feat(sign): 补齐医护端与患者端签署流程

README.md

@@ -8,7 +8,8 @@
 
 - `clinical-web`：医护端布局、工作台、签署任务、文书库、报表和设置页面；
 - `patient-h5`：签署入口、文书确认、签署人信息、手写签名和结果页面；
-- 默认仍使用演示数据，但医护端已按 MEDISIGN 接口文档接入登录、患者/就诊、模板、签署任务、文件产物、投递、用户组织和模板权限等真实接口；患者 H5 已接入一次性 Token 消费和签名上传请求；
+- 默认仍使用演示数据。真实签署流程中，医护端创建任务时提交模板表单答案和实际签署人；患者 H5 消费一次性 Token 后读取服务端固化的患者、签署人和文书上下文，再上传签名 PNG；
+- 真实签署通道目前限于后端已定义的 SMS 与 PAD。短信接口只确认投递意图已排队；短信供应商、微信公众号和 iPad 设备适配仍需后端/集成服务接入；
 - `packages` 目录暂时保留，等接口和公共类型稳定后再接入共享包。
 
 ## 项目定位
@@ -87,6 +88,13 @@ medical-sign/
 - 前端不负责最终权限和签署有效性判断，后端必须重新校验；
 - 患者 H5 不在 URL 中暴露身份证号、完整病历等敏感信息。
 
+## 签署接口契约
+
+- 模板版本的 `formFields` 保存文书字段定义，`signatureFields` 单独保存患者签名在 PDF 中的页码、坐标、宽高和坐标系；编辑器中的坐标单位为 PDF point。发布模板前必须配置 `signature` 字段的位置。
+- `GET /api/v1/templates/available-versions` 返回 `formFields` 和 `needConfirm`。创建任务时将人工填写值放入 `staffAnswers`，并传入 `signerType`、`signerName`、`signerRelation`；患者、性别、年龄、就诊号和电话等已知字段仍由后端快照覆盖。
+- H5 先调用 `POST /api/v1/sign-deliveries/token/consume`，再用返回的 `taskId`、`deliveryId`、`uploadToken` 调用 `POST /api/v1/sign-deliveries/token/context`。上传使用 `POST /api/v1/sign-deliveries/{taskId}/signature` multipart，包含 `file`、`metadata` 和 `signer` JSON 部分，并复用 `Idempotency-Key` 安全重试。
+- 患者签署后，任务可能处于 `GENERATING`、`WAITING_CONFIRM` 或 `SIGNED`。刷新结果页时 H5 使用只读 context 查询恢复服务端状态，不能将这些状态退回为可重复签署。
+
 ## 构建与部署规划
 
 两个应用分别构建为 `dist`：

clinical-web/src/api/management/documents.ts

@@ -136,19 +136,37 @@ export function readVersionContentHtml(dto: TemplateVersionResponseDto | null):
 /**
  * 把正文 HTML 里的占位符编译成后端可留存的结构化字段定义。
  *
- * 后端版本 DTO 的 signatureFields 字段承载「这份模板有哪些填写项」，
+ * 正文填写项和 PDF 签名几何是两个独立契约：formFields 负责字段语义，
- * 正文本身仍以 contentHtml 提交。不提交这个字段的话，后端拿不到字段口径，
+ * signatureFields 只负责患者签名图在服务端生成 PDF 中的位置。
- * 也就无法在签署侧做必填校验与证据固化。
  */
 export function buildSignatureFieldsPayload(contentHtml: string): unknown[] {
+  const field = collectFieldDefs(contentHtml).find((item) => item.id === 'signature')
+  if (!field || field.kind !== 'signature') {
+    throw new Error('请在正文中插入“患者签名”占位符')
+  }
+  if (!field.pdfPosition) {
+    throw new Error('请先为“患者签名”配置 PDF 页码和签名位置')
+  }
+  return [
+    {
+      id: field.id,
+      page: field.pdfPosition.page,
+      x: field.pdfPosition.x,
+      y: field.pdfPosition.y,
+      width: field.pdfPosition.width,
+      height: field.pdfPosition.height,
+      coordinateSystem: field.pdfPosition.coordinateSystem,
+    },
+  ]
+}
+
+export function buildFormFieldsPayload(contentHtml: string): unknown[] {
   return collectFieldDefs(contentHtml).map((field) => ({
     id: field.id,
     label: field.label,
     kind: field.kind,
     required: field.required,
     options: field.options,
-    // 单/多选必须一起上报：后端靠它渲染签署控件与做取值校验，
-    // 缺了这个字段就只能按 kind 猜，多选组会被当成单个勾选框
     ...(field.multi === undefined ? {} : { multi: field.multi }),
     ...(field.risk ? { risk: field.risk } : {}),
   }))
@@ -519,6 +537,7 @@ export async function createTemplateWithContent(
 
   await createTemplateVersion(template.id, {
     ...version,
+    formFields: buildFormFieldsPayload(version.contentHtml),
     signatureFields: buildSignatureFieldsPayload(version.contentHtml),
   })
 
@@ -539,6 +558,7 @@ export async function updateTemplateContent(
 ): Promise<void> {
   await createTemplateVersion(templateId, {
     ...version,
+    formFields: buildFormFieldsPayload(version.contentHtml),
     signatureFields: buildSignatureFieldsPayload(version.contentHtml),
   })
 }

clinical-web/src/api/management/types.ts

@@ -149,6 +149,8 @@ export interface CreateTemplateVersionRequest {
   versionNo?: string
   contentHtml: string
   signatureFields?: unknown[]
+  formFields?: unknown[]
+  needConfirm?: boolean
   fileStorageKey?: string
   fileRelativePath?: string
   fileSizeBytes?: number

clinical-web/src/api/workbench/signing.ts

@@ -10,8 +10,15 @@ import { mockFlags } from '@/utils/mock-flags'
 import { readLocalSigningTemplates } from '@/utils/mock-document-library'
 import { MOCK_STORAGE_KEYS, readMockState, writeMockState } from '@/utils/mock-storage'
 import { request } from '@/utils/request'
-import { ALL_SIGNING_METHODS, formatSigningMethod, toBackendSigningMethod } from '@/utils/signing-method'
+import {
-import { resendSigningSms as resendSigningSmsDelivery } from './deliveries'
+  ALL_SIGNING_METHODS,
+  formatSigningMethod,
+  toBackendSigningMethod,
+} from '@/utils/signing-method'
+import {
+  resendSigningSms as resendSigningSmsDelivery,
+  sendSigningSms as sendSigningSmsDelivery,
+} from './deliveries'
 
 import type {
   ApiPageResponse,
@@ -666,6 +673,7 @@ function mapAvailableTemplate(dto: AvailableTemplateVersionResponseDto): Signing
     supportedMethods: [...ALL_SIGNING_METHODS],
     // 需科室确认随模板带出；后端没给就是 false（签完直接归档）
     needConfirm: dto.needConfirm ?? false,
+    formFields: dto.formFields ?? [],
     // 接口不返回正文，只能带出哈希；正文由 hydrateTemplateContents 按需补回
     contentSha256: dto.contentSha256,
     contentHtml: cachedContent || undefined,
@@ -757,7 +765,7 @@ function mapSigningTask(
     documentName: template?.name ?? `模板版本 ${dto.templateVersionNumber}`,
     department: dto.visitSnapshot.departmentName || '未指定科室',
     departmentId: dto.departmentId,
-    signerName: dto.patientSnapshot.name,
+    signerName: dto.signerName ?? dto.patientSnapshot.name,
     // 签署人类型 / 关系：后端补齐后自动带出，取不到即 undefined，列表不显示代签标签
     signerType: dto.signerType ?? undefined,
     signerRelation: dto.signerRelation ?? undefined,
@@ -1183,7 +1191,11 @@ export async function createSigningTask(input: CreateSigningTaskInput): Promise<
       visitId: input.visitId,
       templateVersionId: input.templateVersionId,
       signMethod: toBackendSigningMethod(input.method),
-      idempotencyKey: createIdempotencyKey(),
+      idempotencyKey: input.idempotencyKey || createIdempotencyKey(),
+      staffAnswers: input.staffAnswers ?? {},
+      signerType: input.signerType ?? 'SELF',
+      signerName: input.signerName,
+      signerRelation: input.signerRelation ?? (input.signerType === 'FAMILY' ? undefined : '本人'),
     }
     const response = await request.post<ApiResponseOf<SignTaskResponseDto>>(
       '/v1/sign-tasks',
@@ -1283,7 +1295,10 @@ export function sendSigningSms(
   mobile: string | null,
 ): Promise<SigningTaskRecord | null> {
   if (!useMockData) {
-    throw new Error('当前后端未提供发送签署短信接口')
+    if (!mobile) return Promise.reject(new Error('请填写完整手机号后发送短信'))
+    return sendSigningSmsDelivery(id, { destination: mobile, templateCode: 'SIGN_LINK' }).then(() =>
+      getSigningTaskDetail(id),
+    )
   }
 
   const task = mockRecords.find((record) => record.id === id)

clinical-web/src/api/workbench/types.ts

@@ -27,13 +27,7 @@ export interface WorkbenchOverviewRequestDto {
  * `confirming` 只能下载患者已签版本。
  */
 export type SigningTaskStatus =
-  | 'pending'
+  'pending' | 'signing' | 'confirming' | 'signed' | 'expired' | 'void' | 'failed'
-  | 'signing'
-  | 'confirming'
-  | 'signed'
-  | 'expired'
-  | 'void'
-  | 'failed'
 
 export type PatientSex = '男' | '女' | '未知'
 
@@ -87,6 +81,8 @@ export interface SigningTemplate {
    * 发起签署时随文书带到任务上，决定签完落「待科室确认」还是「已签署」。
    */
   needConfirm?: boolean
+  /** 医护端发起时必须采集的结构化正文填写项。 */
+  formFields?: SigningFormField[]
   /** 原型：文书定稿 HTML 随模板携带，发起签署时进入任务快照。 */
   contentHtml?: string
   /**
@@ -97,6 +93,16 @@ export interface SigningTemplate {
   contentSha256?: string
 }
 
+export interface SigningFormField {
+  id: string
+  label: string
+  kind: SigningFieldKind
+  required: boolean
+  options?: string[]
+  multi?: boolean
+  risk?: string
+}
+
 export interface WorkbenchSummary {
   todaySigned: number
   todaySignedChange: number
@@ -219,6 +225,15 @@ export type SigningDateRange = 'today' | 'yesterday' | '3d' | '7d' | '30d' | 'al
  */
 export type SigningFieldKind = 'text' | 'date' | 'choice' | 'checkbox' | 'signature'
 
