 - `HOSPITAL_ADMIN`：可查本院全部患者
 - `SYSTEM_ADMIN`：需显式传入目标 `hospitalId`
 
-## 2.1 B 端 CRUD
+## 6. B 端接口
 
-- `GET /b/patients`：按角色查询可见患者
+- `GET /b/patients`：按角色查询可见患者列表
-- `GET /b/patients/doctors`：查询当前角色可见的归属人员候选（医生/主任/组长，用于患者表单）
+- `GET /b/patients/doctors`：查询当前角色可见的归属人员候选
-- `POST /b/patients`：创建患者
+- `POST /b/patients`：创建患者，可选带 `initialSurgery`
+- `POST /b/patients/:id/surgeries`：为患者新增手术
 - `GET /b/patients/:id`：查询患者详情
-- `PATCH /b/patients/:id`：更新患者
+- `PATCH /b/patients/:id`：更新患者基础信息
-- `DELETE /b/patients/:id`：删除患者（若存在关联设备返回 409）
+- `DELETE /b/patients/:id`：删除患者
 
-说明：
+约束：
-患者表只绑定 `doctorId + hospitalId`，不直接绑定小组/科室。医生调组或调科后，
-可见范围会按医生当前组织归属自动变化，无需迁移患者数据。
 
-## 3. C 端生命周期聚合
+- `PATCH /b/patients/:id` 不直接修改手术，手术必须走新增手术接口。
+- 新增二次手术时可传 `abandonedDeviceIds`，后端会将这些旧设备标记为 `INACTIVE + isAbandoned=true`。
+
+## 7. C 端生命周期聚合
 
 接口：`GET /c/patients/lifecycle?phone=...&idCard=...`
 
@@ -36,10 +102,16 @@
 
 1. 不做医院隔离（跨租户）
 2. 先将 `idCard` 做轻量标准化，再做双字段精确匹配
-3. 关联查询 `Patient -> Device -> TaskItem -> Task`
+3. 聚合 `Patient -> PatientSurgery -> Device` 的手术事件
-4. 返回扁平生命周期列表（按 `Task.createdAt DESC`）
+4. 聚合 `Patient -> Device -> TaskItem -> Task` 的调压事件
+5. 全部事件按 `occurredAt DESC` 返回
 
-## 4. 响应结构
+事件类型：
+
+- `SURGERY`
+- `TASK_PRESSURE_ADJUSTMENT`
+
+## 8. 响应结构
 
 全部接口统一返回：
 

prisma/migrations/20260319101507_patient_surgery_implant_architecture/migration.sql

@@ -0,0 +1,82 @@
+-- AlterTable
+ALTER TABLE "Device" ADD COLUMN     "distalShuntDirection" TEXT,
+ADD COLUMN     "implantCatalogId" INTEGER,
+ADD COLUMN     "implantManufacturer" TEXT,
+ADD COLUMN     "implantModel" TEXT,
+ADD COLUMN     "implantName" TEXT,
+ADD COLUMN     "implantNotes" TEXT,
+ADD COLUMN     "initialPressure" INTEGER,
+ADD COLUMN     "isAbandoned" BOOLEAN NOT NULL DEFAULT false,
+ADD COLUMN     "isPressureAdjustable" BOOLEAN NOT NULL DEFAULT true,
+ADD COLUMN     "labelImageUrl" TEXT,
+ADD COLUMN     "proximalPunctureAreas" TEXT[] DEFAULT ARRAY[]::TEXT[],
+ADD COLUMN     "shuntMode" TEXT,
+ADD COLUMN     "surgeryId" INTEGER,
+ADD COLUMN     "valvePlacementSites" TEXT[] DEFAULT ARRAY[]::TEXT[];
+
+-- AlterTable
+ALTER TABLE "Patient" ADD COLUMN     "inpatientNo" TEXT,
+ADD COLUMN     "projectName" TEXT;
+
+-- CreateTable
+CREATE TABLE "PatientSurgery" (
+    "id" SERIAL NOT NULL,
+    "patientId" INTEGER NOT NULL,
+    "surgeryDate" TIMESTAMP(3) NOT NULL,
+    "surgeryName" TEXT NOT NULL,
+    "surgeonName" TEXT NOT NULL,
+    "preOpPressure" INTEGER,
+    "primaryDisease" TEXT NOT NULL,
+    "hydrocephalusTypes" TEXT[] DEFAULT ARRAY[]::TEXT[],
+    "previousShuntSurgeryDate" TIMESTAMP(3),
+    "preOpMaterials" JSONB,
+    "notes" TEXT,
+    "createdAt" TIMESTAMP(3) NOT NULL DEFAULT CURRENT_TIMESTAMP,
+
+    CONSTRAINT "PatientSurgery_pkey" PRIMARY KEY ("id")
+);
+
+-- CreateTable
+CREATE TABLE "ImplantCatalog" (
+    "id" SERIAL NOT NULL,
+    "modelCode" TEXT NOT NULL,
+    "manufacturer" TEXT NOT NULL,
+    "name" TEXT NOT NULL,
+    "hospitalId" INTEGER,
+    "isPressureAdjustable" BOOLEAN NOT NULL DEFAULT true,
+
+    CONSTRAINT "ImplantCatalog_pkey" PRIMARY KEY ("id")
+);
+
+-- CreateIndex
+CREATE INDEX "PatientSurgery_patientId_surgeryDate_idx" ON "PatientSurgery"("patientId", "surgeryDate");
+
+-- CreateIndex
+CREATE UNIQUE INDEX "ImplantCatalog_modelCode_key" ON "ImplantCatalog"("modelCode");
+
+-- CreateIndex
+CREATE INDEX "ImplantCatalog_hospitalId_idx" ON "ImplantCatalog"("hospitalId");
+
+-- CreateIndex
+CREATE INDEX "Device_surgeryId_idx" ON "Device"("surgeryId");
+
+-- CreateIndex
+CREATE INDEX "Device_implantCatalogId_idx" ON "Device"("implantCatalogId");
+
+-- CreateIndex
+CREATE INDEX "Device_patientId_isAbandoned_idx" ON "Device"("patientId", "isAbandoned");
+
+-- CreateIndex
+CREATE INDEX "Patient_inpatientNo_idx" ON "Patient"("inpatientNo");
+
+-- AddForeignKey
+ALTER TABLE "PatientSurgery" ADD CONSTRAINT "PatientSurgery_patientId_fkey" FOREIGN KEY ("patientId") REFERENCES "Patient"("id") ON DELETE CASCADE ON UPDATE CASCADE;
+
+-- AddForeignKey
+ALTER TABLE "ImplantCatalog" ADD CONSTRAINT "ImplantCatalog_hospitalId_fkey" FOREIGN KEY ("hospitalId") REFERENCES "Hospital"("id") ON DELETE SET NULL ON UPDATE CASCADE;
+
+-- AddForeignKey
+ALTER TABLE "Device" ADD CONSTRAINT "Device_surgeryId_fkey" FOREIGN KEY ("surgeryId") REFERENCES "PatientSurgery"("id") ON DELETE SET NULL ON UPDATE CASCADE;
+
+-- AddForeignKey
+ALTER TABLE "Device" ADD CONSTRAINT "Device_implantCatalogId_fkey" FOREIGN KEY ("implantCatalogId") REFERENCES "ImplantCatalog"("id") ON DELETE SET NULL ON UPDATE CASCADE;

prisma/migrations/20260319104958_system_dictionaries/migration.sql

@@ -0,0 +1,21 @@
+-- CreateEnum
+CREATE TYPE "DictionaryType" AS ENUM ('PRIMARY_DISEASE', 'HYDROCEPHALUS_TYPE', 'SHUNT_MODE', 'PROXIMAL_PUNCTURE_AREA', 'VALVE_PLACEMENT_SITE', 'DISTAL_SHUNT_DIRECTION');
+
+-- CreateTable
+CREATE TABLE "DictionaryItem" (
+    "id" SERIAL NOT NULL,
+    "type" "DictionaryType" NOT NULL,
+    "label" TEXT NOT NULL,
+    "sortOrder" INTEGER NOT NULL DEFAULT 0,
+    "enabled" BOOLEAN NOT NULL DEFAULT true,
+    "createdAt" TIMESTAMP(3) NOT NULL DEFAULT CURRENT_TIMESTAMP,
+    "updatedAt" TIMESTAMP(3) NOT NULL,
+
+    CONSTRAINT "DictionaryItem_pkey" PRIMARY KEY ("id")
+);
+
+-- CreateIndex
+CREATE INDEX "DictionaryItem_type_enabled_sortOrder_idx" ON "DictionaryItem"("type", "enabled", "sortOrder");
+
+-- CreateIndex
+CREATE UNIQUE INDEX "DictionaryItem_type_label_key" ON "DictionaryItem"("type", "label");

prisma/migrations/20260319123000_global_implant_catalog_directory/migration.sql

@@ -0,0 +1,15 @@
+-- AlterTable
+ALTER TABLE "ImplantCatalog"
+ADD COLUMN     "pressureLevels" INTEGER[] NOT NULL DEFAULT ARRAY[]::INTEGER[],
+ADD COLUMN     "notes" TEXT,
+ADD COLUMN     "createdAt" TIMESTAMP(3) NOT NULL DEFAULT CURRENT_TIMESTAMP,
+ADD COLUMN     "updatedAt" TIMESTAMP(3) NOT NULL DEFAULT CURRENT_TIMESTAMP;
+
+-- DropForeignKey
+ALTER TABLE "ImplantCatalog" DROP CONSTRAINT IF EXISTS "ImplantCatalog_hospitalId_fkey";
+
+-- DropIndex
+DROP INDEX IF EXISTS "ImplantCatalog_hospitalId_idx";
+
+-- DropColumn
+ALTER TABLE "ImplantCatalog" DROP COLUMN IF EXISTS "hospitalId";

prisma/schema.prisma

@@ -36,6 +36,16 @@ enum TaskStatus {
   CANCELLED
 }
 
+// 医学字典类型：驱动患者手术表单中的单选/多选项。
+enum DictionaryType {
+  PRIMARY_DISEASE
+  HYDROCEPHALUS_TYPE
+  SHUNT_MODE
+  PROXIMAL_PUNCTURE_AREA
+  VALVE_PLACEMENT_SITE
+  DISTAL_SHUNT_DIRECTION
+}
+
 // 医院主表：多租户顶层实体。
 model Hospital {
   id          Int          @id @default(autoincrement())
@@ -102,6 +112,10 @@ model User {
 model Patient {
   id          Int              @id @default(autoincrement())
   name        String
+  // 住院号：用于院内患者检索与病案关联。
+  inpatientNo String?
+  // 项目名称：用于区分患者所属项目/课题。
+  projectName String?
   phone       String
   // 患者身份证号，录入与查询都使用原始证件号。
   idCard      String
@@ -109,23 +123,100 @@ model Patient {
   doctorId    Int
   hospital    Hospital         @relation(fields: [hospitalId], references: [id])
   doctor      User             @relation("DoctorPatients", fields: [doctorId], references: [id])
+  surgeries   PatientSurgery[]
   devices     Device[]
 
   @@index([phone, idCard])
   @@index([hospitalId, doctorId])
+  @@index([inpatientNo])
 }
 
-// 设备表：患者可绑定多个分流设备。
+// 患者手术表：保存每次分流/复手术档案。
+model PatientSurgery {
+  id                       Int       @id @default(autoincrement())
+  patientId                Int
+  surgeryDate              DateTime
+  surgeryName              String
+  surgeonName              String
+  // 术前测压：部分患者可为空。
+  preOpPressure            Int?
+  // 原发病：前端单选，后端先按字符串存储，方便后续补字典。
+  primaryDisease           String
+  // 脑积水类型：前端多选。
+  hydrocephalusTypes       String[]  @default([])
+  // 上次分流手术时间：无既往分流史时为空。
+  previousShuntSurgeryDate DateTime?
+  // 术前影像/资料：支持图片、视频等附件元数据。
+  preOpMaterials           Json?
+  notes                    String?
+  createdAt                DateTime  @default(now())
+  patient                  Patient   @relation(fields: [patientId], references: [id], onDelete: Cascade)
+  devices                  Device[]
+
+  @@index([patientId, surgeryDate])
+}
+
+// 植入物型号字典：供前端单选型号后自动回填厂家与名称。
+model ImplantCatalog {
+  id                   Int      @id @default(autoincrement())
+  modelCode            String   @unique
+  manufacturer         String
+  name                 String
+  // 可调压器械的可选挡位，由系统管理员维护。
+  pressureLevels       Int[]    @default([])
+  isPressureAdjustable Boolean  @default(true)
+  notes                String?
+  createdAt            DateTime @default(now())
+  updatedAt            DateTime @default(now()) @updatedAt
+  devices              Device[]
+}
+
+// 系统级字典项：由系统管理员维护，供患者手术表单选择使用。
+model DictionaryItem {
+  id        Int            @id @default(autoincrement())
+  type      DictionaryType
+  label     String
+  sortOrder Int            @default(0)
+  enabled   Boolean        @default(true)
+  createdAt DateTime       @default(now())
+  updatedAt DateTime       @updatedAt
+
+  @@unique([type, label])
+  @@index([type, enabled, sortOrder])
+}
+
+// 设备表：每次手术植入的设备实例，保留当前压力与历史调压记录。
 model Device {
   id                    Int             @id @default(autoincrement())
   snCode                String          @unique
   currentPressure       Int
   status                DeviceStatus    @default(ACTIVE)
   patientId             Int
+  surgeryId             Int?
+  implantCatalogId      Int?
+  // 植入物快照：避免型号字典修改后影响历史病历。
+  implantModel          String?
+  implantManufacturer   String?
+  implantName           String?
+  isPressureAdjustable  Boolean         @default(true)
+  // 二次手术后旧设备可标记弃用，但历史调压任务仍需保留。
+  isAbandoned           Boolean         @default(false)
+  shuntMode             String?
+  proximalPunctureAreas String[]        @default([])
+  valvePlacementSites   String[]        @default([])
+  distalShuntDirection  String?
+  initialPressure       Int?
+  implantNotes          String?
+  labelImageUrl         String?
   patient               Patient         @relation(fields: [patientId], references: [id])
+  surgery               PatientSurgery? @relation(fields: [surgeryId], references: [id], onDelete: SetNull)
+  implantCatalog        ImplantCatalog? @relation(fields: [implantCatalogId], references: [id], onDelete: SetNull)
   taskItems             TaskItem[]
 
   @@index([patientId, status])
+  @@index([surgeryId])
+  @@index([implantCatalogId])
+  @@index([patientId, isAbandoned])
 }
 
 // 主任务表：记录调压任务主单。

prisma/seed.mjs

@@ -3,7 +3,8 @@ import { PrismaPg } from '@prisma/adapter-pg';
 import { hash } from 'bcrypt';
 import prismaClientPackage from '@prisma/client';
 
-const { DeviceStatus, PrismaClient, Role, TaskStatus } = prismaClientPackage;
+const { DictionaryType, DeviceStatus, PrismaClient, Role, TaskStatus } =
+  prismaClientPackage;
 
 const connectionString = process.env.DATABASE_URL;
 if (!connectionString) {
@@ -60,7 +61,15 @@ async function upsertUserByOpenId(openId, data) {
   });
 }
 
-async function ensurePatient({ hospitalId, doctorId, name, phone, idCard }) {
+async function ensurePatient({
+  hospitalId,
+  doctorId,
+  name,
+  inpatientNo = null,
+  projectName = null,
+  phone,
+  idCard,
+}) {
   const existing = await prisma.patient.findFirst({
     where: {
       hospitalId,
@@ -70,10 +79,15 @@ async function ensurePatient({ hospitalId, doctorId, name, phone, idCard }) {
   });
 
   if (existing) {
-    if (existing.doctorId !== doctorId || existing.name !== name) {
+    if (
+      existing.doctorId !== doctorId ||
+      existing.name !== name ||
+      existing.inpatientNo !== inpatientNo ||
+      existing.projectName !== projectName
+    ) {
       return prisma.patient.update({
         where: { id: existing.id },
-        data: { doctorId, name },
+        data: { doctorId, name, inpatientNo, projectName },
       });
     }
     return existing;
@@ -84,12 +98,124 @@ async function ensurePatient({ hospitalId, doctorId, name, phone, idCard }) {
       hospitalId,
       doctorId,
       name,
+      inpatientNo,
+      projectName,
       phone,
       idCard,
     },
   });
 }
 
+async function ensureImplantCatalog({
+  modelCode,
+  manufacturer,
+  name,
+  pressureLevels = [],
+  isPressureAdjustable = true,
+  notes = null,
+}) {
+  return prisma.implantCatalog.upsert({
+    where: { modelCode },
+    update: {
+      manufacturer,
+      name,
+      pressureLevels,
+      isPressureAdjustable,
+      notes,
+    },
+    create: {
+      modelCode,
+      manufacturer,
+      name,
+      pressureLevels,
+      isPressureAdjustable,
+      notes,
+    },
+  });
+}
+
+async function ensureDictionaryItem({
+  type,
+  label,
+  sortOrder = 0,
+  enabled = true,
+}) {
+  return prisma.dictionaryItem.upsert({
+    where: {
+      type_label: {
+        type,
+        label,
+      },
+    },
+    update: {
+      sortOrder,
+      enabled,
+    },
+    create: {
+      type,
+      label,
+      sortOrder,
+      enabled,
+    },
+  });
+}
+
+async function ensurePatientSurgery({
+  patientId,
+  surgeryDate,
+  surgeryName,
+  surgeonName,
+  preOpPressure = null,
+  primaryDisease,
+  hydrocephalusTypes,
+  previousShuntSurgeryDate = null,
+  preOpMaterials = null,
+  notes = null,
+}) {
+  const normalizedSurgeryDate = new Date(surgeryDate);
+  const normalizedPreviousDate = previousShuntSurgeryDate
+    ? new Date(previousShuntSurgeryDate)
+    : null;
+
+  const existing = await prisma.patientSurgery.findFirst({
+    where: {
+      patientId,
+      surgeryDate: normalizedSurgeryDate,
+      surgeryName,
+    },
+  });
+
+  if (existing) {
+    return prisma.patientSurgery.update({
+      where: { id: existing.id },
+      data: {
+        surgeonName,
+        preOpPressure,
+        primaryDisease,
+        hydrocephalusTypes,
+        previousShuntSurgeryDate: normalizedPreviousDate,
+        preOpMaterials,
+        notes,
+      },
+    });
+  }
+
+  return prisma.patientSurgery.create({
+    data: {
+      patientId,
+      surgeryDate: normalizedSurgeryDate,
+      surgeryName,
+      surgeonName,
+      preOpPressure,
+      primaryDisease,
+      hydrocephalusTypes,
+      previousShuntSurgeryDate: normalizedPreviousDate,
+      preOpMaterials,
+      notes,
+    },
+  });
+}
+
 async function main() {
   const seedPasswordHash = await hash(SEED_PASSWORD_PLAIN, 12);
 
@@ -217,10 +343,61 @@ async function main() {
     groupId: null,
   });
 
+  const dictionarySeeds = {
+    [DictionaryType.PRIMARY_DISEASE]: [
+      '先天性脑积水',
+      '梗阻性脑积水',
+      '交通性脑积水',
+      '出血后脑积水',
+      '肿瘤相关脑积水',
+      '外伤后脑积水',
+      '感染后脑积水',
+      '分流功能障碍',
+    ],
+    [DictionaryType.HYDROCEPHALUS_TYPE]: [
+      '交通性',
+      '梗阻性',
+      '高压性',
+      '正常压力',
+      '先天性',
+      '继发性',
+    ],
+    [DictionaryType.SHUNT_MODE]: ['VPS', 'VPLS', 'LPS', '脑室心房分流'],
+    [DictionaryType.PROXIMAL_PUNCTURE_AREA]: [
+      '额角',
+      '枕角',
+      '三角区',
+      '腰穿',
+      '后角',
+    ],
+    [DictionaryType.VALVE_PLACEMENT_SITE]: [
+      '耳后',
+      '胸前',
+      '锁骨下',
+      '腹壁',
+      '腰背部',
+    ],
+    [DictionaryType.DISTAL_SHUNT_DIRECTION]: ['腹腔', '胸腔', '心房', '腰大池'],
+  };
+
+  await Promise.all(
+    Object.entries(dictionarySeeds).flatMap(([type, labels]) =>
+      labels.map((label, index) =>
+        ensureDictionaryItem({
+          type,
+          label,
+          sortOrder: index * 10,
+        }),
+      ),
+    ),
+  );
+
   const patientA1 = await ensurePatient({
     hospitalId: hospitalA.id,
     doctorId: doctorA.id,
     name: 'Seed Patient A1',
+    inpatientNo: 'ZYH-A-0001',
+    projectName: '脑积水随访项目-A',
     phone: '13800002001',
     idCard: '110101199001010011',
   });
@@ -229,6 +406,8 @@ async function main() {
     hospitalId: hospitalA.id,
     doctorId: doctorA2.id,
     name: 'Seed Patient A2',
+    inpatientNo: 'ZYH-A-0002',
+    projectName: '脑积水随访项目-A',
     phone: '13800002002',
     idCard: '110101199002020022',
   });
@@ -237,6 +416,8 @@ async function main() {
     hospitalId: hospitalA.id,
     doctorId: doctorA3.id,
     name: 'Seed Patient A3',
+    inpatientNo: 'ZYH-A-0003',
+    projectName: '脑积水随访项目-A',
     phone: '13800002003',
     idCard: '110101199003030033',
   });
@@ -245,22 +426,130 @@ async function main() {
     hospitalId: hospitalB.id,
     doctorId: doctorB.id,
     name: 'Seed Patient B1',
+    inpatientNo: 'ZYH-B-0001',
+    projectName: '脑积水随访项目-B',
     phone: '13800002001',
     idCard: '110101199001010011',
   });
 
+  const adjustableCatalog = await ensureImplantCatalog({
+    modelCode: 'SEED-ADJUSTABLE-VALVE',
+    manufacturer: 'Seed MedTech',
+    name: 'Seed 可调压分流阀',
+    pressureLevels: [80, 100, 120, 140, 160],
+    isPressureAdjustable: true,
+    notes: 'Seed 全局可调压目录样例',
+  });
+
+  const fixedCatalog = await ensureImplantCatalog({
+    modelCode: 'SEED-FIXED-VALVE',
+    manufacturer: 'Seed MedTech',
+    name: 'Seed 固定压分流阀',
+    pressureLevels: [],
+    isPressureAdjustable: false,
+    notes: 'Seed 固定压目录样例',
+  });
+
+  const surgeryA1Old = await ensurePatientSurgery({
+    patientId: patientA1.id,
+    surgeryDate: '2024-06-01T08:00:00.000Z',
+    surgeryName: '首次脑室腹腔分流术',
+    surgeonName: 'Seed Director A',
+    preOpPressure: 24,
+    primaryDisease: '先天性脑积水',
+    hydrocephalusTypes: ['交通性'],
+    notes: '首台手术',
+  });
+
+  const surgeryA1New = await ensurePatientSurgery({
+    patientId: patientA1.id,
+    surgeryDate: '2025-09-10T08:00:00.000Z',
+    surgeryName: '分流系统翻修术',
+    surgeonName: 'Seed Director A',
+    preOpPressure: 18,
+    primaryDisease: '分流功能障碍',
+    hydrocephalusTypes: ['交通性', '高压性'],
+    previousShuntSurgeryDate: '2024-06-01T08:00:00.000Z',
+    preOpMaterials: [
+      {
+        type: 'IMAGE',
+        url: 'https://seed.example.com/a1-ct-preop.png',
+        name: 'Seed A1 术前 CT',
+      },
+    ],
+    notes: '二次手术，保留原设备历史',
+  });
+
+  const surgeryA2 = await ensurePatientSurgery({
+    patientId: patientA2.id,
+    surgeryDate: '2025-12-15T08:00:00.000Z',
+    surgeryName: '脑室腹腔分流术',
+    surgeonName: 'Seed Doctor A2',
+    preOpPressure: 20,
+    primaryDisease: '肿瘤相关脑积水',
+    hydrocephalusTypes: ['梗阻性'],
+  });
+
+  const surgeryA3 = await ensurePatientSurgery({
+    patientId: patientA3.id,
+    surgeryDate: '2025-11-20T08:00:00.000Z',
+    surgeryName: '脑室腹腔分流术',
+    surgeonName: 'Seed Doctor A3',
+    preOpPressure: 21,
+    primaryDisease: '外伤后脑积水',
+    hydrocephalusTypes: ['交通性'],
+  });
+
+  const surgeryB1 = await ensurePatientSurgery({
+    patientId: patientB1.id,
+    surgeryDate: '2025-10-05T08:00:00.000Z',
+    surgeryName: '脑室腹腔分流术',
+    surgeonName: 'Seed Doctor B',
+    preOpPressure: 23,
+    primaryDisease: '出血后脑积水',
+    hydrocephalusTypes: ['高压性'],
+  });
+
   const deviceA1 = await prisma.device.upsert({
     where: { snCode: 'SEED-SN-A-001' },
     update: {
       patientId: patientA1.id,
+      surgeryId: surgeryA1New.id,
+      implantCatalogId: adjustableCatalog.id,
       currentPressure: 118,
       status: DeviceStatus.ACTIVE,
+      implantModel: adjustableCatalog.modelCode,
+      implantManufacturer: adjustableCatalog.manufacturer,
+      implantName: adjustableCatalog.name,
+      isPressureAdjustable: adjustableCatalog.isPressureAdjustable,
+      isAbandoned: false,
+      shuntMode: 'VPS',
+      proximalPunctureAreas: ['额角'],
+      valvePlacementSites: ['耳后'],
+      distalShuntDirection: '腹腔',
+      initialPressure: 118,
+      implantNotes: 'Seed A1 当前在用设备',
+      labelImageUrl: 'https://seed.example.com/labels/a1-001.jpg',
     },
     create: {
       snCode: 'SEED-SN-A-001',
       patientId: patientA1.id,
+      surgeryId: surgeryA1New.id,
+      implantCatalogId: adjustableCatalog.id,
       currentPressure: 118,
       status: DeviceStatus.ACTIVE,
+      implantModel: adjustableCatalog.modelCode,
+      implantManufacturer: adjustableCatalog.manufacturer,
+      implantName: adjustableCatalog.name,
+      isPressureAdjustable: adjustableCatalog.isPressureAdjustable,
+      isAbandoned: false,
+      shuntMode: 'VPS',
+      proximalPunctureAreas: ['额角'],
+      valvePlacementSites: ['耳后'],
+      distalShuntDirection: '腹腔',
+      initialPressure: 118,
+      implantNotes: 'Seed A1 当前在用设备',
+      labelImageUrl: 'https://seed.example.com/labels/a1-001.jpg',
     },
   });
 
