feat: 新增处方笺pdf

2026-09-15 13:44:07 +08:00 · 2026-09-15 13:44:07 +08:00 · 8956fb8c8a
commit 8956fb8c8a
parent b886d6d836
8 changed files with 1682 additions and 49 deletions
--- a/.env.dev
+++ b/.env.dev
@ -18,3 +18,8 @@ CONFIG_ALIPAY_MINI_PRIVATE_KEY=MIIEvQIBADANBgkqhkiG9w0BAQEFAASCBKcwggSjAgEAAoIBA
 ## 海宁his api
 CONFIG_HN_HIS_BASE_URL=http://122.225.16.74:8026

+##
+PUPPETEER_EXECUTABLE_PATH="C:\Program Files\Google\Chrome\Application\chrome.exe"
+PRESCRIPTION_PDF_MAX_CONCURRENCY=2
+CONFIG_PRESCRIPTION_PDF_BASE_URL=https://patient.youcan365.com/hn
+
--- a/.env.pro
+++ b/.env.pro
@ -20,3 +20,9 @@ CONFIG_HN_HIS_BASE_URL=http://122.225.16.74:8026

 ## im图片存储服务端的位置
 CONFIG_IM_IMAGE_ROOT=/opt/apps/private-files/im-chat
+
+## 处方 PDF（Linux Chrome）
+PUPPETEER_EXECUTABLE_PATH=/usr/bin/google-chrome
+PRESCRIPTION_PDF_MAX_CONCURRENCY=2
+CONFIG_PRESCRIPTION_PDF_ROOT=/opt/apps/private-files/prescriptions
+CONFIG_PRESCRIPTION_PDF_BASE_URL=https://hlwyy.hnkhhospital.com
--- a/README.md
+++ b/README.md
@ -45,3 +45,23 @@ GET /im-chat/image/:msgId

 当前接口按需求暂未启用 JWT，但仅允许通过 `MsgId` 查询数据库中归档成功的受控路径。
 生产使用前建议补充问诊订单权限验证。
+## 处方 PDF
+
+处方笺下载接口为 `GET /hlw/prescriptions/:id/pdf`；默认输出 A5，传 `paperSize=A4` 可输出 A4。
+
+服务运行环境需要预装 Chromium/Chrome，并配置其可执行文件路径：
+
+```env
+PUPPETEER_EXECUTABLE_PATH=/usr/bin/chromium
+PRESCRIPTION_PDF_MAX_CONCURRENCY=2
+# 推荐挂载到持久化卷；未设置时默认 ../private-files/prescriptions
+CONFIG_PRESCRIPTION_PDF_ROOT=/data/hn-private-files/prescriptions
+```
+
+`PRESCRIPTION_PDF_MAX_CONCURRENCY` 默认为 2，用于限制 Chromium 同时渲染的页面数。首次访问会生成并原子写入持久化目录，之后同一处方和纸张规格直接读取已有文件。该链接当前不需要认证。医生和药师签名支持 `data:image/*;base64,...`、项目上传目录的 `/upload-files/*.png|jpg|jpeg|webp` 路径，或 HTTP(S) 图片 URL。按本地文件、网络下载、姓名文本的顺序回退；网络请求最长 5 秒、最大 1 MB。
+
+PDF 响应使用 `Cache-Control: no-cache`，浏览器每次访问都会向服务端校验文件；已保存的 PDF 仍直接从磁盘读取，不会重复渲染。
+
+PDF 按处方 ObjectId 的 UTC 创建日期分目录保存，例如 `/opt/apps/private-files/prescriptions/2026/09/15/{处方ID}-A5-v5.pdf`，避免大量文件堆积在同一个目录。
+
+Linux 服务端需安装中文字体，否则 Chrome 无法渲染处方中的中文。TencentOS Server 4 可执行 `dnf install -y google-noto-sans-cjk-sc-fonts fontconfig && fc-cache -f`，模板会优先使用 `Noto Sans CJK SC`。
--- a/hlw/diagnostic-record/format.js
+++ b/hlw/diagnostic-record/format.js
@ -6,6 +6,18 @@ const Sm4Util = require("../../utils/sm4-util");
 */
 const ENCRYPTED_FIELDS = ["name", "mobile", "idCard"];

+function getPrescriptionPdfUrl(data) {
+  const id = data && (data._id || data.id);
+  if (id === undefined || id === null || String(id).trim() === "") {
+    return "";
+  }
+  const baseUrl = String(process.env.CONFIG_PRESCRIPTION_PDF_BASE_URL || "")
+    .trim()
+    .replace(/\/+$/, "");
+  if (!baseUrl) return "";
+  return `${baseUrl}/hlw/prescriptions/${encodeURIComponent(String(id))}/pdf`;
+}
+
 /**
 * 加密诊断记录敏感字段
 * @param {Object} data - 诊断记录数据
@ -80,6 +92,7 @@ function decryptDiagnosticRecordList(list) {

 exports.formatUploadRxData = function (data) {
  return {
+    // pdfUrl: getPrescriptionPdfUrl(data), 
    pay_type: data.feeType === 'YB' ? '1' : '0',
    patientid: data.patientId,
    orderno: data.medOrgOrderNo,
@ -266,3 +279,4 @@ exports.decryptDiagnosticRecordList = decryptDiagnosticRecordList;
 exports.buildHybridSearchQuery = buildHybridSearchQuery;