+export interface SigningPdfPosition {
+  page: number
+  x: number
+  y: number
+  width: number
+  height: number
+  coordinateSystem: 'TOP_LEFT' | 'PDF_BOTTOM_LEFT'
+}
+
 /** 文书里的一个填写项定义，由模板内容中的占位符解析得到。 */
 export interface SigningFieldDef {
   /** 稳定字段键：与 HIS / 患者快照取值一一对应，不随占位符显示文字变化 */
@@ -242,6 +257,8 @@ export interface SigningFieldDef {
   multi?: boolean
   /** 取值等于该字符串时视为异常项（如风险筛查选了"是"） */
   risk?: string
+  /** 患者签名位在服务端生成 PDF 中的位置，单位为 PDF point。 */
+  pdfPosition?: SigningPdfPosition
 }
 
 /**
@@ -366,6 +383,11 @@ export interface CreateSigningTaskInput {
   documentContentHtml?: string
   /** 由文书模板带出的「需科室确认」标记；真实接口不提交（后端按 templateVersionId 取）。 */
   needConfirm?: boolean
+  staffAnswers?: Record<string, string>
+  signerType?: 'SELF' | 'FAMILY'
+  signerName?: string
+  signerRelation?: string
+  idempotencyKey?: string
 }
 
 /** MEDISIGN 创建签署任务请求 DTO。不要向后端提交页面快照字段。 */
@@ -375,6 +397,10 @@ export interface CreateSigningTaskRequest {
   templateVersionId: string
   signMethod: BackendSigningMethod
   idempotencyKey?: string
+  staffAnswers?: Record<string, string>
+  signerType?: 'SELF' | 'FAMILY'
+  signerName?: string
+  signerRelation?: string
 }
 
 export interface SigningApiOptions {
@@ -460,6 +486,7 @@ export interface AvailableTemplateVersionResponseDto {
   effectiveAt: string
   /** 患者签署后是否需要科室复核签章；后端补齐后前端无需改动即可带出。 */
   needConfirm?: boolean | null
+  formFields?: SigningFormField[] | null
 }
 
 export interface SignTaskPatientSnapshotDto {
@@ -512,6 +539,7 @@ export interface SignTaskResponseDto {
    * 后端补齐后前端无需改动即可显示；当前取不到时为 undefined。
    */
   signerType?: string | null
+  signerName?: string | null
   signerRelation?: string | null
   /** 患者签署后是否需要科室复核签章（由文书模板标记带出）。 */
   needConfirm?: boolean | null

clinical-web/src/components/signing/NewSigningTaskDialog.vue

@@ -49,10 +49,18 @@ const {
   selectMethod,
   selectTemplate,
   selectVisit,
+  selectedTemplate,
   selectedTemplateId,
   selectedVisit,
   selectedVisitId,
   smsDestination,
+  staffAnswers,
+  manualFormFields,
+  signerType,
+  signerName,
+  signerRelation,
+  staffAnswerHasOption,
+  toggleStaffAnswerOption,
   submit: submitForm,
   submitting,
   suggestionOpen,
@@ -128,7 +136,11 @@ async function submitTask(keepOpen: boolean) {
 
     emit('created', task)
     const smsMessage =
-      task.method === 'sms' ? (isSigningMockEnabled ? '，已生成短信投递意图' : '，短信已发送') : ''
+      task.method === 'sms'
+        ? isSigningMockEnabled
+          ? '，已生成短信投递意图'
+          : '，短信投递已排队'
+        : ''
     ElMessage.success(`已创建 1 个签署任务${smsMessage}`)
 
     if (keepOpen) {
@@ -140,8 +152,8 @@ async function submitTask(keepOpen: boolean) {
     }
 
     emit('close')
-  } catch {
+  } catch (error) {
-    ElMessage.error('签署任务创建失败，请稍后重试')
+    ElMessage.error(error instanceof Error ? error.message : '签署任务创建失败，请稍后重试')
   }
 }
 
@@ -404,7 +416,10 @@ watch(
                     type="button"
                     class="method-option"
                     :class="{ 'method-option--active': method === option.key }"
-                    :disabled="!isMethodAllowed(option.key)"
+                    :disabled="
+                      !isMethodAllowed(option.key) ||
+                      (!isSigningMockEnabled && (option.key === 'wx' || option.key === 'ipad'))
+                    "
                     @click="selectMethod(option.key)"
                   >
                     <span class="method-icon">{{ option.icon }}</span>
@@ -445,9 +460,88 @@ watch(
                     </span>
                   </div>
                 </div>
+                <p
+                  v-if="!isSigningMockEnabled && (method === 'wx' || method === 'ipad')"
+                  class="field-error"
+                >
+                  当前后端尚未接入该渠道的投递或设备适配，请选择短信或已配置的现场手写板。
+                </p>
               </div>
             </section>
           </div>
+
+          <section v-if="selectedTemplate" class="form-section signing-context-section">
+            <header class="section-header">
+              <span class="section-index">E</span>
+              <strong>签署人和文书填写项</strong>
+              <span class="section-hint">按已选模板采集，提交后固化到签署任务</span>
+            </header>
+            <div class="section-body signing-context-grid">
+              <fieldset class="signer-choice">
+                <legend>实际签署人</legend>
+                <label>
+                  <input v-model="signerType" type="radio" value="SELF" />
+                  患者本人
+                </label>
+                <label>
+                  <input v-model="signerType" type="radio" value="FAMILY" />
+                  家属代签
+                </label>
+                <template v-if="signerType === 'FAMILY'">
+                  <input v-model="signerName" maxlength="255" placeholder="代签人姓名" />
+                  <input v-model="signerRelation" maxlength="64" placeholder="与患者关系" />
+                </template>
+                <p v-if="errors.signer" class="field-error">{{ errors.signer }}</p>
+              </fieldset>
+
+              <div v-if="manualFormFields.length" class="staff-answer-fields">
+                <label v-for="field in manualFormFields" :key="field.id" class="staff-answer-field">
+                  <span>{{ field.label }}<b v-if="field.required"> *</b></span>
+                  <select
+                    v-if="field.kind === 'choice'"
+                    v-model="staffAnswers[field.id]"
+                    :required="field.required"
+                  >
+                    <option value="">请选择</option>
+                    <option v-for="option in field.options ?? []" :key="option" :value="option">
+                      {{ option }}
+                    </option>
+                  </select>
+                  <span
+                    v-else-if="field.kind === 'checkbox' && field.options?.length"
+                    class="staff-answer-options"
+                  >
+                    <label v-for="option in field.options" :key="option">
+                      <input
+                        type="checkbox"
+                        :checked="staffAnswerHasOption(field.id, option)"
+                        @change="
+                          toggleStaffAnswerOption(
+                            field.id,
+                            option,
+                            ($event.target as HTMLInputElement).checked,
+                          )
+                        "
+                      />
+                      {{ option }}
+                    </label>
+                  </span>
+                  <input
+                    v-else
+                    v-model="staffAnswers[field.id]"
+                    :type="field.kind === 'date' ? 'date' : 'text'"
+                    :required="field.required"
+                    maxlength="4000"
+                    :placeholder="`填写${field.label}`"
+                  />
+                </label>
+                <p v-if="errors.staffAnswers" class="field-error">{{ errors.staffAnswers }}</p>
+              </div>
+              <p v-else class="section-empty">
+                当前模板没有需要医护端填写的正文项；患者签名和签署日期将在签署环节生成。
+              </p>
+            </div>
+          </section>
         </div>
 
         <footer class="dialog-footer">
@@ -882,6 +976,80 @@ watch(
   font-size: 12px;
 }
 
+.section-hint {
+  margin-left: auto;
+  color: var(--mut);
+  font-size: 11px;
+}
+
+.signing-context-grid {
+  display: grid;
+  grid-template-columns: minmax(220px, 0.7fr) minmax(0, 1.3fr);
+  gap: 14px;
+}
+
+.signer-choice {
+  display: flex;
+  flex-wrap: wrap;
+  gap: 10px;
+  align-content: start;
+  padding: 10px;
+  border: 1px solid var(--line);
+  border-radius: 7px;
+}
+
+.signer-choice legend,
+.staff-answer-field > span:first-child {
+  color: var(--mut);
+  font-size: 12px;
+}
+
+.signer-choice label,
+.staff-answer-options label {
+  display: inline-flex;
+  gap: 5px;
+  align-items: center;
+  color: var(--ink);
+  font-size: 12px;
+}
+
+.signer-choice > input,
+.staff-answer-field > input,
+.staff-answer-field > select {
+  min-width: 0;
+  padding: 7px 9px;
+  border: 1px solid var(--line);
+  border-radius: 6px;
+}
+
+.staff-answer-fields {
+  display: grid;
+  grid-template-columns: repeat(2, minmax(0, 1fr));
+  gap: 10px;
+}
+
+.staff-answer-field {
+  display: grid;
+  gap: 5px;
+  min-width: 0;
+  font-size: 12px;
+}
+
+.staff-answer-field b {
+  color: var(--err);
+}
+
+.staff-answer-options {
+  display: flex;
+  flex-wrap: wrap;
+  gap: 9px;
+}
+
+.signing-context-grid > .section-empty,
+.staff-answer-fields > .field-error {
+  grid-column: 1 / -1;
+}
+
 /* C + D 并排 */
 
 .document-method-grid {
@@ -1292,6 +1460,10 @@ watch(
 }
 
 @media (max-width: 1100px) {
+  .signing-context-grid,
+  .staff-answer-fields {
+    grid-template-columns: 1fr;
+  }
   .document-method-grid {
     flex-direction: column;
   }

clinical-web/src/composables/useSigningTaskForm.ts

@@ -1,11 +1,8 @@
-import { computed, reactive, ref, toValue, type MaybeRefOrGetter } from 'vue'
+import { computed, reactive, ref, toValue, watch, type MaybeRefOrGetter } from 'vue'
 import { ElMessage } from 'element-plus'
 
 import { sendSigningSms } from '@/api/workbench/deliveries'
-import {
+import { buildLinkedPrescription, type LinkedPrescription } from '@/api/workbench/prescriptions'
-  buildLinkedPrescription,
-  type LinkedPrescription,
-} from '@/api/workbench/prescriptions'
 import { collectFieldDefs } from '@/utils/signing-fields'
 import {
   createSigningTask,
@@ -18,6 +15,7 @@ import type {
   PatientProfile,
   PatientVisit,
   SigningMethod,
+  SigningFormField,
   SigningTaskRecord,
   SigningTemplate,
   WorkbenchCampus,
@@ -54,6 +52,14 @@ export interface DocumentListRow {
 export type { LinkedPrescription }
 
 export function useSigningTaskForm(options: UseSigningTaskFormOptions) {
+  const newIdempotencyKey = () =>
+    `clinical-web-${
+      typeof crypto !== 'undefined' && typeof crypto.randomUUID === 'function'
+        ? crypto.randomUUID()
+        : `${Date.now()}-${Math.random().toString(36).slice(2)}`
+    }`
+  let createTaskIdempotencyKey = newIdempotencyKey()
+  let sendSmsIdempotencyKey = newIdempotencyKey()
   const patientId = ref('')
   const patient = ref<PatientProfile | null>(null)
   const visits = ref<PatientVisit[]>([])
@@ -63,6 +69,10 @@ export function useSigningTaskForm(options: UseSigningTaskFormOptions) {
   const selectedVisitId = ref('')
   const method = ref<SigningMethod>('pad')
   const smsDestination = ref('')
+  const staffAnswers = reactive<Record<string, string>>({})
+  const signerType = ref<'SELF' | 'FAMILY'>('SELF')
+  const signerName = ref('')
+  const signerRelation = ref('')
   const loadingTemplates = ref(false)
   const locating = ref(false)
   const submitting = ref(false)
@@ -81,6 +91,8 @@ export function useSigningTaskForm(options: UseSigningTaskFormOptions) {
     visit: '',
     document: '',
     sms: '',
+    staffAnswers: '',
+    signer: '',
   })
 