@@ -268,14 +557,42 @@ async function main() {
     where: { snCode: 'SEED-SN-A-002' },
     update: {
       patientId: patientA2.id,
+      surgeryId: surgeryA2.id,
+      implantCatalogId: adjustableCatalog.id,
       currentPressure: 112,
       status: DeviceStatus.ACTIVE,
+      implantModel: adjustableCatalog.modelCode,
+      implantManufacturer: adjustableCatalog.manufacturer,
+      implantName: adjustableCatalog.name,
+      isPressureAdjustable: adjustableCatalog.isPressureAdjustable,
+      isAbandoned: false,
+      shuntMode: 'VPS',
+      proximalPunctureAreas: ['枕角'],
+      valvePlacementSites: ['胸前'],
+      distalShuntDirection: '腹腔',
+      initialPressure: 112,
+      implantNotes: 'Seed A2 当前在用设备',
+      labelImageUrl: 'https://seed.example.com/labels/a2-002.jpg',
     },
     create: {
       snCode: 'SEED-SN-A-002',
       patientId: patientA2.id,
+      surgeryId: surgeryA2.id,
+      implantCatalogId: adjustableCatalog.id,
       currentPressure: 112,
       status: DeviceStatus.ACTIVE,
+      implantModel: adjustableCatalog.modelCode,
+      implantManufacturer: adjustableCatalog.manufacturer,
+      implantName: adjustableCatalog.name,
+      isPressureAdjustable: adjustableCatalog.isPressureAdjustable,
+      isAbandoned: false,
+      shuntMode: 'VPS',
+      proximalPunctureAreas: ['枕角'],
+      valvePlacementSites: ['胸前'],
+      distalShuntDirection: '腹腔',
+      initialPressure: 112,
+      implantNotes: 'Seed A2 当前在用设备',
+      labelImageUrl: 'https://seed.example.com/labels/a2-002.jpg',
     },
   });
 
@@ -283,14 +600,42 @@ async function main() {
     where: { snCode: 'SEED-SN-A-003' },
     update: {
       patientId: patientA3.id,
+      surgeryId: surgeryA3.id,
+      implantCatalogId: adjustableCatalog.id,
       currentPressure: 109,
       status: DeviceStatus.ACTIVE,
+      implantModel: adjustableCatalog.modelCode,
+      implantManufacturer: adjustableCatalog.manufacturer,
+      implantName: adjustableCatalog.name,
+      isPressureAdjustable: adjustableCatalog.isPressureAdjustable,
+      isAbandoned: false,
+      shuntMode: 'LPS',
+      proximalPunctureAreas: ['腰穿'],
+      valvePlacementSites: ['腰背部'],
+      distalShuntDirection: '腹腔',
+      initialPressure: 109,
+      implantNotes: 'Seed A3 当前在用设备',
+      labelImageUrl: 'https://seed.example.com/labels/a3-003.jpg',
     },
     create: {
       snCode: 'SEED-SN-A-003',
       patientId: patientA3.id,
+      surgeryId: surgeryA3.id,
+      implantCatalogId: adjustableCatalog.id,
       currentPressure: 109,
       status: DeviceStatus.ACTIVE,
+      implantModel: adjustableCatalog.modelCode,
+      implantManufacturer: adjustableCatalog.manufacturer,
+      implantName: adjustableCatalog.name,
+      isPressureAdjustable: adjustableCatalog.isPressureAdjustable,
+      isAbandoned: false,
+      shuntMode: 'LPS',
+      proximalPunctureAreas: ['腰穿'],
+      valvePlacementSites: ['腰背部'],
+      distalShuntDirection: '腹腔',
+      initialPressure: 109,
+      implantNotes: 'Seed A3 当前在用设备',
+      labelImageUrl: 'https://seed.example.com/labels/a3-003.jpg',
     },
   });
 
@@ -298,14 +643,42 @@ async function main() {
     where: { snCode: 'SEED-SN-B-001' },
     update: {
       patientId: patientB1.id,
+      surgeryId: surgeryB1.id,
+      implantCatalogId: adjustableCatalog.id,
       currentPressure: 121,
       status: DeviceStatus.ACTIVE,
+      implantModel: adjustableCatalog.modelCode,
+      implantManufacturer: adjustableCatalog.manufacturer,
+      implantName: adjustableCatalog.name,
+      isPressureAdjustable: adjustableCatalog.isPressureAdjustable,
+      isAbandoned: false,
+      shuntMode: 'VPS',
+      proximalPunctureAreas: ['额角'],
+      valvePlacementSites: ['耳后'],
+      distalShuntDirection: '腹腔',
+      initialPressure: 121,
+      implantNotes: 'Seed B1 当前在用设备',
+      labelImageUrl: 'https://seed.example.com/labels/b1-001.jpg',
     },
     create: {
       snCode: 'SEED-SN-B-001',
       patientId: patientB1.id,
+      surgeryId: surgeryB1.id,
+      implantCatalogId: adjustableCatalog.id,
       currentPressure: 121,
       status: DeviceStatus.ACTIVE,
+      implantModel: adjustableCatalog.modelCode,
+      implantManufacturer: adjustableCatalog.manufacturer,
+      implantName: adjustableCatalog.name,
+      isPressureAdjustable: adjustableCatalog.isPressureAdjustable,
+      isAbandoned: false,
+      shuntMode: 'VPS',
+      proximalPunctureAreas: ['额角'],
+      valvePlacementSites: ['耳后'],
+      distalShuntDirection: '腹腔',
+      initialPressure: 121,
+      implantNotes: 'Seed B1 当前在用设备',
+      labelImageUrl: 'https://seed.example.com/labels/b1-001.jpg',
     },
   });
 
@@ -313,14 +686,42 @@ async function main() {
     where: { snCode: 'SEED-SN-A-004' },
     update: {
       patientId: patientA1.id,
+      surgeryId: surgeryA1Old.id,
+      implantCatalogId: adjustableCatalog.id,
       currentPressure: 130,
       status: DeviceStatus.INACTIVE,
+      implantModel: adjustableCatalog.modelCode,
+      implantManufacturer: adjustableCatalog.manufacturer,
+      implantName: adjustableCatalog.name,
+      isPressureAdjustable: adjustableCatalog.isPressureAdjustable,
+      isAbandoned: true,
+      shuntMode: 'VPS',
+      proximalPunctureAreas: ['额角'],
+      valvePlacementSites: ['耳后'],
+      distalShuntDirection: '腹腔',
+      initialPressure: 130,
+      implantNotes: 'Seed A1 弃用历史设备',
+      labelImageUrl: 'https://seed.example.com/labels/a1-004.jpg',
     },
     create: {
       snCode: 'SEED-SN-A-004',
       patientId: patientA1.id,
+      surgeryId: surgeryA1Old.id,
+      implantCatalogId: adjustableCatalog.id,
       currentPressure: 130,
       status: DeviceStatus.INACTIVE,
+      implantModel: adjustableCatalog.modelCode,
+      implantManufacturer: adjustableCatalog.manufacturer,
+      implantName: adjustableCatalog.name,
+      isPressureAdjustable: adjustableCatalog.isPressureAdjustable,
+      isAbandoned: true,
+      shuntMode: 'VPS',
+      proximalPunctureAreas: ['额角'],
+      valvePlacementSites: ['耳后'],
+      distalShuntDirection: '腹腔',
+      initialPressure: 130,
+      implantNotes: 'Seed A1 弃用历史设备',
+      labelImageUrl: 'https://seed.example.com/labels/a1-004.jpg',
     },
   });
 

src/app.module.ts

@@ -8,6 +8,7 @@ import { AuthModule } from './auth/auth.module.js';
 import { OrganizationModule } from './organization/organization.module.js';
 import { NotificationsModule } from './notifications/notifications.module.js';
 import { DevicesModule } from './devices/devices.module.js';
+import { DictionariesModule } from './dictionaries/dictionaries.module.js';
 
 @Module({
   imports: [
@@ -20,6 +21,7 @@ import { DevicesModule } from './devices/devices.module.js';
     OrganizationModule,
     NotificationsModule,
     DevicesModule,
+    DictionariesModule,
   ],
 })
 export class AppModule {}

src/auth/current-actor.decorator.ts

@@ -6,7 +6,9 @@ import type { ActorContext } from '../common/actor-context.js';
  */
 export const CurrentActor = createParamDecorator(
   (_data: unknown, context: ExecutionContext): ActorContext => {
-    const request = context.switchToHttp().getRequest<{ actor: ActorContext }>();
+    const request = context
+      .switchToHttp()
+      .getRequest<{ actor: ActorContext }>();
     return request.actor;
   },
 );

src/auth/roles.guard.ts

@@ -29,7 +29,9 @@ export class RolesGuard implements CanActivate {
       return true;
     }
 
-    const request = context.switchToHttp().getRequest<{ actor?: { role?: Role } }>();
+    const request = context
+      .switchToHttp()
+      .getRequest<{ actor?: { role?: Role } }>();
     const actorRole = request.actor?.role;
     if (!actorRole || !requiredRoles.includes(actorRole)) {
       throw new ForbiddenException(MESSAGES.DEFAULT_FORBIDDEN);

src/common/http-exception.filter.ts

@@ -24,10 +24,7 @@ export class HttpExceptionFilter implements ExceptionFilter {
     // 非 HttpException 统一记录堆栈，便于定位 500 根因。
     if (!(exception instanceof HttpException)) {
       const error = exception as { message?: string; stack?: string };
-      this.logger.error(
+      this.logger.error(error?.message ?? 'Unhandled exception', error?.stack);
-        error?.message ?? 'Unhandled exception',
-        error?.stack,
-      );
     }
 
     const status = this.resolveStatus(exception);

src/common/messages.ts

@@ -89,6 +89,12 @@ export const MESSAGES = {
     LIFE_CYCLE_NOT_FOUND: '未找到匹配的患者档案，请先确认手机号与身份证号',
     SYSTEM_ADMIN_HOSPITAL_REQUIRED: '系统管理员查询必须显式传入 hospitalId',
     ACTOR_HOSPITAL_REQUIRED: '当前登录上下文缺少医院信息',
+    SURGERY_ITEMS_REQUIRED: '手术下至少需要录入一个植入设备',
+    SURGERY_NOT_FOUND: '手术记录不存在或无权限访问',
+    IMPLANT_CATALOG_NOT_FOUND: '植入物型号不存在或不在当前医院可见范围内',
+    SURGERY_UPDATE_NOT_SUPPORTED:
+      '患者更新接口不支持直接修改手术，请使用新增手术接口',
+    ABANDON_DEVICE_SCOPE_FORBIDDEN: '仅可弃用当前患者名下设备',
   },
 
   DEVICE: {
@@ -102,6 +108,19 @@ export const MESSAGES = {
     PATIENT_SCOPE_FORBIDDEN: '仅可绑定当前权限范围内患者',
     DELETE_CONFLICT: '设备存在关联任务记录，无法删除',
     ACTOR_HOSPITAL_REQUIRED: '当前登录上下文缺少医院信息',
+    CATALOG_NOT_FOUND: '植入物型号不存在',
+    CATALOG_MODEL_DUPLICATE: '植入物型号编码已存在',
+    CATALOG_SCOPE_FORBIDDEN: '当前角色无权限维护该植入物型号',
+    CATALOG_DELETE_CONFLICT: '植入物型号已被患者手术引用，无法删除',
+    PRESSURE_LEVEL_INVALID: '压力值不在该植入物配置的挡位范围内',
+    DEVICE_NOT_ADJUSTABLE: '仅可调压设备允许创建调压任务',
+  },
+
+  DICTIONARY: {
+    NOT_FOUND: '字典项不存在',
+    LABEL_REQUIRED: '字典项名称不能为空',
+    DUPLICATE: '同类型下字典项名称已存在',
+    SYSTEM_ADMIN_ONLY_MAINTAIN: '仅系统管理员可维护字典',
   },
 
   ORG: {

src/common/transforms/to-boolean.transform.ts

@@ -0,0 +1,24 @@
+import { Transform } from 'class-transformer';
+
+/**
+ * 将常见布尔输入统一转换为 boolean。
+ */
+export const ToBoolean = () =>
+  Transform(({ value }) => {
+    if (value === undefined || value === null || value === '') {
+      return value;
+    }
+    if (typeof value === 'boolean') {
+      return value;
+    }
+    if (typeof value === 'string') {
+      const normalized = value.trim().toLowerCase();
+      if (normalized === 'true' || normalized === '1') {
+        return true;
+      }
+      if (normalized === 'false' || normalized === '0') {
+        return false;
+      }
+    }
+    return value;
+  });

src/departments/departments.controller.ts

@@ -55,12 +55,7 @@ export class DepartmentsController {
    * 查询科室列表。
    */
   @Get()
-  @Roles(
+  @Roles(Role.SYSTEM_ADMIN, Role.HOSPITAL_ADMIN, Role.DIRECTOR, Role.LEADER)
-    Role.SYSTEM_ADMIN,
-    Role.HOSPITAL_ADMIN,
-    Role.DIRECTOR,
-    Role.LEADER,
-  )
   @ApiOperation({ summary: '查询科室列表' })
   @ApiQuery({ name: 'hospitalId', required: false, description: '医院 ID' })
   findAll(
@@ -74,12 +69,7 @@ export class DepartmentsController {
    * 查询科室详情。
    */
   @Get(':id')
-  @Roles(
+  @Roles(Role.SYSTEM_ADMIN, Role.HOSPITAL_ADMIN, Role.DIRECTOR, Role.LEADER)
-    Role.SYSTEM_ADMIN,
-    Role.HOSPITAL_ADMIN,
-    Role.DIRECTOR,
-    Role.LEADER,
-  )
   @ApiOperation({ summary: '查询科室详情' })
   @ApiParam({ name: 'id', description: '科室 ID' })
   findOne(
@@ -93,12 +83,7 @@ export class DepartmentsController {
    * 更新科室。
    */
   @Patch(':id')
-  @Roles(
+  @Roles(Role.SYSTEM_ADMIN, Role.HOSPITAL_ADMIN, Role.DIRECTOR, Role.LEADER)
-    Role.SYSTEM_ADMIN,
-    Role.HOSPITAL_ADMIN,
-    Role.DIRECTOR,
-    Role.LEADER,
-  )
   @ApiOperation({ summary: '更新科室' })
   update(
     @CurrentActor() actor: ActorContext,

src/departments/departments.service.ts

@@ -29,13 +29,19 @@ export class DepartmentsService {
    */
   async create(actor: ActorContext, dto: CreateDepartmentDto) {
     this.access.assertRole(actor, [Role.SYSTEM_ADMIN, Role.HOSPITAL_ADMIN]);
-    const hospitalId = this.access.toInt(dto.hospitalId, MESSAGES.ORG.HOSPITAL_ID_REQUIRED);
+    const hospitalId = this.access.toInt(
+      dto.hospitalId,
+      MESSAGES.ORG.HOSPITAL_ID_REQUIRED,
+    );
     await this.access.ensureHospitalExists(hospitalId);
     this.access.assertHospitalScope(actor, hospitalId);
 
     return this.prisma.department.create({
       data: {
-        name: this.access.normalizeName(dto.name, MESSAGES.ORG.DEPARTMENT_NAME_REQUIRED),
+        name: this.access.normalizeName(
+          dto.name,
+          MESSAGES.ORG.DEPARTMENT_NAME_REQUIRED,
+        ),
         hospitalId,
       },
     });
@@ -73,7 +79,10 @@ export class DepartmentsService {
       this.prisma.department.count({ where }),
       this.prisma.department.findMany({
         where,
-        include: { hospital: true, _count: { select: { users: true, groups: true } } },
+        include: {
+          hospital: true,
+          _count: { select: { users: true, groups: true } },
+        },
         skip: paging.skip,
         take: paging.take,
         orderBy: { id: 'desc' },
@@ -93,7 +102,10 @@ export class DepartmentsService {
       Role.DIRECTOR,
       Role.LEADER,
     ]);
-    const departmentId = this.access.toInt(id, MESSAGES.ORG.DEPARTMENT_ID_REQUIRED);
+    const departmentId = this.access.toInt(
+      id,
+      MESSAGES.ORG.DEPARTMENT_ID_REQUIRED,
+    );
     const department = await this.prisma.department.findUnique({
       where: { id: departmentId },
       include: {
@@ -128,7 +140,10 @@ export class DepartmentsService {
     }
 
     if (dto.name !== undefined) {
-      data.name = this.access.normalizeName(dto.name, MESSAGES.ORG.DEPARTMENT_NAME_REQUIRED);
+      data.name = this.access.normalizeName(
+        dto.name,
+        MESSAGES.ORG.DEPARTMENT_NAME_REQUIRED,
+      );
     }
 
     return this.prisma.department.update({

src/devices/b-devices/b-devices.controller.ts

@@ -14,6 +14,7 @@ import {
   ApiBearerAuth,
   ApiOperation,
   ApiParam,
+  ApiQuery,
   ApiTags,
 } from '@nestjs/swagger';
 import { AccessTokenGuard } from '../../auth/access-token.guard.js';
@@ -22,8 +23,10 @@ import { Roles } from '../../auth/roles.decorator.js';
 import { RolesGuard } from '../../auth/roles.guard.js';
 import type { ActorContext } from '../../common/actor-context.js';
 import { Role } from '../../generated/prisma/enums.js';
+import { CreateImplantCatalogDto } from '../dto/create-implant-catalog.dto.js';
 import { CreateDeviceDto } from '../dto/create-device.dto.js';
 import { DeviceQueryDto } from '../dto/device-query.dto.js';
+import { UpdateImplantCatalogDto } from '../dto/update-implant-catalog.dto.js';
 import { UpdateDeviceDto } from '../dto/update-device.dto.js';
 import { DevicesService } from '../devices.service.js';
 
@@ -37,6 +40,73 @@ import { DevicesService } from '../devices.service.js';
 export class BDevicesController {
   constructor(private readonly devicesService: DevicesService) {}
 
+  /**
+   * 查询可见植入物型号字典。
+   */
+  @Get('catalogs')
+  @Roles(
+    Role.SYSTEM_ADMIN,
+    Role.HOSPITAL_ADMIN,
+    Role.DIRECTOR,
+    Role.LEADER,
+    Role.DOCTOR,
+    Role.ENGINEER,
+  )
+  @ApiOperation({ summary: '查询植入物型号字典' })
+  @ApiQuery({
+    name: 'keyword',
+    required: false,
+    description: '支持按型号、厂家、名称模糊查询',
+  })
+  findCatalogs(
+    @CurrentActor() actor: ActorContext,
+    @Query('keyword') keyword?: string,
+  ) {
+    return this.devicesService.findCatalogs(actor, keyword);
+  }
+
+  /**
+   * 新增植入物型号字典。
+   */
+  @Post('catalogs')
+  @Roles(Role.SYSTEM_ADMIN)
+  @ApiOperation({ summary: '新增植入物目录（SYSTEM_ADMIN）' })
+  createCatalog(
+    @CurrentActor() actor: ActorContext,
+    @Body() dto: CreateImplantCatalogDto,
+  ) {
+    return this.devicesService.createCatalog(actor, dto);
+  }
+
+  /**
+   * 更新植入物型号字典。
+   */
+  @Patch('catalogs/:id')
+  @Roles(Role.SYSTEM_ADMIN)
+  @ApiOperation({ summary: '更新植入物目录（SYSTEM_ADMIN）' })
+  @ApiParam({ name: 'id', description: '型号字典 ID' })
+  updateCatalog(
+    @CurrentActor() actor: ActorContext,
+    @Param('id', ParseIntPipe) id: number,
+    @Body() dto: UpdateImplantCatalogDto,
+  ) {
+    return this.devicesService.updateCatalog(actor, id, dto);
+  }
+
+  /**
+   * 删除植入物目录。
+   */
+  @Delete('catalogs/:id')
+  @Roles(Role.SYSTEM_ADMIN)
+  @ApiOperation({ summary: '删除植入物目录（SYSTEM_ADMIN）' })
+  @ApiParam({ name: 'id', description: '型号字典 ID' })
+  removeCatalog(
+    @CurrentActor() actor: ActorContext,
+    @Param('id', ParseIntPipe) id: number,
+  ) {
+    return this.devicesService.removeCatalog(actor, id);
+  }
+
   /**
    * 查询设备列表。
    */

src/devices/devices.service.ts

@@ -10,15 +10,30 @@ import { DeviceStatus, Role } from '../generated/prisma/enums.js';
 import type { ActorContext } from '../common/actor-context.js';
 import { MESSAGES } from '../common/messages.js';
 import { PrismaService } from '../prisma.service.js';
+import { CreateImplantCatalogDto } from './dto/create-implant-catalog.dto.js';
 import { CreateDeviceDto } from './dto/create-device.dto.js';
 import { DeviceQueryDto } from './dto/device-query.dto.js';
+import { UpdateImplantCatalogDto } from './dto/update-implant-catalog.dto.js';
 import { UpdateDeviceDto } from './dto/update-device.dto.js';
 
+const CATALOG_SELECT = {
+  id: true,
+  modelCode: true,
+  manufacturer: true,
+  name: true,
+  pressureLevels: true,
+  isPressureAdjustable: true,
+  notes: true,
+  createdAt: true,
+  updatedAt: true,
+} as const;
+
 const DEVICE_DETAIL_INCLUDE = {
   patient: {
     select: {
       id: true,
       name: true,
+      inpatientNo: true,
       phone: true,
       hospitalId: true,
       hospital: {
@@ -36,6 +51,17 @@ const DEVICE_DETAIL_INCLUDE = {
       },
     },
   },
+  surgery: {
+    select: {
+      id: true,
+      surgeryDate: true,
+      surgeryName: true,
+      surgeonName: true,
+    },
+  },
+  implantCatalog: {
+    select: CATALOG_SELECT,
+  },
   _count: {
     select: {
       taskItems: true,
@@ -44,7 +70,7 @@ const DEVICE_DETAIL_INCLUDE = {
 } as const;
 
 /**
- * 设备服务：承载管理员设备 CRUD、租户隔离与分页筛选。
+ * 设备服务：承载患者植入实例 CRUD 与全局植入物目录维护。
  */
 @Injectable()
 export class DevicesService {
@@ -114,7 +140,8 @@ export class DevicesService {
     return this.prisma.device.create({
       data: {
         snCode,
-        currentPressure: this.normalizePressure(dto.currentPressure),
+        // 当前压力只允许由调压任务流转维护，手工创建设备时先置 0。
+        currentPressure: 0,
         status: dto.status ?? DeviceStatus.ACTIVE,
         patientId: patient.id,
       },
@@ -123,7 +150,7 @@ export class DevicesService {
   }
 
   /**
-   * 更新设备：允许修改 SN、当前压力、状态和归属患者。
+   * 更新设备：允许修改 SN、状态和归属患者；当前压力仅由任务完成时更新。
    */
   async update(actor: ActorContext, id: number, dto: UpdateDeviceDto) {
     const current = await this.findOne(actor, id);
@@ -134,9 +161,6 @@ export class DevicesService {
       await this.assertSnCodeUnique(snCode, current.id);
       data.snCode = snCode;
     }
-    if (dto.currentPressure !== undefined) {
-      data.currentPressure = this.normalizePressure(dto.currentPressure);
-    }
     if (dto.status !== undefined) {
       data.status = this.normalizeStatus(dto.status);
     }
@@ -174,6 +198,142 @@ export class DevicesService {
     }
   }
 
+  /**
+   * 查询当前角色可见的植入物型号字典。
+   */
+  async findCatalogs(actor: ActorContext, keyword?: string) {
+    this.assertCatalogReadable(actor);
+
+    const where = this.buildCatalogWhere(keyword);
+
+    return this.prisma.implantCatalog.findMany({
+      where,
+      select: CATALOG_SELECT,
+      orderBy: [{ manufacturer: 'asc' }, { name: 'asc' }, { modelCode: 'asc' }],
+    });
+  }
+
+  /**
+   * 新增植入物型号字典。
+   */
+  async createCatalog(actor: ActorContext, dto: CreateImplantCatalogDto) {
+    this.assertSystemAdmin(actor);
+    const isPressureAdjustable = dto.isPressureAdjustable ?? true;
+
+    try {
+      return await this.prisma.implantCatalog.create({
+        data: {
+          modelCode: this.normalizeModelCode(dto.modelCode),
+          manufacturer: this.normalizeRequiredString(
+            dto.manufacturer,
+            'manufacturer',
+          ),
+          name: this.normalizeRequiredString(dto.name, 'name'),
+          pressureLevels: this.normalizePressureLevels(
+            dto.pressureLevels,
+            isPressureAdjustable,
+          ),
+          isPressureAdjustable,
+          notes:
+            dto.notes === undefined
+              ? undefined
+              : this.normalizeNullableString(dto.notes, 'notes'),
+        },
+        select: CATALOG_SELECT,
+      });
+    } catch (error) {
+      if (
+        error instanceof Prisma.PrismaClientKnownRequestError &&
+        error.code === 'P2002'
+      ) {
+        throw new ConflictException(MESSAGES.DEVICE.CATALOG_MODEL_DUPLICATE);
+      }
+      throw error;
+    }
+  }
+
+  /**
+   * 更新植入物型号字典。
+   */
+  async updateCatalog(
+    actor: ActorContext,
+    id: number,
+    dto: UpdateImplantCatalogDto,
+  ) {
+    this.assertSystemAdmin(actor);
+    const current = await this.findWritableCatalog(id);
+    const nextIsPressureAdjustable =
+      dto.isPressureAdjustable ?? current.isPressureAdjustable;
+
+    const data: Prisma.ImplantCatalogUpdateInput = {};
+    if (dto.modelCode !== undefined) {
+      data.modelCode = this.normalizeModelCode(dto.modelCode);
+    }
+    if (dto.manufacturer !== undefined) {
+      data.manufacturer = this.normalizeRequiredString(
+        dto.manufacturer,
+        'manufacturer',
+      );
+    }
+    if (dto.name !== undefined) {
+      data.name = this.normalizeRequiredString(dto.name, 'name');
+    }
+    if (dto.isPressureAdjustable !== undefined) {
+      data.isPressureAdjustable = dto.isPressureAdjustable;
+    }
+    if (
+      dto.pressureLevels !== undefined ||
+      dto.isPressureAdjustable !== undefined
+    ) {
+      data.pressureLevels = this.normalizePressureLevels(
+        dto.pressureLevels ?? current.pressureLevels,
+        nextIsPressureAdjustable,
+      );
+    }
+    if (dto.notes !== undefined) {
+      data.notes = this.normalizeNullableString(dto.notes, 'notes');
+    }
+
+    try {
+      return await this.prisma.implantCatalog.update({
+        where: { id: current.id },
+        data,
+        select: CATALOG_SELECT,
+      });
+    } catch (error) {
+      if (
+        error instanceof Prisma.PrismaClientKnownRequestError &&
+        error.code === 'P2002'
+      ) {
+        throw new ConflictException(MESSAGES.DEVICE.CATALOG_MODEL_DUPLICATE);
+      }
+      throw error;
+    }
+  }
+
+  /**
+   * 删除植入物目录：若已被患者手术引用，则返回 409。
+   */
+  async removeCatalog(actor: ActorContext, id: number) {
+    this.assertSystemAdmin(actor);
+    const current = await this.findWritableCatalog(id);
+
+    try {
+      return await this.prisma.implantCatalog.delete({
+        where: { id: current.id },
+        select: CATALOG_SELECT,
+      });
+    } catch (error) {
+      if (
+        error instanceof Prisma.PrismaClientKnownRequestError &&
+        (error.code === 'P2003' || error.code === 'P2014')
+      ) {
+        throw new ConflictException(MESSAGES.DEVICE.CATALOG_DELETE_CONFLICT);
+      }
+      throw error;
+    }
+  }
+
   /**
    * 构造列表筛选：支持按医院、患者、状态和关键词组合查询。
    */
@@ -212,6 +372,18 @@ export class DevicesService {
               mode: 'insensitive',
             },
           },
+          {
+            implantModel: {
+              contains: keyword,
+              mode: 'insensitive',
+            },
+          },
+          {
+            implantName: {
+              contains: keyword,
+              mode: 'insensitive',
+            },
+          },
           {
             patient: {
               is: {
@@ -238,6 +410,47 @@ export class DevicesService {
     return andConditions.length > 0 ? { AND: andConditions } : {};
   }
 
