feat(emr): plan 的"建议"接入 recommendation + 病历显示 + 牙位全展示

医生建议(plan 字段长尾"建议X")原先 MVP 直接 drop,现忠实保留并在病历快读显示:
- transforms 新增 union 算子(表级合并)— 补上"transforms 无 union"的 TODO
- manifest:plan 的"建议"→ _plan_recommendation_raw → union 并入 treat_plan 的 _recommendation_raw
- recommendation.yaml:加 name(医生原文,无 enum)+ sourceEncounterExternalId(按接诊匹配)
- fact-content-schemas:recommendation.code 改可空 + 加 name / source_encounter_external_id
- recommendation.parser:未命中白名单不再丢(code=null 但保留原文 name);空 code 不触发召回
- emr-soap-view:P 段加「医生建议」(忠实原文,如"建议更换 · 11;12;…")

病历牙位:SOAP 全部牙位完整展示(formatToothPosition maxShow=999),不再"等 N 颗"。

注:存量患者需重摄入才有历史"建议";新增量自动带。无 DB migration(content 为 JSON)。

Co-Authored-By: Claude Opus 4.8 (1M context) <noreply@anthropic.com>

apps/pac-service/data/jvs-dw/assemblers/recommendation.yaml

@@ -21,6 +21,8 @@ field_mapping:
   clinicId:          organization_id
   occurredAt:        created_date          # 精确就诊时刻(rq 只到日);created_date=医生写建议的时点,100% 同 rq 日
   code:              treat_name             # "建议种植" 等 → enum_mapping 翻译到 PAC 推荐码
+  name:              treat_name             # 医生原文(无 enum,原样)— 病历忠实展示;长尾建议靠它
+  sourceEncounterExternalId: emr_id         # 同次接诊病历 id — 病历快读按接诊匹配
   toothPosition:     tooth_position
   doctorId:          user_id                # 建议医生(从 emr 父级继承)
   doctorName:        doctor_name            # 建议医生名(快照)

apps/pac-service/data/jvs-dw/manifest.yaml

@@ -402,13 +402,13 @@ transforms:
         when:
           default: true
 
-  # ── C.4 plan 路由分流(MVP:只取真治疗,推荐/复查暂 drop)──
+  # ── C.4 plan 路由分流(plan 的"建议"也接入 recommendation;复查暂 drop)──
   - kind: route_by_pattern
     input: _plan_raw
     field: treat_name
     routes:
-      # MVP:plan 的"建议"暂时 drop(transforms 无 union,合并 treat_plan 留 TODO)
-      - output: _drop_plan_recommendation
+      # plan 的"建议"→ recommendation(下面 C.4.5 union 合并到 treat_plan 的 _recommendation_raw)
+      - output: _plan_recommendation_raw
         when:
           starts_with: ['建议', '推荐']
       # MVP:plan 的"复查/暂观/流程性/咨询"暂 drop(避免 kind 冲突 + 防止流程性话流入 planned 治疗)
@@ -459,7 +459,12 @@ transforms:
         when:
           default: true
 
-  # ── C.5 推荐(来自 treat_plan) ──
+  # ── C.4.5 合并两源建议 ── treat_plan 的 _recommendation_raw + plan 的 _plan_recommendation_raw
+  - kind: union
+    inputs: ['_recommendation_raw', '_plan_recommendation_raw']
+    output: _recommendation_raw
+
+  # ── C.5 推荐(来自 treat_plan + plan 合并) ──
   - kind: derive
     input: _recommendation_raw
     output: recommendation_rows

apps/pac-service/src/modules/sync/pipeline/fact-content-schemas.ts

@@ -140,7 +140,12 @@ const TreatmentRecordContent = z
  */
 const RecommendationRecordContent = z
   .object({
-    code: PACDiagnosisCodeSchema, // IMPLANT_RECOMMENDED 等"推荐码"
+    /// 推荐码(IMPLANT_RECOMMENDED 等);未命中白名单的长尾建议 → null(仅展示、不触发召回)
+    code: PACDiagnosisCodeSchema.nullable(),
+    /// 医生原文建议(如"建议更换")— 病历忠实展示用;canonical code 缺失时靠它显示
+    name: nullableString(),
+    /// 同次接诊病历 id — 病历快读按接诊匹配展示
+    source_encounter_external_id: nullableString(),
     tooth_position: toothPositionText(),
     /// 建议医生(继承 emr 父级 user_id;话术个性化用)
     doctor_id: nullableString(),

apps/pac-service/src/modules/sync/pipeline/parsers/recommendation.parser.ts

@@ -37,13 +37,14 @@ export class RecommendationParser implements Parser {
       return [];
     }
 