   /** 演示候选患者（真实模式为空数组，候选下拉自然不出现） */
@@ -94,6 +106,26 @@ export function useSigningTaskForm(options: UseSigningTaskFormOptions) {
     () => templates.value.find((template) => template.id === selectedTemplateId.value) ?? null,
   )
 
+  const manualFormFields = computed(() => {
+    const systemFields = new Set([
+      'patient',
+      'sex',
+      'age',
+      'visit',
+      'phone',
+      'doctor',
+      'signedDate',
+    ])
+    return (selectedTemplate.value?.formFields ?? []).filter(
+      (field) => field.kind !== 'signature' && !systemFields.has(field.id),
+    )
+  })
+
+  watch(selectedTemplateId, () => {
+    Object.keys(staffAnswers).forEach((key) => delete staffAnswers[key])
+    errors.staffAnswers = ''
+  })
+
   /** 关联处方：随选中就诊带出（仅演示数据） */
   const prescription = computed<LinkedPrescription | null>(() =>
     isSigningMockEnabled ? buildLinkedPrescription(selectedVisit.value) : null,
@@ -302,6 +334,8 @@ export function useSigningTaskForm(options: UseSigningTaskFormOptions) {
     errors.visit = ''
     errors.document = ''
     errors.sms = ''
+    errors.staffAnswers = ''
+    errors.signer = ''
   }
 
   function resetForm() {
@@ -315,12 +349,18 @@ export function useSigningTaskForm(options: UseSigningTaskFormOptions) {
     selectedVisitId.value = ''
     method.value = initialTemplate?.supportedMethods[0] ?? 'pad'
     smsDestination.value = ''
+    Object.keys(staffAnswers).forEach((key) => delete staffAnswers[key])
+    signerType.value = 'SELF'
+    signerName.value = ''
+    signerRelation.value = ''
     phonePlain.value = false
     suggestionOpen.value = false
     selectedDepartment.value = ''
     selectedCategory.value = ''
     expandedDepartments.value = []
     clearErrors()
+    createTaskIdempotencyKey = newIdempotencyKey()
+    sendSmsIdempotencyKey = newIdempotencyKey()
   }
 
   function resetForNextTask() {
@@ -330,8 +370,14 @@ export function useSigningTaskForm(options: UseSigningTaskFormOptions) {
     selectedTemplateId.value = initialTemplate?.id ?? ''
     method.value = initialTemplate?.supportedMethods[0] ?? method.value
     smsDestination.value = ''
+    Object.keys(staffAnswers).forEach((key) => delete staffAnswers[key])
+    signerType.value = 'SELF'
+    signerName.value = ''
+    signerRelation.value = ''
     errors.document = ''
     errors.sms = ''
+    createTaskIdempotencyKey = newIdempotencyKey()
+    sendSmsIdempotencyKey = newIdempotencyKey()
     initDocumentTree()
   }
 
@@ -481,6 +527,9 @@ export function useSigningTaskForm(options: UseSigningTaskFormOptions) {
    * 演示模板一律声明全部四种；真实模式由文档库配置决定。
    */
   function isMethodAllowed(nextMethod: SigningMethod) {
+    if (!isSigningMockEnabled && (nextMethod === 'wx' || nextMethod === 'ipad')) {
+      return false
+    }
     const template = selectedTemplate.value
 
     if (!template) {
@@ -511,6 +560,18 @@ export function useSigningTaskForm(options: UseSigningTaskFormOptions) {
     return `${value.slice(0, 3)}****${value.slice(-4)}`
   }
 
+  function toggleStaffAnswerOption(fieldId: string, option: string, checked: boolean) {
+    const selected = (staffAnswers[fieldId] ?? '').split('、').filter(Boolean)
+    const next = checked
+      ? [...new Set([...selected, option])]
+      : selected.filter((item) => item !== option)
+    staffAnswers[fieldId] = next.join('、')
+  }
+
+  function staffAnswerHasOption(fieldId: string, option: string) {
+    return (staffAnswers[fieldId] ?? '').split('、').includes(option)
+  }
+
   function validate() {
     clearErrors()
     let valid = true
@@ -542,6 +603,22 @@ export function useSigningTaskForm(options: UseSigningTaskFormOptions) {
       }
     }
 
+    const missingField = manualFormFields.value.find(
+      (field: SigningFormField) => field.required && !staffAnswers[field.id]?.trim(),
+    )
+    if (missingField) {
+      errors.staffAnswers = `请填写必填项：${missingField.label}`
+      valid = false
+    }
+
+    if (
+      signerType.value === 'FAMILY' &&
+      (!signerName.value.trim() || !signerRelation.value.trim())
+    ) {
+      errors.signer = '家属代签必须填写签署人姓名和与患者关系'
+      valid = false
+    }
+
     return valid
   }
 
@@ -567,13 +644,29 @@ export function useSigningTaskForm(options: UseSigningTaskFormOptions) {
         documentContentHtml: selectedTemplate.value.contentHtml,
         // 需科室确认由文书模板标记带出（原型 V6.9 起弹窗里不再让人选）
         needConfirm: selectedTemplate.value.needConfirm ?? false,
+        staffAnswers: { ...staffAnswers },
+        signerType: signerType.value,
+        signerName: signerType.value === 'FAMILY' ? signerName.value.trim() : patient.value.name,
+        signerRelation: signerType.value === 'FAMILY' ? signerRelation.value.trim() : '本人',
+        idempotencyKey: createTaskIdempotencyKey,
       })
 
       if (!isSigningMockEnabled && method.value === 'sms') {
-        await sendSigningSms(task.id, {
+        try {
+          await sendSigningSms(
+            task.id,
+            {
               destination: smsDestination.value.trim().replace(/\s+/g, ''),
               templateCode: 'SIGN_LINK',
-        })
+            },
+            sendSmsIdempotencyKey,
+          )
+        } catch {
+          throw new Error(
+            `签署任务 ${task.id} 已创建，但短信投递失败。请在工作台任务详情中重试发送。`,
+          )
+        }
+        sendSmsIdempotencyKey = newIdempotencyKey()
       }
 
       return task
@@ -612,6 +705,13 @@ export function useSigningTaskForm(options: UseSigningTaskFormOptions) {
     selectedVisit,
     selectedVisitId,
     smsDestination,
+    staffAnswers,
+    manualFormFields,
+    signerType,
+    signerName,
+    signerRelation,
+    staffAnswerHasOption,
+    toggleStaffAnswerOption,
     submit,
     submitting,
     suggestionOpen,

clinical-web/src/utils/signing-field-node.ts

@@ -98,6 +98,7 @@ export interface SignFieldElement {
   fieldOptions: string[]
   fieldMulti?: boolean
   fieldRisk?: string
+  fieldPdfPosition?: SigningFieldDef['pdfPosition']
   /** void 元素也要有一个空文本子节点，否则 Slate 会认为结构非法 */
   children: [{ text: '' }]
 }
@@ -118,6 +119,7 @@ function buildSignFieldProps(field: SigningFieldDef): Omit<SignFieldElement, 'ty
     fieldOptions: [...field.options],
     fieldMulti: field.multi,
     fieldRisk: field.risk,
+    fieldPdfPosition: field.pdfPosition ? { ...field.pdfPosition } : undefined,
   }
 }
 
@@ -205,6 +207,7 @@ export function readFieldFromSignFieldNode(elem: SignFieldElement): SigningField
     options: [...elem.fieldOptions],
     ...(elem.fieldMulti === undefined ? {} : { multi: elem.fieldMulti }),
     ...(elem.fieldRisk ? { risk: elem.fieldRisk } : {}),
+    ...(elem.fieldPdfPosition ? { pdfPosition: { ...elem.fieldPdfPosition } } : {}),
   }
 }
 
@@ -232,11 +235,7 @@ function isSelected(editor: IDomEditor, elemNode: unknown): boolean {
  * 编辑器内渲染：一个只靠属性展示的胶囊。
  * 不渲染 children，也不放文本节点，理由见文件头的 ③。
  */
-function renderSignField(
+function renderSignField(elemNode: unknown, _children: VNode[] | null, editor: IDomEditor): VNode {
-  elemNode: unknown,
-  _children: VNode[] | null,
-  editor: IDomEditor,
-): VNode {
   const elem = elemNode as SignFieldElement
   const kindLabel = SIGNING_FIELD_KIND_LABELS[elem.fieldKind] ?? '文本'
   const selected = isSelected(editor, elemNode)

clinical-web/src/utils/signing-fields.ts

@@ -48,6 +48,12 @@ export const FIELD_REQUIRED_ATTR = 'data-required'
 export const FIELD_OPTIONS_ATTR = 'data-options'
 export const FIELD_MULTI_ATTR = 'data-multi'
 export const FIELD_RISK_ATTR = 'data-risk'
+export const FIELD_PDF_PAGE_ATTR = 'data-pdf-page'
+export const FIELD_PDF_X_ATTR = 'data-pdf-x'
+export const FIELD_PDF_Y_ATTR = 'data-pdf-y'
+export const FIELD_PDF_WIDTH_ATTR = 'data-pdf-width'
+export const FIELD_PDF_HEIGHT_ATTR = 'data-pdf-height'
+export const FIELD_PDF_COORDINATE_SYSTEM_ATTR = 'data-pdf-coordinate-system'
 
 /** 结构化占位符的选择器：渲染端与解析端必须用同一个。 */
 export const FIELD_ELEMENT_SELECTOR = `${FIELD_ELEMENT_TAG}[${FIELD_ID_ATTR}]`
@@ -81,6 +87,15 @@ export function createFieldElement(doc: Document, field: SigningFieldDef): HTMLE
     element.setAttribute(FIELD_RISK_ATTR, field.risk)
   }
 