 exports.buildMultiFieldHybridSearch = buildMultiFieldHybridSearch;
 exports.ENCRYPTED_FIELDS = ENCRYPTED_FIELDS;
+exports.getPrescriptionPdfUrl = getPrescriptionPdfUrl;
--- a/hlw/prescription-pdf/index.js
+++ b/hlw/prescription-pdf/index.js
@ -0,0 +1,430 @@
+const fs = require("fs");
+const fsp = require("fs/promises");
+const path = require("path");
+const crypto = require("crypto");
+const { ObjectId } = require("mongodb");
+const dayjs = require("dayjs");
+const axios = require("axios");
+const puppeteer = require("puppeteer-core");
+const { decryptDiagnosticRecordFields } = require("../diagnostic-record/format");
+
+let browserPromise;
+let activeJobs = 0;
+const waiters = [];
+const cachedPdfJobs = new Map();
+const PDF_TEMPLATE_VERSION = "v5";
+const MAX_SIGNATURE_IMAGE_BYTES = 1024 * 1024;
+const SIGNATURE_DOWNLOAD_TIMEOUT_MS = 5000;
+
+const signatureMimeTypes = {
+  ".png": "image/png",
+  ".jpg": "image/jpeg",
+  ".jpeg": "image/jpeg",
+  ".webp": "image/webp",
+};
+
+function resolveDefaultPdfRoot(
+  moduleDirectory = __dirname,
+  isBuilt = process.env.IS_BUILDED === "YES"
+) {
+  const serviceRoot = isBuilt
+    ? moduleDirectory
+    : path.resolve(moduleDirectory, "../..");
+  return path.resolve(serviceRoot, "../private-files/prescriptions");
+}
+
+function getPdfRoot() {
+  return path.resolve(
+    process.env.CONFIG_PRESCRIPTION_PDF_ROOT || resolveDefaultPdfRoot()
+  );
+}
+
+async function initializeStorage() {
+  const pdfRoot = getPdfRoot();
+  await fsp.mkdir(pdfRoot, { recursive: true });
+  await fsp.access(pdfRoot, fs.constants.R_OK | fs.constants.W_OK);
+  return pdfRoot;
+}
+
+function maxConcurrency() {
+  const value = Number.parseInt(process.env.PRESCRIPTION_PDF_MAX_CONCURRENCY, 10);
+  return Number.isInteger(value) && value > 0 ? value : 2;
+}
+
+async function acquireSlot() {
+  if (activeJobs < maxConcurrency()) {
+    activeJobs += 1;
+    return;
+  }
+  await new Promise((resolve) => waiters.push(resolve));
+  activeJobs += 1;
+}
+
+function releaseSlot() {
+  activeJobs -= 1;
+  const next = waiters.shift();
+  if (next) next();
+}
+
+function getExecutablePath() {
+  const platformCandidates = process.platform === "linux"
+    ? [
+      "/usr/bin/google-chrome",
+      "/usr/bin/google-chrome-stable",
+      "/usr/bin/chromium",
+      "/usr/bin/chromium-browser",
+    ]
+    : [
+      "C:\\Program Files\\Google\\Chrome\\Application\\chrome.exe",
+      "C:\\Program Files (x86)\\Google\\Chrome\\Application\\chrome.exe",
+    ];
+  const candidates = [process.env.PUPPETEER_EXECUTABLE_PATH, ...platformCandidates]
+    .filter(Boolean);
+  const executablePath = candidates.find((candidate) => fs.existsSync(candidate));
+  if (!executablePath) {
+    throw new Error(
+      `未找到 Chrome/Chromium，请配置 PUPPETEER_EXECUTABLE_PATH。已检查：${candidates.join(", ")}`
+    );
+  }
+  return executablePath;
+}
+
+async function getBrowser() {
+  if (!browserPromise) {
+    browserPromise = puppeteer.launch({
+      executablePath: getExecutablePath(),
+      headless: true,
+      args: ["--no-sandbox", "--disable-setuid-sandbox", "--disable-dev-shm-usage"],
+    });
+    const browser = await browserPromise;
+    browser.on("disconnected", () => {