-    const code = String(c.code ?? '').trim();
-    const codeParsed = PACDiagnosisCodeSchema.safeParse(code);
-    if (!codeParsed.success) {
-      this.logger.warn(
-        `recommendation parser: code="${code}" not in PACDiagnosisCodes ` +
-          `(externalId=${externalId});skip`,
-      );
+    // code 命中白名单 → canonical 推荐码(触发召回);未命中 → null(长尾建议,仅病历展示)
+    const rawCode = String(c.code ?? '').trim();
+    const codeParsed = PACDiagnosisCodeSchema.safeParse(rawCode);
+    const code = codeParsed.success ? codeParsed.data : null;
+    // 医生原文(如"建议更换")— 忠实展示;选 A:长尾建议也保留(不再 drop)
+    const name = String(c.name ?? '').trim() || null;
+    if (!code && !name) {
+      // 既无 canonical 码、又无原文 → 无可展示内容,跳过
       return [];
     }
 
@@ -63,10 +64,13 @@ export class RecommendationParser implements Parser {
         status: FactStatus.ACTIVE,
         clinicId: ctx.transaction.clinicId,
         plannedFor: ctx.transaction.occurredAt,
-        title: `建议 ${codeParsed.data}`,
+        title: name ? `建议:${name}` : `建议 ${code}`,
         summary: null,
         content: {
-          code: codeParsed.data,
+          code,
+          name,
+          source_encounter_external_id:
+            (c.sourceEncounterExternalId as string | undefined) ?? null,
           tooth_position: normalizeToothPosition(c.toothPosition as string | undefined),
           doctor_id: c.doctorId ? String(c.doctorId) : null,
           doctor_name: (c.doctorName as string | undefined) ?? null,

apps/pac-service/src/modules/sync/transforms/transform-engine.ts

@@ -43,6 +43,15 @@ export class TransformEngine {
     }
 
     for (const op of opts.transforms) {
+      // union 是多输入(op.inputs),不走下面的单 input 取值;缺失表当空表
+      if (op.kind === 'union') {
+        const merged = op.inputs.flatMap((n) => tables[n] ?? []);
+        tables[op.output] = merged;
+        this.logger.log(
+          `[transform/union] [${op.inputs.join(',')}] → "${op.output}"(${merged.length})`,
+        );
+        continue;
+      }
       const inputName = op.input;
       const input = tables[inputName];
       if (!input) {

apps/pac-service/src/modules/sync/transforms/transforms.schema.ts

@@ -271,8 +271,20 @@ export const FilterOpSchema = z.object({
 });
 export type FilterOp = z.infer<typeof FilterOpSchema>;
 
+/**
+ * union — 把多个同结构表合并成一个(行级 concat)。
+ * 场景:treat_plan 与 plan 两源各自 route 出的"建议"行,合并进同一 recommendation 表。
+ * inputs 缺失的表当空表;output 可与某 input 同名(in-place 合并)。
+ */
+export const UnionOpSchema = z.object({
+  kind: z.literal('union'),
+  inputs: z.array(tableNameSchema).min(1),
+  output: tableNameSchema,
+});
+export type UnionOp = z.infer<typeof UnionOpSchema>;
+
 // ─────────────────────────────────────────────────────────
-// 6 operator union + transforms[] 顶层
+// 7 operator union + transforms[] 顶层
 // ─────────────────────────────────────────────────────────
 
 export const TransformOpSchema = z.discriminatedUnion('kind', [
@@ -282,6 +294,7 @@ export const TransformOpSchema = z.discriminatedUnion('kind', [
   RouteByPatternOpSchema,
   PickFirstNonzeroOpSchema,
   FilterOpSchema,
+  UnionOpSchema,
 ]);
 export type TransformOp = z.infer<typeof TransformOpSchema>;
 

apps/pac-web/src/components/plan-detail/emr-soap-view.tsx

@@ -161,6 +161,8 @@ function EmrSection({
   const plannedTx = facts.filter((f) => f.type === 'treatment_record' && f.kind === 'planned' && sameEncounter(f));
   // 本次实际做的治疗(actual,同次接诊)— 病历里体现"这次到底做了什么"
   const actualTx = facts.filter((f) => f.type === 'treatment_record' && f.kind === 'actual' && sameEncounter(f));
+  // 医生建议(同次接诊)— 忠实展示医生原文建议(如"建议更换"),含长尾(code 可能为空)
+  const recommendations = facts.filter((f) => f.type === 'recommendation_record' && sameEncounter(f));
   const images = facts.filter((f) => f.type === 'image_record' && sameEncounter(f));
 