+  if (field.pdfPosition) {
+    element.setAttribute(FIELD_PDF_PAGE_ATTR, String(field.pdfPosition.page))
+    element.setAttribute(FIELD_PDF_X_ATTR, String(field.pdfPosition.x))
+    element.setAttribute(FIELD_PDF_Y_ATTR, String(field.pdfPosition.y))
+    element.setAttribute(FIELD_PDF_WIDTH_ATTR, String(field.pdfPosition.width))
+    element.setAttribute(FIELD_PDF_HEIGHT_ATTR, String(field.pdfPosition.height))
+    element.setAttribute(FIELD_PDF_COORDINATE_SYSTEM_ATTR, field.pdfPosition.coordinateSystem)
+  }
+
   element.textContent = field.label
 
   return element
@@ -109,10 +124,35 @@ export function readFieldFromElement(element: Element): SigningFieldDef | null {
   // 没有 data-field 时用标签反查目录，签名位这类字段至少还能还原成正确的控件
   const resolved = id ? null : resolveFieldByLabel(label)
 
+  const pdfPositionValues = [
+    element.getAttribute(FIELD_PDF_PAGE_ATTR),
+    element.getAttribute(FIELD_PDF_X_ATTR),
+    element.getAttribute(FIELD_PDF_Y_ATTR),
+    element.getAttribute(FIELD_PDF_WIDTH_ATTR),
+    element.getAttribute(FIELD_PDF_HEIGHT_ATTR),
+  ]
+  const pdfNumbers = pdfPositionValues.map((value) => Number(value))
+  const hasPdfPosition = pdfPositionValues.every((value) => value !== null && value.trim() !== '')
+  const pdfCoordinateSystem = element.getAttribute(FIELD_PDF_COORDINATE_SYSTEM_ATTR)
+  const pdfPosition =
+    hasPdfPosition && pdfNumbers.every(Number.isFinite)
+      ? {
+          page: pdfNumbers[0],
+          x: pdfNumbers[1],
+          y: pdfNumbers[2],
+          width: pdfNumbers[3],
+          height: pdfNumbers[4],
+          coordinateSystem:
+            pdfCoordinateSystem === 'PDF_BOTTOM_LEFT'
+              ? ('PDF_BOTTOM_LEFT' as const)
+              : ('TOP_LEFT' as const),
+        }
+      : undefined
+
   return {
     id: id || (resolved as SigningFieldDef).id,
     label: label || id,
-    kind: ((element.getAttribute(FIELD_KIND_ATTR) ?? resolved?.kind ?? 'text') as SigningFieldKind),
+    kind: (element.getAttribute(FIELD_KIND_ATTR) ?? resolved?.kind ?? 'text') as SigningFieldKind,
     required:
       element.getAttribute(FIELD_REQUIRED_ATTR) === 'true' ||
       (!element.hasAttribute(FIELD_REQUIRED_ATTR) && resolved?.required === true),
@@ -122,6 +162,7 @@ export function readFieldFromElement(element: Element): SigningFieldDef | null {
       .filter(Boolean),
     multi: readMultiAttribute(element, resolved),
     risk: element.getAttribute(FIELD_RISK_ATTR)?.trim() || resolved?.risk || undefined,
+    pdfPosition,
   }
 }
 
@@ -375,11 +416,7 @@ export interface ScannedFieldToken {
  * 只对自定义文本项有意义（调用方保证），目录里的字段同名共用一份取值是刻意的。
  * claimed 是有限集合、next 严格递增，所以循环一定收敛。
  */
-function nextFreeCustomSequence(
+function nextFreeCustomSequence(label: string, sequence: number, claimed: Set<string>): number {
-  label: string,
-  sequence: number,
-  claimed: Set<string>,
-): number {
   let next = sequence
 
   while (claimed.has(createCustomField(label, 'text', [], next).id)) {

clinical-web/src/views/management/documents/components/WordEditorDialog.vue

@@ -55,6 +55,7 @@ interface EditorPaneHandle {
 }
 
 const valueHtml = ref('<p><br></p>')
+const needConfirm = ref(false)
 const docxInput = ref<HTMLInputElement | null>(null)
 const importing = ref(false)
 const paneRef = ref<EditorPaneHandle | null>(null)
@@ -128,17 +129,19 @@ const fieldDraft = reactive({
   options: [] as string[],
   multi: false,
   risk: '',
+  pdfPage: '',
+  pdfX: '',
+  pdfY: '',
+  pdfWidth: '',
+  pdfHeight: '',
+  pdfCoordinateSystem: 'TOP_LEFT' as 'TOP_LEFT' | 'PDF_BOTTOM_LEFT',
 })
 
 /** 类型下拉的取值（原型 fpKind 的 5 个选项） */
-const KIND_OPTIONS = Object.entries(SIGNING_FIELD_KIND_LABELS) as Array<
+const KIND_OPTIONS = Object.entries(SIGNING_FIELD_KIND_LABELS) as Array<[SigningFieldKind, string]>
-  [SigningFieldKind, string]
->
 
 /** 选项行与高危值行只在选项类出现（原型 docFpKind） */
-const isOptionKind = computed(
+const isOptionKind = computed(() => fieldDraft.kind === 'choice' || fieldDraft.kind === 'checkbox')
-  () => fieldDraft.kind === 'choice' || fieldDraft.kind === 'checkbox',
-)
 
 function syncDraft(field: SigningFieldDef | null) {
   fieldDraft.label = field?.label ?? ''
@@ -148,6 +151,12 @@ function syncDraft(field: SigningFieldDef | null) {
   // 缺省口径与 signing-fields 的 SigningFieldDef.multi 一致：勾选类默认可多选
   fieldDraft.multi = field?.multi ?? field?.kind === 'checkbox'
   fieldDraft.risk = field?.risk ?? ''
+  fieldDraft.pdfPage = field?.pdfPosition ? String(field.pdfPosition.page) : ''
+  fieldDraft.pdfX = field?.pdfPosition ? String(field.pdfPosition.x) : ''
+  fieldDraft.pdfY = field?.pdfPosition ? String(field.pdfPosition.y) : ''
+  fieldDraft.pdfWidth = field?.pdfPosition ? String(field.pdfPosition.width) : ''
+  fieldDraft.pdfHeight = field?.pdfPosition ? String(field.pdfPosition.height) : ''
+  fieldDraft.pdfCoordinateSystem = field?.pdfPosition?.coordinateSystem ?? 'TOP_LEFT'
 }
 
 /**
@@ -167,7 +176,11 @@ watch(
 watch(
   () => fieldDraft.kind,
   (kind) => {
-    if ((kind === 'choice' || kind === 'checkbox') && !fieldDraft.options.length && kind === 'choice') {
+    if (
+      (kind === 'choice' || kind === 'checkbox') &&
+      !fieldDraft.options.length &&
+      kind === 'choice'
+    ) {
       fieldDraft.options = ['否', '是']
     }
   },
@@ -186,6 +199,7 @@ watch(
     // 升级沿用同一套解析口径，字段键前后完全一致，历史 fieldAnswers 不受影响；
     // 正文里没有 ｛ 时这一步原样返回，不会白白做一次 DOM 往返。
     valueHtml.value = upgradeFieldTokensToStructured(rawContent)
+    needConfirm.value = Boolean(props.template?.needConfirm)
     message.text = ''
     message.tone = ''
     selectedFieldId.value = ''
@@ -238,6 +252,33 @@ function applyFieldDraft() {
 
   const options = fieldDraft.options.map((option) => option.trim()).filter(Boolean)
 
+  let pdfPosition: SigningFieldDef['pdfPosition']
+  if (field.id === 'signature' && fieldDraft.kind === 'signature') {
+    const page = Number(fieldDraft.pdfPage)
+    const x = Number(fieldDraft.pdfX)
+    const y = Number(fieldDraft.pdfY)
+    const width = Number(fieldDraft.pdfWidth)
+    const height = Number(fieldDraft.pdfHeight)
+    if (
+      !fieldDraft.pdfPage.trim() ||
+      !fieldDraft.pdfX.trim() ||
+      !fieldDraft.pdfY.trim() ||
+      !fieldDraft.pdfWidth.trim() ||
+      !fieldDraft.pdfHeight.trim() ||
+      ![page, x, y, width, height].every(Number.isFinite) ||
+      !Number.isInteger(page) ||
+      page < 1 ||
+      x < 0 ||
+      y < 0 ||
+      width <= 0 ||
+      height <= 0
+    ) {
+      setMessage('患者签名位置须填写有效页码及 PDF point 坐标', 'warn')
+      return
+    }
+    pdfPosition = { page, x, y, width, height, coordinateSystem: fieldDraft.pdfCoordinateSystem }
+  }
+
   if (isOptionKind.value && new Set(options).size !== options.length) {
     setMessage('存在重复选项，请修改后重试', 'warn')
     return
@@ -261,6 +302,7 @@ function applyFieldDraft() {
     options,
     multi: options.length ? fieldDraft.multi : undefined,
     risk: fieldDraft.risk.trim() || undefined,
+    pdfPosition,
   })
 
   if (!changed) {
@@ -307,17 +349,20 @@ const stats = computed(() => {
  * 只挡"确定是错的"：选项类少于两个选项、同名占位符写重复。
  * 不挡"没有签名位"这类业务判断——那属于提示，不该拦住保存。
  */
-function validate(): string | null {
+function validate(requireSignaturePosition = true): string | null {
   const broken = detectedFields.value.find(
-    (field) =>
+    (field) => (field.kind === 'choice' || field.kind === 'checkbox') && field.options.length === 1,
-      (field.kind === 'choice' || field.kind === 'checkbox') &&
-      field.options.length === 1,
   )
 
   if (broken) {
     return `「${broken.label}」只配了一个选项，勾选类至少要两个（或删掉选项改成单个勾选框）`
   }
 
+  const patientSignature = detectedFields.value.find((field) => field.id === 'signature')
+  if (requireSignaturePosition && !patientSignature?.pdfPosition) {
+    return '请选中“患者签名”占位符，配置其 PDF 页码和签名位置后再保存'
+  }
+
   return null
 }
 
@@ -342,7 +387,7 @@ const previewing = ref(false)
 
 function togglePreview() {
   if (!previewing.value) {
-    const error = validate()
+    const error = validate(false)
 
     if (error) {
       setMessage(error, 'warn')
@@ -418,7 +463,11 @@ function save() {
     return
   }
 
-  emit('save', { id: props.template.id, contentHtml: valueHtml.value })
+  emit('save', {
+    id: props.template.id,
+    contentHtml: valueHtml.value,
+    needConfirm: needConfirm.value,
+  })
 }
 