+      browserPromise = undefined;
+    });
+  }
+  return browserPromise;
+}
+
+function escapeHtml(value) {
+  return String(value ?? "")
+    .replace(/&/g, "&amp;")
+    .replace(/</g, "&lt;")
+    .replace(/>/g, "&gt;")
+    .replace(/\"/g, "&quot;")
+    .replace(/'/g, "&#39;");
+}
+
+function safeDataImage(value) {
+  if (typeof value !== "string" || value.length > 1024 * 1024) return "";
+  return /^data:image\/(png|jpeg|webp);base64,[a-z0-9+/=\s]+$/i.test(value)
+    ? value
+    : "";
+}
+
+function getUploadRoot() {
+  // 与 upload.js 使用相同的共享上传目录，拒绝任意文件系统路径。
+  return path.resolve(__dirname, "../../../upload-files");
+}
+
+function getImageMimeType(buffer, contentType = "") {
+  const normalizedContentType = String(contentType).split(";", 1)[0].trim().toLowerCase();
+  if (["image/png", "image/jpeg", "image/webp"].includes(normalizedContentType)) {
+    return normalizedContentType;
+  }
+  if (buffer.length >= 8 && buffer.subarray(0, 8).equals(Buffer.from("89504e470d0a1a0a", "hex"))) return "image/png";
+  if (buffer.length >= 3 && buffer.subarray(0, 3).equals(Buffer.from([0xff, 0xd8, 0xff]))) return "image/jpeg";
+  if (buffer.length >= 12 && buffer.subarray(0, 4).toString() === "RIFF" && buffer.subarray(8, 12).toString() === "WEBP") return "image/webp";
+  return "";
+}
+
+function getLocalSignaturePath(value) {
+  if (typeof value !== "string") return "";
+  let pathname = value;
+  if (/^https?:\/\//i.test(value)) {
+    try {
+      pathname = new URL(value).pathname;
+    } catch (_error) {
+      return "";
+    }
+  }
+  if (!pathname.startsWith("/upload-files/")) return "";
+
+  const uploadRoot = getUploadRoot();
+  let relativePath;
+  try {
+    relativePath = decodeURIComponent(pathname.slice("/upload-files/".length));
+  } catch (_error) {
+    return "";
+  }
+  const filePath = path.resolve(uploadRoot, relativePath);
+  return filePath.startsWith(`${uploadRoot}${path.sep}`) ? filePath : "";
+}
+
+async function loadLocalSignatureDataImage(value) {
+  const filePath = getLocalSignaturePath(value);
+  if (!filePath) return "";
+  const mimeType = signatureMimeTypes[path.extname(filePath).toLowerCase()];
+  if (!mimeType) return "";
+  try {
+    const file = await fsp.readFile(filePath);
+    if (file.length === 0 || file.length > MAX_SIGNATURE_IMAGE_BYTES) return "";
+    return `data:${mimeType};base64,${file.toString("base64")}`;
+  } catch (_error) {
+    return "";
+  }
+}
+
+async function downloadSignatureDataImage(value) {
+  if (typeof value !== "string" || !/^https?:\/\//i.test(value)) return "";
+  try {
+    const url = new URL(value);
+    if (url.protocol !== "http:" && url.protocol !== "https:") return "";
+    const response = await axios.get(url.toString(), {
+      responseType: "arraybuffer",
+      timeout: SIGNATURE_DOWNLOAD_TIMEOUT_MS,
+      maxContentLength: MAX_SIGNATURE_IMAGE_BYTES,
+      maxBodyLength: MAX_SIGNATURE_IMAGE_BYTES,
+      maxRedirects: 2,
+      validateStatus: (status) => status >= 200 && status < 300,
+    });
+    const image = Buffer.from(response.data);
+    if (image.length === 0 || image.length > MAX_SIGNATURE_IMAGE_BYTES) return "";