   // S 主观 — 自由文本
@@ -217,7 +219,7 @@ function EmrSection({
                   <li key={i} className="text-[12px] text-slate-700 leading-relaxed">
                     {x.toothPosition && (
                       <span className="inline-block px-1.5 py-0 mr-1.5 bg-slate-100 text-slate-700 rounded text-[10.5px] tabular-nums align-middle">
-                        {formatToothPosition(x.toothPosition)}
+                        {formatToothPosition(x.toothPosition, 999)}
                       </span>
                     )}
                     {x.message}
@@ -262,7 +264,7 @@ function EmrSection({
                     <span className="px-1.5 py-px mr-1.5 bg-rose-50 text-rose-700 rounded text-[10.5px] font-medium">
                       {badgeText}
                     </span>
-                    {tooth && <span className="text-[11px] text-slate-500">牙位 {formatToothPosition(tooth)}</span>}
+                    {tooth && <span className="text-[11px] text-slate-500">牙位 {formatToothPosition(tooth, 999)}</span>}
                   </li>
                 );
               })}
@@ -271,7 +273,7 @@ function EmrSection({
         )}
 
         {/* P */}
-        {(disposals.length > 0 || actualTx.length > 0 || plannedTx.length > 0 || doctorAdvice) && (
+        {(disposals.length > 0 || actualTx.length > 0 || plannedTx.length > 0 || recommendations.length > 0 || doctorAdvice) && (
           <SoapBlock letter="P" tone="emerald" title="计划(Plan)">
             {disposals.length > 0 && (
               <div className="mb-2">
@@ -281,7 +283,7 @@ function EmrSection({
                     <li key={i} className="text-[12px] text-slate-700 leading-relaxed whitespace-pre-line">
                       {x.toothPosition && (
                         <span className="inline-block px-1.5 py-0 mr-1.5 bg-slate-100 text-slate-700 rounded text-[10.5px] tabular-nums align-middle">
-                          {formatToothPosition(x.toothPosition)}
+                          {formatToothPosition(x.toothPosition, 999)}
                         </span>
                       )}
                       {x.message}
@@ -306,7 +308,7 @@ function EmrSection({
                           {badgeText}
                         </span>
                         <span className="font-medium">{subtype}</span>
-                        {tooth && <span className="ml-1.5 text-[11px] text-slate-500">· 牙位 {formatToothPosition(tooth)}</span>}
+                        {tooth && <span className="ml-1.5 text-[11px] text-slate-500">· 牙位 {formatToothPosition(tooth, 999)}</span>}
                       </li>
                     );
                   })}
@@ -330,7 +332,26 @@ function EmrSection({
                           {badgeText}
                         </span>
                         <span className="font-medium">{subtype}</span>
-                        {tooth && <span className="ml-1.5 text-[11px] text-slate-500">· 牙位 {formatToothPosition(tooth)}</span>}
+                        {tooth && <span className="ml-1.5 text-[11px] text-slate-500">· 牙位 {formatToothPosition(tooth, 999)}</span>}
+                      </li>
+                    );
+                  })}
+                </ul>
+              </div>
+            )}
+            {recommendations.length > 0 && (
+              <div className="mb-2">
+                <div className="text-[11px] text-slate-500 mb-1">医生建议:</div>
+                <ul className="space-y-1">
+                  {recommendations.map((rec) => {
+                    const rc = rec.content as Record<string, unknown>;
+                    const text = String(rc.name ?? '') || rec.title || '建议';
+                    const tooth = String(rc.tooth_position ?? '');
+                    return (
+                      <li key={rec.id} className="text-[12px] text-slate-700 leading-relaxed">
+                        <span className="px-1.5 py-px mr-1.5 bg-amber-50 text-amber-700 rounded text-[10.5px] font-medium">建议</span>
+                        <span className="font-medium">{text}</span>
+                        {tooth && <span className="ml-1.5 text-[11px] text-slate-500">· 牙位 {formatToothPosition(tooth, 999)}</span>}
                       </li>
                     );
                   })}