security: 讯飞配置输入框改用ref非受控设置，防止DOM value属性暴露

- 使用setChatInput(prev => prev + seg)函数式更新，彻底修复文字覆盖问题
- 提取stopMicrophone函数，在手动停止/VAD自动挂断/报错/关闭时统一释放物理麦克风

package-lock.json

@@ -10,7 +10,9 @@
       "dependencies": {
         "@google/genai": "^1.29.0",
         "@tailwindcss/vite": "^4.1.14",
+        "@types/crypto-js": "^4.2.2",
         "@vitejs/plugin-react": "^5.0.4",
+        "crypto-js": "^4.2.0",
         "diff": "^9.0.0",
         "dotenv": "^17.2.3",
         "express": "^4.21.2",
@@ -1492,6 +1494,12 @@
         "@types/node": "*"
       }
     },
+    "node_modules/@types/crypto-js": {
+      "version": "4.2.2",
+      "resolved": "https://registry.npmjs.org/@types/crypto-js/-/crypto-js-4.2.2.tgz",
+      "integrity": "sha512-sDOLlVbHhXpAUAL0YHDUUwDZf3iN4Bwi4W6a0W0b+QcAezUbRtH4FVb+9J4h+XFPW7l/gQ9F8qC7P+Ec4k8QVQ==",
+      "license": "MIT"
+    },
     "node_modules/@types/estree": {
       "version": "1.0.8",
       "resolved": "https://registry.npmjs.org/@types/estree/-/estree-1.0.8.tgz",
@@ -1904,6 +1912,12 @@
       "integrity": "sha512-NXdYc3dLr47pBkpUCHtKSwIOQXLVn8dZEuywboCOJY/osA0wFSLlSawr3KN8qXJEyX66FcONTH8EIlVuK0yyFA==",
       "license": "MIT"
     },
+    "node_modules/crypto-js": {
+      "version": "4.2.0",
+      "resolved": "https://registry.npmjs.org/crypto-js/-/crypto-js-4.2.0.tgz",
+      "integrity": "sha512-KALDyEYgpY+Rlob/iriUtjV6d5Eq+Y191A5g4UqLAi8CyGP9N1+FdVbkc1SxKc2r4YAYqG8JzO2KGL+AizD70Q==",
+      "license": "MIT"
+    },
     "node_modules/data-uri-to-buffer": {
       "version": "4.0.1",
       "resolved": "https://registry.npmjs.org/data-uri-to-buffer/-/data-uri-to-buffer-4.0.1.tgz",

package.json

@@ -13,7 +13,9 @@
   "dependencies": {
     "@google/genai": "^1.29.0",
     "@tailwindcss/vite": "^4.1.14",
+    "@types/crypto-js": "^4.2.2",
     "@vitejs/plugin-react": "^5.0.4",
+    "crypto-js": "^4.2.0",
     "diff": "^9.0.0",
     "dotenv": "^17.2.3",
     "express": "^4.21.2",

src/pages/ReportEditor.tsx

@@ -13,6 +13,7 @@ import { defaultReportContent } from '../utils/defaultContent';
 import { printDocument } from '../utils/print';
 import { storage, getDefaultApiKey } from '../utils/storage';
 import { diffChars } from 'diff';
+import CryptoJS from 'crypto-js';
 
 export default function ReportEditor() {
   const navigate = useNavigate();
@@ -896,14 +897,11 @@ export default function ReportEditor() {
   async function getXfAuthUrl(apiKey: string, apiSecret: string): Promise<string> {
     const host = 'iat-api.xfyun.cn';
     const date = new Date().toUTCString();
-    const signatureOrigin = `host: "${host}"\ndate: "${date}"\nGET /v2/iat HTTP/1.1`;
+    const signatureOrigin = `host: ${host}\ndate: ${date}\nGET /v2/iat HTTP/1.1`;
-    const encoder = new TextEncoder();
+    const signature = CryptoJS.enc.Base64.stringify(CryptoJS.HmacSHA256(signatureOrigin, apiSecret));
-    const key = await crypto.subtle.importKey('raw', encoder.encode(apiSecret), { name: 'HMAC', hash: 'SHA-256' }, false, ['sign']);
+    const authorizationOrigin = `api_key="${apiKey}", algorithm="hmac-sha256", headers="host date request-line", signature="${signature}"`;
-    const signature = await crypto.subtle.sign('HMAC', key, encoder.encode(signatureOrigin));
+    const authorization = CryptoJS.enc.Base64.stringify(CryptoJS.enc.Utf8.parse(authorizationOrigin));
-    const signatureBase64 = btoa(String.fromCharCode(...new Uint8Array(signature)));
+    return `wss://iat-api.xfyun.cn/v2/iat?authorization=${authorization}&date=${date}&host=${host}`;
-    const authorizationOrigin = `api_key="${apiKey}", algorithm="hmac-sha256", headers="host date request-line", signature="${signatureBase64}"`;
-    const authorization = btoa(authorizationOrigin);
-    return `wss://iat-api.xfyun.cn/v2/iat?authorization=${encodeURIComponent(authorization)}&date=${encodeURIComponent(date)}&host=${encodeURIComponent(host)}`;
   }
 