+  /**
+   * 构造型号字典查询条件。
+   */
+  private buildCatalogWhere(keyword?: string): Prisma.ImplantCatalogWhereInput {
+    const andConditions: Prisma.ImplantCatalogWhereInput[] = [];
+    const normalizedKeyword = keyword?.trim();
+
+    if (normalizedKeyword) {
+      andConditions.push({
+        OR: [
+          {
+            modelCode: {
+              contains: normalizedKeyword,
+              mode: 'insensitive',
+            },
+          },
+          {
+            manufacturer: {
+              contains: normalizedKeyword,
+              mode: 'insensitive',
+            },
+          },
+          {
+            name: {
+              contains: normalizedKeyword,
+              mode: 'insensitive',
+            },
+          },
+          {
+            notes: {
+              contains: normalizedKeyword,
+              mode: 'insensitive',
+            },
+          },
+        ],
+      });
+    }
+
+    return andConditions.length > 0 ? { AND: andConditions } : {};
+  }
+
   /**
    * 解析列表分页。
    */
@@ -301,6 +514,23 @@ export class DevicesService {
     return patient;
   }
 
+  /**
+   * 查询当前管理员可写的型号字典。
+   */
+  private async findWritableCatalog(id: number) {
+    const catalogId = this.toInt(id, 'id');
+    const catalog = await this.prisma.implantCatalog.findUnique({
+      where: { id: catalogId },
+      select: CATALOG_SELECT,
+    });
+
+    if (!catalog) {
+      throw new NotFoundException(MESSAGES.DEVICE.CATALOG_NOT_FOUND);
+    }
+
+    return catalog;
+  }
+
   /**
    * 校验当前用户是否可读/写该设备。
    */
@@ -315,7 +545,7 @@ export class DevicesService {
   }
 
   /**
-   * 管理员角色校验：仅系统管理员与院管可操作设备。
+   * 管理员角色校验：仅系统管理员与院管可操作患者植入实例。
    */
   private assertAdmin(actor: ActorContext) {
     if (
@@ -326,21 +556,98 @@ export class DevicesService {
     }
   }
 
+  /**
+   * 型号字典读权限：B 端全部已登录角色可访问。
+   */
+  private assertCatalogReadable(actor: ActorContext) {
+    if (
+      actor.role === Role.SYSTEM_ADMIN ||
+      actor.role === Role.HOSPITAL_ADMIN ||
+      actor.role === Role.DIRECTOR ||
+      actor.role === Role.LEADER ||
+      actor.role === Role.DOCTOR ||
+      actor.role === Role.ENGINEER
+    ) {
+      return;
+    }
+
+    throw new ForbiddenException(MESSAGES.DEFAULT_FORBIDDEN);
+  }
+
+  /**
+   * 全局植入物目录仅系统管理员可维护。
+   */
+  private assertSystemAdmin(actor: ActorContext) {
+    if (actor.role !== Role.SYSTEM_ADMIN) {
+      throw new ForbiddenException(MESSAGES.DEFAULT_FORBIDDEN);
+    }
+  }
+
+  /**
+   * 型号编码标准化：统一去空白并转大写。
+   */
+  private normalizeModelCode(value: unknown) {
+    return this.normalizeRequiredString(value, 'modelCode').toUpperCase();
+  }
+
   /**
    * 设备 SN 标准化：统一去空白并转大写，避免大小写重复。
    */
   private normalizeSnCode(value: unknown) {
-    if (typeof value !== 'string') {
+    return this.normalizeRequiredString(value, 'snCode').toUpperCase();
-      throw new BadRequestException(MESSAGES.DEVICE.SN_CODE_REQUIRED);
   }
 
-    const normalized = value.trim().toUpperCase();
+  private normalizeRequiredString(value: unknown, fieldName: string) {
+    if (typeof value !== 'string') {
+      throw new BadRequestException(`${fieldName} 必须是字符串`);
+    }
+
+    const normalized = value.trim();
     if (!normalized) {
-      throw new BadRequestException(MESSAGES.DEVICE.SN_CODE_REQUIRED);
+      throw new BadRequestException(`${fieldName} 不能为空`);
     }
     return normalized;
   }
 
+  private normalizeNullableString(value: unknown, fieldName: string) {
+    if (typeof value !== 'string') {
+      throw new BadRequestException(`${fieldName} 必须是字符串`);
+    }
+
+    const normalized = value.trim();
+    return normalized || null;
+  }
+
+  /**
+   * 挡位列表标准化：去重、排序，并在非可调压目录下自动清空。
+   */
+  private normalizePressureLevels(
+    pressureLevels: number[] | undefined,
+    isPressureAdjustable: boolean,
+  ) {
+    if (!isPressureAdjustable) {
+      return [];
+    }
+
+    if (!Array.isArray(pressureLevels) || pressureLevels.length === 0) {
+      return [];
+    }
+
+    return Array.from(
+      new Set(
+        pressureLevels.map((level) => {
+          const normalized = Number(level);
+          if (!Number.isInteger(normalized) || normalized < 0) {
+            throw new BadRequestException(
+              'pressureLevels 必须为大于等于 0 的整数数组',
+            );
+          }
+          return normalized;
+        }),
+      ),
+    ).sort((left, right) => left - right);
+  }
+
   /**
    * 压力值必须是非负整数。
    */

src/devices/dto/create-device.dto.ts

@@ -11,12 +11,6 @@ export class CreateDeviceDto {
   @IsString({ message: 'snCode 必须是字符串' })
   snCode!: string;
 
-  @ApiProperty({ description: '当前压力值', example: 120 })
-  @Type(() => Number)
-  @IsInt({ message: 'currentPressure 必须是整数' })
-  @Min(0, { message: 'currentPressure 必须大于等于 0' })
-  currentPressure!: number;
-
   @ApiPropertyOptional({
     description: '设备状态，默认 ACTIVE',
     enum: DeviceStatus,

src/devices/dto/create-implant-catalog.dto.ts

@@ -0,0 +1,70 @@
+import { ApiProperty, ApiPropertyOptional } from '@nestjs/swagger';
+import { Type } from 'class-transformer';
+import {
+  ArrayMaxSize,
+  IsArray,
+  IsBoolean,
+  IsInt,
+  IsOptional,
+  IsString,
+  MaxLength,
+  Min,
+} from 'class-validator';
+import { ToBoolean } from '../../common/transforms/to-boolean.transform.js';
+
+/**
+ * 植入物目录创建 DTO。
+ */
+export class CreateImplantCatalogDto {
+  @ApiProperty({
+    description: '型号编码',
+    example: 'CODMAN-HAKIM-120',
+  })
+  @IsString({ message: 'modelCode 必须是字符串' })
+  modelCode!: string;
+
+  @ApiProperty({
+    description: '厂家',
+    example: 'Codman',
+  })
+  @IsString({ message: 'manufacturer 必须是字符串' })
+  manufacturer!: string;
+
+  @ApiProperty({
+    description: '名称',
+    example: 'Hakim 可调压阀',
+  })
+  @IsString({ message: 'name 必须是字符串' })
+  name!: string;
+
+  @ApiPropertyOptional({
+    description: '可调压器械的挡位列表，按整数录入',
+    type: [Number],
+    example: [80, 100, 120, 140],
+  })
+  @IsOptional()
+  @IsArray({ message: 'pressureLevels 必须是数组' })
+  @ArrayMaxSize(30, { message: 'pressureLevels 最多 30 项' })
+  @Type(() => Number)
+  @IsInt({ each: true, message: 'pressureLevels 必须为整数数组' })
+  @Min(0, { each: true, message: 'pressureLevels 必须大于等于 0' })
+  pressureLevels?: number[];
+
+  @ApiPropertyOptional({
+    description: '是否支持调压，默认 true',
+    example: true,
+  })
+  @IsOptional()
+  @ToBoolean()
+  @IsBoolean({ message: 'isPressureAdjustable 必须是布尔值' })
+  isPressureAdjustable?: boolean;
+
+  @ApiPropertyOptional({
+    description: '植入物备注',
+    example: '适用于儿童脑积水病例',
+  })
+  @IsOptional()
+  @IsString({ message: 'notes 必须是字符串' })
+  @MaxLength(200, { message: 'notes 最长 200 个字符' })
+  notes?: string;
+}

src/devices/dto/update-implant-catalog.dto.ts

@@ -0,0 +1,9 @@
+import { PartialType } from '@nestjs/swagger';
+import { CreateImplantCatalogDto } from './create-implant-catalog.dto.js';
+
+/**
+ * 植入物型号更新 DTO。
+ */
+export class UpdateImplantCatalogDto extends PartialType(
+  CreateImplantCatalogDto,
+) {}

src/dictionaries/b-dictionaries/b-dictionaries.controller.ts

@@ -0,0 +1,112 @@
+import {
+  Body,
+  Controller,
+  Delete,
+  Get,
+  Param,
+  ParseIntPipe,
+  Patch,
+  Post,
+  Query,
+  UseGuards,
+} from '@nestjs/common';
+import {
+  ApiBearerAuth,
+  ApiOperation,
+  ApiParam,
+  ApiQuery,
+  ApiTags,
+} from '@nestjs/swagger';
+import { AccessTokenGuard } from '../../auth/access-token.guard.js';
+import { CurrentActor } from '../../auth/current-actor.decorator.js';
+import { Roles } from '../../auth/roles.decorator.js';
+import { RolesGuard } from '../../auth/roles.guard.js';
+import type { ActorContext } from '../../common/actor-context.js';
+import { Role } from '../../generated/prisma/enums.js';
+import { CreateDictionaryItemDto } from '../dto/create-dictionary-item.dto.js';
+import { DictionaryQueryDto } from '../dto/dictionary-query.dto.js';
+import { UpdateDictionaryItemDto } from '../dto/update-dictionary-item.dto.js';
+import { DictionariesService } from '../dictionaries.service.js';
+
+/**
+ * B 端字典控制器：供患者表单读取和系统管理员维护选项字典。
+ */
+@ApiTags('字典管理(B端)')
+@ApiBearerAuth('bearer')
+@Controller('b/dictionaries')
+@UseGuards(AccessTokenGuard, RolesGuard)
+export class BDictionariesController {
+  constructor(private readonly dictionariesService: DictionariesService) {}
+
+  /**
+   * 查询字典项列表。
+   */
+  @Get()
+  @Roles(
+    Role.SYSTEM_ADMIN,
+    Role.HOSPITAL_ADMIN,
+    Role.DIRECTOR,
+    Role.LEADER,
+    Role.DOCTOR,
+    Role.ENGINEER,
+  )
+  @ApiOperation({ summary: '查询系统字典' })
+  @ApiQuery({
+    name: 'type',
+    required: false,
+    description: '字典类型，不传返回全部类型',
+  })
+  @ApiQuery({
+    name: 'includeDisabled',
+    required: false,
+    description: '是否包含停用项，仅系统管理员生效',
+  })
+  findAll(
+    @CurrentActor() actor: ActorContext,
+    @Query() query: DictionaryQueryDto,
+  ) {
+    return this.dictionariesService.findAll(actor, query);
+  }
+
+  /**
+   * 创建字典项。
+   */
+  @Post()
+  @Roles(Role.SYSTEM_ADMIN)
+  @ApiOperation({ summary: '创建系统字典项（SYSTEM_ADMIN）' })
+  create(
+    @CurrentActor() actor: ActorContext,
+    @Body() dto: CreateDictionaryItemDto,
+  ) {
+    return this.dictionariesService.create(actor, dto);
+  }
+
+  /**
+   * 更新字典项。
+   */
+  @Patch(':id')
+  @Roles(Role.SYSTEM_ADMIN)
+  @ApiOperation({ summary: '更新系统字典项（SYSTEM_ADMIN）' })
+  @ApiParam({ name: 'id', description: '字典项 ID' })
+  update(
+    @CurrentActor() actor: ActorContext,
+    @Param('id', ParseIntPipe) id: number,
+    @Body() dto: UpdateDictionaryItemDto,
+  ) {
+    return this.dictionariesService.update(actor, id, dto);
+  }
+
+  /**
+   * 删除字典项。
+   */
+  @Delete(':id')
+  @Roles(Role.SYSTEM_ADMIN)
+  @ApiOperation({ summary: '删除系统字典项（SYSTEM_ADMIN）' })
+  @ApiParam({ name: 'id', description: '字典项 ID' })
+  remove(
+    @CurrentActor() actor: ActorContext,
+    @Param('id', ParseIntPipe) id: number,
+  ) {
+    return this.dictionariesService.remove(actor, id);
+  }
+}

src/dictionaries/dictionaries.module.ts

@@ -0,0 +1,12 @@
+import { Module } from '@nestjs/common';
+import { AccessTokenGuard } from '../auth/access-token.guard.js';
+import { RolesGuard } from '../auth/roles.guard.js';
+import { BDictionariesController } from './b-dictionaries/b-dictionaries.controller.js';
+import { DictionariesService } from './dictionaries.service.js';
+
+@Module({
+  controllers: [BDictionariesController],
+  providers: [DictionariesService, AccessTokenGuard, RolesGuard],
+  exports: [DictionariesService],
+})
+export class DictionariesModule {}

src/dictionaries/dictionaries.service.ts

@@ -0,0 +1,156 @@
+import {
+  BadRequestException,
+  ConflictException,
+  ForbiddenException,
+  Injectable,
+  NotFoundException,
+} from '@nestjs/common';
+import { Prisma } from '../generated/prisma/client.js';
+import { Role } from '../generated/prisma/enums.js';
+import type { ActorContext } from '../common/actor-context.js';
+import { MESSAGES } from '../common/messages.js';
+import { PrismaService } from '../prisma.service.js';
+import { CreateDictionaryItemDto } from './dto/create-dictionary-item.dto.js';
+import { DictionaryQueryDto } from './dto/dictionary-query.dto.js';
+import { UpdateDictionaryItemDto } from './dto/update-dictionary-item.dto.js';
+
+@Injectable()
+export class DictionariesService {
+  constructor(private readonly prisma: PrismaService) {}
+
+  /**
+   * 查询字典项列表。
+   */
+  async findAll(actor: ActorContext, query: DictionaryQueryDto) {
+    const where: Prisma.DictionaryItemWhereInput = {};
+
+    if (query.type) {
+      where.type = query.type;
+    }
+
+    // 非系统管理员一律只看启用项，避免业务页面误拿到停用值。
+    if (actor.role !== Role.SYSTEM_ADMIN || !query.includeDisabled) {
+      where.enabled = true;
+    }
+
+    return this.prisma.dictionaryItem.findMany({
+      where,
+      orderBy: [{ type: 'asc' }, { sortOrder: 'asc' }, { id: 'asc' }],
+    });
+  }
+
+  /**
+   * 创建字典项：仅系统管理员可维护。
+   */
+  async create(actor: ActorContext, dto: CreateDictionaryItemDto) {
+    this.assertSystemAdmin(actor);
+
+    try {
+      return await this.prisma.dictionaryItem.create({
+        data: {
+          type: dto.type,
+          label: this.normalizeLabel(dto.label),
+          sortOrder: dto.sortOrder ?? 0,
+          enabled: dto.enabled ?? true,
+        },
+      });
+    } catch (error) {
+      this.handleDuplicate(error);
+      throw error;
+    }
+  }
+
+  /**
+   * 更新字典项：支持调整分类、排序和启停状态。
+   */
+  async update(actor: ActorContext, id: number, dto: UpdateDictionaryItemDto) {
+    this.assertSystemAdmin(actor);
+    await this.ensureExists(id);
+
+    const data: Prisma.DictionaryItemUpdateInput = {};
+    if (dto.type !== undefined) {
+      data.type = dto.type;
+    }
+    if (dto.label !== undefined) {
+      data.label = this.normalizeLabel(dto.label);
+    }
+    if (dto.sortOrder !== undefined) {
+      data.sortOrder = dto.sortOrder;
+    }
+    if (dto.enabled !== undefined) {
+      data.enabled = dto.enabled;
+    }
+
+    try {
+      return await this.prisma.dictionaryItem.update({
+        where: { id },
+        data,
+      });
+    } catch (error) {
+      this.handleDuplicate(error);
+      throw error;
+    }
+  }
+
+  /**
+   * 删除字典项。
+   */
+  async remove(actor: ActorContext, id: number) {
+    this.assertSystemAdmin(actor);
+    await this.ensureExists(id);
+
+    return this.prisma.dictionaryItem.delete({
+      where: { id },
+    });
+  }
+
+  /**
+   * 标准化字典名称并确保非空。
+   */
+  private normalizeLabel(value: string) {
+    const label = value?.trim();
+    if (!label) {
+      throw new BadRequestException(MESSAGES.DICTIONARY.LABEL_REQUIRED);
+    }
+    return label;
+  }
+
+  /**
+   * 校验系统管理员权限。
+   */
+  private assertSystemAdmin(actor: ActorContext) {
+    if (actor.role !== Role.SYSTEM_ADMIN) {
+      throw new ForbiddenException(
+        MESSAGES.DICTIONARY.SYSTEM_ADMIN_ONLY_MAINTAIN,
+      );
+    }
+  }
+
+  /**
+   * 确认字典项存在。
+   */
+  private async ensureExists(id: number) {
+    const current = await this.prisma.dictionaryItem.findUnique({
+      where: { id },
+      select: { id: true },
+    });
+
+    if (!current) {
+      throw new NotFoundException(MESSAGES.DICTIONARY.NOT_FOUND);
+    }
+
+    return current;
+  }
+
+  /**
+   * 统一处理唯一键冲突。
+   */
+  private handleDuplicate(error: unknown) {
+    if (
+      error instanceof Prisma.PrismaClientKnownRequestError &&
+      error.code === 'P2002'
+    ) {
+      throw new ConflictException(MESSAGES.DICTIONARY.DUPLICATE);
+    }
+  }
+}

src/dictionaries/dto/create-dictionary-item.dto.ts

@@ -0,0 +1,55 @@
+import { ApiProperty, ApiPropertyOptional } from '@nestjs/swagger';
+import { Type } from 'class-transformer';
+import {
+  IsBoolean,
+  IsEnum,
+  IsInt,
+  IsOptional,
+  IsString,
+  Max,
+  Min,
+} from 'class-validator';
+import { ToBoolean } from '../../common/transforms/to-boolean.transform.js';
+import { DictionaryType } from '../../generated/prisma/enums.js';
+
+/**
+ * 系统字典项创建 DTO。
+ */
+export class CreateDictionaryItemDto {
+  @ApiProperty({
+    description: '字典类型',
+    enum: DictionaryType,
+    example: DictionaryType.PRIMARY_DISEASE,
+  })
+  @IsEnum(DictionaryType, { message: 'type 枚举值不合法' })
+  type!: DictionaryType;
+
+  @ApiProperty({
+    description: '字典项名称',
+    example: '先天性脑积水',
+  })
+  @IsString({ message: 'label 必须是字符串' })
+  label!: string;
+
+  @ApiPropertyOptional({
+    description: '排序值，越小越靠前，默认 0',
+    example: 10,
+    default: 0,
+  })
+  @IsOptional()
+  @Type(() => Number)
+  @IsInt({ message: 'sortOrder 必须是整数' })
+  @Min(-9999, { message: 'sortOrder 不能小于 -9999' })
+  @Max(9999, { message: 'sortOrder 不能大于 9999' })
+  sortOrder?: number;
+
+  @ApiPropertyOptional({
+    description: '是否启用，默认 true',
+    example: true,
+    default: true,
+  })
+  @IsOptional()
+  @ToBoolean()
+  @IsBoolean({ message: 'enabled 必须是布尔值' })
+  enabled?: boolean;
+}

src/dictionaries/dto/dictionary-query.dto.ts

@@ -0,0 +1,30 @@
+import { ApiPropertyOptional } from '@nestjs/swagger';
+import { IsBoolean, IsEnum, IsOptional } from 'class-validator';
+import { EmptyStringToUndefined } from '../../common/transforms/empty-string-to-undefined.transform.js';
+import { ToBoolean } from '../../common/transforms/to-boolean.transform.js';
+import { DictionaryType } from '../../generated/prisma/enums.js';
+
+/**
+ * 字典查询 DTO：支持按类型筛选，并允许系统管理员查看停用项。
+ */
+export class DictionaryQueryDto {
+  @ApiPropertyOptional({
+    description: '字典类型，不传返回全部类型',
+    enum: DictionaryType,
+    example: DictionaryType.PRIMARY_DISEASE,
+  })
+  @IsOptional()
+  @EmptyStringToUndefined()
+  @IsEnum(DictionaryType, { message: 'type 枚举值不合法' })
+  type?: DictionaryType;
+
+  @ApiPropertyOptional({
+    description: '是否包含停用项，仅系统管理员生效',
+    example: true,
+  })
+  @IsOptional()
+  @EmptyStringToUndefined()
+  @ToBoolean()
+  @IsBoolean({ message: 'includeDisabled 必须是布尔值' })
+  includeDisabled?: boolean;
+}

src/dictionaries/dto/update-dictionary-item.dto.ts

@@ -0,0 +1,9 @@
+import { PartialType } from '@nestjs/swagger';
+import { CreateDictionaryItemDto } from './create-dictionary-item.dto.js';
+
+/**
+ * 系统字典项更新 DTO。
+ */
+export class UpdateDictionaryItemDto extends PartialType(
+  CreateDictionaryItemDto,
+) {}

src/groups/groups.controller.ts

@@ -43,10 +43,7 @@ export class GroupsController {
   @Post()
   @Roles(Role.SYSTEM_ADMIN, Role.HOSPITAL_ADMIN, Role.DIRECTOR)
   @ApiOperation({ summary: '创建小组' })
-  create(
+  create(@CurrentActor() actor: ActorContext, @Body() dto: CreateGroupDto) {
-    @CurrentActor() actor: ActorContext,
-    @Body() dto: CreateGroupDto,
-  ) {
     return this.groupsService.create(actor, dto);
   }
 
@@ -54,12 +51,7 @@ export class GroupsController {
    * 查询小组列表。
    */
   @Get()
-  @Roles(
+  @Roles(Role.SYSTEM_ADMIN, Role.HOSPITAL_ADMIN, Role.DIRECTOR, Role.LEADER)
-    Role.SYSTEM_ADMIN,
-    Role.HOSPITAL_ADMIN,
-    Role.DIRECTOR,
-    Role.LEADER,
-  )
   @ApiOperation({ summary: '查询小组列表' })
   findAll(
     @CurrentActor() actor: ActorContext,
@@ -72,12 +64,7 @@ export class GroupsController {
    * 查询小组详情。
    */
   @Get(':id')
-  @Roles(
+  @Roles(Role.SYSTEM_ADMIN, Role.HOSPITAL_ADMIN, Role.DIRECTOR, Role.LEADER)
-    Role.SYSTEM_ADMIN,
-    Role.HOSPITAL_ADMIN,
-    Role.DIRECTOR,
-    Role.LEADER,
-  )
   @ApiOperation({ summary: '查询小组详情' })
   @ApiParam({ name: 'id', description: '小组 ID' })
   findOne(
@@ -91,12 +78,7 @@ export class GroupsController {
    * 更新小组。
    */
   @Patch(':id')
-  @Roles(
+  @Roles(Role.SYSTEM_ADMIN, Role.HOSPITAL_ADMIN, Role.DIRECTOR, Role.LEADER)
-    Role.SYSTEM_ADMIN,
-    Role.HOSPITAL_ADMIN,
-    Role.DIRECTOR,
-    Role.LEADER,
-  )
   @ApiOperation({ summary: '更新小组' })
   update(
     @CurrentActor() actor: ActorContext,

src/groups/groups.module.ts

@@ -10,7 +10,12 @@ import { OrganizationAccessService } from '../organization-common/organization-a
  */
 @Module({
   controllers: [GroupsController],
-  providers: [GroupsService, OrganizationAccessService, AccessTokenGuard, RolesGuard],
+  providers: [
+    GroupsService,
+    OrganizationAccessService,
+    AccessTokenGuard,
+    RolesGuard,
+  ],
   exports: [GroupsService],
 })
 export class GroupsModule {}

src/hospitals/hospitals.controller.ts

@@ -43,10 +43,7 @@ export class HospitalsController {
   @Post()
   @Roles(Role.SYSTEM_ADMIN)
   @ApiOperation({ summary: '创建医院（SYSTEM_ADMIN）' })
-  create(
+  create(@CurrentActor() actor: ActorContext, @Body() dto: CreateHospitalDto) {
-    @CurrentActor() actor: ActorContext,
-    @Body() dto: CreateHospitalDto,
-  ) {
     return this.hospitalsService.create(actor, dto);
   }
 
