149 lines
4.1 KiB
PHP
149 lines
4.1 KiB
PHP
<?php
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namespace App\Models;
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use Illuminate\Database\Eloquent\Model;
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use Illuminate\Database\Eloquent\Relations\BelongsTo;
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use Carbon\Carbon;
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class Patient extends Model
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{
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protected $fillable = [
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'user_id',
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'name',
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'gender',
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'age',
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'diagnosis',
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'discharge_date',
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'address',
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'phone',
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'remark',
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'follow_up_count',
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'last_follow_up_date',
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];
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/**
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* 获取患者所属用户
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*/
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public function user(): BelongsTo
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{
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return $this->belongsTo(User::class);
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}
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protected $casts = [
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'discharge_date' => 'date',
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'last_follow_up_date' => 'date',
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];
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/**
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* 获取随访时间规则（月数）
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* 脑卒中/心肌梗塞: 1, 3, 6, 12 个月
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* 慢性肾脏病: 1, 2, 3, 6 个月
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*/
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public function getFollowUpSchedule(): array
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{
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$diagnosis = $this->diagnosis;
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if (str_contains($diagnosis, '慢性肾') || str_contains($diagnosis, '肾脏病')) {
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return [1, 2, 3, 6]; // 慢性肾脏病
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}
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// 脑卒中、心肌梗塞及其他
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return [1, 3, 6, 12];
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}
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/**
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* 自动计算已完成的随访次数（过期的月份自动算已完成）
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*/
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public function getAutoFollowUpCount(): int
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{
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$schedule = $this->getFollowUpSchedule();
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$currentMonth = Carbon::now()->startOfMonth();
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$completed = 0;
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foreach ($schedule as $months) {
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$followUpDate = $this->discharge_date->copy()->addMonths($months);
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// 如果随访日期的月份早于当前月份，则算作已完成
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if ($followUpDate->startOfMonth()->lt($currentMonth)) {
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$completed++;
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} else {
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break;
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}
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}
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return $completed;
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}
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/**
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* 获取当月需要随访的日期（如果有的话）
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*/
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public function getCurrentMonthFollowUpDate(): ?Carbon
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{
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$schedule = $this->getFollowUpSchedule();
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$currentMonth = Carbon::now();
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$monthStart = $currentMonth->copy()->startOfMonth();
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$monthEnd = $currentMonth->copy()->endOfMonth();
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foreach ($schedule as $index => $months) {
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$followUpDate = $this->discharge_date->copy()->addMonths($months);
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// 如果随访日期在当月内
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if ($followUpDate->gte($monthStart) && $followUpDate->lte($monthEnd)) {
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return $followUpDate;
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}
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}
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return null;
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}
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/**
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* 获取当月随访是第几次
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*/
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public function getCurrentMonthFollowUpNumber(): ?int
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{
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$schedule = $this->getFollowUpSchedule();
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$currentMonth = Carbon::now();
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$monthStart = $currentMonth->copy()->startOfMonth();
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$monthEnd = $currentMonth->copy()->endOfMonth();
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foreach ($schedule as $index => $months) {
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$followUpDate = $this->discharge_date->copy()->addMonths($months);
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if ($followUpDate->gte($monthStart) && $followUpDate->lte($monthEnd)) {
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return $index + 1;
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}
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}
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return null;
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}
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/**
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* 检查当月是否需要随访
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*/
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public function needsFollowUpThisMonth(): bool
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{
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return $this->getCurrentMonthFollowUpDate() !== null;
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}
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/**
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* 检查是否已完成所有随访
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*/
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public function isCompleted(): bool
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{
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return $this->getAutoFollowUpCount() >= count($this->getFollowUpSchedule());
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}
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/**
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* 获取诊断类型名称
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*/
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public function getDiagnosisType(): string
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{
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if (str_contains($this->diagnosis, '脑卒中')) {
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return '脑卒中';
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} elseif (str_contains($this->diagnosis, '心肌梗') || str_contains($this->diagnosis, '心梗')) {
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return '心肌梗塞';
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} elseif (str_contains($this->diagnosis, '慢性肾') || str_contains($this->diagnosis, '肾脏病')) {
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return '慢性肾脏病';
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}
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return $this->diagnosis;
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}
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}
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