 /** 关闭前先退出预览态：预览里正文是只读渲染，直接关掉会让人以为编辑内容没了 */
@@ -431,7 +480,12 @@ function requestClose() {
 <template>
   <Teleport to="body">
     <div v-if="visible" class="dialog-mask" role="presentation" @click.self="requestClose">
-      <section class="word-editor" role="dialog" aria-modal="true" aria-labelledby="word-editor-title">
+      <section
+        class="word-editor"
+        role="dialog"
+        aria-modal="true"
+        aria-labelledby="word-editor-title"
+      >
         <header class="dialog-header">
           <div class="dialog-title">
             <h2 id="word-editor-title">编辑 Word 文书</h2>
@@ -464,13 +518,23 @@ function requestClose() {
             <button type="button" class="action-button" @click="togglePreview">
               {{ previewing ? '✏️ 返回编辑' : '👁 签署预览' }}
             </button>
-            <span class="editor-stats">正文 {{ stats.chars }} 字 · {{ stats.fields }} 个填写项</span>
+            <span class="editor-stats"
+              >正文 {{ stats.chars }} 字 · {{ stats.fields }} 个填写项</span
+            >
+            <label class="confirm-setting">
+              <input v-model="needConfirm" type="checkbox" />
+              患者签署后需科室确认
+            </label>
             <span class="editor-tip">
               勾选项支持配置多个选项（可多选）；导入 Word 后表格「勾选」列自动转为交互勾选项
             </span>
           </div>
 
-          <p v-if="message.text" class="editor-message" :class="message.tone ? `is-${message.tone}` : ''">
+          <p
+            v-if="message.text"
+            class="editor-message"
+            :class="message.tone ? `is-${message.tone}` : ''"
+          >
             {{ message.text }}
           </p>
 
@@ -525,9 +589,44 @@ function requestClose() {
               </label>
             </div>
 
+            <div
+              v-if="selectedField.id === 'signature' && fieldDraft.kind === 'signature'"
+              class="fp-row signature-position-row"
+            >
+              <b class="fp-title">患者签名 PDF 位置</b>
+              <span class="fp-hint">PDF point；页码从 1 开始</span>
+              <label class="fp-field"
+                ><span>页码</span><input v-model="fieldDraft.pdfPage" inputmode="numeric"
+              /></label>
+              <label class="fp-field"
+                ><span>X</span><input v-model="fieldDraft.pdfX" inputmode="decimal"
+              /></label>
+              <label class="fp-field"
+                ><span>Y</span><input v-model="fieldDraft.pdfY" inputmode="decimal"
+              /></label>
+              <label class="fp-field"
+                ><span>宽</span><input v-model="fieldDraft.pdfWidth" inputmode="decimal"
+              /></label>
+              <label class="fp-field"
+                ><span>高</span><input v-model="fieldDraft.pdfHeight" inputmode="decimal"
+              /></label>
+              <label class="fp-field">
+                <span>坐标系</span>
+                <select v-model="fieldDraft.pdfCoordinateSystem">
+                  <option value="TOP_LEFT">左上为原点</option>
+                  <option value="PDF_BOTTOM_LEFT">左下为原点</option>
+                </select>
+              </label>
+            </div>
+
             <div v-if="isOptionKind" class="fp-row">
               <span v-for="(_, index) in fieldDraft.options" :key="index" class="option-item">
-                <input v-model="fieldDraft.options[index]" type="text" maxlength="40" placeholder="选项内容" />
+                <input
+                  v-model="fieldDraft.options[index]"
+                  type="text"
+                  maxlength="40"
+                  placeholder="选项内容"
+                />
                 <button
                   type="button"
                   class="option-remove"

clinical-web/src/views/management/documents/index.vue

@@ -183,8 +183,7 @@ const filteredTemplates = computed(() => {
 
   return allTemplates.value.filter((template) => {
     const matchesDepartment = !filters.department || template.departmentKey === filters.department
-    const matchesStatus =
+    const matchesStatus = filters.status === 'all' || readLibraryStatus(template) === filters.status
-      filters.status === 'all' || readLibraryStatus(template) === filters.status
     // 搜索范围照原型：模板名 / 编号 / 科室 / 分类，外加检查类型与关联项目编码。
     // 后两者是卡片上看得见的字段，搜不到会让人以为这份文书不存在。
     const matchesKeyword =
@@ -710,6 +709,7 @@ function updateLocalContent(form: DocumentContentForm) {
   }
 
   located.document.contentHtml = form.contentHtml
+  located.document.needConfirm = form.needConfirm
   located.document.updatedAt = new Date().toISOString()
 }
 
@@ -739,7 +739,10 @@ async function handleContentSubmit(form: DocumentContentForm) {
     // 新建的文书还没有任何版本：第一个版本用 createTemplateWithContent 的版本那一步等价路径，
     // 这里统一走 createTemplateVersion（见 updateTemplateContent），
     // 后端会把它当成该模板的第一个版本
-    await updateTemplateContent(form.id, { contentHtml: form.contentHtml })
+    await updateTemplateContent(form.id, {
+      contentHtml: form.contentHtml,
+      needConfirm: form.needConfirm,
+    })
     closeContentDialog()
     await loadLibrary()
     ElMessage.success('正文已保存为新版本')

clinical-web/src/views/management/documents/types.ts

@@ -62,6 +62,7 @@ export interface DocumentContentForm {
   id: string
   /** 正文 HTML（含结构化占位符 <span data-field>） */
   contentHtml: string
+  needConfirm: boolean
 }
 
 /**

clinical-web/src/views/workbench/signing/components/SmsSendDialog.vue

@@ -15,6 +15,7 @@ import type { SigningTaskRecord } from '@/api/workbench/types'
 const props = defineProps<{
   visible: boolean
   task: SigningTaskRecord | null
+  isMock: boolean
 }>()
 
 const emit = defineEmits<{
@@ -38,7 +39,7 @@ watch(
 
     const masked = props.task?.smsMobileMasked?.trim() ?? ''
     registeredMasked.value = masked
-    inputValue.value = masked
+    inputValue.value = props.isMock ? masked : ''
     error.value = ''
   },
 )
@@ -54,10 +55,13 @@ function submit() {
   }
 
   if (unchanged.value) {
-    // 登记号码本来就是脱敏的，前端拿不到完整值 —— 直接交给后端按任务解析
+    if (props.isMock) {
       emit('send', null)
       return
     }
+    error.value = '请填写完整手机号；登记号码仅展示脱敏值，不能直接用于投递'
+    return
+  }
 
   if (!/^1[3-9]\d{9}$/.test(raw)) {
     error.value = '请输入正确的 11 位手机号'
@@ -108,7 +112,8 @@ function submit() {
 
           <p v-if="error" class="field-error">{{ error }}</p>
           <p v-else class="field-hint">
-            不改号码即发送到登记号码；发送后任务进入「等待患者签署」，链接 48 小时内有效。
+            {{ isMock ? '演示模式可保留登记号码；' : '真实模式需输入完整手机号；' }}
+            短信投递排队后，任务进入「等待患者签署」。
           </p>
         </div>
 

clinical-web/src/views/workbench/signing/index.vue

@@ -44,7 +44,11 @@ import { useAppStore } from '@/stores/app'
 import { useLoginStore } from '@/stores/login'
 import type { SigningFieldProgress, SigningSignatureRequest } from '@/utils/signing-document'
 import { PRIMARY_SIGNATURE_FIELD_ID } from '@/utils/signing-fields'
-import { formatSigningMethodTitle, readSigningMethod, toggleSigningMethod } from '@/utils/signing-method'
+import {
+  formatSigningMethodTitle,
+  readSigningMethod,
+  toggleSigningMethod,
+} from '@/utils/signing-method'
 import { downloadSigningPdf } from '@/utils/signing-pdf'
 
 import OnlineSigningDialog from './components/OnlineSigningDialog.vue'
@@ -833,7 +837,7 @@ async function handleTaskAction(action: SigningTaskAction, targetMethod?: Signin
           ...signingApiOptions.value,
           expectedRowVersion: task.rowVersion,
         }),
-        '短信已重新发送',
+        '短信投递已重新排队',
       )
       return
     }
@@ -1036,7 +1040,7 @@ async function handleSmsSent(mobile: string | null) {
     smsSendVisible.value = false
     await refreshTask(
       updated,
-      `签署短信已发送${updated?.smsMobileMasked ? `至 ${updated.smsMobileMasked}` : ''}，等待患者签署`,
+      `签署短信投递已排队${updated?.smsMobileMasked ? `至 ${updated.smsMobileMasked}` : ''}，等待患者签署`,
     )
   } catch {
     ElMessage.error('发送签署短信失败，请稍后重试')
@@ -1180,6 +1184,7 @@ onMounted(() => {
     <SmsSendDialog
       :visible="smsSendVisible"
       :task="selectedTask"
+      :is-mock="isSigningMockEnabled"
       @close="smsSendVisible = false"
       @send="handleSmsSent"
     />

patient-h5/src/api/index.ts

@@ -5,16 +5,20 @@ import type {
   ApiResponse,
   SignatureUploadInput,
   SignatureUploadResponse,
+  SigningProof,
   SigningContextResponse,
   TokenConsumeRequest,
   TokenConsumeResponse,
 } from './types'
 
-export function consumeSigningToken(payload: TokenConsumeRequest): Promise<TokenConsumeResponse> {
+export function consumeSigningToken(
+  payload: TokenConsumeRequest,
+  idempotencyKey: string,
+): Promise<TokenConsumeResponse> {
   return request
     .post<ApiResponse<TokenConsumeResponse>>('/v1/sign-deliveries/token/consume', payload, {
       headers: {
-        'Idempotency-Key': createIdempotencyKey(),
+        'Idempotency-Key': idempotencyKey,
       },
     })
     .then(unwrapApiResponse)
@@ -23,48 +27,37 @@ export function consumeSigningToken(payload: TokenConsumeRequest): Promise<Token
 /**
  * 读取本次签署的完整上下文：患者信息 / 签署人 / 文书正文 / 医生已填结果。
  *
- * 契约见 `.workbuddy-ai/患者端H5真实接入方案-2026-09-28.md` 第三节。
+ * Context 使用已消费凭证，不再把原始一次性 Token 放进请求 URL、日志或后续请求。
- * **后端就绪前这个调用会失败**，所以调用方必须能优雅降级 ——
- * 拿不到正文就不能放行签署（见 `useSignFlow` 的 `documentError`）。
  */
-export function fetchSigningContext(token: string): Promise<SigningContextResponse> {
+export function fetchSigningContext(proof: SigningProof): Promise<SigningContextResponse> {
   return request
-    .get<ApiResponse<SigningContextResponse>>('/v1/sign-deliveries/token/context', {
+    .post<ApiResponse<SigningContextResponse>>('/v1/sign-deliveries/token/context', proof)
-      params: { token },
-    })
     .then(unwrapApiResponse)
 }
 