@@ -54,12 +51,7 @@ export class HospitalsController {
    * 查询医院列表（系统管理员全量，院管仅本院）。
    */
   @Get()
-  @Roles(
+  @Roles(Role.SYSTEM_ADMIN, Role.HOSPITAL_ADMIN, Role.DIRECTOR, Role.LEADER)
-    Role.SYSTEM_ADMIN,
-    Role.HOSPITAL_ADMIN,
-    Role.DIRECTOR,
-    Role.LEADER,
-  )
   @ApiOperation({ summary: '查询医院列表' })
   findAll(
     @CurrentActor() actor: ActorContext,
@@ -72,12 +64,7 @@ export class HospitalsController {
    * 查询医院详情。
    */
   @Get(':id')
-  @Roles(
+  @Roles(Role.SYSTEM_ADMIN, Role.HOSPITAL_ADMIN, Role.DIRECTOR, Role.LEADER)
-    Role.SYSTEM_ADMIN,
-    Role.HOSPITAL_ADMIN,
-    Role.DIRECTOR,
-    Role.LEADER,
-  )
   @ApiOperation({ summary: '查询医院详情' })
   @ApiParam({ name: 'id', description: '医院 ID' })
   findOne(

src/hospitals/hospitals.service.ts

@@ -23,10 +23,16 @@ export class HospitalsService {
    * 创建医院：仅系统管理员可调用。
    */
   async create(actor: ActorContext, dto: CreateHospitalDto) {
-    this.access.assertSystemAdmin(actor, MESSAGES.ORG.SYSTEM_ADMIN_ONLY_CREATE_HOSPITAL);
+    this.access.assertSystemAdmin(
+      actor,
+      MESSAGES.ORG.SYSTEM_ADMIN_ONLY_CREATE_HOSPITAL,
+    );
     return this.prisma.hospital.create({
       data: {
-        name: this.access.normalizeName(dto.name, MESSAGES.ORG.HOSPITAL_NAME_REQUIRED),
+        name: this.access.normalizeName(
+          dto.name,
+          MESSAGES.ORG.HOSPITAL_NAME_REQUIRED,
+        ),
       },
     });
   }
@@ -79,7 +85,12 @@ export class HospitalsService {
       where: { id: hospitalId },
       include: {
         _count: {
-          select: { departments: true, users: true, patients: true, tasks: true },
+          select: {
+            departments: true,
+            users: true,
+            patients: true,
+            tasks: true,
+          },
         },
       },
     });
@@ -97,7 +108,10 @@ export class HospitalsService {
     const current = await this.findOne(actor, id);
     const data: Prisma.HospitalUpdateInput = {};
     if (dto.name !== undefined) {
-      data.name = this.access.normalizeName(dto.name, MESSAGES.ORG.HOSPITAL_NAME_REQUIRED);
+      data.name = this.access.normalizeName(
+        dto.name,
+        MESSAGES.ORG.HOSPITAL_NAME_REQUIRED,
+      );
     }
     return this.prisma.hospital.update({
       where: { id: current.id },
@@ -109,7 +123,10 @@ export class HospitalsService {
    * 删除医院：仅系统管理员允许。
    */
   async remove(actor: ActorContext, id: number) {
-    this.access.assertSystemAdmin(actor, MESSAGES.ORG.SYSTEM_ADMIN_ONLY_DELETE_HOSPITAL);
+    this.access.assertSystemAdmin(
+      actor,
+      MESSAGES.ORG.SYSTEM_ADMIN_ONLY_DELETE_HOSPITAL,
+    );
     const hospitalId = this.access.toInt(id, MESSAGES.ORG.HOSPITAL_ID_REQUIRED);
     await this.access.ensureHospitalExists(hospitalId);
 

src/organization-common/dto/organization-query.dto.ts

@@ -7,7 +7,10 @@ import { IsInt, IsOptional, IsString, Max, Min } from 'class-validator';
  * 组织查询 DTO：用于医院/科室/小组列表筛选与分页。
  */
 export class OrganizationQueryDto {
-  @ApiPropertyOptional({ description: '关键词（按名称模糊匹配）', example: '神经' })
+  @ApiPropertyOptional({
+    description: '关键词（按名称模糊匹配）',
+    example: '神经',
+  })
   @IsOptional()
   @IsString({ message: 'keyword 必须是字符串' })
   keyword?: string;
@@ -28,7 +31,11 @@ export class OrganizationQueryDto {
   @Min(1, { message: 'departmentId 必须大于 0' })
   departmentId?: number;
 
-  @ApiPropertyOptional({ description: '页码（默认 1）', example: 1, default: 1 })
+  @ApiPropertyOptional({
+    description: '页码（默认 1）',
+    example: 1,
+    default: 1,
+  })
   @IsOptional()
   @EmptyStringToUndefined()
   @Type(() => Number)

src/organization-common/organization-access.service.ts

@@ -66,9 +66,9 @@ export class OrganizationAccessService {
    */
   requireActorHospitalId(actor: ActorContext): number {
     if (
-      typeof actor.hospitalId !== 'number'
+      typeof actor.hospitalId !== 'number' ||
-      || !Number.isInteger(actor.hospitalId)
+      !Number.isInteger(actor.hospitalId) ||
-      || actor.hospitalId <= 0
+      actor.hospitalId <= 0
     ) {
       throw new BadRequestException(MESSAGES.ORG.ACTOR_HOSPITAL_REQUIRED);
     }
@@ -80,9 +80,9 @@ export class OrganizationAccessService {
    */
   requireActorDepartmentId(actor: ActorContext): number {
     if (
-      typeof actor.departmentId !== 'number'
+      typeof actor.departmentId !== 'number' ||
-      || !Number.isInteger(actor.departmentId)
+      !Number.isInteger(actor.departmentId) ||
-      || actor.departmentId <= 0
+      actor.departmentId <= 0
     ) {
       throw new BadRequestException(MESSAGES.ORG.ACTOR_DEPARTMENT_REQUIRED);
     }
@@ -94,9 +94,9 @@ export class OrganizationAccessService {
    */
   requireActorGroupId(actor: ActorContext): number {
     if (
-      typeof actor.groupId !== 'number'
+      typeof actor.groupId !== 'number' ||
-      || !Number.isInteger(actor.groupId)
+      !Number.isInteger(actor.groupId) ||
-      || actor.groupId <= 0
+      actor.groupId <= 0
     ) {
       throw new BadRequestException(MESSAGES.ORG.ACTOR_GROUP_REQUIRED);
     }

src/patients/b-patients/b-patients.controller.ts

@@ -25,6 +25,7 @@ import { Roles } from '../../auth/roles.decorator.js';
 import { Role } from '../../generated/prisma/enums.js';
 import { BPatientsService } from './b-patients.service.js';
 import { CreatePatientDto } from '../dto/create-patient.dto.js';
+import { CreatePatientSurgeryDto } from '../dto/create-patient-surgery.dto.js';
 import { UpdatePatientDto } from '../dto/update-patient.dto.js';
 
 /**
@@ -102,10 +103,34 @@ export class BPatientsController {
     Role.DOCTOR,
   )
   @ApiOperation({ summary: '创建患者' })
-  createPatient(@CurrentActor() actor: ActorContext, @Body() dto: CreatePatientDto) {
+  createPatient(
+    @CurrentActor() actor: ActorContext,
+    @Body() dto: CreatePatientDto,
+  ) {
     return this.patientsService.createPatient(actor, dto);
   }
 
+  /**
+   * 为患者新增手术记录。
+   */
+  @Post(':id/surgeries')
+  @Roles(
+    Role.SYSTEM_ADMIN,
+    Role.HOSPITAL_ADMIN,
+    Role.DIRECTOR,
+    Role.LEADER,
+    Role.DOCTOR,
+  )
+  @ApiOperation({ summary: '为患者新增手术记录' })
+  @ApiParam({ name: 'id', description: '患者 ID' })
+  createPatientSurgery(
+    @CurrentActor() actor: ActorContext,
+    @Param('id', ParseIntPipe) id: number,
+    @Body() dto: CreatePatientSurgeryDto,
+  ) {
+    return this.patientsService.createPatientSurgery(actor, id, dto);
+  }
+
   /**
    * 查询患者详情。
    */

src/patients/b-patients/b-patients.service.ts

@@ -1,3 +1,4 @@
+import { randomUUID } from 'node:crypto';
 import {
   BadRequestException,
   ConflictException,
@@ -6,18 +7,118 @@ import {
   NotFoundException,
 } from '@nestjs/common';
 import { Prisma } from '../../generated/prisma/client.js';
-import { Role } from '../../generated/prisma/enums.js';
+import { DeviceStatus, Role } from '../../generated/prisma/enums.js';
 import { PrismaService } from '../../prisma.service.js';
 import type { ActorContext } from '../../common/actor-context.js';
 import { MESSAGES } from '../../common/messages.js';
 import { CreatePatientDto } from '../dto/create-patient.dto.js';
+import { CreatePatientSurgeryDto } from '../dto/create-patient-surgery.dto.js';
 import { UpdatePatientDto } from '../dto/update-patient.dto.js';
 import { normalizePatientIdCard } from '../patient-id-card.util.js';
 
+type PrismaExecutor = Prisma.TransactionClient | PrismaService;
+
 const PATIENT_OWNER_ROLES: Role[] = [Role.DOCTOR, Role.DIRECTOR, Role.LEADER];
 
+const IMPLANT_CATALOG_SELECT = {
+  id: true,
+  modelCode: true,
+  manufacturer: true,
+  name: true,
+  pressureLevels: true,
+  isPressureAdjustable: true,
+  notes: true,
+} as const;
+
+const PATIENT_LIST_INCLUDE = {
+  hospital: { select: { id: true, name: true } },
+  doctor: { select: { id: true, name: true, role: true } },
+  devices: {
+    select: {
+      id: true,
+      snCode: true,
+      status: true,
+      currentPressure: true,
+      isAbandoned: true,
+      implantModel: true,
+      implantManufacturer: true,
+      implantName: true,
+      isPressureAdjustable: true,
+    },
+    orderBy: { id: 'desc' },
+  },
+  surgeries: {
+    select: {
+      id: true,
+      surgeryDate: true,
+      surgeryName: true,
+      surgeonName: true,
+    },
+    orderBy: { surgeryDate: 'desc' },
+    take: 1,
+  },
+  _count: {
+    select: {
+      surgeries: true,
+    },
+  },
+} as const;
+
+const PATIENT_DETAIL_INCLUDE = {
+  hospital: { select: { id: true, name: true } },
+  doctor: {
+    select: {
+      id: true,
+      name: true,
+      role: true,
+      hospitalId: true,
+      departmentId: true,
+      groupId: true,
+    },
+  },
+  devices: {
+    include: {
+      implantCatalog: {
+        select: IMPLANT_CATALOG_SELECT,
+      },
+      surgery: {
+        select: {
+          id: true,
+          surgeryDate: true,
+          surgeryName: true,
+        },
+      },
+    },
+    orderBy: { id: 'desc' },
+  },
+  surgeries: {
+    include: {
+      devices: {
+        include: {
+          implantCatalog: {
+            select: IMPLANT_CATALOG_SELECT,
+          },
+        },
+        orderBy: { id: 'desc' },
+      },
+    },
+    orderBy: { surgeryDate: 'desc' },
+  },
+} as const;
+
+const PATIENT_SURGERY_DETAIL_INCLUDE = {
+  devices: {
+    include: {
+      implantCatalog: {
+        select: IMPLANT_CATALOG_SELECT,
+      },
+    },
+    orderBy: { id: 'desc' },
+  },
+} as const;
+
 /**
- * B 端患者服务：承载院内可见性隔离与患者 CRUD。
+ * B 端患者服务：承载院内可见性隔离、患者 CRUD 与手术档案录入。
  */
 @Injectable()
 export class BPatientsService {
@@ -30,15 +131,27 @@ export class BPatientsService {
     const hospitalId = this.resolveHospitalId(actor, requestedHospitalId);
     const where = this.buildVisiblePatientWhere(actor, hospitalId);
 
-    return this.prisma.patient.findMany({
+    const patients = await this.prisma.patient.findMany({
       where,
-      include: {
+      include: PATIENT_LIST_INCLUDE,
-        hospital: { select: { id: true, name: true } },
-        doctor: { select: { id: true, name: true, role: true } },
-        devices: true,
-      },
       orderBy: { id: 'desc' },
     });
+
+    return patients.map((patient) => {
+      const { _count, surgeries, ...rest } = patient;
+      return {
+        ...rest,
+        shuntSurgeryCount: _count.surgeries,
+        latestSurgery: surgeries[0] ?? null,
+        activeDeviceCount: patient.devices.filter(
+          (device) =>
+            device.status === DeviceStatus.ACTIVE && !device.isAbandoned,
+        ).length,
+        abandonedDeviceCount: patient.devices.filter(
+          (device) => device.isAbandoned,
+        ).length,
+      };
+    });
   }
 
   /**
@@ -90,25 +203,73 @@ export class BPatientsService {
   }
 
   /**
-   * 创建患者。
+   * 创建患者，可选一并创建首台手术及植入设备。
    */
   async createPatient(actor: ActorContext, dto: CreatePatientDto) {
     const doctor = await this.resolveWritableDoctor(actor, dto.doctorId);
 
-    return this.prisma.patient.create({
+    return this.prisma.$transaction(async (tx) => {
+      const patient = await tx.patient.create({
         data: {
           name: this.normalizeRequiredString(dto.name, 'name'),
+          inpatientNo:
+            dto.inpatientNo === undefined
+              ? undefined
+              : this.normalizeNullableString(dto.inpatientNo, 'inpatientNo'),
+          projectName:
+            dto.projectName === undefined
+              ? undefined
+              : this.normalizeNullableString(dto.projectName, 'projectName'),
           phone: this.normalizePhone(dto.phone),
           // 身份证统一做轻量标准化后落库，数据库中保存原始证件号而不是哈希。
           idCard: this.normalizeIdCard(dto.idCard),
           hospitalId: doctor.hospitalId!,
           doctorId: doctor.id,
         },
-      include: {
+      });
-        hospital: { select: { id: true, name: true } },
+
-        doctor: { select: { id: true, name: true, role: true } },
+      if (dto.initialSurgery) {
-        devices: true,
+        await this.createPatientSurgeryRecord(
-      },
+          tx,
+          patient.id,
+          dto.initialSurgery,
+        );
+      }
+
+      const detail = await this.loadPatientDetail(tx, patient.id);
+      return this.decoratePatientDetail(detail);
+    });
+  }
+
+  /**
+   * 为患者新增一台手术，并支持弃用旧设备。
+   */
+  async createPatientSurgery(
+    actor: ActorContext,
+    patientId: number,
+    dto: CreatePatientSurgeryDto,
+  ) {
+    const patient = await this.findPatientWithScope(patientId);
+    this.assertPatientScope(actor, patient);
+
+    return this.prisma.$transaction(async (tx) => {
+      const createdSurgery = await this.createPatientSurgeryRecord(
+        tx,
+        patient.id,
+        dto,
+      );
+
+      const detail = await this.loadPatientDetail(tx, patient.id);
+      const decoratedPatient = this.decoratePatientDetail(detail);
+      const created = decoratedPatient.surgeries.find(
+        (surgery) => surgery.id === createdSurgery.id,
+      );
+
+      if (!created) {
+        throw new NotFoundException(MESSAGES.PATIENT.SURGERY_NOT_FOUND);
+      }
+
+      return created;
     });
   }
 
@@ -118,20 +279,38 @@ export class BPatientsService {
   async findPatientById(actor: ActorContext, id: number) {
     const patient = await this.findPatientWithScope(id);
     this.assertPatientScope(actor, patient);
-    return patient;
+    return this.decoratePatientDetail(patient);
   }
 
   /**
-   * 更新患者信息。
+   * 更新患者基础信息。
    */
   async updatePatient(actor: ActorContext, id: number, dto: UpdatePatientDto) {
     const patient = await this.findPatientWithScope(id);
     this.assertPatientScope(actor, patient);
 
+    if (dto.initialSurgery !== undefined) {
+      throw new BadRequestException(
+        MESSAGES.PATIENT.SURGERY_UPDATE_NOT_SUPPORTED,
+      );
+    }
+
     const data: Prisma.PatientUpdateInput = {};
     if (dto.name !== undefined) {
       data.name = this.normalizeRequiredString(dto.name, 'name');
     }
+    if (dto.inpatientNo !== undefined) {
+      data.inpatientNo = this.normalizeNullableString(
+        dto.inpatientNo,
+        'inpatientNo',
+      );
+    }
+    if (dto.projectName !== undefined) {
+      data.projectName = this.normalizeNullableString(
+        dto.projectName,
+        'projectName',
+      );
+    }
     if (dto.phone !== undefined) {
       data.phone = this.normalizePhone(dto.phone);
     }
@@ -145,15 +324,13 @@ export class BPatientsService {
       data.hospital = { connect: { id: doctor.hospitalId! } };
     }
 
-    return this.prisma.patient.update({
+    const updated = await this.prisma.patient.update({
       where: { id: patient.id },
       data,
-      include: {
-        hospital: { select: { id: true, name: true } },
-        doctor: { select: { id: true, name: true, role: true } },
-        devices: true,
-      },
     });
+
+    const detail = await this.loadPatientDetail(this.prisma, updated.id);
+    return this.decoratePatientDetail(detail);
   }
 
   /**
@@ -164,14 +341,11 @@ export class BPatientsService {
     this.assertPatientScope(actor, patient);
 
     try {
-      return await this.prisma.patient.delete({
+      const deleted = await this.prisma.patient.delete({
         where: { id: patient.id },
-        include: {
+        include: PATIENT_DETAIL_INCLUDE,
-          hospital: { select: { id: true, name: true } },
-          doctor: { select: { id: true, name: true, role: true } },
-          devices: true,
-        },
       });
+      return this.decoratePatientDetail(deleted);
     } catch (error) {
       if (
         error instanceof Prisma.PrismaClientKnownRequestError &&
@@ -192,22 +366,16 @@ export class BPatientsService {
       throw new BadRequestException('id 必须为整数');
     }
 
-    const patient = await this.prisma.patient.findUnique({
+    return this.loadPatientDetail(this.prisma, patientId);
+  }
+
+  /**
+   * 统一加载患者详情。
+   */
+  private async loadPatientDetail(prisma: PrismaExecutor, patientId: number) {
+    const patient = await prisma.patient.findUnique({
       where: { id: patientId },
-      include: {
+      include: PATIENT_DETAIL_INCLUDE,
-        hospital: { select: { id: true, name: true } },
-        doctor: {
-          select: {
-            id: true,
-            name: true,
-            role: true,
-            hospitalId: true,
-            departmentId: true,
-            groupId: true,
-          },
-        },
-        devices: true,
-      },
     });
 
     if (!patient) {
@@ -380,6 +548,304 @@ export class BPatientsService {
     return actor.hospitalId;
   }
 
+  /**
+   * 创建患者手术记录并写入设备快照。
+   */
+  private async createPatientSurgeryRecord(
+    prisma: PrismaExecutor,
+    patientId: number,
+    dto: CreatePatientSurgeryDto,
+  ) {
+    if (!Array.isArray(dto.devices) || dto.devices.length === 0) {
+      throw new BadRequestException(MESSAGES.PATIENT.SURGERY_ITEMS_REQUIRED);
+    }
+
+    const catalogIds = Array.from(
+      new Set(
+        dto.devices.map((device) =>
+          this.toInt(device.implantCatalogId, 'implantCatalogId'),
+        ),
+      ),
+    );
+    const abandonedDeviceIds = Array.from(
+      new Set(dto.abandonedDeviceIds ?? []),
+    );
+
+    const [catalogMap, latestSurgery] = await Promise.all([
+      this.resolveImplantCatalogMap(prisma, catalogIds),
+      prisma.patientSurgery.findFirst({
+        where: { patientId },
+        orderBy: { surgeryDate: 'desc' },
+        select: { surgeryDate: true },
+      }),
+    ]);
+
+    if (abandonedDeviceIds.length > 0) {
+      const devices = await prisma.device.findMany({
+        where: {
+          id: { in: abandonedDeviceIds },
+          patientId,
+        },
+        select: { id: true },
+      });
+
+      if (devices.length !== abandonedDeviceIds.length) {
+        throw new ForbiddenException(
+          MESSAGES.PATIENT.ABANDON_DEVICE_SCOPE_FORBIDDEN,
+        );
+      }
+    }
+
+    const deviceDrafts = dto.devices.map((device, index) => {
+      const catalog = catalogMap.get(device.implantCatalogId);
+      if (!catalog) {
+        throw new NotFoundException(MESSAGES.PATIENT.IMPLANT_CATALOG_NOT_FOUND);
+      }
+
+      const initialPressure =
+        device.initialPressure == null
+          ? null
+          : this.assertPressureLevelAllowed(
+              catalog,
+              this.normalizeNonNegativeInteger(
+                device.initialPressure,
+                'initialPressure',
+              ),
+            );
+      const fallbackPressureLevel =
+        catalog.isPressureAdjustable && catalog.pressureLevels.length > 0
+          ? catalog.pressureLevels[0]
+          : 0;
+      const currentPressure = catalog.isPressureAdjustable
+        ? this.assertPressureLevelAllowed(
+            catalog,
+            initialPressure ?? fallbackPressureLevel,
+          )
+        : 0;
+
+      return {
+        patient: { connect: { id: patientId } },
+        implantCatalog: { connect: { id: catalog.id } },
+        snCode: this.resolveDeviceSnCode(device.snCode, patientId, index),
+        currentPressure,
+        status: DeviceStatus.ACTIVE,
+        implantModel: catalog.modelCode,
+        implantManufacturer: catalog.manufacturer,
+        implantName: catalog.name,
+        isPressureAdjustable: catalog.isPressureAdjustable,
+        isAbandoned: false,
+        shuntMode: this.normalizeRequiredString(device.shuntMode, 'shuntMode'),
+        proximalPunctureAreas: this.normalizeStringArray(
+          device.proximalPunctureAreas,
+          'proximalPunctureAreas',
+        ),
+        valvePlacementSites: this.normalizeStringArray(
+          device.valvePlacementSites,
+          'valvePlacementSites',
+        ),
+        distalShuntDirection: this.normalizeRequiredString(
+          device.distalShuntDirection,
+          'distalShuntDirection',
+        ),
+        initialPressure,
+        implantNotes:
+          device.implantNotes === undefined
+            ? undefined
+            : this.normalizeNullableString(device.implantNotes, 'implantNotes'),
+        labelImageUrl:
+          device.labelImageUrl === undefined
+            ? undefined
+            : this.normalizeNullableString(
+                device.labelImageUrl,
+                'labelImageUrl',
+              ),
+      };
+    });
+
+    await this.assertSnCodesUnique(
+      prisma,
+      deviceDrafts.map((device) => device.snCode),
+    );
+
+    const surgery = await prisma.patientSurgery.create({
+      data: {
+        patientId,
+        surgeryDate: this.normalizeIsoDate(dto.surgeryDate, 'surgeryDate'),
+        surgeryName: this.normalizeRequiredString(
+          dto.surgeryName,
+          'surgeryName',
+        ),
+        surgeonName: this.normalizeRequiredString(
+          dto.surgeonName,
+          'surgeonName',
+        ),
+        preOpPressure:
+          dto.preOpPressure == null
+            ? null
+            : this.normalizeNonNegativeInteger(
+                dto.preOpPressure,
+                'preOpPressure',
+              ),
+        primaryDisease: this.normalizeRequiredString(
+          dto.primaryDisease,
+          'primaryDisease',
+        ),
+        hydrocephalusTypes: this.normalizeStringArray(
+          dto.hydrocephalusTypes,
+          'hydrocephalusTypes',
+        ),
+        previousShuntSurgeryDate: dto.previousShuntSurgeryDate
+          ? this.normalizeIsoDate(
+              dto.previousShuntSurgeryDate,
+              'previousShuntSurgeryDate',
+            )
+          : (latestSurgery?.surgeryDate ?? null),
+        preOpMaterials:
+          dto.preOpMaterials == null
+            ? undefined
+            : this.normalizePreOpMaterials(dto.preOpMaterials),
+        notes:
+          dto.notes === undefined
+            ? undefined
+            : this.normalizeNullableString(dto.notes, 'notes'),
+        devices: {
+          create: deviceDrafts,
+        },
+      },
+      include: PATIENT_SURGERY_DETAIL_INCLUDE,
+    });
+
+    if (abandonedDeviceIds.length > 0) {
+      await prisma.device.updateMany({
+        where: {
+          id: { in: abandonedDeviceIds },
+          patientId,
+        },
+        data: {
+          isAbandoned: true,
+          status: DeviceStatus.INACTIVE,
+        },
+      });
+    }
+
+    return surgery;
+  }
+
+  /**
+   * 解析并校验植入物型号字典。
+   */
+  private async resolveImplantCatalogMap(
+    prisma: PrismaExecutor,
+    implantCatalogIds: number[],
+  ) {
+    if (implantCatalogIds.length === 0) {
+      return new Map<
+        number,
+        Awaited<ReturnType<typeof prisma.implantCatalog.findFirst>>
+      >();
+    }
+
+    const catalogs = await prisma.implantCatalog.findMany({
+      where: {
+        id: { in: implantCatalogIds },
+      },
+      select: IMPLANT_CATALOG_SELECT,
+    });
+
+    if (catalogs.length !== implantCatalogIds.length) {
+      throw new NotFoundException(MESSAGES.PATIENT.IMPLANT_CATALOG_NOT_FOUND);
+    }
+
+    return new Map(catalogs.map((catalog) => [catalog.id, catalog]));
+  }
+
+  /**
+   * 可调压植入物若配置了挡位，录入压力时必须命中其中一项。
+   */
+  private assertPressureLevelAllowed(
+    catalog: {
+      isPressureAdjustable: boolean;
+      pressureLevels: number[];
+    },
+    pressure: number,
+  ) {
+    if (
+      catalog.isPressureAdjustable &&
+      Array.isArray(catalog.pressureLevels) &&
+      catalog.pressureLevels.length > 0 &&
+      !catalog.pressureLevels.includes(pressure)
+    ) {
+      throw new BadRequestException(MESSAGES.DEVICE.PRESSURE_LEVEL_INVALID);
+    }
+
+    return pressure;
+  }
+
+  /**
+   * 将患者详情补全为前端可直接消费的结构。
+   */
+  private decoratePatientDetail(
+    patient: Awaited<ReturnType<BPatientsService['findPatientWithScope']>>,
+  ) {
+    const surgeries = this.decorateSurgeries(patient.surgeries);
+
+    return {
+      ...patient,
+      surgeries,
+      shuntSurgeryCount: surgeries.length,
+      latestSurgery: surgeries[0] ?? null,
+      activeDeviceCount: patient.devices.filter(
+        (device) =>
+          device.status === DeviceStatus.ACTIVE && !device.isAbandoned,
+      ).length,
+      abandonedDeviceCount: patient.devices.filter(
+        (device) => device.isAbandoned,
+      ).length,
+    };
+  }
+
+  /**
+   * 计算每次手术的自动分流手术次数。
+   */
+  private decorateSurgeries<
+    TSurgery extends {
+      id: number;
+      surgeryDate: Date;
+      devices: Array<{
+        id: number;
+        status: DeviceStatus;
+        isAbandoned: boolean;
+      }>;
+    },
+  >(surgeries: TSurgery[]) {
+    const sortedAsc = [...surgeries].sort(
+      (left, right) =>
+        new Date(left.surgeryDate).getTime() -
+        new Date(right.surgeryDate).getTime(),
+    );
+    const sequenceById = new Map(
+      sortedAsc.map((surgery, index) => [surgery.id, index + 1] as const),
+    );
+
+    return [...surgeries]
+      .sort(
+        (left, right) =>
+          new Date(right.surgeryDate).getTime() -
+          new Date(left.surgeryDate).getTime(),
+      )
+      .map((surgery) => ({
+        ...surgery,
+        shuntSurgeryCount: sequenceById.get(surgery.id) ?? surgeries.length,
+        activeDeviceCount: surgery.devices.filter(
+          (device) =>
+            device.status === DeviceStatus.ACTIVE && !device.isAbandoned,
+        ).length,
+        abandonedDeviceCount: surgery.devices.filter(
+          (device) => device.isAbandoned,
+        ).length,
+      }));
+  }
+
   private normalizeRequiredString(value: unknown, fieldName: string) {
     if (typeof value !== 'string') {
       throw new BadRequestException(`${fieldName} 必须是字符串`);
@@ -391,6 +857,14 @@ export class BPatientsService {
     return trimmed;
   }
 