+    const mimeType = getImageMimeType(image, response.headers["content-type"]);
+    return mimeType ? `data:${mimeType};base64,${image.toString("base64")}` : "";
+  } catch (_error) {
+    return "";
+  }
+}
+
+async function loadSignatureDataImage(value) {
+  const embeddedImage = safeDataImage(value);
+  if (embeddedImage) return embeddedImage;
+  const localImage = await loadLocalSignatureDataImage(value);
+  if (localImage) return localImage;
+  return downloadSignatureDataImage(value);
+}
+
+function getAge(record) {
+  if (Number.isFinite(Number(record.age)) && Number(record.age) >= 0) {
+    return `${Number(record.age)}岁`;
+  }
+  const idCard = String(record.idCard || "");
+  if (!/^\d{17}[\dXx]$/.test(idCard)) return "";
+  const birth = dayjs(`${idCard.slice(6, 10)}-${idCard.slice(10, 12)}-${idCard.slice(12, 14)}`);
+  const reference = dayjs(record.prescriptionEndTime || record.createTime);
+  return birth.isValid() && reference.isValid() ? `${reference.diff(birth, "year")}岁` : "";
+}
+
+function getSex(record) {
+  if (record.sex === "男" || record.sex === "女") return record.sex;
+  const idCard = String(record.idCard || "");
+  return /^\d{17}[\dXx]$/.test(idCard) ? (Number(idCard[16]) % 2 ? "男" : "女") : "";
+}
+
+function medicineUsage(drug) {
+  return [
+    drug.usageName,
+    drug.frequencyName,
+    drug.dosage ? `每次${drug.dosage}${drug.dosage_unit || ""}` : "",
+  ].filter(Boolean).join(" ");
+}
+
+function signature(value, fallback) {
+  const image = safeDataImage(value);
+  return image
+    ? `<img class="signature-image" src="${image}" alt="签名" />`
+    : `<span>${escapeHtml(fallback)}</span>`;
+}
+
+function buildPrescriptionHtml(record, paperSize = "A5", signatureImages = {}) {
+  const size = paperSize === "A4" ? "A4" : "A5";
+  const diagnosis = Array.isArray(record.diagnosisList) ? record.diagnosisList : [];
+  const drugs = Array.isArray(record.drugs) ? record.drugs : [];
+  const prescriptionTime = dayjs(record.prescriptionEndTime || record.createTime);
+  const diagnosisHtml = diagnosis.length
+    ? diagnosis.map((item, index) => `<div>${index + 1}. ${escapeHtml(item.name)}</div>`).join("")
+    : "<div>—</div>";
+  const drugHtml = drugs.length
+    ? drugs.map((drug, index) => `
+      <section class="medicine-item">
+        <div class="medicine-name">${index + 1}. ${escapeHtml(drug.drugName)} x ${escapeHtml(drug.quantity)} ${escapeHtml(drug.unit)}</div>
+        <div class="medicine-detail">规格：${escapeHtml(drug.specification)}</div>
+        <div class="medicine-detail">用法：${escapeHtml(medicineUsage(drug))}</div>
+      </section>`).join("")
+    : "<section class=\"medicine-item\">暂无药品</section>";
+
+  return `<!doctype html>
+<html lang="zh-CN"><head><meta charset="utf-8" />
+<style>
+  @page { size: ${size} portrait; margin: 6mm; }
+  * { box-sizing: border-box; }
+  html, body { margin: 0; padding: 0; color: #111; font-family: "Noto Sans CJK SC", "Noto Sans SC", SimSun, "Songti SC", serif; font-size: 12px; }
+  body { -webkit-print-color-adjust: exact; print-color-adjust: exact; }
+  .prescription { min-height: ${size === "A5" ? "198mm" : "285mm"}; display: flex; flex-direction: column; line-height: 1.5; }