-function createIdempotencyKey(value?: string) {
-  if (value) {
-    return value
-  }
-
-  if (typeof crypto !== 'undefined' && typeof crypto.randomUUID === 'function') {
-    return `patient-h5-${crypto.randomUUID()}`
-  }
-
-  return `patient-h5-${Date.now()}-${Math.random().toString(36).slice(2)}`
-}
-
 export function uploadSigningSignature(
   payload: SignatureUploadInput,
 ): Promise<SignatureUploadResponse> {
   const formData = new FormData()
   formData.append('file', payload.file, 'signature.png')
-  formData.append('metadata', payload.metadata)
+  formData.append('deliveryId', payload.deliveryId)
+  formData.append('uploadToken', payload.uploadToken)
+  formData.append(
+    'metadata',
+    new Blob([JSON.stringify(payload.metadata)], { type: 'application/json' }),
+  )
+  formData.append(
+    'signer',
+    new Blob([JSON.stringify(payload.signer)], { type: 'application/json' }),
+  )
 
   return request
     .post<ApiResponse<SignatureUploadResponse>>(
       `/v1/sign-deliveries/${encodeURIComponent(payload.taskId)}/signature`,
       formData,
       {
-        params: {
-          deliveryId: payload.deliveryId,
-          uploadToken: payload.uploadToken,
-        },
         headers: {
-          'Idempotency-Key': createIdempotencyKey(payload.idempotencyKey),
+          'Idempotency-Key': payload.idempotencyKey,
         },
       },
     )

patient-h5/src/api/types.ts

@@ -24,6 +24,38 @@ export interface TokenConsumeRequest {
   taskId?: string
 }
 
+export interface SignatureFieldPosition {
+  id: string
+  page: number
+  x: number
+  y: number
+  width: number
+  height: number
+  coordinateSystem: 'TOP_LEFT' | 'PDF_BOTTOM_LEFT'
+}
+
+/** Facts read from the actual PNG plus an optional assertion against a configured PDF field. */
+export interface SignaturePngMetadata {
+  imageWidth: number
+  imageHeight: number
+  sizeBytes: number
+  sha256: string
+  contentType: 'image/png'
+  fieldId: string
+  page: number
+  x: number
+  y: number
+  width: number
+  height: number
+  coordinateSystem: SignatureFieldPosition['coordinateSystem']
+}
+
+export interface SigningProof {
+  taskId: string
+  deliveryId: string
+  uploadToken: string
+}
+
 export interface TokenConsumeResponse {
   deliveryId: string
   taskId: string
@@ -35,12 +67,7 @@ export interface TokenConsumeResponse {
 
 /** 患者端看到的任务状态。不是 `WAITING_SIGN` 时不该放行签署 */
 export type SigningTaskSignStatus =
-  | 'WAITING_SIGN'
+  'WAITING_SIGN' | 'WAITING_CONFIRM' | 'SIGNED' | 'EXPIRED' | 'VOIDED' | 'FAILED' | string
-  | 'SIGNED'
-  | 'EXPIRED'
-  | 'VOIDED'
-  | 'FAILED'
-  | string
 
 export interface SigningContextPatient {
   name?: string | null
@@ -107,10 +134,24 @@ export interface SigningContextResponse {
   staffAnswers?: Record<string, string> | null
   /** 患者端可交互的字段。按约定只有主签名位（`id === 'signature'`） */
   fields?: SigningContextField[] | null
+  /** Configured PDF signature locations, separate from body form-field definitions. */
+  signatureFields?: SignatureFieldPosition[] | null
+  /** Recoverable summary of the real server pipeline and artifacts after a successful upload. */
+  uploadResult?: SignatureUploadResponse | null
+  /** Server-owned patient signature completion timestamp (separate from department confirmation). */
+  signedAt?: string | null
 }
 
 export type SignatureUploadStatus =
-  'CREATED' | 'WAITING_SIGN' | 'SIGNED' | 'EXPIRED' | 'VOIDED' | 'GENERATING' | 'FAILED' | string
+  | 'CREATED'
+  | 'WAITING_SIGN'
+  | 'SIGNED'
+  | 'EXPIRED'
+  | 'VOIDED'
+  | 'GENERATING'
+  | 'WAITING_CONFIRM'
+  | 'FAILED'
+  | string
 
 export interface SignatureUploadResponse {
   taskId: string
@@ -132,6 +173,13 @@ export interface SignatureUploadInput {
   deliveryId: string
   uploadToken: string
   file: Blob
-  metadata: string
+  metadata: SignaturePngMetadata
-  idempotencyKey?: string
+  signer: {
+    type: string
+    name: string
+    relation: string
+    consentAccepted: true
+    observedSignedAt: string
+  }
+  idempotencyKey: string
 }

patient-h5/src/composables/useSignFlow.ts

@@ -9,6 +9,12 @@ import type {
 import { DEMO_DOCUMENT_HTML, DEMO_PATIENT_FIELD_ID, DEMO_STAFF_ANSWERS } from '@/mock/demo-document'
 import { DEMO_NARCOTIC_HTML, DEMO_NARCOTIC_STAFF_ANSWERS } from '@/mock/demo-narcotic'
 import type { SignerRelation, SignFlowState } from '@/types/signing'
+import {
+  readPendingSigningUpload,
+  removePendingSigningUpload,
+  savePendingSigningUpload,
+} from '@/utils/signing-vault'
+import { buildSignaturePngMetadata } from '@/utils/signing-png'
 
 /**
  * 本地会话（sessionStorage）。
@@ -22,17 +28,18 @@ import type { SignerRelation, SignFlowState } from '@/types/signing'
  */
 const SESSION_KEY = 'medical-sign:patient-session'
 
-/** 后端没给 `expiresAt` 时的兜底有效期，避免本地会话永不过期 */
-const SESSION_FALLBACK_TTL_MS = 2 * 60 * 60 * 1000
-
 interface PersistedSession {
-  taskId: string
+  taskId: string | null
   taskNo: string
-  deliveryId: string
+  deliveryId: string | null
-  uploadToken: string
+  uploadToken: string | null
   channel: SignDeliveryChannel | ''
   expiresAt: string | null
   savedAt: number
+  /** 保存于首次 consume 之前；响应丢失后使用同一 token 和 key 安全重试。 */
+  pendingToken: string | null
+  consumeIdempotencyKey: string | null
+  uploadIdempotencyKey: string | null
   /** 连上下文一起缓存：刷新后没有 token 可再用，重拉不了 */
   context: SigningContextResponse | null
 }
@@ -52,6 +59,7 @@ const initialState: SignFlowState = {
   contentSha256: '',
   staffAnswers: {},
   fields: [],
+  signatureFields: [],
   documentLoaded: false,
   documentError: '',
   taskNo: 'CT-20260827-001',
@@ -75,18 +83,24 @@ export const signingState = reactive<SignFlowState>({ ...initialState })
 
 /** 最近一次拿到的上下文，只用于写本地缓存 */
 let lastContext: SigningContextResponse | null = null
-/** 会话有效期：consume 不返回，由 context 补上 */
 let sessionExpiresAt: string | null = null
+let pendingToken: string | null = null
+let consumeIdempotencyKey: string | null = null
+let uploadIdempotencyKey: string | null = null
 
 export function resetSignFlow() {
   Object.assign(signingState, {
     ...initialState,
     staffAnswers: {},
     fields: [],
+    signatureFields: [],
     uploadResult: null,
   })
   lastContext = null
   sessionExpiresAt = null
+  pendingToken = null
+  consumeIdempotencyKey = null
+  uploadIdempotencyKey = null
 }
 
 function getErrorMessage(error: unknown) {
@@ -105,7 +119,10 @@ function readPersistedSession(): PersistedSession | null {
 
     const parsed = JSON.parse(raw) as PersistedSession
 
-    if (!parsed?.taskId || !parsed?.uploadToken) {
+    if (
+      !parsed ||
+      (!parsed.pendingToken && (!parsed.taskId || !parsed.deliveryId || !parsed.uploadToken))
+    ) {
       return null
     }
 
@@ -115,26 +132,40 @@ function readPersistedSession(): PersistedSession | null {
   }
 }
 
+function createIdempotencyKey() {
+  if (typeof crypto !== 'undefined' && typeof crypto.randomUUID === 'function') {
+    return `patient-h5-${crypto.randomUUID()}`
+  }
+
+  return `patient-h5-${Date.now()}-${Math.random().toString(36).slice(2)}`
+}
+
 function persistSession() {
-  if (!signingState.taskId || !signingState.uploadToken) {
+  if (
+    !pendingToken &&
+    (!signingState.taskId || !signingState.deliveryId || !signingState.uploadToken)
+  ) {
     return
   }
 
   try {
     const payload: PersistedSession = {
-      taskId: signingState.taskId,
+      taskId: signingState.taskId || null,
       taskNo: signingState.taskNo,
-      deliveryId: signingState.deliveryId,
+      deliveryId: signingState.deliveryId || null,
-      uploadToken: signingState.uploadToken,
+      uploadToken: signingState.uploadToken || null,
       channel: signingState.channel,
       expiresAt: sessionExpiresAt,
       savedAt: Date.now(),
+      pendingToken,
+      consumeIdempotencyKey,
+      uploadIdempotencyKey,
       context: lastContext,
     }
 
     sessionStorage.setItem(SESSION_KEY, JSON.stringify(payload))
   } catch {
-    // 无痕模式 / 配额写满：存不下就不存，不影响本次签署
+    throw new Error('浏览器无法保存本次签署恢复凭证，请检查隐私或存储设置后重新打开链接。')
   }
 }
 
@@ -153,7 +184,8 @@ function isSessionExpired(session: PersistedSession) {
     return expiresAt <= Date.now()
   }
 
-  return Date.now() - session.savedAt > SESSION_FALLBACK_TTL_MS
+  // A response without an explicit expiry is still bounded to the service's 48h signing window.
+  return Date.now() - session.savedAt > 48 * 60 * 60 * 1000
 }
 
 /** 用本地会话恢复现场。恢复不了返回 false，由调用方走「链接无效」分支 */
@@ -170,18 +202,21 @@ function restoreSession() {
   }
 
   signingState.mode = 'real'
-  signingState.taskId = session.taskId
+  signingState.taskId = session.taskId ?? ''
-  signingState.taskNo = session.taskNo || session.taskId
+  signingState.taskNo = session.taskNo || session.taskId || ''
-  signingState.deliveryId = session.deliveryId
+  signingState.deliveryId = session.deliveryId ?? ''
-  signingState.uploadToken = session.uploadToken
+  signingState.uploadToken = session.uploadToken ?? ''
   signingState.channel = session.channel
   sessionExpiresAt = session.expiresAt
+  pendingToken = session.pendingToken
+  consumeIdempotencyKey = session.consumeIdempotencyKey
+  uploadIdempotencyKey = session.uploadIdempotencyKey
 
   if (session.context) {
     applyContext(session.context)
   }
 
-  signingState.status = 'ready'
+  signingState.status = session.pendingToken ? 'loading' : 'ready'
   return true
 }
 