+  private normalizeNullableString(value: unknown, fieldName: string) {
+    if (typeof value !== 'string') {
+      throw new BadRequestException(`${fieldName} 必须是字符串`);
+    }
+    const trimmed = value.trim();
+    return trimmed || null;
+  }
+
   private normalizePhone(phone: unknown) {
     const normalized = this.normalizeRequiredString(phone, 'phone');
     if (!/^1\d{10}$/.test(normalized)) {
@@ -406,4 +880,91 @@ export class BPatientsService {
     const normalized = this.normalizeRequiredString(value, 'idCard');
     return normalizePatientIdCard(normalized);
   }
+
+  private normalizeIsoDate(value: unknown, fieldName: string) {
+    const normalized = this.normalizeRequiredString(value, fieldName);
+    const parsed = new Date(normalized);
+    if (Number.isNaN(parsed.getTime())) {
+      throw new BadRequestException(`${fieldName} 必须是合法日期`);
+    }
+    return parsed;
+  }
+
+  private normalizeNonNegativeInteger(value: unknown, fieldName: string) {
+    const parsed = Number(value);
+    if (!Number.isInteger(parsed) || parsed < 0) {
+      throw new BadRequestException(`${fieldName} 必须是大于等于 0 的整数`);
+    }
+    return parsed;
+  }
+
+  private normalizeStringArray(value: unknown, fieldName: string) {
+    if (!Array.isArray(value) || value.length === 0) {
+      throw new BadRequestException(`${fieldName} 必须为非空数组`);
+    }
+
+    return Array.from(
+      new Set(
+        value.map((item) => this.normalizeRequiredString(item, fieldName)),
+      ),
+    );
+  }
+
+  private normalizePreOpMaterials(
+    materials: CreatePatientSurgeryDto['preOpMaterials'],
+  ): Prisma.InputJsonArray {
+    if (!Array.isArray(materials)) {
+      throw new BadRequestException('preOpMaterials 必须是数组');
+    }
+
+    return materials.map((material) => ({
+      type: this.normalizeRequiredString(material.type, 'type'),
+      url: this.normalizeRequiredString(material.url, 'url'),
+      name:
+        material.name === undefined
+          ? null
+          : this.normalizeNullableString(material.name, 'name'),
+    })) as Prisma.InputJsonArray;
+  }
+
+  private resolveDeviceSnCode(
+    snCode: string | undefined,
+    patientId: number,
+    index: number,
+  ) {
+    if (snCode) {
+      return this.normalizeRequiredString(snCode, 'snCode').toUpperCase();
+    }
+
+    return `SURG-${patientId}-${Date.now()}-${index + 1}-${randomUUID()
+      .slice(0, 8)
+      .toUpperCase()}`;
+  }
+
+  private async assertSnCodesUnique(prisma: PrismaExecutor, snCodes: string[]) {
+    const uniqueSnCodes = Array.from(new Set(snCodes));
+    if (uniqueSnCodes.length !== snCodes.length) {
+      throw new ConflictException(MESSAGES.DEVICE.SN_CODE_DUPLICATE);
+    }
+
+    const existing = await prisma.device.findMany({
+      where: {
+        snCode: { in: uniqueSnCodes },
+      },
+      select: { id: true },
+      take: 1,
+    });
+
+    if (existing.length > 0) {
+      throw new ConflictException(MESSAGES.DEVICE.SN_CODE_DUPLICATE);
+    }
+  }
+
+  private toInt(value: unknown, fieldName: string) {
+    const parsed = Number(value);
+    if (!Number.isInteger(parsed) || parsed <= 0) {
+      throw new BadRequestException(`${fieldName} 必须为正整数`);
+    }
+    return parsed;
+  }
 }

src/patients/c-patients/c-patients.service.ts

@@ -32,8 +32,46 @@ export class CPatientsService {
       },
       include: {
         hospital: { select: { id: true, name: true } },
+        surgeries: {
+          include: {
             devices: {
               include: {
+                implantCatalog: {
+                  select: {
+                    id: true,
+                    modelCode: true,
+                    manufacturer: true,
+                    name: true,
+                    pressureLevels: true,
+                    isPressureAdjustable: true,
+                    notes: true,
+                  },
+                },
+              },
+            },
+          },
+          orderBy: { surgeryDate: 'desc' },
+        },
+        devices: {
+          include: {
+            surgery: {
+              select: {
+                id: true,
+                surgeryDate: true,
+                surgeryName: true,
+              },
+            },
+            implantCatalog: {
+              select: {
+                id: true,
+                modelCode: true,
+                manufacturer: true,
+                name: true,
+                pressureLevels: true,
+                isPressureAdjustable: true,
+                notes: true,
+              },
+            },
             taskItems: {
               include: {
                 task: true,
@@ -48,8 +86,49 @@ export class CPatientsService {
     }
 
     const lifecycle = patients
-      .flatMap((patient) =>
+      .flatMap((patient) => {
-        patient.devices.flatMap((device) =>
+        const surgeryEvents = patient.surgeries.map(
+          (surgery, index, surgeries) => ({
+            eventType: 'SURGERY',
+            occurredAt: surgery.surgeryDate,
+            hospital: patient.hospital,
+            patient: {
+              id: this.toJsonNumber(patient.id),
+              name: patient.name,
+              inpatientNo: patient.inpatientNo,
+              projectName: patient.projectName,
+            },
+            surgery: {
+              id: this.toJsonNumber(surgery.id),
+              surgeryDate: surgery.surgeryDate,
+              surgeryName: surgery.surgeryName,
+              surgeonName: surgery.surgeonName,
+              primaryDisease: surgery.primaryDisease,
+              hydrocephalusTypes: surgery.hydrocephalusTypes,
+              previousShuntSurgeryDate: surgery.previousShuntSurgeryDate,
+              shuntSurgeryCount: surgeries.length - index,
+            },
+            devices: surgery.devices.map((device) => ({
+              id: this.toJsonNumber(device.id),
+              snCode: device.snCode,
+              status: device.status,
+              isAbandoned: device.isAbandoned,
+              currentPressure: this.toJsonNumber(device.currentPressure),
+              initialPressure: this.toJsonNumber(device.initialPressure),
+              implantModel: device.implantModel,
+              implantManufacturer: device.implantManufacturer,
+              implantName: device.implantName,
+              isPressureAdjustable: device.isPressureAdjustable,
+              shuntMode: device.shuntMode,
+              distalShuntDirection: device.distalShuntDirection,
+              proximalPunctureAreas: device.proximalPunctureAreas,
+              valvePlacementSites: device.valvePlacementSites,
+              implantCatalog: device.implantCatalog,
+            })),
+          }),
+        );
+
+        const taskEvents = patient.devices.flatMap((device) =>
           device.taskItems.flatMap((taskItem) => {
             // 容错：若存在脏数据导致 task 为空，直接跳过该条明细，避免接口 500。
             if (!taskItem.task) {
@@ -65,13 +144,27 @@ export class CPatientsService {
                 patient: {
                   id: this.toJsonNumber(patient.id),
                   name: patient.name,
+                  inpatientNo: patient.inpatientNo,
+                  projectName: patient.projectName,
                 },
                 device: {
                   id: this.toJsonNumber(device.id),
                   snCode: device.snCode,
                   status: device.status,
+                  isAbandoned: device.isAbandoned,
                   currentPressure: this.toJsonNumber(device.currentPressure),
+                  implantModel: device.implantModel,
+                  implantManufacturer: device.implantManufacturer,
+                  implantName: device.implantName,
+                  isPressureAdjustable: device.isPressureAdjustable,
                 },
+                surgery: device.surgery
+                  ? {
+                      id: this.toJsonNumber(device.surgery.id),
+                      surgeryDate: device.surgery.surgeryDate,
+                      surgeryName: device.surgery.surgeryName,
+                    }
+                  : null,
                 task: {
                   id: this.toJsonNumber(task.id),
                   status: task.status,
@@ -85,8 +178,10 @@ export class CPatientsService {
               },
             ];
           }),
-        ),
+        );
-      )
+
+        return [...surgeryEvents, ...taskEvents];
+      })
       .sort(
         (a, b) =>
           new Date(b.occurredAt).getTime() - new Date(a.occurredAt).getTime(),

src/patients/dto/create-patient-surgery.dto.ts

@@ -0,0 +1,116 @@
+import { ApiProperty, ApiPropertyOptional } from '@nestjs/swagger';
+import { Type } from 'class-transformer';
+import {
+  ArrayMinSize,
+  ArrayUnique,
+  IsArray,
+  IsISO8601,
+  IsInt,
+  IsOptional,
+  IsString,
+  Min,
+  ValidateNested,
+} from 'class-validator';
+import { CreateSurgeryDeviceDto } from './create-surgery-device.dto.js';
+import { SurgeryMaterialDto } from './surgery-material.dto.js';
+
+/**
+ * 患者手术 DTO：支持首术与二次手术录入。
+ */
+export class CreatePatientSurgeryDto {
+  @ApiProperty({
+    description: '手术日期',
+    example: '2026-03-19T08:00:00.000Z',
+  })
+  @IsISO8601({}, { message: 'surgeryDate 必须是合法 ISO 日期' })
+  surgeryDate!: string;
+
+  @ApiProperty({
+    description: '手术名称',
+    example: '脑室腹腔分流术',
+  })
+  @IsString({ message: 'surgeryName 必须是字符串' })
+  surgeryName!: string;
+
+  @ApiProperty({
+    description: '主刀医生',
+    example: '张主任',
+  })
+  @IsString({ message: 'surgeonName 必须是字符串' })
+  surgeonName!: string;
+
+  @ApiPropertyOptional({
+    description: '术前测压，可为空',
+    example: 22,
+  })
+  @IsOptional()
+  @Type(() => Number)
+  @IsInt({ message: 'preOpPressure 必须是整数' })
+  preOpPressure?: number;
+
+  @ApiProperty({
+    description: '原发病',
+    example: '梗阻性脑积水',
+  })
+  @IsString({ message: 'primaryDisease 必须是字符串' })
+  primaryDisease!: string;
+
+  @ApiProperty({
+    description: '脑积水类型，多选',
+    type: [String],
+    example: ['交通性', '高压性'],
+  })
+  @IsArray({ message: 'hydrocephalusTypes 必须是数组' })
+  @ArrayMinSize(1, { message: 'hydrocephalusTypes 至少选择 1 项' })
+  @IsString({ each: true, message: 'hydrocephalusTypes 必须为字符串数组' })
+  hydrocephalusTypes!: string[];
+
+  @ApiPropertyOptional({
+    description: '上次分流手术时间，可为空',
+    example: '2024-08-01T00:00:00.000Z',
+  })
+  @IsOptional()
+  @IsISO8601({}, { message: 'previousShuntSurgeryDate 必须是合法 ISO 日期' })
+  previousShuntSurgeryDate?: string;
+
+  @ApiPropertyOptional({
+    description: '手术备注',
+    example: '二次手术，弃用原右侧分流装置',
+  })
+  @IsOptional()
+  @IsString({ message: 'notes 必须是字符串' })
+  notes?: string;
+
+  @ApiPropertyOptional({
+    description: '术前 CT 影像/资料',
+    type: [SurgeryMaterialDto],
+  })
+  @IsOptional()
+  @IsArray({ message: 'preOpMaterials 必须是数组' })
+  @ValidateNested({ each: true })
+  @Type(() => SurgeryMaterialDto)
+  preOpMaterials?: SurgeryMaterialDto[];
+
+  @ApiProperty({
+    description: '本次手术植入设备列表',
+    type: [CreateSurgeryDeviceDto],
+  })
+  @IsArray({ message: 'devices 必须是数组' })
+  @ArrayMinSize(1, { message: 'devices 至少录入 1 个设备' })
+  @ValidateNested({ each: true })
+  @Type(() => CreateSurgeryDeviceDto)
+  devices!: CreateSurgeryDeviceDto[];
+
+  @ApiPropertyOptional({
+    description: '本次手术后需弃用的历史设备 ID 列表',
+    type: [Number],
+    example: [1],
+  })
+  @IsOptional()
+  @IsArray({ message: 'abandonedDeviceIds 必须是数组' })
+  @ArrayUnique({ message: 'abandonedDeviceIds 不能重复' })
+  @Type(() => Number)
+  @IsInt({ each: true, message: 'abandonedDeviceIds 必须为整数数组' })
+  @Min(1, { each: true, message: 'abandonedDeviceIds 必须大于 0' })
+  abandonedDeviceIds?: number[];
+}

src/patients/dto/create-patient.dto.ts

@@ -1,6 +1,14 @@
-import { ApiProperty } from '@nestjs/swagger';
+import { ApiProperty, ApiPropertyOptional } from '@nestjs/swagger';
 import { Type } from 'class-transformer';
-import { IsInt, IsString, Matches, Min } from 'class-validator';
+import {
+  IsInt,
+  IsOptional,
+  IsString,
+  Matches,
+  Min,
+  ValidateNested,
+} from 'class-validator';
+import { CreatePatientSurgeryDto } from './create-patient-surgery.dto.js';
 
 /**
  * 患者创建 DTO：B 端新增患者使用。
@@ -10,6 +18,16 @@ export class CreatePatientDto {
   @IsString({ message: 'name 必须是字符串' })
   name!: string;
 
+  @ApiPropertyOptional({ description: '住院号', example: 'ZYH-20260319001' })
+  @IsOptional()
+  @IsString({ message: 'inpatientNo 必须是字符串' })
+  inpatientNo?: string;
+
+  @ApiPropertyOptional({ description: '项目名称', example: '脑积水随访项目' })
+  @IsOptional()
+  @IsString({ message: 'projectName 必须是字符串' })
+  projectName?: string;
+
   @ApiProperty({ description: '手机号', example: '13800002001' })
   @IsString({ message: 'phone 必须是字符串' })
   @Matches(/^1\d{10}$/, { message: 'phone 必须是合法手机号' })
@@ -27,4 +45,13 @@ export class CreatePatientDto {
   @IsInt({ message: 'doctorId 必须是整数' })
   @Min(1, { message: 'doctorId 必须大于 0' })
   doctorId!: number;
+
+  @ApiPropertyOptional({
+    description: '首台手术信息，可在创建患者时一并录入',
+    type: CreatePatientSurgeryDto,
+  })
+  @IsOptional()
+  @ValidateNested()
+  @Type(() => CreatePatientSurgeryDto)
+  initialSurgery?: CreatePatientSurgeryDto;
 }

src/patients/dto/create-surgery-device.dto.ts

@@ -0,0 +1,95 @@
+import { ApiProperty, ApiPropertyOptional } from '@nestjs/swagger';
+import { Type } from 'class-transformer';
+import {
+  ArrayMaxSize,
+  ArrayMinSize,
+  IsArray,
+  IsInt,
+  IsOptional,
+  IsString,
+  Min,
+} from 'class-validator';
+
+/**
+ * 手术下设备 DTO：描述一次手术中植入的设备实例。
+ */
+export class CreateSurgeryDeviceDto {
+  @ApiProperty({
+    description: '植入物型号 ID，选中后自动回填厂家与名称',
+    example: 1,
+  })
+  @Type(() => Number)
+  @IsInt({ message: 'implantCatalogId 必须是整数' })
+  @Min(1, { message: 'implantCatalogId 必须大于 0' })
+  implantCatalogId!: number;
+
+  @ApiPropertyOptional({
+    description: '设备 SN，可不传；不传时系统自动生成',
+    example: 'TYT-SHUNT-001',
+  })
+  @IsOptional()
+  @IsString({ message: 'snCode 必须是字符串' })
+  snCode?: string;
+
+  @ApiProperty({
+    description: '分流方式',
+    example: 'VPS',
+  })
+  @IsString({ message: 'shuntMode 必须是字符串' })
+  shuntMode!: string;
+
+  @ApiProperty({
+    description: '近端穿刺区域，最多 2 个',
+    type: [String],
+    example: ['额角', '枕角'],
+  })
+  @IsArray({ message: 'proximalPunctureAreas 必须是数组' })
+  @ArrayMinSize(1, { message: 'proximalPunctureAreas 至少选择 1 项' })
+  @ArrayMaxSize(2, { message: 'proximalPunctureAreas 最多选择 2 项' })
+  @IsString({ each: true, message: 'proximalPunctureAreas 必须为字符串数组' })
+  proximalPunctureAreas!: string[];
+
+  @ApiProperty({
+    description: '阀门植入部位，最多 2 个',
+    type: [String],
+    example: ['耳后', '胸前'],
+  })
+  @IsArray({ message: 'valvePlacementSites 必须是数组' })
+  @ArrayMinSize(1, { message: 'valvePlacementSites 至少选择 1 项' })
+  @ArrayMaxSize(2, { message: 'valvePlacementSites 最多选择 2 项' })
+  @IsString({ each: true, message: 'valvePlacementSites 必须为字符串数组' })
+  valvePlacementSites!: string[];
+
+  @ApiProperty({
+    description: '远端分流方向',
+    example: '腹腔',
+  })
+  @IsString({ message: 'distalShuntDirection 必须是字符串' })
+  distalShuntDirection!: string;
+
+  @ApiPropertyOptional({
+    description: '初始压力，可为空',
+    example: 120,
+  })
+  @IsOptional()
+  @Type(() => Number)
+  @IsInt({ message: 'initialPressure 必须是整数' })
+  @Min(0, { message: 'initialPressure 必须大于等于 0' })
+  initialPressure?: number;
+
+  @ApiPropertyOptional({
+    description: '植入物备注',
+    example: '术中顺利，通畅良好',
+  })
+  @IsOptional()
+  @IsString({ message: 'implantNotes 必须是字符串' })
+  implantNotes?: string;
+
+  @ApiPropertyOptional({
+    description: '植入物标签图片地址',
+    example: 'https://cdn.example.com/patients/device-label-001.jpg',
+  })
+  @IsOptional()
+  @IsString({ message: 'labelImageUrl 必须是字符串' })
+  labelImageUrl?: string;
+}

src/patients/dto/surgery-material.dto.ts

@@ -0,0 +1,32 @@
+import { ApiProperty, ApiPropertyOptional } from '@nestjs/swagger';
+import { IsIn, IsOptional, IsString } from 'class-validator';
+
+/**
+ * 手术资料 DTO：用于术前 CT 影像/视频等附件元数据。
+ */
+export class SurgeryMaterialDto {
+  @ApiProperty({
+    description: '资料类型',
+    enum: ['IMAGE', 'VIDEO', 'FILE'],
+    example: 'IMAGE',
+  })
+  @IsIn(['IMAGE', 'VIDEO', 'FILE'], {
+    message: 'type 必须是 IMAGE、VIDEO 或 FILE',
+  })
+  type!: 'IMAGE' | 'VIDEO' | 'FILE';
+
+  @ApiProperty({
+    description: '资料访问地址',
+    example: 'https://cdn.example.com/patients/ct-001.png',
+  })
+  @IsString({ message: 'url 必须是字符串' })
+  url!: string;
+
+  @ApiPropertyOptional({
+    description: '资料名称',
+    example: '术前 CT 第 1 张',
+  })
+  @IsOptional()
+  @IsString({ message: 'name 必须是字符串' })
+  name?: string;
+}

src/tasks/task.service.ts

@@ -56,9 +56,19 @@ export class TaskService {
       where: {
         id: { in: deviceIds },
         status: DeviceStatus.ACTIVE,
+        isAbandoned: false,
+        isPressureAdjustable: true,
         patient: { hospitalId },
       },
-      select: { id: true, currentPressure: true },
+      select: {
+        id: true,
+        currentPressure: true,
+        implantCatalog: {
+          select: {
+            pressureLevels: true,
+          },
+        },
+      },
     });
 
     if (devices.length !== deviceIds.length) {
@@ -82,6 +92,24 @@ export class TaskService {
     const pressureByDeviceId = new Map(
       devices.map((device) => [device.id, device.currentPressure] as const),
     );
+    const pressureLevelsByDeviceId = new Map(
+      devices.map((device) => [
+        device.id,
+        Array.isArray(device.implantCatalog?.pressureLevels)
+          ? device.implantCatalog.pressureLevels
+          : [],
+      ]),
+    );
+
+    dto.items.forEach((item) => {
+      const pressureLevels = pressureLevelsByDeviceId.get(item.deviceId) ?? [];
+      if (
+        pressureLevels.length > 0 &&
+        !pressureLevels.includes(item.targetPressure)
+      ) {
+        throw new BadRequestException(MESSAGES.DEVICE.PRESSURE_LEVEL_INVALID);
+      }
+    });
 
     const task = await this.prisma.task.create({
       data: {

src/users/b-users/b-users.controller.ts

@@ -1,5 +1,10 @@
 import { Body, Controller, Param, Patch, UseGuards } from '@nestjs/common';
-import { ApiBearerAuth, ApiOperation, ApiParam, ApiTags } from '@nestjs/swagger';
+import {
+  ApiBearerAuth,
+  ApiOperation,
+  ApiParam,
+  ApiTags,
+} from '@nestjs/swagger';
 import type { ActorContext } from '../../common/actor-context.js';
 import { CurrentActor } from '../../auth/current-actor.decorator.js';
 import { AccessTokenGuard } from '../../auth/access-token.guard.js';

src/users/dto/create-user.dto.ts

@@ -31,7 +31,10 @@ export class CreateUserDto {
   @MinLength(8, { message: 'password 长度至少 8 位' })
   password?: string;
 
-  @ApiPropertyOptional({ description: '微信 openId', example: 'wx-open-id-demo' })
+  @ApiPropertyOptional({
+    description: '微信 openId',
+    example: 'wx-open-id-demo',
+  })
   @IsOptional()
   @IsString({ message: 'openId 必须是字符串' })
   openId?: string;

src/users/dto/login.dto.ts

@@ -30,7 +30,10 @@ export class LoginDto {
   @IsEnum(Role, { message: 'role 枚举值不合法' })
   role!: Role;
 
-  @ApiPropertyOptional({ description: '医院 ID（多账号场景建议传入）', example: 1 })
+  @ApiPropertyOptional({
+    description: '医院 ID（多账号场景建议传入）',
+    example: 1,
+  })
   @IsOptional()
   @EmptyStringToUndefined()
   @Type(() => Number)

test/e2e/specs/devices.e2e-spec.ts

@@ -29,7 +29,6 @@ describe('BDevicesController (e2e)', () => {
       .set('Authorization', `Bearer ${token}`)
       .send({
         snCode: uniqueSeedValue('device-sn'),
-        currentPressure: 118,
         status: DeviceStatus.ACTIVE,
         patientId,
       });
@@ -38,6 +37,7 @@ describe('BDevicesController (e2e)', () => {
     return response.body.data as {
       id: number;
       snCode: string;
+      currentPressure: number;
       status: DeviceStatus;
       patient: { id: number };
     };
@@ -95,6 +95,91 @@ describe('BDevicesController (e2e)', () => {
     });
   });
 
+  describe('植入物型号字典', () => {
+    it('成功：DOCTOR 可查询可见型号字典', async () => {
+      const response = await request(ctx.app.getHttpServer())
+        .get('/b/devices/catalogs')
+        .set('Authorization', `Bearer ${ctx.tokens[Role.DOCTOR]}`);
+
+      expectSuccessEnvelope(response, 200);
+      expect(
+        (response.body.data as Array<{ modelCode: string }>).some(
+          (item) => item.modelCode === 'SEED-ADJUSTABLE-VALVE',
+        ),
+      ).toBe(true);
+    });
+
+    it('成功：SYSTEM_ADMIN 可新增、更新并删除全局植入物目录', async () => {
+      const createResponse = await request(ctx.app.getHttpServer())
+        .post('/b/devices/catalogs')
+        .set('Authorization', `Bearer ${ctx.tokens[Role.SYSTEM_ADMIN]}`)
+        .send({
+          modelCode: uniqueSeedValue('catalog').toUpperCase(),
+          manufacturer: 'Global Vendor',
+          name: '全局可调压阀',
+          isPressureAdjustable: true,
+          pressureLevels: [70, 90, 110],
+          notes: '测试全局目录',
+        });
+
+      expectSuccessEnvelope(createResponse, 201);
+      expect(createResponse.body.data.pressureLevels).toEqual([70, 90, 110]);
+
+      const updateResponse = await request(ctx.app.getHttpServer())
+        .patch(`/b/devices/catalogs/${createResponse.body.data.id}`)
+        .set('Authorization', `Bearer ${ctx.tokens[Role.SYSTEM_ADMIN]}`)
+        .send({
+          name: '全局可调压阀-更新版',
+          pressureLevels: [80, 100, 120],
+        });
+
+      expectSuccessEnvelope(updateResponse, 200);
+      expect(updateResponse.body.data.name).toBe('全局可调压阀-更新版');
+      expect(updateResponse.body.data.pressureLevels).toEqual([80, 100, 120]);
+
+      const deleteResponse = await request(ctx.app.getHttpServer())
+        .delete(`/b/devices/catalogs/${createResponse.body.data.id}`)
+        .set('Authorization', `Bearer ${ctx.tokens[Role.SYSTEM_ADMIN]}`);
+
+      expectSuccessEnvelope(deleteResponse, 200);
+      expect(deleteResponse.body.data.id).toBe(createResponse.body.data.id);
+    });
+
+    it('角色矩阵：仅 SYSTEM_ADMIN 可维护全局植入物目录', async () => {
+      await assertRoleMatrix({
+        name: 'POST /b/devices/catalogs role matrix',
+        tokens: ctx.tokens,
+        expectedStatusByRole: {
+          [Role.SYSTEM_ADMIN]: 201,
+          [Role.HOSPITAL_ADMIN]: 403,
+          [Role.DIRECTOR]: 403,
+          [Role.LEADER]: 403,
+          [Role.DOCTOR]: 403,
+          [Role.ENGINEER]: 403,
+        },
+        sendAsRole: async (_role, token) =>
+          request(ctx.app.getHttpServer())
+            .post('/b/devices/catalogs')
+            .set('Authorization', `Bearer ${token}`)
+            .send({
+              modelCode: uniqueSeedValue('catalog-role').toUpperCase(),
+              manufacturer: 'Role Matrix Vendor',
+              name: '角色矩阵目录',
+              isPressureAdjustable: true,
+              pressureLevels: [50, 80],
+            }),
+        sendWithoutToken: async () =>
+          request(ctx.app.getHttpServer())
+            .post('/b/devices/catalogs')
+            .send({
+              modelCode: uniqueSeedValue('catalog-anon').toUpperCase(),
+              manufacturer: 'Anon Vendor',
+              name: '匿名目录',
+            }),
+      });
+    });
+  });
+
   describe('设备 CRUD 流程', () => {
     it('成功：HOSPITAL_ADMIN 可创建设备', async () => {
       const created = await createDevice(
@@ -103,6 +188,7 @@ describe('BDevicesController (e2e)', () => {
       );
 