+  .header { position: relative; border-bottom: 1px solid #111; padding: 1px 0 5px; }
+  .title { font-weight: 700; font-size: 16px; text-align: center; line-height: 1.75; }
+  .rx-type { position: absolute; top: 0; right: 0; width: 38px; border: 1px solid #555; text-align: center; color: #555; line-height: 1.55; }
+  .rx-number { margin-top: 4px; font-size: 12px; }
+  .patient-info { padding-top: 5px; }
+  .info-row { display: flex; padding: 2px 0; gap: 5px; }
+  .info-cell { flex: 1; min-width: 0; overflow-wrap: anywhere; }
+  .info-half { width: 50%; overflow-wrap: anywhere; }
+  .diagnosis { margin-top: 5px; }
+  .diagnosis-head { display: flex; justify-content: space-between; gap: 8px; }
+  .diagnosis-list { padding-top: 2px; min-height: 18px; }
+  .date { white-space: nowrap; color: #555; }
+  .medicine { margin-top: 4px; }
+  .rp { font-size: 16px; font-weight: 700; margin-bottom: 3px; }
+  .medicine-item { break-inside: avoid; margin: 0 0 11px; padding-left: 2px; }
+  .medicine-name { font-weight: 700; font-size: 13px; }
+  .medicine-detail { color: #444; margin-top: 2px; }
+  .footer { margin-top: auto; border-top: 1px dashed #999; padding-top: 6px; break-inside: avoid; }
+  .signature-row, .action-row { display: flex; padding: 2px 0; }
+  .signature-cell, .action-cell { width: 33.333%; min-height: 20px; }
+  .signature-image { display: inline-block; width: 82px; height: 28px; object-fit: contain; vertical-align: middle; }
+  .notice { margin-top: 4px; color: #b33; font-size: 10px; line-height: 1.4; }
+  .blank-line { display: inline-block; width: 35px; border-bottom: 1px solid currentColor; }
+  @media print { .medicine-item, .footer { page-break-inside: avoid; } }
+</style></head><body>
+  <main class="prescription">
+    <header class="header">
+      <div class="rx-type">普通<br>处方</div>
+      <div class="title">海宁康华医院互联网医院<br>处方笺</div>
+      <div class="rx-number">NO:${escapeHtml(record.medOrgOrderNo || record._id)}</div>
+    </header>
+    <section class="patient-info">
+      <div class="info-row"><div class="info-cell">姓名：${escapeHtml(record.name)}</div><div class="info-cell">性别：${escapeHtml(getSex(record))}</div><div class="info-cell">费别：${record.feeType === "YB" ? "医保" : "自费"}</div><div class="info-cell">年龄：${escapeHtml(getAge(record))}</div></div>
+      <div class="info-row"><div class="info-half">门诊病历号：${escapeHtml(record.blhno)}</div><div class="info-half">科别：${escapeHtml(record.deptName)}</div></div>
+      <div class="info-row"><div class="info-cell">地址：${escapeHtml(record.address)}</div></div>
+      <div class="info-row"><div class="info-cell">电话号：${escapeHtml(record.mobile)}</div></div>
+    </section>
+    <section class="diagnosis"><div class="diagnosis-head"><div>诊断：</div><div class="date">开方日期：${prescriptionTime.isValid() ? prescriptionTime.format("YYYY-MM-DD HH:mm") : ""}</div></div><div class="diagnosis-list">${diagnosisHtml}</div></section>
+    <section class="medicine"><div class="rp">Rp</div>${drugHtml}</section>