@@ -256,6 +291,15 @@ function applyContext(context: SigningContextResponse) {
     signingState.fields = [...context.fields]
   }
 
+  if (context.signatureFields) {
+    const patientField = context.signatureFields.find((field) => field.id === 'signature')
+    signingState.signatureFields = patientField
+      ? [patientField]
+      : context.signatureFields.length === 1
+        ? [...context.signatureFields]
+        : []
+  }
+
   if (context.status) {
     signingState.taskStatus = context.status
   }
@@ -268,24 +312,96 @@ function applyContext(context: SigningContextResponse) {
     signingState.deliveryId = context.deliveryId
   }
 
+  if (context.uploadResult) {
+    signingState.uploadResult = context.uploadResult
+    signingState.pipelineId = context.uploadResult.pipelineId
+  }
+
+  signingState.backendStatus = context.status ?? signingState.backendStatus
+  signingState.signatureCaptured = Boolean(
+    context.uploadResult ||
+    context.status === 'GENERATING' ||
+    context.status === 'WAITING_CONFIRM' ||
+    context.status === 'SIGNED',
+  )
+
+  if (context.uploadResult?.completedAt) {
+    signingState.submittedAt = context.uploadResult.completedAt
+  } else if (context.signedAt) {
+    signingState.submittedAt = context.signedAt
+  }
+
   if (context.expiresAt) {
     sessionExpiresAt = context.expiresAt
   }
 
-  signingState.documentLoaded = Boolean(signingState.documentContentHtml)
+  const hasPatientSignatureField = signingState.signatureFields.length > 0
+  signingState.documentLoaded =
+    Boolean(signingState.documentContentHtml) && hasPatientSignatureField
   signingState.documentError = signingState.documentLoaded
     ? ''
+    : signingState.documentContentHtml
+      ? '本文书尚未配置有效的患者 PDF 签名位置，请联系医务人员。'
       : '暂未读取到本次签署的文书正文，无法展示正式文书。'
 }
 
-async function loadSigningContext(token: string) {
+function getHttpStatus(error: unknown) {
-  try {
+  if (typeof error !== 'object' || error === null || !('response' in error)) {
-    applyContext(await fetchSigningContext(token))
+    return undefined
-  } catch {
+  }
-    // 接口未接入 / 任务无效：如实告知，**不放行签署** ——
+
-    // 让患者在没看过正式文书的情况下签名，比签不了更严重
+  const response = (error as { response?: { status?: unknown } }).response
+  return typeof response?.status === 'number' ? response.status : undefined
+}
+
+function isRejectedProof(error: unknown) {
+  const status = getHttpStatus(error)
+  return status === 401 || status === 403 || status === 404 || status === 410 || status === 422
+}
+
+function currentProof() {
+  if (!signingState.taskId || !signingState.deliveryId || !signingState.uploadToken) {
+    return null
+  }
+
+  return {
+    taskId: signingState.taskId,
+    deliveryId: signingState.deliveryId,
+    uploadToken: signingState.uploadToken,
+  }
+}
+
+function isPostUploadStatus(status: string) {
+  return status === 'GENERATING' || status === 'WAITING_CONFIRM' || status === 'SIGNED'
+}
+
+async function loadSigningContext(): Promise<SigningContextResponse | null> {
+  const proof = currentProof()
+
+  if (!proof) {
     signingState.documentLoaded = false
-    signingState.documentError = '暂时无法读取本次签署的文书内容，请联系现场医务人员。'
+    signingState.documentError = '签署凭证不完整，请重新打开签署链接。'
+    return null
+  }
+
+  try {
+    const context = await fetchSigningContext(proof)
+    applyContext(context)
+    persistSession()
+    return context
+  } catch (error) {
+    if (isRejectedProof(error)) {
+      clearPersistedSession()
+      await removePendingSigningUpload(signingState.taskId).catch(() => undefined)
+      signingState.taskId = ''
+      signingState.deliveryId = ''
+      signingState.uploadToken = ''
+    }
+    signingState.documentLoaded = false
+    signingState.documentError = isRejectedProof(error)
+      ? '签署凭证已失效或被撤销，请联系现场医务人员重新发起。'
+      : '暂时无法读取本次签署的文书内容，请检查网络后重试。'
+    return null
   }
 }
 
@@ -299,8 +415,7 @@ async function loadSigningContext(token: string) {
 function applyDemoContext() {
   // `?demo=narcotic` 切到精麻同意书：它是演示文库（clinical-web）里唯一真实存在的模板，
   // 字段也最多（代办人 / 身份核验 / 用药信息），最能压出占位符渲染的问题
-  const useNarcotic =
+  const useNarcotic = new URLSearchParams(window.location.search).get('demo') === 'narcotic'
-    new URLSearchParams(window.location.search).get('demo') === 'narcotic'
 
   signingState.documentTitle = useNarcotic
     ? '麻醉药品、精神药品知情同意书'
@@ -327,9 +442,15 @@ export async function initializeSignFlow(token?: string) {
 
   const candidate = token?.trim()
 
-  // 地址栏没有 token 时先尝试恢复本地会话（刷新 / 切后台回来都会走到这里）
+  // 地址栏没有 token 时恢复：若上次消费响应丢失，按原 key 重放；若已经拿到 proof，重取上下文。
   if (!candidate && restoreSession()) {
-    return true
+    if (pendingToken && consumeIdempotencyKey) {
+      return consumeAndLoad(pendingToken, consumeIdempotencyKey)
+    }
+    const context = await loadSigningContext()
+    signingState.status = context ? 'ready' : 'error'
+    signingState.errorMessage = context ? '' : signingState.documentError
+    return Boolean(context)
   }
 
   const shouldUseRealFlow = Boolean(candidate) || import.meta.env.VITE_USE_MOCK === 'false'
@@ -350,19 +471,38 @@ export async function initializeSignFlow(token?: string) {
   }
 
   signingState.status = 'loading'
+  pendingToken = candidate
+  consumeIdempotencyKey = createIdempotencyKey()
+  // Store before the network call so a response lost after server commit can be replayed safely.
+  persistSession()
+  return consumeAndLoad(candidate, consumeIdempotencyKey)
+}
 
+async function consumeAndLoad(token: string, idempotencyKey: string) {
+  signingState.status = 'loading'
   try {
-    const session = await consumeSigningToken({ token: candidate })
+    const session = await consumeSigningToken({ token }, idempotencyKey)
-
     signingState.taskId = session.taskId
     signingState.taskNo = session.taskId
     signingState.deliveryId = session.deliveryId
     signingState.uploadToken = session.uploadToken
     signingState.channel = session.channel
+    pendingToken = null
     signingState.status = 'ready'
-
-    await loadSigningContext(candidate)
     persistSession()
+
+    const context = await loadSigningContext()
+    if (!context) {
+      signingState.status = 'error'
+      signingState.errorMessage = signingState.documentError
+      return false
+    }
+
+    // The server status is authoritative after response loss; do not ask the patient to sign twice.
+    if (isPostUploadStatus(context.status ?? '')) {
+      signingState.signatureCaptured = true
+      signingState.status = 'submitted'
+    }
     return true
   } catch (error) {
     signingState.status = 'error'
@@ -374,7 +514,7 @@ export async function initializeSignFlow(token?: string) {
 export async function submitRealSignature(input: {
   file: Blob
   consentAccepted: boolean
-}): Promise<SignatureUploadResponse> {
+}): Promise<SignatureUploadResponse | null> {
   if (signingState.mode !== 'real') {
     throw new Error('当前是演示签署流程')
   }
@@ -392,32 +532,77 @@ export async function submitRealSignature(input: {
   signingState.errorMessage = ''
 
   try {
+    const signatureField = signingState.signatureFields[0]
+    if (!signatureField) {
+      throw new Error('当前文书未配置患者签名位置，请联系现场医务人员。')
+    }
+    const signerType = signingState.signerType.toUpperCase() === 'FAMILY' ? 'FAMILY' : 'SELF'
+    const signerName = signingState.signerName.trim() || signingState.patientName.trim()
+    const relation = signingState.relation || '本人'
+    if (!signerName) {
+      throw new Error('签署人信息不完整，请联系现场医务人员。')
+    }
+    const observedSignedAt = new Date().toISOString()
+    const metadata = await buildSignaturePngMetadata(input.file, signatureField)
+    const pending = await readPendingSigningUpload(signingState.taskId)
+    const idempotencyKey = pending?.idempotencyKey ?? uploadIdempotencyKey ?? createIdempotencyKey()
+    uploadIdempotencyKey = idempotencyKey
+    const signer = {
+      type: signerType,
+      name: signerName,
+      relation,
+      consentAccepted: true as const,
+      observedSignedAt,
+    }
+
+    // Preserve the exact PNG and idempotency key before upload; response loss can then retry
+    // without asking the patient to redraw or creating a second pipeline.
+    await savePendingSigningUpload({
+      taskId: signingState.taskId,
+      deliveryId: signingState.deliveryId,
+      expiresAt: sessionExpiresAt,
+      file: input.file,
+      metadata: pending?.metadata ?? metadata,
+      signer: pending?.signer ?? signer,
+      idempotencyKey,
+      savedAt: Date.now(),
+    })
+
+    const payload = await readPendingSigningUpload(signingState.taskId)
+    if (!payload) {
+      throw new Error('签署恢复信息已过期，请联系现场医务人员重新发起。')
+    }
     const result = await uploadSigningSignature({
       taskId: signingState.taskId,
       deliveryId: signingState.deliveryId,
       uploadToken: signingState.uploadToken,
-      file: input.file,
+      file: payload.file,
-      metadata: JSON.stringify({
+      metadata: payload.metadata,
-        // 签署人信息由医生在医护端填好，患者端原样带上，不再自己填
+      signer: payload.signer,
-        signerName: signingState.signerName,
+      idempotencyKey: payload.idempotencyKey,
-        signerType: signingState.signerType,
-        relation: signingState.relation,
-        consentAccepted: input.consentAccepted,
-        signedAt: new Date().toISOString(),
-      }),
     })
 
     signingState.signatureCaptured = true
-    signingState.submittedAt = new Date().toLocaleString('zh-CN')
+    signingState.submittedAt = result.completedAt ?? new Date().toLocaleString('zh-CN')
     signingState.backendStatus = result.status
     signingState.pipelineId = result.pipelineId
     signingState.uploadResult = result
-    // 凭证用掉了就清掉：既避免重复提交，也不在这台设备上留着
+    // 保留短期 proof 以便结果页刷新时安全读取状态；服务端只允许它读上下文，不能重复上传。
-    signingState.uploadToken = ''
     signingState.status = 'submitted'
-    clearPersistedSession()
+    await removePendingSigningUpload(signingState.taskId)
+    persistSession()
     return result
   } catch (error) {
+    const refreshedContext = await loadSigningContext().catch(() => null)
+    if (refreshedContext && isPostUploadStatus(refreshedContext.status ?? '')) {
+      signingState.signatureCaptured = true
+      signingState.status = 'submitted'
+      signingState.backendStatus = refreshedContext.status ?? ''
+      signingState.submittedAt = refreshedContext.signedAt ?? new Date().toISOString()
+      await removePendingSigningUpload(signingState.taskId).catch(() => undefined)
+      persistSession()
+      return null
+    }
     signingState.status = 'ready'
     signingState.errorMessage = getErrorMessage(error)
     throw error

patient-h5/src/types/signing.ts

@@ -1,4 +1,9 @@
-import type { SignDeliveryChannel, SignatureUploadResponse, SigningContextField } from '@/api/types'
+import type {
+  SignDeliveryChannel,
+  SignatureFieldPosition,
+  SignatureUploadResponse,
+  SigningContextField,
+} from '@/api/types'
 
 export type SignerRelation = '本人' | '父亲' | '母亲' | '其他监护人' | '其他'
 