       expect(created.status).toBe(DeviceStatus.ACTIVE);
+      expect(created.currentPressure).toBe(0);
       expect(created.patient.id).toBe(ctx.fixtures.patients.patientA1Id);
       expect(created.snCode).toMatch(/^DEVICE-SN-/);
     });
@@ -113,7 +199,6 @@ describe('BDevicesController (e2e)', () => {
         .set('Authorization', `Bearer ${ctx.tokens[Role.HOSPITAL_ADMIN]}`)
         .send({
           snCode: uniqueSeedValue('cross-hospital-device'),
-          currentPressure: 120,
           status: DeviceStatus.ACTIVE,
           patientId: ctx.fixtures.patients.patientB1Id,
         });
@@ -133,7 +218,6 @@ describe('BDevicesController (e2e)', () => {
         .send({
           status: DeviceStatus.INACTIVE,
           patientId: ctx.fixtures.patients.patientA2Id,
-          currentPressure: 99,
         });
 
       expectSuccessEnvelope(response, 200);
@@ -141,7 +225,23 @@ describe('BDevicesController (e2e)', () => {
       expect(response.body.data.patient.id).toBe(
         ctx.fixtures.patients.patientA2Id,
       );
-      expect(response.body.data.currentPressure).toBe(99);
+      expect(response.body.data.currentPressure).toBe(0);
+    });
+
+    it('失败：设备实例接口不允许手工更新 currentPressure', async () => {
+      const created = await createDevice(
+        ctx.tokens[Role.SYSTEM_ADMIN],
+        ctx.fixtures.patients.patientA1Id,
+      );
+
+      const response = await request(ctx.app.getHttpServer())
+        .patch(`/b/devices/${created.id}`)
+        .set('Authorization', `Bearer ${ctx.tokens[Role.SYSTEM_ADMIN]}`)
+        .send({
+          currentPressure: 99,
+        });
+
+      expectErrorEnvelope(response, 400, 'currentPressure should not exist');
     });
 
     it('成功：SYSTEM_ADMIN 可删除未被任务引用的设备', async () => {

test/e2e/specs/dictionaries.e2e-spec.ts

@@ -0,0 +1,133 @@
+import request from 'supertest';
+import { Role } from '../../../src/generated/prisma/enums.js';
+import {
+  closeE2EContext,
+  createE2EContext,
+  type E2EContext,
+} from '../helpers/e2e-context.helper.js';
+import {
+  expectSuccessEnvelope,
+  uniqueSeedValue,
+} from '../helpers/e2e-http.helper.js';
+import { assertRoleMatrix } from '../helpers/e2e-matrix.helper.js';
+
+describe('BDictionariesController (e2e)', () => {
+  let ctx: E2EContext;
+
+  beforeAll(async () => {
+    ctx = await createE2EContext();
+  });
+
+  afterAll(async () => {
+    await closeE2EContext(ctx);
+  });
+
+  describe('GET /b/dictionaries', () => {
+    it('成功：DOCTOR 可查询启用中的系统字典', async () => {
+      const response = await request(ctx.app.getHttpServer())
+        .get('/b/dictionaries')
+        .query({ type: 'PRIMARY_DISEASE' })
+        .set('Authorization', `Bearer ${ctx.tokens[Role.DOCTOR]}`);
+
+      expectSuccessEnvelope(response, 200);
+      expect(
+        (response.body.data as Array<{ label: string; enabled: boolean }>).some(
+          (item) => item.label === '先天性脑积水' && item.enabled === true,
+        ),
+      ).toBe(true);
+    });
+  });
+
+  describe('字典维护流程', () => {
+    it('成功：SYSTEM_ADMIN 可新增、更新、删除字典项，非管理员读取不到停用项', async () => {
+      const createLabel = uniqueSeedValue('字典项');
+      const updateLabel = `${createLabel}-启用`;
+
+      const createResponse = await request(ctx.app.getHttpServer())
+        .post('/b/dictionaries')
+        .set('Authorization', `Bearer ${ctx.tokens[Role.SYSTEM_ADMIN]}`)
+        .send({
+          type: 'SHUNT_MODE',
+          label: createLabel,
+          sortOrder: 999,
+          enabled: false,
+        });
+
+      expectSuccessEnvelope(createResponse, 201);
+      const createdId = createResponse.body.data.id as number;
+
+      const doctorReadResponse = await request(ctx.app.getHttpServer())
+        .get('/b/dictionaries')
+        .query({ type: 'SHUNT_MODE' })
+        .set('Authorization', `Bearer ${ctx.tokens[Role.DOCTOR]}`);
+
+      expectSuccessEnvelope(doctorReadResponse, 200);
+      expect(
+        (doctorReadResponse.body.data as Array<{ label: string }>).some(
+          (item) => item.label === createLabel,
+        ),
+      ).toBe(false);
+
+      const adminReadResponse = await request(ctx.app.getHttpServer())
+        .get('/b/dictionaries')
+        .query({ type: 'SHUNT_MODE', includeDisabled: true })
+        .set('Authorization', `Bearer ${ctx.tokens[Role.SYSTEM_ADMIN]}`);
+
+      expectSuccessEnvelope(adminReadResponse, 200);
+      expect(
+        (adminReadResponse.body.data as Array<{ label: string }>).some(
+          (item) => item.label === createLabel,
+        ),
+      ).toBe(true);
+
+      const updateResponse = await request(ctx.app.getHttpServer())
+        .patch(`/b/dictionaries/${createdId}`)
+        .set('Authorization', `Bearer ${ctx.tokens[Role.SYSTEM_ADMIN]}`)
+        .send({
+          label: updateLabel,
+          enabled: true,
+        });
+
+      expectSuccessEnvelope(updateResponse, 200);
+      expect(updateResponse.body.data.label).toBe(updateLabel);
+      expect(updateResponse.body.data.enabled).toBe(true);
+
+      const deleteResponse = await request(ctx.app.getHttpServer())
+        .delete(`/b/dictionaries/${createdId}`)
+        .set('Authorization', `Bearer ${ctx.tokens[Role.SYSTEM_ADMIN]}`);
+
+      expectSuccessEnvelope(deleteResponse, 200);
+      expect(deleteResponse.body.data.id).toBe(createdId);
+    });
+
+    it('角色矩阵：仅 SYSTEM_ADMIN 可维护字典，其他角色 403，未登录 401', async () => {
+      await assertRoleMatrix({
+        name: 'POST /b/dictionaries role matrix',
+        tokens: ctx.tokens,
+        expectedStatusByRole: {
+          [Role.SYSTEM_ADMIN]: 201,
+          [Role.HOSPITAL_ADMIN]: 403,
+          [Role.DIRECTOR]: 403,
+          [Role.LEADER]: 403,
+          [Role.DOCTOR]: 403,
+          [Role.ENGINEER]: 403,
+        },
+        sendAsRole: async (_role, token) =>
+          request(ctx.app.getHttpServer())
+            .post('/b/dictionaries')
+            .set('Authorization', `Bearer ${token}`)
+            .send({
+              type: 'DISTAL_SHUNT_DIRECTION',
+              label: uniqueSeedValue('矩阵字典项'),
+            }),
+        sendWithoutToken: async () =>
+          request(ctx.app.getHttpServer())
+            .post('/b/dictionaries')
+            .send({
+              type: 'DISTAL_SHUNT_DIRECTION',
+              label: uniqueSeedValue('匿名字典项'),
+            }),
+      });
+    });
+  });
+});

test/e2e/specs/patients.e2e-spec.ts

@@ -1,5 +1,9 @@
 import request from 'supertest';
-import { Role } from '../../../src/generated/prisma/enums.js';
+import {
+  DeviceStatus,
+  Role,
+  TaskStatus,
+} from '../../../src/generated/prisma/enums.js';
 import {
   closeE2EContext,
   createE2EContext,
@@ -9,8 +13,17 @@ import { assertRoleMatrix } from '../helpers/e2e-matrix.helper.js';
 import {
   expectErrorEnvelope,
   expectSuccessEnvelope,
+  uniquePhone,
+  uniqueSeedValue,
 } from '../helpers/e2e-http.helper.js';
 
+function uniqueIdCard() {
+  const suffix = `${Date.now()}${Math.floor(Math.random() * 1000)}`
+    .replace(/\D/g, '')
+    .slice(-4);
+  return `11010119990101${suffix.padStart(4, '0')}`;
+}
+
 describe('Patients Controllers (e2e)', () => {
   let ctx: E2EContext;
 
@@ -185,4 +198,209 @@ describe('Patients Controllers (e2e)', () => {
       expectErrorEnvelope(response, 404, '未找到匹配的患者档案');
     });
   });
+
+  describe('患者手术录入', () => {
+    it('成功：DOCTOR 可创建患者并附带首台手术和植入设备', async () => {
+      const adjustableCatalog = await ctx.prisma.implantCatalog.findFirst({
+        where: { modelCode: 'SEED-ADJUSTABLE-VALVE' },
+        select: { id: true },
+      });
+      expect(adjustableCatalog).toBeTruthy();
+
+      const response = await request(ctx.app.getHttpServer())
+        .post('/b/patients')
+        .set('Authorization', `Bearer ${ctx.tokens[Role.DOCTOR]}`)
+        .send({
+          name: '首术患者',
+          inpatientNo: uniqueSeedValue('zyh'),
+          projectName: '脑积水手术项目',
+          phone: uniquePhone(),
+          idCard: uniqueIdCard(),
+          doctorId: ctx.fixtures.users.doctorAId,
+          initialSurgery: {
+            surgeryDate: '2026-03-19T08:00:00.000Z',
+            surgeryName: '脑室腹腔分流术',
+            surgeonName: 'Seed Doctor A',
+            preOpPressure: 20,
+            primaryDisease: '梗阻性脑积水',
+            hydrocephalusTypes: ['交通性'],
+            devices: [
+              {
+                implantCatalogId: adjustableCatalog!.id,
+                shuntMode: 'VPS',
+                proximalPunctureAreas: ['额角'],
+                valvePlacementSites: ['耳后'],
+                distalShuntDirection: '腹腔',
+                initialPressure: 120,
+                implantNotes: '首术植入',
+                labelImageUrl:
+                  'https://seed.example.com/tests/first-surgery.jpg',
+              },
+            ],
+          },
+        });
+
+      expectSuccessEnvelope(response, 201);
+      expect(response.body.data.shuntSurgeryCount).toBe(1);
+      expect(response.body.data.surgeries).toHaveLength(1);
+      expect(response.body.data.surgeries[0].devices).toHaveLength(1);
+      expect(response.body.data.surgeries[0].devices[0].implantModel).toBe(
+        'SEED-ADJUSTABLE-VALVE',
+      );
+    });
+
+    it('成功：新增二次手术时可弃用旧设备且保留旧设备调压历史', async () => {
+      const adjustableCatalog = await ctx.prisma.implantCatalog.findFirst({
+        where: { modelCode: 'SEED-ADJUSTABLE-VALVE' },
+        select: { id: true },
+      });
+      expect(adjustableCatalog).toBeTruthy();
+
+      const createPatientResponse = await request(ctx.app.getHttpServer())
+        .post('/b/patients')
+        .set('Authorization', `Bearer ${ctx.tokens[Role.DOCTOR]}`)
+        .send({
+          name: '二次手术患者',
+          inpatientNo: uniqueSeedValue('zyh'),
+          projectName: '二次手术项目',
+          phone: uniquePhone(),
+          idCard: uniqueIdCard(),
+          doctorId: ctx.fixtures.users.doctorAId,
+          initialSurgery: {
+            surgeryDate: '2026-03-01T08:00:00.000Z',
+            surgeryName: '首次分流术',
+            surgeonName: 'Seed Doctor A',
+            preOpPressure: 18,
+            primaryDisease: '出血后脑积水',
+            hydrocephalusTypes: ['高压性'],
+            devices: [
+              {
+                implantCatalogId: adjustableCatalog!.id,
+                shuntMode: 'VPS',
+                proximalPunctureAreas: ['额角'],
+                valvePlacementSites: ['耳后'],
+                distalShuntDirection: '腹腔',
+                initialPressure: 100,
+                implantNotes: '首术设备',
+                labelImageUrl:
+                  'https://seed.example.com/tests/initial-device.jpg',
+              },
+            ],
+          },
+        });
+      expectSuccessEnvelope(createPatientResponse, 201);
+
+      const patient = createPatientResponse.body.data as {
+        id: number;
+        devices: Array<{ id: number }>;
+      };
+      const oldDeviceId = patient.devices[0].id;
+
+      await ctx.prisma.task.create({
+        data: {
+          status: TaskStatus.COMPLETED,
+          creatorId: ctx.fixtures.users.doctorAId,
+          engineerId: ctx.fixtures.users.engineerAId,
+          hospitalId: ctx.fixtures.hospitalAId,
+          items: {
+            create: [
+              {
+                deviceId: oldDeviceId,
+                oldPressure: 100,
+                targetPressure: 120,
+              },
+            ],
+          },
+        },
+      });
+
+      const surgeryResponse = await request(ctx.app.getHttpServer())
+        .post(`/b/patients/${patient.id}/surgeries`)
+        .set('Authorization', `Bearer ${ctx.tokens[Role.DOCTOR]}`)
+        .send({
+          surgeryDate: '2026-03-18T08:00:00.000Z',
+          surgeryName: '二次翻修术',
+          surgeonName: 'Seed Doctor A',
+          preOpPressure: 16,
+          primaryDisease: '分流功能障碍',
+          hydrocephalusTypes: ['交通性', '高压性'],
+          abandonedDeviceIds: [oldDeviceId],
+          devices: [
+            {
+              implantCatalogId: adjustableCatalog!.id,
+              shuntMode: 'VPS',
+              proximalPunctureAreas: ['枕角'],
+              valvePlacementSites: ['耳后'],
+              distalShuntDirection: '腹腔',
+              initialPressure: 120,
+              implantNotes: '二次手术新设备-1',
+              labelImageUrl: 'https://seed.example.com/tests/revision-1.jpg',
+            },
+            {
+              implantCatalogId: adjustableCatalog!.id,
+              shuntMode: 'VPS',
+              proximalPunctureAreas: ['额角'],
+              valvePlacementSites: ['胸前'],
+              distalShuntDirection: '胸腔',
+              initialPressure: 140,
+              implantNotes: '二次手术新设备-2',
+              labelImageUrl: 'https://seed.example.com/tests/revision-2.jpg',
+            },
+          ],
+        });
+
+      expectSuccessEnvelope(surgeryResponse, 201);
+      expect(surgeryResponse.body.data.devices).toHaveLength(2);
+      expect(surgeryResponse.body.data.shuntSurgeryCount).toBe(2);
+
+      const oldDevice = await ctx.prisma.device.findUnique({
+        where: { id: oldDeviceId },
+        include: { taskItems: true },
+      });
+
+      expect(oldDevice?.isAbandoned).toBe(true);
+      expect(oldDevice?.status).toBe(DeviceStatus.INACTIVE);
+      expect(oldDevice?.taskItems).toHaveLength(1);
+    });
+
+    it('失败：手术录入设备不允许手工传 currentPressure', async () => {
+      const adjustableCatalog = await ctx.prisma.implantCatalog.findFirst({
+        where: { modelCode: 'SEED-ADJUSTABLE-VALVE' },
+        select: { id: true },
+      });
+      expect(adjustableCatalog).toBeTruthy();
+
+      const response = await request(ctx.app.getHttpServer())
+        .post('/b/patients')
+        .set('Authorization', `Bearer ${ctx.tokens[Role.DOCTOR]}`)
+        .send({
+          name: '非法当前压力患者',
+          inpatientNo: uniqueSeedValue('zyh'),
+          projectName: '非法字段校验',
+          phone: uniquePhone(),
+          idCard: uniqueIdCard(),
+          doctorId: ctx.fixtures.users.doctorAId,
+          initialSurgery: {
+            surgeryDate: '2026-03-19T08:00:00.000Z',
+            surgeryName: '脑室腹腔分流术',
+            surgeonName: 'Seed Doctor A',
+            primaryDisease: '梗阻性脑积水',
+            hydrocephalusTypes: ['交通性'],
+            devices: [
+              {
+                implantCatalogId: adjustableCatalog!.id,
+                shuntMode: 'VPS',
+                proximalPunctureAreas: ['额角'],
+                valvePlacementSites: ['耳后'],
+                distalShuntDirection: '腹腔',
+                initialPressure: 120,
+                currentPressure: 120,
+              },
+            ],
+          },
+        });
+
+      expectErrorEnvelope(response, 400, '请求参数不合法');
+    });
+  });
 });

test/e2e/specs/tasks.e2e-spec.ts

@@ -49,7 +49,7 @@ describe('BTasksController (e2e)', () => {
           items: [
             {
               deviceId: ctx.fixtures.devices.deviceA2Id,
-              targetPressure: 126,
+              targetPressure: 120,
             },
           ],
         });
@@ -58,6 +58,22 @@ describe('BTasksController (e2e)', () => {
       expect(response.body.data.status).toBe(TaskStatus.PENDING);
     });
 
+    it('失败：可调压设备使用非法挡位返回 400', async () => {
+      const response = await request(ctx.app.getHttpServer())
+        .post('/b/tasks/publish')
+        .set('Authorization', `Bearer ${ctx.tokens[Role.DOCTOR]}`)
+        .send({
+          items: [
+            {
+              deviceId: ctx.fixtures.devices.deviceA2Id,
+              targetPressure: 126,
+            },
+          ],
+        });
+
+      expectErrorEnvelope(response, 400, '压力值不在该植入物配置的挡位范围内');
+    });
+
     it('失败：发布跨院设备任务返回 404', async () => {
       const response = await request(ctx.app.getHttpServer())
         .post('/b/tasks/publish')
@@ -101,7 +117,7 @@ describe('BTasksController (e2e)', () => {
     it('成功：ENGINEER 可接收待处理任务', async () => {
       const task = await publishPendingTask(
         ctx.fixtures.devices.deviceA2Id,
-        127,
+        140,
       );
 
       const response = await request(ctx.app.getHttpServer())
@@ -128,7 +144,7 @@ describe('BTasksController (e2e)', () => {
     it('状态机失败：重复接收返回 409', async () => {
       const task = await publishPendingTask(
         ctx.fixtures.devices.deviceA3Id,
-        122,
+        120,
       );
 
       const firstAccept = await request(ctx.app.getHttpServer())
@@ -172,7 +188,7 @@ describe('BTasksController (e2e)', () => {
 
   describe('POST /b/tasks/complete', () => {
     it('成功：ENGINEER 完成已接收任务并同步设备压力', async () => {
-      const targetPressure = 135;
+      const targetPressure = 140;
       const task = await publishPendingTask(
         ctx.fixtures.devices.deviceA1Id,
         targetPressure,
@@ -211,7 +227,7 @@ describe('BTasksController (e2e)', () => {
     it('状态机失败：未接收任务直接完成返回 409', async () => {
       const task = await publishPendingTask(
         ctx.fixtures.devices.deviceA2Id,
-        124,
+        100,
       );
 
       const response = await request(ctx.app.getHttpServer())
@@ -275,7 +291,7 @@ describe('BTasksController (e2e)', () => {
     it('状态机失败：已完成任务不可取消返回 409', async () => {
       const task = await publishPendingTask(
         ctx.fixtures.devices.deviceA2Id,
-        123,
+        160,
       );
 
       const acceptResponse = await request(ctx.app.getHttpServer())

tyt-admin/components.d.ts

@@ -18,6 +18,7 @@ declare module 'vue' {
     ElCol: typeof import('element-plus/es')['ElCol']
     ElConfigProvider: typeof import('element-plus/es')['ElConfigProvider']
     ElContainer: typeof import('element-plus/es')['ElContainer']
+    ElDatePicker: typeof import('element-plus/es')['ElDatePicker']
     ElDescriptions: typeof import('element-plus/es')['ElDescriptions']
     ElDescriptionsItem: typeof import('element-plus/es')['ElDescriptionsItem']
     ElDialog: typeof import('element-plus/es')['ElDialog']
@@ -31,6 +32,7 @@ declare module 'vue' {
     ElIcon: typeof import('element-plus/es')['ElIcon']
     ElInput: typeof import('element-plus/es')['ElInput']
     ElInputNumber: typeof import('element-plus/es')['ElInputNumber']
+    ElLink: typeof import('element-plus/es')['ElLink']
     ElMain: typeof import('element-plus/es')['ElMain']
     ElMenu: typeof import('element-plus/es')['ElMenu']
     ElMenuItem: typeof import('element-plus/es')['ElMenuItem']
@@ -39,8 +41,11 @@ declare module 'vue' {
     ElRow: typeof import('element-plus/es')['ElRow']
     ElSelect: typeof import('element-plus/es')['ElSelect']
     ElSubMenu: typeof import('element-plus/es')['ElSubMenu']
+    ElSwitch: typeof import('element-plus/es')['ElSwitch']
     ElTable: typeof import('element-plus/es')['ElTable']
     ElTableColumn: typeof import('element-plus/es')['ElTableColumn']
+    ElTabPane: typeof import('element-plus/es')['ElTabPane']
+    ElTabs: typeof import('element-plus/es')['ElTabs']
     ElTag: typeof import('element-plus/es')['ElTag']
     ElTimeline: typeof import('element-plus/es')['ElTimeline']
     ElTimelineItem: typeof import('element-plus/es')['ElTimelineItem']

tyt-admin/src/api/devices.js

@@ -11,6 +11,22 @@ export const getDeviceById = (id) => {
   return request.get(`/b/devices/${id}`);
 };
 
+export const getImplantCatalogs = (params) => {
+  return request.get('/b/devices/catalogs', { params });
+};
+
+export const createImplantCatalog = (data) => {
+  return request.post('/b/devices/catalogs', data);
+};
+
+export const updateImplantCatalog = (id, data) => {
+  return request.patch(`/b/devices/catalogs/${id}`, data);
+};
+
+export const deleteImplantCatalog = (id) => {
+  return request.delete(`/b/devices/catalogs/${id}`);
+};
+
 export const createDevice = (data) => {
   return request.post('/b/devices', data);
 };

tyt-admin/src/api/dictionaries.js

@@ -0,0 +1,17 @@
+import request from './request';
+
+export const getDictionaries = (params) => {
+  return request.get('/b/dictionaries', { params });
+};
+
+export const createDictionaryItem = (data) => {
+  return request.post('/b/dictionaries', data);
+};
+
+export const updateDictionaryItem = (id, data) => {
+  return request.patch(`/b/dictionaries/${id}`, data);
+};
+
+export const deleteDictionaryItem = (id) => {
+  return request.delete(`/b/dictionaries/${id}`);
+};

tyt-admin/src/api/patients.js

@@ -20,6 +20,10 @@ export const updatePatient = (id, data) => {
   return request.patch(`/b/patients/${id}`, data);
 };
 
+export const createPatientSurgery = (id, data) => {
+  return request.post(`/b/patients/${id}/surgeries`, data);
+};
+
 export const deletePatient = (id) => {
   return request.delete(`/b/patients/${id}`);
 };

tyt-admin/src/constants/medical-dictionaries.js

@@ -0,0 +1,73 @@
+export const MEDICAL_DICTIONARY_TYPES = Object.freeze({
+  PRIMARY_DISEASE: 'PRIMARY_DISEASE',
+  HYDROCEPHALUS_TYPE: 'HYDROCEPHALUS_TYPE',
+  SHUNT_MODE: 'SHUNT_MODE',
+  PROXIMAL_PUNCTURE_AREA: 'PROXIMAL_PUNCTURE_AREA',
+  VALVE_PLACEMENT_SITE: 'VALVE_PLACEMENT_SITE',
+  DISTAL_SHUNT_DIRECTION: 'DISTAL_SHUNT_DIRECTION',
+});
+
+export const MEDICAL_DICTIONARY_TYPE_OPTIONS = Object.freeze([
+  {
+    label: '原发病',
+    value: MEDICAL_DICTIONARY_TYPES.PRIMARY_DISEASE,
+    optionKey: 'primaryDiseaseOptions',
+  },
+  {
+    label: '脑积水类型',
+    value: MEDICAL_DICTIONARY_TYPES.HYDROCEPHALUS_TYPE,
+    optionKey: 'hydrocephalusTypeOptions',
+  },
+  {
+    label: '分流方式',
+    value: MEDICAL_DICTIONARY_TYPES.SHUNT_MODE,
+    optionKey: 'shuntModeOptions',
+  },
+  {
+    label: '近端穿刺区域',
+    value: MEDICAL_DICTIONARY_TYPES.PROXIMAL_PUNCTURE_AREA,
+    optionKey: 'proximalPunctureOptions',
+  },
+  {
+    label: '阀门植入部位',
+    value: MEDICAL_DICTIONARY_TYPES.VALVE_PLACEMENT_SITE,
+    optionKey: 'valvePlacementOptions',
+  },
+  {
+    label: '远端分流方向',
+    value: MEDICAL_DICTIONARY_TYPES.DISTAL_SHUNT_DIRECTION,
+    optionKey: 'distalShuntDirectionOptions',
+  },
+]);
+
+export function createEmptyMedicalDictionaryOptions() {
+  return {
+    primaryDiseaseOptions: [],
+    hydrocephalusTypeOptions: [],
+    shuntModeOptions: [],
+    proximalPunctureOptions: [],
+    valvePlacementOptions: [],
+    distalShuntDirectionOptions: [],
+  };
+}
+
+export function groupMedicalDictionaryItems(items) {
+  const grouped = createEmptyMedicalDictionaryOptions();
+
+  MEDICAL_DICTIONARY_TYPE_OPTIONS.forEach((typeOption) => {
+    grouped[typeOption.optionKey] = [];
+  });
+
+  (Array.isArray(items) ? items : []).forEach((item) => {
+    const typeOption = MEDICAL_DICTIONARY_TYPE_OPTIONS.find(
+      (option) => option.value === item.type,
+    );
+    if (!typeOption || !item.enabled) {
+      return;
+    }
+
+    grouped[typeOption.optionKey].push(item.label);
+  });
+
+  return grouped;
+}

tyt-admin/src/constants/role-permissions.js

@@ -29,8 +29,9 @@ export const ROLE_PERMISSIONS = Object.freeze({
   // 主任/组长仍可通过接口读取科室信息，但不再开放独立“科室管理”页面。
   ORG_DEPARTMENTS: ADMIN_ROLES,
   ORG_GROUPS: ORG_MANAGER_ROLES,
+  DICTIONARIES: Object.freeze(['SYSTEM_ADMIN']),
   USERS: USER_MANAGER_ROLES,
-  DEVICES: ADMIN_ROLES,
+  DEVICES: Object.freeze(['SYSTEM_ADMIN']),
   TASKS: TASK_ROLES,
   PATIENTS: PATIENT_ROLES,
 });

tyt-admin/src/layouts/AdminLayout.vue

@@ -36,7 +36,10 @@
             <el-icon><Share /></el-icon>
             <span>组织架构图</span>
           </el-menu-item>
-          <el-menu-item v-if="canAccessDepartments" index="/organization/departments">
+          <el-menu-item
+            v-if="canAccessDepartments"
+            index="/organization/departments"
+          >
             <el-icon><OfficeBuilding /></el-icon>
             <span>科室管理</span>
           </el-menu-item>
@@ -51,6 +54,11 @@
           <span>{{ usersMenuLabel }}</span>
         </el-menu-item>
 
