feat: 后端架构重构 — Endpoint→Service→Repository分层 + AI确认机制 + 异步任务持久化
- 核心业务拆分为 Endpoint → Application Service → Repository 三层 - AI写入操作必须用户确认后才写库(确认卡片机制) - 报告/饮食/用药分析改为持久化任务队列(原子领取/重试/重启恢复) - 运动计划修复: 连续真实日期替代周模板 - 用药提醒去重 + 通知Outbox预留 - 认证收拢到AuthService, 管理员收拢到AdminService - AI会话加用户归属校验防串号 - 提示词调整为患者视角 - 开发假数据已关闭 - 21/21测试通过, 0警告0错误
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MingNian
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using Health.Application.Reports;
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using Health.Infrastructure.AI;
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using Microsoft.Extensions.Logging;
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namespace Health.Infrastructure.Reports;
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public sealed class ReportAnalysisService(
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IReportRepository reports,
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VisionClient vision,
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DeepSeekClient llm,
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ILogger<ReportAnalysisService> logger) : IReportAnalysisService
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{
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private readonly IReportRepository _reports = reports;
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private readonly VisionClient _vision = vision;
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private readonly DeepSeekClient _llm = llm;
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private readonly ILogger<ReportAnalysisService> _logger = logger;
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public async Task AnalyzeAsync(ReportAnalysisJob job, CancellationToken ct)
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{
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var report = await _reports.GetByIdAsync(job.ReportId, ct);
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if (report == null) return;
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try
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{
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var vlmJson = await ExtractIndicatorsAsync(job.FilePath, ct);
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var isReport = vlmJson.TryGetProperty("isReport", out var ir) && ir.GetBoolean();
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var reason = vlmJson.TryGetProperty("reason", out var rsn) ? rsn.GetString() : null;
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if (!isReport)
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{
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report.AiSummary = $"AI 暂时无法完成解读：{reason ?? "这可能不是一份医学报告"}。请重新上传清晰的报告图片。";
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report.AiIndicators = "[]";
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report.Status = ReportStatus.AnalysisFailed;
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await _reports.SaveChangesAsync(ct);
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return;
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}
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var reportType = vlmJson.TryGetProperty("reportType", out var rt) ? rt.GetString() ?? "Other" : "Other";
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var indicatorsJson = vlmJson.TryGetProperty("indicators", out var inds) ? inds.GetRawText() : "[]";
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report.Category = Enum.TryParse<ReportCategory>(reportType, out var cat) ? cat : ReportCategory.Other;
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report.AiIndicators = indicatorsJson;
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report.AiSummary = await GenerateSummaryAsync(indicatorsJson, ct);
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report.Status = ReportStatus.PendingDoctor;
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await _reports.SaveChangesAsync(ct);
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_logger.LogInformation("报告 AI 分析完成: {ReportId}", job.ReportId);
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}
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catch (Exception ex)
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{
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_logger.LogError(ex, "报告 AI 分析失败: {ReportId}", job.ReportId);
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report.Status = ReportStatus.AnalysisFailed;
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report.AiSummary = "AI 暂时无法完成解读，可能是图片不清晰或服务暂时不可用。请稍后重试，或重新上传更清晰的报告图片。";
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report.AiIndicators = "[]";
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await _reports.SaveChangesAsync(ct);
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}
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}
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private async Task<JsonElement> ExtractIndicatorsAsync(string filePath, CancellationToken ct)
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{
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var imageUrl = await GetLocalImageUrl(filePath, ct);
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if (imageUrl == null)
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throw new InvalidOperationException("报告图片文件不存在或无法读取");
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var prompt = """
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你是一名医学检验报告分析专家。请仔细识别这份医学报告。
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第一步：判断这到底是不是一份医学检验报告。
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如果不是（比如是自拍、风景照、食物、文件等），直接返回：
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{"isReport": false, "reason": "这不是医学报告，原因：..."}
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如果是医学报告，提取所有检测指标，返回严格JSON格式（不要markdown包裹）：
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{
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"isReport": true,
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"reportType": "BloodTest/Biochemistry/Ecg/Ultrasound/Discharge/Other",
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"indicators": [
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{"name": "指标名称", "value": "数值", "unit": "单位", "referenceRange": "参考范围", "status": "normal/high/low"}
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]
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}
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注意：
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- status 判断：数值在参考范围内=normal，超出上限=high，低于下限=low
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- 如果参考范围不明确，根据常见医学标准判断
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""";
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var response = await _vision.VisionAsync(
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prompt,
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[imageUrl],
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userText: "请分析这份医学报告",
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maxTokens: 2048,
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ct: ct);
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var content = response.Choices?.FirstOrDefault()?.Message?.Content ?? "";
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_logger.LogInformation("报告 VLM 返回: {Content}", content[..Math.Min(content.Length, 200)]);
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var json = TryParseJson(content);
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return json ?? throw new InvalidOperationException("报告识别结果格式异常");
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}
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private async Task<string> GenerateSummaryAsync(string indicatorsJson, CancellationToken ct)
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{
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var prompt = $"""
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你是患者端医学报告预解读助手。请根据以下检验指标，用通俗易懂的语言写一份报告解读。
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检测指标：{indicatorsJson}
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要求：
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1. 总字数200-300字
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2. 先总结整体情况
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3. 指出异常指标及其可能原因，但不要给出确定诊断
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4. 给出生活方式和复查/就医沟通建议，不要给出处方、停药、换药或调药建议
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5. 如指标明显异常或存在急症风险，优先建议及时就医
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6. 末尾提醒"以上为AI预解读，不能替代医生诊断和治疗建议"
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只返回解读文本，不要JSON格式。
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""";
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var messages = new List<ChatMessage>
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{
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new() { Role = "system", Content = "你是患者端医学报告预解读助手，不替代医生诊断、处方或治疗决策。" },
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new() { Role = "user", Content = prompt }
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};
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var response = await _llm.ChatAsync(messages, maxTokens: 800, temperature: 0.3f, ct: ct);
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var summary = response.Choices?.FirstOrDefault()?.Message?.Content?.Trim() ?? "";
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return !string.IsNullOrWhiteSpace(summary)
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? summary
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: throw new InvalidOperationException("AI 未返回有效解读内容");
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}
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private static async Task<string?> GetLocalImageUrl(string filePath, CancellationToken ct)
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{
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if (!File.Exists(filePath)) return null;
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var bytes = await File.ReadAllBytesAsync(filePath, ct);
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var base64 = Convert.ToBase64String(bytes);
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var ext = Path.GetExtension(filePath).ToLowerInvariant().TrimStart('.');
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var mime = ext switch
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{
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"png" => "image/png",
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"jpg" or "jpeg" => "image/jpeg",
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"webp" => "image/webp",
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_ => "image/png"
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};
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return $"data:{mime};base64,{base64}";
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}
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private static JsonElement? TryParseJson(string? content)
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{
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if (string.IsNullOrWhiteSpace(content)) return null;
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content = content.Trim();
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if (content.StartsWith("```"))
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{
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var end = content.IndexOf('\n');
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if (end > 0) content = content[(end + 1)..];
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if (content.EndsWith("```"))
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content = content[..^3];
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}
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content = content.Trim();
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try { return JsonDocument.Parse(content).RootElement; }
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catch { return null; }
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}
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}
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