@@ -34,6 +39,8 @@ export interface SignFlowState {
   staffAnswers: Record<string, string>
   /** 患者端可交互的字段。按约定只有主签名位（`id === 'signature'`） */
   fields: SigningContextField[]
+  /** PDF points and page number supplied by the task's frozen template version. */
+  signatureFields: SignatureFieldPosition[]
   /** 有没有真的拿到正文 —— 没拿到就不该让患者签 */
   documentLoaded: boolean
   documentError: string

patient-h5/src/utils/signing-png.ts

@@ -0,0 +1,73 @@
+import type { SignatureFieldPosition, SignaturePngMetadata } from '@/api/types'
+
+const PNG_SIGNATURE = [137, 80, 78, 71, 13, 10, 26, 10]
+
+function hex(value: ArrayBuffer) {
+  return [...new Uint8Array(value)].map((byte) => byte.toString(16).padStart(2, '0')).join('')
+}
+
+async function readImageSize(file: Blob) {
+  if (typeof createImageBitmap === 'function') {
+    const bitmap = await createImageBitmap(file)
+    const size = { width: bitmap.width, height: bitmap.height }
+    bitmap.close()
+    return size
+  }
+
+  const objectUrl = URL.createObjectURL(file)
+
+  try {
+    const image = new Image()
+    image.src = objectUrl
+    await new Promise<void>((resolve, reject) => {
+      image.onload = () => resolve()
+      image.onerror = () => reject(new Error('无法读取签名图片尺寸，请重新签名。'))
+    })
+    return { width: image.naturalWidth, height: image.naturalHeight }
+  } finally {
+    URL.revokeObjectURL(objectUrl)
+  }
+}
+
+export async function buildSignaturePngMetadata(
+  file: Blob,
+  signatureField: SignatureFieldPosition,
+): Promise<SignaturePngMetadata> {
+  if (file.type !== 'image/png') {
+    throw new Error('签名图片必须是 PNG 格式。')
+  }
+
+  const header = new Uint8Array(await file.slice(0, PNG_SIGNATURE.length).arrayBuffer())
+
+  if (!PNG_SIGNATURE.every((byte, index) => header[index] === byte)) {
+    throw new Error('签名图片内容不是有效的 PNG 文件，请重新签名。')
+  }
+
+  if (!globalThis.crypto?.subtle) {
+    throw new Error('当前浏览器无法校验签名图片，请通过 HTTPS 页面重新打开签署链接。')
+  }
+
+  const [{ width, height }, digest] = await Promise.all([
+    readImageSize(file),
+    crypto.subtle.digest('SHA-256', await file.arrayBuffer()),
+  ])
+
+  if (!width || !height) {
+    throw new Error('签名图片尺寸无效，请重新签名。')
+  }
+
+  return {
+    imageWidth: width,
+    imageHeight: height,
+    sizeBytes: file.size,
+    sha256: hex(digest),
+    contentType: 'image/png',
+    fieldId: signatureField.id,
+    page: signatureField.page,
+    x: signatureField.x,
+    y: signatureField.y,
+    width: signatureField.width,
+    height: signatureField.height,
+    coordinateSystem: signatureField.coordinateSystem,
+  }
+}

patient-h5/src/utils/signing-vault.ts

@@ -0,0 +1,99 @@
+import type { SignaturePngMetadata } from '@/api/types'
+
+export interface PendingSigningUpload {
+  taskId: string
+  deliveryId: string
+  expiresAt: string | null
+  file: Blob
+  metadata: SignaturePngMetadata
+  signer: {
+    type: string
+    name: string
+    relation: string
+    consentAccepted: true
+    observedSignedAt: string
+  }
+  idempotencyKey: string
+  savedAt: number
+}
+
+const DATABASE_NAME = 'medical-sign:patient-vault'
+const DATABASE_VERSION = 1
+const UPLOAD_STORE = 'pending-uploads'
+
+function openDatabase(): Promise<IDBDatabase> {
+  if (typeof indexedDB === 'undefined') {
+    return Promise.reject(new Error('此浏览器不支持安全保存签署恢复信息，请使用最新版浏览器。'))
+  }
+
+  return new Promise((resolve, reject) => {
+    const request = indexedDB.open(DATABASE_NAME, DATABASE_VERSION)
+    request.onupgradeneeded = () => {
+      const database = request.result
+
+      if (!database.objectStoreNames.contains(UPLOAD_STORE)) {
+        database.createObjectStore(UPLOAD_STORE, { keyPath: 'taskId' })
+      }
+    }
+    request.onsuccess = () => resolve(request.result)
+    request.onerror = () => reject(new Error('无法保存签署恢复信息，请检查浏览器存储设置。'))
+  })
+}
+
+async function withStore<T>(
+  mode: IDBTransactionMode,
+  action: (store: IDBObjectStore) => IDBRequest<T>,
+) {
+  const database = await openDatabase()
+
+  return new Promise<T>((resolve, reject) => {
+    const transaction = database.transaction(UPLOAD_STORE, mode)
+    const request = action(transaction.objectStore(UPLOAD_STORE))
+    let result: T
+    request.onsuccess = () => {
+      result = request.result
+    }
+    request.onerror = () => reject(new Error('签署恢复信息保存失败，请稍后重试。'))
+    transaction.oncomplete = () => {
+      database.close()
+      resolve(result)
+    }
+    transaction.onerror = () => {
+      database.close()
+      reject(new Error('签署恢复信息保存失败，请稍后重试。'))
+    }
+    transaction.onabort = () => {
+      database.close()
+      reject(new Error('签署恢复信息保存失败，请稍后重试。'))
+    }
+  })
+}
+
+export function savePendingSigningUpload(upload: PendingSigningUpload): Promise<IDBValidKey> {
+  return withStore('readwrite', (store) => store.put(upload))
+}
+
+export async function readPendingSigningUpload(
+  taskId: string,
+): Promise<PendingSigningUpload | null> {
+  const upload = await withStore<PendingSigningUpload | undefined>('readonly', (store) =>
+    store.get(taskId),
+  )
+
+  if (!upload) {
+    return null
+  }
+
+  const expiresAt = upload.expiresAt ? new Date(upload.expiresAt).getTime() : Number.NaN
+
+  if (!Number.isNaN(expiresAt) && expiresAt <= Date.now()) {
+    await removePendingSigningUpload(taskId)
+    return null
+  }
+
+  return upload
+}
+
+export async function removePendingSigningUpload(taskId: string): Promise<void> {
+  await withStore<undefined>('readwrite', (store) => store.delete(taskId))
+}

patient-h5/src/views/entry/EntryView.vue

@@ -69,6 +69,20 @@ const terminal = computed(() => {
           ? `签署时间：${signingState.submittedAt}。无需重复签署。`
           : '本次文书已完成签署，无需重复签署。',
       }
+    case 'WAITING_CONFIRM':
+      return {
+        eyebrow: '患者已签署',
+        title: '签署已提交，等待科室确认',
+        copy: signingState.submittedAt
+          ? `提交时间：${signingState.submittedAt}。无需重复签署。`
+          : '患者签名已提交，等待医务人员完成后续确认。无需重复签署。',
+      }
+    case 'GENERATING':
+      return {
+        eyebrow: '签名已提交',
+        title: '文书正在生成',
+        copy: '签名已收到，系统正在生成正式文书。无需重复签署。',
+      }
     case 'EXPIRED':
       return {
         eyebrow: '链接已过期',
@@ -197,7 +211,9 @@ onMounted(() => {
         <div>
           <strong>请使用实际签署人的信息</strong>
           <p>
-            本次签署人：{{ signerLine }}。文书内容已由医务人员填写完成，如与实际不符请联系现场医务人员。
+            本次签署人：{{
+              signerLine
+            }}。文书内容已由医务人员填写完成，如与实际不符请联系现场医务人员。
           </p>
         </div>
       </section>

patient-h5/src/views/result/ResultView.vue

@@ -6,15 +6,18 @@ import { clearPersistedSession, resetSignFlow, signingState } from '@/composable
 
 const router = useRouter()
 
-const resultTitle = computed(() =>
+const resultTitle = computed(() => {
-  signingState.mode === 'real' && signingState.backendStatus === 'GENERATING'
+  if (signingState.mode !== 'real') return '知情同意书已提交'
-    ? '签名已提交，文书生成中'
+  if (signingState.backendStatus === 'GENERATING') return '签名已提交，文书生成中'
-    : '知情同意书已提交',
+  if (signingState.backendStatus === 'WAITING_CONFIRM') return '签署已提交，等待科室确认'
-)
+  return '知情同意书已提交'
+})
 
 const resultCopy = computed(() =>
   signingState.mode === 'real' && signingState.backendStatus === 'GENERATING'
     ? '签名图片已安全提交，系统正在生成签署后文书。最终状态以医签通服务端为准。'
+    : signingState.mode === 'real' && signingState.backendStatus === 'WAITING_CONFIRM'
+      ? '患者签名和签署文书已安全保存，等待医务人员完成科室确认。请勿重复签署。'
       : '本次签署结果已提交至医签通。请按照医务人员指引完成后续诊疗安排。',
 )
 
@@ -25,6 +28,7 @@ const statusLabel = computed(() => {
 
   const labels: Record<string, string> = {
     SIGNED: '已签署',
+    WAITING_CONFIRM: '待科室确认',
     GENERATING: '生成中',
     WAITING_SIGN: '待签署',
     FAILED: '处理失败',