+        <el-menu-item v-if="canAccessDictionaries" index="/dictionaries">
+          <el-icon><CollectionTag /></el-icon>
+          <span>字典管理</span>
+        </el-menu-item>
+
         <el-menu-item v-if="canAccessDevices" index="/devices">
           <el-icon><Monitor /></el-icon>
           <span>设备管理</span>
@@ -119,6 +127,7 @@ import {
   Connection,
   Share,
   Monitor,
+  CollectionTag,
 } from '@element-plus/icons-vue';
 
 const route = useRoute();
@@ -136,6 +145,9 @@ const canAccessUsers = computed(() =>
 const canAccessDevices = computed(() =>
   hasRolePermission(userStore.role, ROLE_PERMISSIONS.DEVICES),
 );
+const canAccessDictionaries = computed(() =>
+  hasRolePermission(userStore.role, ROLE_PERMISSIONS.DICTIONARIES),
+);
 const canAccessOrgTree = computed(() =>
   hasRolePermission(userStore.role, ROLE_PERMISSIONS.ORG_TREE),
 );

tyt-admin/src/router/index.js

@@ -77,6 +77,16 @@ const routes = [
           allowedRoles: ROLE_PERMISSIONS.USERS,
         },
       },
+      {
+        path: 'dictionaries',
+        name: 'Dictionaries',
+        component: () => import('../views/dictionaries/Dictionaries.vue'),
+        meta: {
+          title: '字典管理',
+          requiresAuth: true,
+          allowedRoles: ROLE_PERMISSIONS.DICTIONARIES,
+        },
+      },
       {
         path: 'devices',
         name: 'Devices',

tyt-admin/src/views/devices/Devices.vue

@@ -1,76 +1,42 @@
 <template>
   <div class="devices-container">
-    <el-card>
+    <el-card class="panel-card">
-      <div class="header-actions">
+      <template #header>
-        <el-form :inline="true" :model="searchForm" class="search-form">
+        <div class="panel-head">
-          <el-form-item label="所属医院" v-if="isSystemAdmin">
+          <div>
-            <el-select
+            <div class="panel-title">植入物目录</div>
-              v-model="searchForm.hospitalId"
+            <div class="panel-subtitle">
-              clearable
+              这里维护患者手术里可选的全局植入物目录，不再按医院或患者单独建档
-              filterable
+            </div>
-              placeholder="全部医院"
+          </div>
-              style="width: 220px"
+        </div>
-              @change="handleSearchHospitalChange"
+      </template>
-            >
-              <el-option
-                v-for="hospital in hospitals"
-                :key="hospital.id"
-                :label="hospital.name"
-                :value="hospital.id"
-              />
-            </el-select>
-          </el-form-item>
 
-          <el-form-item label="归属患者">
+      <el-alert
-            <el-select
+        type="info"
-              v-model="searchForm.patientId"
+        :closable="false"
-              clearable
+        class="page-alert"
-              filterable
+        title="一个目录项可被多个患者手术重复绑定；患者手术里形成的是患者自己的植入记录，不会占用或锁定目录。"
-              placeholder="全部患者"
-              style="width: 260px"
-              :disabled="isSystemAdmin && !searchForm.hospitalId"
-            >
-              <el-option
-                v-for="patient in searchPatients"
-                :key="patient.id"
-                :label="formatPatientLabel(patient)"
-                :value="patient.id"
       />
-            </el-select>
-          </el-form-item>
-
-          <el-form-item label="设备状态">
-            <el-select
-              v-model="searchForm.status"
-              clearable
-              placeholder="全部状态"
-              style="width: 160px"
-            >
-              <el-option
-                v-for="item in DEVICE_STATUS_OPTIONS"
-                :key="item.value"
-                :label="item.label"
-                :value="item.value"
-              />
-            </el-select>
-          </el-form-item>
 
+      <div class="toolbar">
+        <el-form :inline="true" :model="searchForm">
           <el-form-item label="关键词">
             <el-input
               v-model="searchForm.keyword"
               clearable
-              placeholder="设备 SN / 患者姓名 / 手机号"
+              placeholder="型号编码 / 厂家 / 名称"
-              style="width: 260px"
+              style="width: 280px"
             />
           </el-form-item>
 
           <el-form-item>
-            <el-button type="primary" @click="handleSearch" icon="Search">
+            <el-button type="primary" @click="fetchData" icon="Search">
               查询
             </el-button>
             <el-button @click="resetSearch" icon="Refresh">重置</el-button>
             <el-button type="success" @click="openCreateDialog" icon="Plus">
-              新增设备
+              新增植入物
             </el-button>
           </el-form-item>
         </el-form>
@@ -83,44 +49,40 @@
         stripe
         style="width: 100%"
       >
-        <el-table-column prop="id" label="ID" width="80" align="center" />
+        <el-table-column prop="id" label="ID" width="90" align="center" />
-        <el-table-column prop="snCode" label="设备 SN" min-width="180" />
+        <el-table-column prop="modelCode" label="型号编码" min-width="180" />
-        <el-table-column
+        <el-table-column prop="manufacturer" label="厂家" min-width="180" />
-          prop="currentPressure"
+        <el-table-column prop="name" label="名称" min-width="180" />
-          label="当前压力"
+        <el-table-column label="器械类型" width="120" align="center">
-          width="120"
-          align="center"
-        />
-        <el-table-column label="设备状态" width="120" align="center">
           <template #default="{ row }">
-            <el-tag :type="getStatusTagType(row.status)">
+            <el-tag :type="row.isPressureAdjustable ? 'success' : 'info'">
-              {{ getStatusName(row.status) }}
+              {{ row.isPressureAdjustable ? '可调压' : '非调压' }}
             </el-tag>
           </template>
         </el-table-column>
-        <el-table-column label="归属患者" min-width="140">
+        <el-table-column label="挡位" min-width="220">
           <template #default="{ row }">
-            {{ row.patient?.name || '-' }}
+            <div v-if="row.pressureLevels?.length" class="pressure-tag-list">
+              <el-tag
+                v-for="level in row.pressureLevels"
+                :key="`${row.id}-${level}`"
+                size="small"
+                type="warning"
+              >
+                {{ level }}
+              </el-tag>
+            </div>
+            <span v-else>-</span>
           </template>
         </el-table-column>
-        <el-table-column label="患者手机号" min-width="150">
+        <el-table-column label="备注" min-width="220">
           <template #default="{ row }">
-            {{ row.patient?.phone || '-' }}
+            {{ row.notes || '-' }}
           </template>
         </el-table-column>
-        <el-table-column label="所属医院" min-width="160">
+        <el-table-column label="更新时间" min-width="180">
           <template #default="{ row }">
-            {{ row.patient?.hospital?.name || '-' }}
+            {{ formatDateTime(row.updatedAt) }}
-          </template>
-        </el-table-column>
-        <el-table-column label="归属医生" min-width="140">
-          <template #default="{ row }">
-            {{ row.patient?.doctor?.name || '-' }}
-          </template>
-        </el-table-column>
-        <el-table-column label="关联任务数" width="120" align="center">
-          <template #default="{ row }">
-            {{ row._count?.taskItems ?? 0 }}
           </template>
         </el-table-column>
         <el-table-column label="操作" width="180" fixed="right" align="center">
@@ -134,93 +96,98 @@
           </template>
         </el-table-column>
       </el-table>
-
-      <div class="pagination-container">
-        <el-pagination
-          v-model:current-page="page"
-          v-model:page-size="pageSize"
-          :page-sizes="[10, 20, 50, 100]"
-          :total="total"
-          background
-          layout="total, sizes, prev, pager, next, jumper"
-          @size-change="fetchData"
-          @current-change="fetchData"
-        />
-      </div>
     </el-card>
 
     <el-dialog
-      :title="isEdit ? '编辑设备' : '新增设备'"
+      :title="isEdit ? '编辑植入物目录' : '新增植入物目录'"
       v-model="dialogVisible"
-      width="560px"
+      width="760px"
+      destroy-on-close
       @close="resetForm"
     >
-      <el-form :model="form" :rules="rules" ref="formRef" label-width="100px">
+      <el-form :model="form" :rules="rules" ref="formRef" label-width="110px">
-        <el-form-item label="所属医院" prop="hospitalId" v-if="isSystemAdmin">
+        <el-row :gutter="16">
-          <el-select
+          <el-col :xs="24" :md="12">
-            v-model="form.hospitalId"
+            <el-form-item label="型号编码" prop="modelCode">
-            filterable
-            placeholder="请选择医院"
-            style="width: 100%"
-            @change="handleFormHospitalChange"
-          >
-            <el-option
-              v-for="hospital in hospitals"
-              :key="hospital.id"
-              :label="hospital.name"
-              :value="hospital.id"
-            />
-          </el-select>
-        </el-form-item>
-
-        <el-form-item label="归属患者" prop="patientId">
-          <el-select
-            v-model="form.patientId"
-            filterable
-            placeholder="请选择患者"
-            style="width: 100%"
-            :disabled="isSystemAdmin && !form.hospitalId"
-          >
-            <el-option
-              v-for="patient in formPatients"
-              :key="patient.id"
-              :label="formatPatientLabel(patient)"
-              :value="patient.id"
-            />
-          </el-select>
-        </el-form-item>
-
-        <el-form-item label="设备 SN" prop="snCode">
               <el-input
-            v-model="form.snCode"
+                v-model="form.modelCode"
-            placeholder="请输入设备 SN"
                 maxlength="64"
+                placeholder="请输入型号编码"
               />
             </el-form-item>
-
+          </el-col>
-        <el-form-item label="当前压力" prop="currentPressure">
+          <el-col :xs="24" :md="12">
-          <el-input-number
+            <el-form-item label="厂家" prop="manufacturer">
-            v-model="form.currentPressure"
+              <el-input
-            :min="0"
+                v-model="form.manufacturer"
-            :step="1"
+                maxlength="100"
-            :controls="false"
+                placeholder="请输入厂家"
-            style="width: 100%"
               />
             </el-form-item>
+          </el-col>
+          <el-col :xs="24" :md="12">
+            <el-form-item label="名称" prop="name">
+              <el-input
+                v-model="form.name"
+                maxlength="100"
+                placeholder="请输入植入物名称"
+              />
+            </el-form-item>
+          </el-col>
+          <el-col :xs="24" :md="12">
+            <el-form-item label="可调压">
+              <el-switch
+                v-model="form.isPressureAdjustable"
+                active-text="是"
+                inactive-text="否"
+                @change="handleAdjustableChange"
+              />
+            </el-form-item>
+          </el-col>
+        </el-row>
 
-        <el-form-item label="设备状态" prop="status">
+        <el-form-item label="压力挡位" v-if="form.isPressureAdjustable">
-          <el-select
+          <div class="pressure-level-panel">
-            v-model="form.status"
+            <div
-            placeholder="请选择状态"
+              v-for="(level, index) in form.pressureLevels"
-            style="width: 100%"
+              :key="`pressure-level-${index}`"
+              class="pressure-level-row"
             >
-            <el-option
+              <el-input-number
-              v-for="item in DEVICE_STATUS_OPTIONS"
+                v-model="form.pressureLevels[index]"
-              :key="item.value"
+                :min="0"
-              :label="item.label"
+                :controls="false"
-              :value="item.value"
+                placeholder="请输入挡位值"
+                style="width: 180px"
+              />
+              <el-button
+                type="danger"
+                plain
+                @click="removePressureLevel(index)"
+                :disabled="form.pressureLevels.length === 1"
+              >
+                删除
+              </el-button>
+            </div>
+
+            <el-button type="primary" plain @click="addPressureLevel">
+              新增挡位
+            </el-button>
+            <div class="field-hint">
+              每个挡位填一个整数值，保存时会自动去重并按从小到大排序
+            </div>
+          </div>
+        </el-form-item>
+
+        <el-form-item label="备注">
+          <el-input
+            v-model="form.notes"
+            type="textarea"
+            :rows="3"
+            maxlength="200"
+            show-word-limit
+            placeholder="可填写适用说明、材质、适配场景等"
           />
-          </el-select>
         </el-form-item>
       </el-form>
 
@@ -232,7 +199,7 @@
             :loading="submitLoading"
             @click="handleSubmit"
           >
-            确定
+            {{ isEdit ? '保存修改' : '创建目录' }}
           </el-button>
         </div>
       </template>
@@ -241,26 +208,14 @@
 </template>
 
 <script setup>
-import { computed, onMounted, reactive, ref } from 'vue';
+import { onMounted, reactive, ref } from 'vue';
 import { ElMessage, ElMessageBox } from 'element-plus';
 import {
-  getDevices,
+  createImplantCatalog,
-  createDevice,
+  deleteImplantCatalog,
-  updateDevice,
+  getImplantCatalogs,
-  deleteDevice,
+  updateImplantCatalog,
 } from '../../api/devices';
-import { getHospitals } from '../../api/organization';
-import { getPatients } from '../../api/patients';
-import { useUserStore } from '../../store/user';
-
-const userStore = useUserStore();
-
-const DEVICE_STATUS_OPTIONS = [
-  { label: '启用', value: 'ACTIVE' },
-  { label: '停用', value: 'INACTIVE' },
-];
-
-const isSystemAdmin = computed(() => userStore.role === 'SYSTEM_ADMIN');
 
 const loading = ref(false);
 const submitLoading = ref(false);
@@ -268,221 +223,165 @@ const dialogVisible = ref(false);
 const isEdit = ref(false);
 const formRef = ref(null);
 const currentId = ref(null);
-
-const hospitals = ref([]);
-const searchPatients = ref([]);
-const formPatients = ref([]);
-
 const tableData = ref([]);
-const total = ref(0);
-const page = ref(1);
-const pageSize = ref(10);
 
 const searchForm = reactive({
-  hospitalId: null,
-  patientId: null,
-  status: '',
   keyword: '',
 });
 
-const form = reactive({
+const form = reactive(createDefaultForm());
-  hospitalId: null,
-  patientId: null,
-  snCode: '',
-  currentPressure: 0,
-  status: 'ACTIVE',
-});
 
-const rules = computed(() => ({
+const rules = {
-  hospitalId: isSystemAdmin.value
+  modelCode: [{ required: true, message: '请输入型号编码', trigger: 'blur' }],
-    ? [{ required: true, message: '请选择所属医院', trigger: 'change' }]
+  manufacturer: [{ required: true, message: '请输入厂家', trigger: 'blur' }],
-    : [],
+  name: [{ required: true, message: '请输入名称', trigger: 'blur' }],
-  patientId: [{ required: true, message: '请选择归属患者', trigger: 'change' }],
-  snCode: [{ required: true, message: '请输入设备 SN', trigger: 'blur' }],
-  currentPressure: [
-    { required: true, message: '请输入当前压力', trigger: 'blur' },
-  ],
-  status: [{ required: true, message: '请选择设备状态', trigger: 'change' }],
-}));
-
-const getStatusName = (status) => {
-  return (
-    DEVICE_STATUS_OPTIONS.find((item) => item.value === status)?.label || status
-  );
 };
 
-const getStatusTagType = (status) => {
+function createDefaultForm() {
-  return status === 'ACTIVE' ? 'success' : 'info';
+  return {
-};
+    modelCode: '',
+    manufacturer: '',
+    name: '',
+    isPressureAdjustable: true,
+    pressureLevels: [null],
+    notes: '',
+  };
+}
 
-const formatPatientLabel = (patient) => {
+function formatDateTime(value) {
-  const hospitalName = patient.hospital?.name
+  if (!value) {
-    ? ` / ${patient.hospital.name}`
+    return '-';
-    : '';
-  return `${patient.name}（${patient.phone}${hospitalName}）`;
-};
-
-const fetchHospitals = async () => {
-  if (!isSystemAdmin.value) {
-    return;
   }
 
-  const res = await getHospitals({ page: 1, pageSize: 100 });
+  const date = new Date(value);
-  hospitals.value = res.list || [];
+  if (Number.isNaN(date.getTime())) {
-};
+    return '-';
-
-// 搜索区患者下拉只跟筛选条件联动，避免和弹窗下拉状态互相干扰。
-const fetchSearchPatients = async () => {
-  if (isSystemAdmin.value && !searchForm.hospitalId) {
-    searchPatients.value = [];
-    searchForm.patientId = null;
-    return;
   }
 
-  const params = {};
+  return date.toLocaleString('zh-CN', { hour12: false });
-  if (isSystemAdmin.value) {
+}
-    params.hospitalId = searchForm.hospitalId;
-  }
 
-  const res = await getPatients(params);
+function normalizePressureLevels(levels) {
-  searchPatients.value = Array.isArray(res) ? res : [];
+  return Array.from(
+    new Set(
+      (Array.isArray(levels) ? levels : [])
+        .filter(
+          (level) => level !== null && level !== undefined && level !== '',
+        )
+        .map((level) => Number(level))
+        .filter((level) => Number.isInteger(level) && level >= 0),
+    ),
+  ).sort((left, right) => left - right);
+}
 
-  if (!searchPatients.value.some((item) => item.id === searchForm.patientId)) {
+async function fetchData() {
-    searchForm.patientId = null;
-  }
-};
-
-// 表单患者下拉按当前选择的医院动态刷新，确保 patientId 可写且合法。
-const fetchFormPatients = async (hospitalId = form.hospitalId) => {
-  if (isSystemAdmin.value && !hospitalId) {
-    formPatients.value = [];
-    form.patientId = null;
-    return;
-  }
-
-  const params = {};
-  if (isSystemAdmin.value) {
-    params.hospitalId = hospitalId;
-  }
-
-  const res = await getPatients(params);
-  formPatients.value = Array.isArray(res) ? res : [];
-
-  if (!formPatients.value.some((item) => item.id === form.patientId)) {
-    form.patientId = null;
-  }
-};
-
-const fetchData = async () => {
   loading.value = true;
   try {
-    const params = {
+    const res = await getImplantCatalogs({
-      page: page.value,
-      pageSize: pageSize.value,
       keyword: searchForm.keyword || undefined,
-      status: searchForm.status || undefined,
+    });
-      patientId: searchForm.patientId || undefined,
+    tableData.value = Array.isArray(res) ? res : [];
-    };
-
-    if (isSystemAdmin.value && searchForm.hospitalId) {
-      params.hospitalId = searchForm.hospitalId;
-    }
-
-    const res = await getDevices(params);
-    tableData.value = res.list || [];
-    total.value = res.total || 0;
   } finally {
     loading.value = false;
   }
-};
+}
 
-const handleSearchHospitalChange = async () => {
+async function resetSearch() {
-  page.value = 1;
-  await fetchSearchPatients();
-  await fetchData();
-};
-
-const handleFormHospitalChange = async (hospitalId) => {
-  form.patientId = null;
-  await fetchFormPatients(hospitalId);
-};
-
-const handleSearch = () => {
-  page.value = 1;
-  fetchData();
-};
-
-const resetSearch = async () => {
-  searchForm.hospitalId = null;
-  searchForm.patientId = null;
-  searchForm.status = '';
   searchForm.keyword = '';
-  page.value = 1;
-  await fetchSearchPatients();
   await fetchData();
-};
+}
 
-const resetForm = () => {
+function resetForm() {
-  formRef.value?.resetFields();
+  formRef.value?.clearValidate?.();
-  form.hospitalId = null;
+  const next = createDefaultForm();
-  form.patientId = null;
+  form.modelCode = next.modelCode;
-  form.snCode = '';
+  form.manufacturer = next.manufacturer;
-  form.currentPressure = 0;
+  form.name = next.name;
-  form.status = 'ACTIVE';
+  form.isPressureAdjustable = next.isPressureAdjustable;
+  form.pressureLevels = next.pressureLevels;
+  form.notes = next.notes;
   currentId.value = null;
-  formPatients.value = [];
+}
-};
 
-const openCreateDialog = async () => {
+function handleAdjustableChange(enabled) {
-  isEdit.value = false;
+  if (!enabled) {
-  resetForm();
+    form.pressureLevels = [null];
-
+    return;
-  // 系统管理员可沿用当前筛选医院，院管则固定为本人医院。
-  if (isSystemAdmin.value) {
-    form.hospitalId = searchForm.hospitalId || null;
-  } else {
-    form.hospitalId = userStore.userInfo?.hospitalId || null;
   }
 
-  await fetchFormPatients(form.hospitalId);
+  if (!Array.isArray(form.pressureLevels) || form.pressureLevels.length === 0) {
-  dialogVisible.value = true;
+    form.pressureLevels = [null];
-};
+  }
+}
 
-const openEditDialog = async (row) => {
+function addPressureLevel() {
+  form.pressureLevels.push(null);
+}
+
+function removePressureLevel(index) {
+  if (form.pressureLevels.length === 1) {
+    form.pressureLevels.splice(index, 1, null);
+    return;
+  }
+  form.pressureLevels.splice(index, 1);
+}
+
+function openCreateDialog() {
+  isEdit.value = false;
+  resetForm();
+  dialogVisible.value = true;
+}
+
+function openEditDialog(row) {
   isEdit.value = true;
+  formRef.value?.clearValidate?.();
   currentId.value = row.id;
-  form.snCode = row.snCode;
+  form.modelCode = row.modelCode || '';
-  form.currentPressure = row.currentPressure;
+  form.manufacturer = row.manufacturer || '';
-  form.status = row.status;
+  form.name = row.name || '';
-  form.hospitalId =
+  form.isPressureAdjustable = Boolean(row.isPressureAdjustable);
-    row.patient?.hospital?.id || row.patient?.hospitalId || null;
+  form.pressureLevels =
-
+    Array.isArray(row.pressureLevels) && row.pressureLevels.length > 0
-  await fetchFormPatients(form.hospitalId);
+      ? [...row.pressureLevels]
-  form.patientId = row.patient?.id || null;
+      : [null];
+  form.notes = row.notes || '';
   dialogVisible.value = true;
-};
+}
 
-const handleSubmit = async () => {
+async function handleSubmit() {
-  if (!formRef.value) return;
+  if (!formRef.value) {
+    return;
+  }
 
-  await formRef.value.validate(async (valid) => {
+  try {
-    if (!valid) return;
+    await formRef.value.validate();
+  } catch {
+    return;
+  }
+
+  const normalizedLevels = normalizePressureLevels(form.pressureLevels);
+  if (form.isPressureAdjustable && normalizedLevels.length === 0) {
+    ElMessage.warning('可调压植入物至少需要录入一个挡位');
+    return;
+  }
 
   submitLoading.value = true;
   try {
     const payload = {
-        snCode: form.snCode,
+      modelCode: form.modelCode,
-        currentPressure: Number(form.currentPressure),
+      manufacturer: form.manufacturer,
-        status: form.status,
+      name: form.name,
-        patientId: form.patientId,
+      isPressureAdjustable: form.isPressureAdjustable,
+      pressureLevels: form.isPressureAdjustable ? normalizedLevels : [],
+      notes: form.notes || undefined,
     };
 
     if (isEdit.value) {
-        await updateDevice(currentId.value, payload);
+      await updateImplantCatalog(currentId.value, payload);
-        ElMessage.success('更新成功');
+      ElMessage.success('植入物目录已更新');
     } else {
-        await createDevice(payload);
+      await createImplantCatalog(payload);
-        ElMessage.success('创建成功');
+      ElMessage.success('植入物目录已创建');
     }
 
     dialogVisible.value = false;
@@ -490,27 +389,26 @@ const handleSubmit = async () => {
   } finally {
     submitLoading.value = false;
   }
-  });
+}
-};
 
-const handleDelete = (row) => {
+async function handleDelete(row) {
-  ElMessageBox.confirm(`确定要删除设备 "${row.snCode}" 吗？`, '警告', {
+  await ElMessageBox.confirm(
-    confirmButtonText: '确定',
+    `确认删除植入物目录「${row.name}」吗？已绑定到患者手术的目录项将无法删除。`,
-    cancelButtonText: '取消',
+    '删除确认',
+    {
       type: 'warning',
-  })
+      confirmButtonText: '删除',
-    .then(async () => {
+      cancelButtonText: '取消',
-      await deleteDevice(row.id);
+    },
-      ElMessage.success('删除成功');
+  );
-      await fetchData();
-    })
-    .catch(() => {});
-};
 
-onMounted(async () => {
+  await deleteImplantCatalog(row.id);
-  await fetchHospitals();
+  ElMessage.success('植入物目录已删除');
-  await fetchSearchPatients();
   await fetchData();
+}
+
+onMounted(() => {
+  fetchData();
 });
 </script>
 
@@ -519,13 +417,63 @@ onMounted(async () => {
   padding: 0;
 }
 
-.header-actions {
+.panel-card {
-  margin-bottom: 20px;
+  border-radius: 18px;
 }
 