+    <footer class="footer"><div class="signature-row"><div class="signature-cell">医生：${signature(signatureImages.doctor || record.doctorSignImg, record.doctorName)}</div><div class="signature-cell">审方药师：${signature(signatureImages.pharmacist || record.pharmacistSignImg, record.pharmacist)}</div></div><div class="action-row"><div class="action-cell">调配：</div><div class="action-cell">核对：</div><div class="action-cell">发药：</div></div><div class="notice">注意：请勿丢失，处方当日有效，因特殊情况，该处方有效为<span class="blank-line"></span>天（签名：<span class="blank-line"></span>）</div></footer>
+  </main>
+</body></html>`;
+}
+
+async function generatePrescriptionPdf(record, options = {}) {
+  await acquireSlot();
+  let page;
+  try {
+    const browser = await getBrowser();
+    page = await browser.newPage();
+    const [doctor, pharmacist] = await Promise.all([
+      loadSignatureDataImage(record.doctorSignImg),
+      loadSignatureDataImage(record.pharmacistSignImg),
+    ]);
+    await page.setContent(
+      buildPrescriptionHtml(record, options.paperSize, { doctor, pharmacist }),
+      { waitUntil: "load" }
+    );
+    await page.evaluate(() => document.fonts && document.fonts.ready);
+    return Buffer.from(await page.pdf({
+      format: options.paperSize === "A4" ? "A4" : "A5",
+      preferCSSPageSize: true,
+      printBackground: true,
+      margin: { top: 0, right: 0, bottom: 0, left: 0 },
+    }));
+  } finally {
+    if (page) await page.close().catch(() => {});
+    releaseSlot();
+  }
+}
+
+async function createPrescriptionPdf(db, id, options) {
+  if (typeof id !== "string" || !ObjectId.isValid(id)) {
+    const error = new Error("处方 id 格式错误");
+    error.statusCode = 400;
+    throw error;
+  }
+  const record = await db.collection("diagnostic-record").findOne({ _id: new ObjectId(id) });
+  if (!record) {
+    const error = new Error("处方不存在");
+    error.statusCode = 404;
+    throw error;
+  }
+  return generatePrescriptionPdf(decryptDiagnosticRecordFields(record), options);
+}
+
+function getPdfPath(id, paperSize) {
+  const size = paperSize === "A4" ? "A4" : "A5";
+  // MongoDB ObjectId 的前四字节是创建时间戳；用 UTC 日期分目录，避免因服务器时区不同写入不同路径。
+  const createdAt = new ObjectId(id).getTimestamp();
+  const year = String(createdAt.getUTCFullYear());
+  const month = String(createdAt.getUTCMonth() + 1).padStart(2, "0");
+  const day = String(createdAt.getUTCDate()).padStart(2, "0");
+  return path.join(
+    getPdfRoot(),
+    year,
+    month,
+    day,
+    `${id}-${size}-${PDF_TEMPLATE_VERSION}.pdf`
+  );
+}
+
+async function getOrCreatePrescriptionPdf(db, id, options = {}) {
+  if (typeof id !== "string" || !ObjectId.isValid(id)) {
+    const error = new Error("处方 id 格式错误");
+    error.statusCode = 400;
+    throw error;
+  }
+  const paperSize = options.paperSize === "A4" ? "A4" : "A5";
+  const pdfPath = getPdfPath(id, paperSize);
+  try {
+    await fsp.access(pdfPath, fs.constants.R_OK);
+    return { pdfPath, cached: true };
+  } catch (_error) {
+    // 文件尚未生成，继续生成；不要将 access 错误泄漏给客户端。
+  }
+
+  const key = `${id}:${paperSize}`;
+  if (!cachedPdfJobs.has(key)) {
+    cachedPdfJobs.set(key, (async () => {
+      await initializeStorage();
+      await fsp.mkdir(path.dirname(pdfPath), { recursive: true });
+      try {
+        await fsp.access(pdfPath, fs.constants.R_OK);
+        return;
+      } catch (_error) {
+        // 仍不存在，当前请求负责生成。
+      }