-.pagination-container {
+.panel-head {
-  margin-top: 20px;
+  display: flex;
+  align-items: center;
+  justify-content: space-between;
+}
+
+.panel-title {
+  font-size: 18px;
+  font-weight: 700;
+  color: #1f2937;
+}
+
+.panel-subtitle {
+  margin-top: 6px;
+  font-size: 13px;
+  color: #6b7280;
+}
+
+.page-alert {
+  margin-bottom: 16px;
+}
+
+.toolbar {
+  margin-bottom: 16px;
+}
+
+.pressure-tag-list {
+  display: flex;
+  flex-wrap: wrap;
+  gap: 6px;
+}
+
+.pressure-level-panel {
+  display: flex;
+  flex-direction: column;
+  gap: 10px;
+  width: 100%;
+}
+
+.pressure-level-row {
+  display: flex;
+  align-items: center;
+  gap: 12px;
+}
+
+.field-hint {
+  font-size: 12px;
+  color: #6b7280;
+}
+
+.dialog-footer {
   display: flex;
   justify-content: flex-end;
+  gap: 12px;
 }
 </style>

tyt-admin/src/views/dictionaries/Dictionaries.vue

@@ -0,0 +1,376 @@
+<template>
+  <div class="dictionaries-container">
+    <el-card class="panel-card">
+      <template #header>
+        <div class="panel-head">
+          <div>
+            <div class="panel-title">医学选项字典</div>
+            <div class="panel-subtitle">
+              系统管理员维护患者手术表单中的标准选项，停用后不会再出现在录入页
+            </div>
+          </div>
+        </div>
+      </template>
+
+      <el-alert
+        type="info"
+        :closable="false"
+        class="page-alert"
+        title="当前字典为系统级公共配置，所有医院患者录入表单共享同一套选项。"
+      />
+
+      <div class="toolbar">
+        <el-form :inline="true" :model="searchForm">
+          <el-form-item label="字典类型">
+            <el-select
+              v-model="searchForm.type"
+              clearable
+              filterable
+              placeholder="全部类型"
+              style="width: 220px"
+            >
+              <el-option
+                v-for="option in MEDICAL_DICTIONARY_TYPE_OPTIONS"
+                :key="option.value"
+                :label="option.label"
+                :value="option.value"
+              />
+            </el-select>
+          </el-form-item>
+
+          <el-form-item label="关键词">
+            <el-input
+              v-model="searchForm.keyword"
+              clearable
+              placeholder="按字典项名称筛选"
+              style="width: 260px"
+            />
+          </el-form-item>
+
+          <el-form-item>
+            <el-button type="primary" @click="fetchData" icon="Search">
+              查询
+            </el-button>
+            <el-button @click="resetSearch" icon="Refresh">重置</el-button>
+            <el-button type="success" @click="openCreateDialog" icon="Plus">
+              新增字典项
+            </el-button>
+          </el-form-item>
+        </el-form>
+      </div>
+
+      <el-table
+        :data="filteredTableData"
+        v-loading="loading"
+        border
+        stripe
+        style="width: 100%"
+      >
+        <el-table-column prop="id" label="ID" width="90" align="center" />
+        <el-table-column label="字典类型" min-width="180">
+          <template #default="{ row }">
+            {{ getTypeLabel(row.type) }}
+          </template>
+        </el-table-column>
+        <el-table-column prop="label" label="字典项名称" min-width="240" />
+        <el-table-column
+          prop="sortOrder"
+          label="排序"
+          width="110"
+          align="center"
+        />
+        <el-table-column label="状态" width="110" align="center">
+          <template #default="{ row }">
+            <el-tag :type="row.enabled ? 'success' : 'info'">
+              {{ row.enabled ? '启用' : '停用' }}
+            </el-tag>
+          </template>
+        </el-table-column>
+        <el-table-column label="更新时间" min-width="180">
+          <template #default="{ row }">
+            {{ formatDateTime(row.updatedAt) }}
+          </template>
+        </el-table-column>
+        <el-table-column label="操作" width="180" fixed="right" align="center">
+          <template #default="{ row }">
+            <el-button size="small" type="primary" @click="openEditDialog(row)">
+              编辑
+            </el-button>
+            <el-button size="small" type="danger" @click="handleDelete(row)">
+              删除
+            </el-button>
+          </template>
+        </el-table-column>
+      </el-table>
+    </el-card>
+
+    <el-dialog
+      :title="isEdit ? '编辑字典项' : '新增字典项'"
+      v-model="dialogVisible"
+      width="560px"
+      destroy-on-close
+      @close="resetForm"
+    >
+      <el-form :model="form" :rules="rules" ref="formRef" label-width="110px">
+        <el-form-item label="字典类型" prop="type">
+          <el-select
+            v-model="form.type"
+            filterable
+            placeholder="请选择字典类型"
+            style="width: 100%"
+          >
+            <el-option
+              v-for="option in MEDICAL_DICTIONARY_TYPE_OPTIONS"
+              :key="option.value"
+              :label="option.label"
+              :value="option.value"
+            />
+          </el-select>
+        </el-form-item>
+
+        <el-form-item label="字典项名称" prop="label">
+          <el-input
+            v-model="form.label"
+            maxlength="50"
+            show-word-limit
+            placeholder="请输入字典项名称"
+          />
+        </el-form-item>
+
+        <el-form-item label="排序值" prop="sortOrder">
+          <el-input-number
+            v-model="form.sortOrder"
+            :controls="false"
+            :step="10"
+            style="width: 100%"
+          />
+        </el-form-item>
+
+        <el-form-item label="是否启用" prop="enabled">
+          <el-switch
+            v-model="form.enabled"
+            active-text="启用"
+            inactive-text="停用"
+          />
+        </el-form-item>
+      </el-form>
+
+      <template #footer>
+        <div class="dialog-footer">
+          <el-button @click="dialogVisible = false">取消</el-button>
+          <el-button
+            type="primary"
+            :loading="submitLoading"
+            @click="handleSubmit"
+          >
+            {{ isEdit ? '保存修改' : '创建字典项' }}
+          </el-button>
+        </div>
+      </template>
+    </el-dialog>
+  </div>
+</template>
+
+<script setup>
+import { computed, onMounted, reactive, ref } from 'vue';
+import { ElMessage, ElMessageBox } from 'element-plus';
+import {
+  createDictionaryItem,
+  deleteDictionaryItem,
+  getDictionaries,
+  updateDictionaryItem,
+} from '../../api/dictionaries';
+import { MEDICAL_DICTIONARY_TYPE_OPTIONS } from '../../constants/medical-dictionaries';
+
+const loading = ref(false);
+const submitLoading = ref(false);
+const dialogVisible = ref(false);
+const isEdit = ref(false);
+const formRef = ref(null);
+const currentId = ref(null);
+const tableData = ref([]);
+
+const searchForm = reactive({
+  type: '',
+  keyword: '',
+});
+
+const form = reactive({
+  type: MEDICAL_DICTIONARY_TYPE_OPTIONS[0]?.value || '',
+  label: '',
+  sortOrder: 0,
+  enabled: true,
+});
+
+const rules = {
+  type: [{ required: true, message: '请选择字典类型', trigger: 'change' }],
+  label: [{ required: true, message: '请输入字典项名称', trigger: 'blur' }],
+};
+
+const filteredTableData = computed(() => {
+  const keyword = String(searchForm.keyword || '').trim();
+  if (!keyword) {
+    return tableData.value;
+  }
+
+  return tableData.value.filter((item) =>
+    String(item.label || '').includes(keyword),
+  );
+});
+
+const getTypeLabel = (type) => {
+  return (
+    MEDICAL_DICTIONARY_TYPE_OPTIONS.find((option) => option.value === type)
+      ?.label || type
+  );
+};
+
+const formatDateTime = (value) => {
+  if (!value) {
+    return '-';
+  }
+
+  const date = new Date(value);
+  if (Number.isNaN(date.getTime())) {
+    return '-';
+  }
+
+  return date.toLocaleString('zh-CN', { hour12: false });
+};
+
+const fetchData = async () => {
+  loading.value = true;
+  try {
+    const params = {
+      includeDisabled: true,
+      type: searchForm.type || undefined,
+    };
+    const res = await getDictionaries(params);
+    tableData.value = Array.isArray(res) ? res : [];
+  } finally {
+    loading.value = false;
+  }
+};
+
+const resetSearch = async () => {
+  searchForm.type = '';
+  searchForm.keyword = '';
+  await fetchData();
+};
+
+const resetForm = () => {
+  formRef.value?.clearValidate?.();
+  form.type = MEDICAL_DICTIONARY_TYPE_OPTIONS[0]?.value || '';
+  form.label = '';
+  form.sortOrder = 0;
+  form.enabled = true;
+  currentId.value = null;
+};
+
+const openCreateDialog = () => {
+  isEdit.value = false;
+  resetForm();
+  if (searchForm.type) {
+    form.type = searchForm.type;
+  }
+  dialogVisible.value = true;
+};
+
+const openEditDialog = (row) => {
+  isEdit.value = true;
+  formRef.value?.clearValidate?.();
+  currentId.value = row.id;
+  form.type = row.type;
+  form.label = row.label;
+  form.sortOrder = row.sortOrder ?? 0;
+  form.enabled = Boolean(row.enabled);
+  dialogVisible.value = true;
+};
+
+const handleSubmit = async () => {
+  if (!formRef.value) {
+    return;
+  }
+
+  try {
+    await formRef.value.validate();
+  } catch {
+    return;
+  }
+
+  submitLoading.value = true;
+  try {
+    const payload = {
+      type: form.type,
+      label: form.label,
+      sortOrder: form.sortOrder,
+      enabled: form.enabled,
+    };
+
+    if (isEdit.value) {
+      await updateDictionaryItem(currentId.value, payload);
+      ElMessage.success('字典项已更新');
+    } else {
+      await createDictionaryItem(payload);
+      ElMessage.success('字典项已创建');
+    }
+
+    dialogVisible.value = false;
+    await fetchData();
+  } finally {
+    submitLoading.value = false;
+  }
+};
+
+const handleDelete = async (row) => {
+  await ElMessageBox.confirm(
+    `确认删除字典项「${row.label}」吗？删除后将无法继续在表单中选择该值。`,
+    '删除确认',
+    {
+      type: 'warning',
+      confirmButtonText: '删除',
+      cancelButtonText: '取消',
+    },
+  );
+
+  await deleteDictionaryItem(row.id);
+  ElMessage.success('字典项已删除');
+  await fetchData();
+};
+
+onMounted(() => {
+  fetchData();
+});
+</script>
+
+<style scoped>
+.panel-card {
+  border-radius: 18px;
+}
+
+.panel-head {
+  display: flex;
+  align-items: center;
+  justify-content: space-between;
+}
+
+.panel-title {
+  font-size: 18px;
+  font-weight: 700;
+  color: #1f2937;
+}
+
+.panel-subtitle {
+  margin-top: 6px;
+  font-size: 13px;
+  color: #6b7280;
+}
+
+.page-alert {
+  margin-bottom: 16px;
+}
+
+.toolbar {
+  margin-bottom: 16px;
+}
+</style>

tyt-admin/src/views/patients/components/SurgeryFormSection.vue

@@ -0,0 +1,657 @@
+<template>
+  <div class="surgery-section">
+    <div class="section-head" v-if="title || description">
+      <div>
+        <div class="section-title" v-if="title">{{ title }}</div>
+        <div class="section-description" v-if="description">
+          {{ description }}
+        </div>
+      </div>
+    </div>
+
+    <el-row :gutter="16">
+      <el-col :xs="24" :md="12">
+        <el-form-item label="手术日期">
+          <el-date-picker
+            v-model="form.surgeryDate"
+            type="datetime"
+            value-format="YYYY-MM-DDTHH:mm:ss"
+            format="YYYY-MM-DD HH:mm"
+            placeholder="请选择手术日期"
+            style="width: 100%"
+          />
+        </el-form-item>
+      </el-col>
+      <el-col :xs="24" :md="12">
+        <el-form-item label="手术名称">
+          <el-input
+            v-model="form.surgeryName"
+            placeholder="例如：脑室腹腔分流术"
+          />
+        </el-form-item>
+      </el-col>
+      <el-col :xs="24" :md="12">
+        <el-form-item label="主刀医生">
+          <el-input v-model="form.surgeonName" placeholder="请输入主刀医生" />
+        </el-form-item>
+      </el-col>
+      <el-col :xs="24" :md="12">
+        <el-form-item label="术前测压">
+          <el-input-number
+            v-model="form.preOpPressure"
+            :min="0"
+            :controls="false"
+            placeholder="可为空"
+            style="width: 100%"
+          />
+        </el-form-item>
+      </el-col>
+      <el-col :xs="24" :md="12">
+        <el-form-item label="原发病">
+          <el-select
+            v-model="form.primaryDisease"
+            filterable
+            placeholder="请选择原发病"
+            style="width: 100%"
+          >
+            <el-option
+              v-for="item in dictionaryOptions.primaryDiseaseOptions"
+              :key="item"
+              :label="item"
+              :value="item"
+            />
+          </el-select>
+        </el-form-item>
+      </el-col>
+      <el-col :xs="24" :md="12">
+        <el-form-item label="脑积水类型">
+          <el-select
+            v-model="form.hydrocephalusTypes"
+            multiple
+            filterable
+            collapse-tags
+            collapse-tags-tooltip
+            placeholder="请选择脑积水类型"
+            style="width: 100%"
+          >
+            <el-option
+              v-for="item in dictionaryOptions.hydrocephalusTypeOptions"
+              :key="item"
+              :label="item"
+              :value="item"
+            />
+          </el-select>
+        </el-form-item>
+      </el-col>
+      <el-col :xs="24" :md="12">
+        <el-form-item label="上次分流时间">
+          <el-date-picker
+            v-model="form.previousShuntSurgeryDate"
+            type="datetime"
+            value-format="YYYY-MM-DDTHH:mm:ss"
+            format="YYYY-MM-DD HH:mm"
+            placeholder="可为空"
+            style="width: 100%"
+          />
+        </el-form-item>
+      </el-col>
+      <el-col :xs="24" :md="12">
+        <el-form-item label="手术备注">
+          <el-input
+            v-model="form.notes"
+            maxlength="200"
+            show-word-limit
+            placeholder="二次手术原因、术中特殊情况等"
+          />
+        </el-form-item>
+      </el-col>
+      <el-col :span="24" v-if="showAbandonSelector">
+        <el-form-item label="弃用旧设备">
+          <el-select
+            v-model="form.abandonedDeviceIds"
+            multiple
+            clearable
+            collapse-tags
+            collapse-tags-tooltip
+            placeholder="可选择本次手术后弃用的旧设备"
+            style="width: 100%"
+          >
+            <el-option
+              v-for="device in abandonableDevices"
+              :key="device.id"
+              :label="formatAbandonDeviceLabel(device)"
+              :value="device.id"
+            />
+          </el-select>
+        </el-form-item>
+      </el-col>
+    </el-row>
+
+    <el-card shadow="never" class="block-card">
+      <template #header>
+        <div class="block-head">
+          <div>
+            <div class="block-title">术前 CT 影像/资料</div>
+            <div class="block-subtitle">支持图片、视频、文件链接</div>
+          </div>
+          <el-button type="primary" plain @click="addMaterial"
+            >新增资料</el-button
+          >
+        </div>
+      </template>
+
+      <div v-if="form.preOpMaterials.length === 0" class="empty-hint">
+        暂未录入术前资料
+      </div>
+
+      <div
+        v-for="(material, index) in form.preOpMaterials"
+        :key="`material-${index}`"
+        class="material-row"
+      >
+        <el-row :gutter="12">
+          <el-col :xs="24" :md="5">
+            <el-select
+              v-model="material.type"
+              placeholder="类型"
+              style="width: 100%"
+            >
+              <el-option
+                v-for="item in MATERIAL_TYPE_OPTIONS"
+                :key="item.value"
+                :label="item.label"
+                :value="item.value"
+              />
+            </el-select>
+          </el-col>
+          <el-col :xs="24" :md="5">
+            <el-input v-model="material.name" placeholder="资料名称" />
+          </el-col>
+          <el-col :xs="24" :md="12">
+            <el-input v-model="material.url" placeholder="资料地址 URL" />
+          </el-col>
+          <el-col :xs="24" :md="2" class="material-remove">
+            <el-button
+              type="danger"
+              plain
+              @click="removeMaterial(index)"
+              :disabled="
+                form.preOpMaterials.length === 1 &&
+                !material.url &&
+                !material.name
+              "
+            >
+              删除
+            </el-button>
+          </el-col>
+        </el-row>
+      </div>
+    </el-card>
+
+    <el-card shadow="never" class="block-card">
+      <template #header>
+        <div class="block-head">
+          <div>
+            <div class="block-title">植入设备</div>
+            <div class="block-subtitle">
+              选型号后自动联动厂家和名称；支持一次手术录入多台设备
+            </div>
+          </div>
+          <el-button type="primary" @click="addDevice">新增设备</el-button>
+        </div>
+      </template>
+
+      <div
+        v-for="(device, index) in form.devices"
+        :key="`device-${index}`"
+        class="device-card"
+      >
+        <div class="device-card-head">
+          <div class="device-card-title">设备 {{ index + 1 }}</div>
+          <el-button
+            type="danger"
+            plain
+            @click="removeDevice(index)"
+            :disabled="form.devices.length <= 1"
+          >
+            删除设备
+          </el-button>
+        </div>
+
+        <el-row :gutter="16">
+          <el-col :xs="24" :md="12">
+            <el-form-item label="植入物型号">
+              <el-select
+                v-model="device.implantCatalogId"
+                filterable
+                placeholder="请选择植入物型号"
+                style="width: 100%"
+                @change="handleCatalogChange(device)"
+              >
+                <el-option
+                  v-for="item in catalogOptions"
+                  :key="item.id"
+                  :label="formatCatalogLabel(item)"
+                  :value="item.id"
+                />
+              </el-select>
+            </el-form-item>
+          </el-col>
+          <el-col :xs="24" :md="12">
+            <el-form-item label="设备 SN">
+              <el-input
+                v-model="device.snCode"
+                placeholder="可不填，系统自动生成"
+              />
+            </el-form-item>
+          </el-col>
+          <el-col :xs="24" :md="12">
+            <el-form-item label="植入物厂商">
+              <el-input
+                :model-value="
+                  resolveCatalog(device.implantCatalogId)?.manufacturer || '-'
+                "
+                disabled
+              />
+            </el-form-item>
+          </el-col>
+          <el-col :xs="24" :md="12">
+            <el-form-item label="植入物名称">
+              <div class="catalog-name-box">
+                <el-input
+                  :model-value="
+                    resolveCatalog(device.implantCatalogId)?.name || '-'
+                  "
+                  disabled
+                />
+                <el-tag
+                  v-if="resolveCatalog(device.implantCatalogId)"
+                  :type="
+                    resolveCatalog(device.implantCatalogId)
+                      ?.isPressureAdjustable
+                      ? 'success'
+                      : 'info'
+                  "
+                >
+                  {{
+                    resolveCatalog(device.implantCatalogId)
+                      ?.isPressureAdjustable
+                      ? '可调压'
+                      : '固定压'
+                  }}
+                </el-tag>
+              </div>
+              <div
+                v-if="resolvePressureLevels(device.implantCatalogId).length"
+                class="pressure-level-hint"
+              >
+                挡位：
+                {{ resolvePressureLevels(device.implantCatalogId).join(' / ') }}
+              </div>
+            </el-form-item>
+          </el-col>
+          <el-col :xs="24" :md="12">
+            <el-form-item label="分流方式">
+              <el-select
+                v-model="device.shuntMode"
+                filterable
+                placeholder="请选择分流方式"
+                style="width: 100%"
+              >
+                <el-option
+                  v-for="item in dictionaryOptions.shuntModeOptions"
+                  :key="item"
+                  :label="item"
+                  :value="item"
+                />
+              </el-select>
+            </el-form-item>
+          </el-col>
+          <el-col :xs="24" :md="12">
+            <el-form-item label="远端分流方向">
+              <el-select
+                v-model="device.distalShuntDirection"
+                filterable
+                placeholder="请选择远端方向"
+                style="width: 100%"
+              >
+                <el-option
+                  v-for="item in dictionaryOptions.distalShuntDirectionOptions"
+                  :key="item"
+                  :label="item"
+                  :value="item"
+                />
+              </el-select>
+            </el-form-item>
+          </el-col>
+          <el-col :xs="24" :md="12">
+            <el-form-item label="近端穿刺区域">
+              <el-select
+                v-model="device.proximalPunctureAreas"
+                multiple
+                filterable
+                collapse-tags
+                collapse-tags-tooltip
+                :multiple-limit="2"
+                placeholder="最多 2 项"
+                style="width: 100%"
+              >
+                <el-option
+                  v-for="item in dictionaryOptions.proximalPunctureOptions"
+                  :key="item"
+                  :label="item"
+                  :value="item"
+                />
+              </el-select>
+            </el-form-item>
+          </el-col>
+          <el-col :xs="24" :md="12">
+            <el-form-item label="阀门植入部位">
+              <el-select
+                v-model="device.valvePlacementSites"
+                multiple
+                filterable
+                collapse-tags
+                collapse-tags-tooltip
+                :multiple-limit="2"
+                placeholder="最多 2 项"
+                style="width: 100%"
+              >
+                <el-option
+                  v-for="item in dictionaryOptions.valvePlacementOptions"
+                  :key="item"
+                  :label="item"
+                  :value="item"
+                />
+              </el-select>
+            </el-form-item>
+          </el-col>
+          <el-col :xs="24" :md="12">
+            <el-form-item label="初始压力">
+              <el-select
+                v-if="resolvePressureLevels(device.implantCatalogId).length"
+                v-model="device.initialPressure"
+                clearable
+                placeholder="请选择初始挡位"
+                style="width: 100%"
+              >
+                <el-option
+                  v-for="level in resolvePressureLevels(
+                    device.implantCatalogId,
+                  )"
+                  :key="`${device.implantCatalogId}-initial-${level}`"
+                  :label="String(level)"
+                  :value="level"
+                />
+              </el-select>
+              <el-input-number
+                v-else
+                v-model="device.initialPressure"
+                :min="0"
+                :controls="false"
+                :disabled="
+                  !resolveCatalog(device.implantCatalogId)?.isPressureAdjustable
+                "
+                placeholder="可为空"
+                style="width: 100%"
+              />
+              <div class="field-hint">
+                当前压力创建后默认继承初始压力，后续以调压任务完成结果为准
+              </div>
+            </el-form-item>
+          </el-col>
+          <el-col :span="24">
+            <el-form-item label="植入物备注">
+              <el-input
+                v-model="device.implantNotes"
+                maxlength="200"
+                show-word-limit
+                placeholder="记录术中情况、位置说明等"
+              />
+            </el-form-item>
+          </el-col>
+          <el-col :span="24">
+            <el-form-item label="植入物标签">
+              <el-input
+                v-model="device.labelImageUrl"
+                placeholder="请输入图片地址 URL"
+              />
+            </el-form-item>
+          </el-col>
+        </el-row>
+      </div>
+    </el-card>
+  </div>
+</template>
+
+<script setup>
+import { MATERIAL_TYPE_OPTIONS } from '../patient-form-options';
+import { createEmptyMedicalDictionaryOptions } from '../../../constants/medical-dictionaries';
+
+const props = defineProps({
+  form: {
+    type: Object,
+    required: true,
+  },
+  catalogOptions: {
+    type: Array,
+    default: () => [],
+  },
+  dictionaryOptions: {
+    type: Object,
+    default: () => createEmptyMedicalDictionaryOptions(),
+  },
+  abandonableDevices: {
+    type: Array,
+    default: () => [],
+  },
+  showAbandonSelector: {
+    type: Boolean,
+    default: false,
+  },
+  title: {
+    type: String,
+    default: '',
+  },
+  description: {
+    type: String,
+    default: '',
+  },
+});
+
+const createMaterial = () => ({
+  type: 'IMAGE',
+  name: '',
+  url: '',
+});
+
+const createDevice = () => ({
+  implantCatalogId: null,
+  snCode: '',
+  shuntMode: '',
+  proximalPunctureAreas: [],
+  valvePlacementSites: [],
+  distalShuntDirection: '',
+  initialPressure: null,
+  implantNotes: '',
+  labelImageUrl: '',
+});
+
+const addMaterial = () => {
+  props.form.preOpMaterials.push(createMaterial());
+};
+
+const removeMaterial = (index) => {
+  if (props.form.preOpMaterials.length === 1) {
+    props.form.preOpMaterials.splice(index, 1, createMaterial());
+    return;
+  }
+  props.form.preOpMaterials.splice(index, 1);
+};
+
+const addDevice = () => {
+  props.form.devices.push(createDevice());
+};
+
+const removeDevice = (index) => {
+  if (props.form.devices.length <= 1) {
+    return;
+  }
+  props.form.devices.splice(index, 1);
+};
+
+const resolveCatalog = (catalogId) => {
+  return props.catalogOptions.find((item) => item.id === catalogId) || null;
+};
+
+const resolvePressureLevels = (catalogId) => {
+  const pressureLevels = resolveCatalog(catalogId)?.pressureLevels;
+  return Array.isArray(pressureLevels) ? pressureLevels : [];
+};
+
+const formatCatalogLabel = (catalog) => {
+  return `${catalog.modelCode} ｜ ${catalog.manufacturer} ｜ ${catalog.name}`;
+};
+
+const handleCatalogChange = (device) => {
+  const catalog = resolveCatalog(device.implantCatalogId);
+  if (!catalog?.isPressureAdjustable) {
+    device.initialPressure = null;
+    return;
+  }
+
+  const pressureLevels = resolvePressureLevels(device.implantCatalogId);
+  if (pressureLevels.length === 0) {
+    return;
+  }
+
+  if (!pressureLevels.includes(device.initialPressure)) {
+    device.initialPressure = pressureLevels[0];
+  }
+};
+
+const formatAbandonDeviceLabel = (device) => {
+  const implantLabel =
+    device.implantModel || device.implantName || '未命名设备';
+  return `${implantLabel} ｜ ${device.snCode || '无 SN'} ｜ 当前压力 ${
+    device.currentPressure ?? '-'
+  }`;
+};
+</script>
+
+<style scoped>
+.section-head {
+  margin-bottom: 16px;
+}
+
+.section-title {
+  font-size: 15px;
+  font-weight: 600;
+  color: #1f2a37;
+}
+
+.section-description {
+  margin-top: 4px;
+  font-size: 12px;
+  color: #6b7280;
+}
+
+.block-card {
+  margin-top: 12px;
+  border-radius: 14px;
+  border-color: #d9e4f3;
+  background: linear-gradient(180deg, #ffffff 0%, #f8fbff 100%);
+}
+
+.block-head {
+  display: flex;
+  align-items: center;
+  justify-content: space-between;
+  gap: 12px;
+}
+
+.block-title {
+  font-size: 14px;
+  font-weight: 600;
+  color: #1f2a37;
+}
+
+.block-subtitle {
+  margin-top: 4px;
+  font-size: 12px;
+  color: #6b7280;
+}
+
+.field-hint {
+  margin-top: 6px;
+  font-size: 12px;
+  color: #6b7280;
+}
+
+.empty-hint {
+  padding: 12px 0;
+  color: #6b7280;
+  font-size: 13px;
+}
+
+.material-row + .material-row {
+  margin-top: 12px;
+}
+
+.material-remove {
+  display: flex;
+  justify-content: flex-end;
+}
+
+.device-card {
+  padding: 16px;
+  border: 1px solid #dbe7f5;
+  border-radius: 14px;
+  background: #fff;
+}
+
+.device-card + .device-card {
+  margin-top: 16px;
+}
+
+.device-card-head {
+  display: flex;
+  align-items: center;
+  justify-content: space-between;
+  margin-bottom: 12px;
+}
+
+.device-card-title {
+  font-size: 14px;
+  font-weight: 600;
+  color: #1f2a37;
+}
+
+.catalog-name-box {
+  display: grid;
+  grid-template-columns: minmax(0, 1fr) auto;
+  gap: 8px;
+  align-items: center;
+  width: 100%;
+}
+
+.pressure-level-hint {
+  margin-top: 6px;
+  font-size: 12px;
+  color: #6b7280;
+  line-height: 1.5;
+}
+
+@media (max-width: 768px) {
+  .block-head,
+  .device-card-head {
+    flex-direction: column;
+    align-items: flex-start;
+  }
+
+  .material-remove {
+    justify-content: flex-start;
+    margin-top: 8px;
+  }
+}
+</style>

tyt-admin/src/views/patients/patient-form-options.js

@@ -0,0 +1,15 @@
+export const MATERIAL_TYPE_OPTIONS = [
+  { label: '图片', value: 'IMAGE' },
+  { label: '视频', value: 'VIDEO' },
+  { label: '文件', value: 'FILE' },
+];
+
+export const LIFECYCLE_EVENT_LABELS = {
+  SURGERY: '手术',
+  TASK_PRESSURE_ADJUSTMENT: '调压',
+};
+
+export const LIFECYCLE_EVENT_TAG_TYPES = {
+  SURGERY: 'success',
+  TASK_PRESSURE_ADJUSTMENT: 'warning',
+};