+      const record = await db.collection("diagnostic-record").findOne({ _id: new ObjectId(id) });
+      if (!record) {
+        const error = new Error("处方不存在");
+        error.statusCode = 404;
+        throw error;
+      }
+      const pdf = await generatePrescriptionPdf(decryptDiagnosticRecordFields(record), { paperSize });
+      const temporaryPath = `${pdfPath}.${crypto.randomUUID()}.tmp`;
+      try {
+        await fsp.writeFile(temporaryPath, pdf, { flag: "wx" });
+        await fsp.rename(temporaryPath, pdfPath);
+      } catch (error) {
+        await fsp.unlink(temporaryPath).catch(() => {});
+        throw error;
+      }
+    })().finally(() => cachedPdfJobs.delete(key)));
+  }
+  await cachedPdfJobs.get(key);
+  return { pdfPath, cached: false };
+}
+
+async function closeBrowser() {
+  if (!browserPromise) return;
+  const browser = await browserPromise;
+  browserPromise = undefined;
+  await browser.close();
+}
+
+module.exports = {
+  buildPrescriptionHtml,
+  createPrescriptionPdf,
+  generatePrescriptionPdf,
+  getOrCreatePrescriptionPdf,
+  initializeStorage,
+  loadSignatureDataImage,
+  loadLocalSignatureDataImage,
+  downloadSignatureDataImage,
+  getPdfPath,
+  closeBrowser,
+};
--- a/index.js
+++ b/index.js
@ -42,6 +42,7 @@ const customerHisSync = require("./customerHisSync");
 const hlw = require("./hlw");
 const automation = require("./hlw/automation");
 const imImageArchive = require("./hlw/im-image-archive");
+const { getOrCreatePrescriptionPdf, initializeStorage: initializePrescriptionPdfStorage } = require("./hlw/prescription-pdf");
 const trigger = require("./trigger");
 const consultTrigger = require("./hlw/consult-order/trigger");
 const callBack = require("./callBack");
@ -207,6 +208,11 @@ const imageStorageReadyPromise = imImageArchive.initializeStorage().catch((err)
  return null;
 });

+const prescriptionPdfStorageReadyPromise = initializePrescriptionPdfStorage().catch((err) => {
+  logger.error("处方 PDF 目录初始化失败:", err);
+  return null;
+});
+
 app.get(
  "/zyt/stats",
  asyncHandler(async (req, res) => {
@ -277,6 +283,24 @@ app.get(
  })
 );

+// 服务端渲染处方笺。Chromium 路径由 PUPPETEER_EXECUTABLE_PATH 配置，避免应用镜像携带浏览器。
+app.get(
+  "/hlw/prescriptions/:id/pdf",
+  asyncHandler(async (req, res) => {
+    const db = await getDatabase("Internet-hospital");
+    const paperSize = req.query.paperSize === "A4" ? "A4" : "A5";
+    const { pdfPath } = await getOrCreatePrescriptionPdf(db, req.params.id, { paperSize });
+    res.set({
+      "Content-Type": "application/pdf",
+      "Content-Disposition": `inline; filename=\"prescription-${req.params.id}.pdf\"`,
+      "Cache-Control": "no-cache",
+    });
+    await new Promise((resolve, reject) => {
+      res.sendFile(pdfPath, (error) => (error ? reject(error) : resolve()));
+    });
+  })
+);
+
 // POST请求处理器
 app.post(
  "/getYoucanData/member",
--- a/package-lock.json
+++ b/package-lock.json
--- a/package.json
+++ b/package.json
@ -47,6 +47,7 @@
    "multer": "^1.4.5-lts.1",
    "node-fetch": "^3.3.2",
    "node-schedule": "^2.1.1",
+    "puppeteer-core": "^24.0.0",
    "querystring": "^0.2.1",
    "sm-crypto": "^0.3.13",
    "web-streams-polyfill": "^4.1.0",