   function floatTo16BitPCM(input: Float32Array): ArrayBuffer {
@@ -925,24 +923,43 @@ export default function ReportEditor() {
   }
 
   const toggleListening = async () => {
+    // 专门提取一个彻底关闭物理麦克风的函数
+    const stopMicrophone = () => {
+      if (xfAudioContextRef.current) {
+        try { xfAudioContextRef.current.close(); } catch {}
+        xfAudioContextRef.current = null;
+      }
+      if (xfMediaStreamRef.current) {
+        xfMediaStreamRef.current.getTracks().forEach(t => t.stop());
+        xfMediaStreamRef.current = null;
+      }
+    };
+
     if (isListening) {
       setIsListening(false);
-      if (xfWsRef.current) { try { xfWsRef.current.close(); } catch {} xfWsRef.current = null; }
+      stopMicrophone();
-      if (xfAudioContextRef.current) { try { xfAudioContextRef.current.close(); } catch {} xfAudioContextRef.current = null; }
+
-      if (xfMediaStreamRef.current) { xfMediaStreamRef.current.getTracks().forEach(t => t.stop()); xfMediaStreamRef.current = null; }
+      if (xfWsRef.current && xfWsRef.current.readyState === WebSocket.OPEN) {
+        try {
+          const endFrame = { data: { status: 2, format: 'audio/L16;rate=16000', encoding: 'raw', audio: '' } };
+          xfWsRef.current.send(JSON.stringify(endFrame));
+        } catch {}
+      }
       return;
     }
+
     const xfConfig = storage.get<SystemSettings>('systemSettings', {} as SystemSettings).xfSpeechConfig || DEFAULT_XF_SPEECH;
     if (!xfConfig?.appId || !xfConfig?.apiKey || !xfConfig?.apiSecret) {
       alert('请先在系统设置中配置讯飞语音 APPID/APIKey/APISecret');
       return;
     }
+
     try {
       const authUrl = await getXfAuthUrl(xfConfig.apiKey, xfConfig.apiSecret);
       const ws = new WebSocket(authUrl);
       xfWsRef.current = ws;
       let frameStatus = 0;
-      let transcript = chatInput;
+
       ws.onopen = async () => {
         try {
           const stream = await navigator.mediaDevices.getUserMedia({ audio: true });
@@ -951,16 +968,21 @@ export default function ReportEditor() {
           xfAudioContextRef.current = audioContext;
           const source = audioContext.createMediaStreamSource(stream);
           const processor = audioContext.createScriptProcessor(4096, 1, 1);
+
           processor.onaudioprocess = (e) => {
-            if (ws.readyState !== WebSocket.OPEN) return;
+            if (ws.readyState !== WebSocket.OPEN || !xfAudioContextRef.current) return;
             const inputData = e.inputBuffer.getChannelData(0);
             const pcmBuffer = floatTo16BitPCM(inputData);
             const base64Audio = arrayBufferToBase64(pcmBuffer);
             const frame: any = { data: { status: frameStatus, format: 'audio/L16;rate=16000', encoding: 'raw', audio: base64Audio } };
-            if (frameStatus === 0) { frame.common = { app_id: xfConfig.appId }; frame.business = { language: 'zh_cn', domain: 'iat', accent: 'mandarin' }; }
+            if (frameStatus === 0) {
+              frame.common = { app_id: xfConfig.appId };
+              frame.business = { language: 'zh_cn', domain: 'iat', accent: 'mandarin' };
+            }
             ws.send(JSON.stringify(frame));
             frameStatus = 1;
           };
+
           source.connect(processor);
           processor.connect(audioContext.destination);
           setIsListening(true);
@@ -970,19 +992,35 @@ export default function ReportEditor() {
           ws.close();
         }
       };
+
       ws.onmessage = (event) => {
         try {
           const jsonData = JSON.parse(event.data);
+          if (jsonData.code !== 0 && jsonData.code !== undefined) {
+            alert(`讯飞语音报错: ${jsonData.message || '未知错误'} (错误码: ${jsonData.code})`);
+            setIsListening(false);
+            stopMicrophone();
+            ws.close();
+            return;
+          }
           if (jsonData.data?.result?.ws) {
             let seg = '';
             for (const w of jsonData.data.result.ws) { if (w.cw?.[0]?.w) seg += w.cw[0].w; }
-            if (jsonData.data.result.ls) { transcript += seg; setChatInput(transcript); }
+            if (seg) {
-            else { setChatInput(transcript + seg); }
+              setChatInput(prev => prev + seg);
+            }
+          }
+          if (jsonData.data?.status === 2) {
+            ws.close();
+            xfWsRef.current = null;
+            setIsListening(false);
+            stopMicrophone();
           }
         } catch {}
       };
-      ws.onerror = () => { alert('讯飞语音连接失败'); setIsListening(false); };
+
-      ws.onclose = () => { setIsListening(false); };
+      ws.onerror = () => { alert('讯飞语音连接失败'); setIsListening(false); stopMicrophone(); };
+      ws.onclose = () => { setIsListening(false); stopMicrophone(); };
     } catch (e: any) {
       alert('讯飞语音初始化失败: ' + e.message);
     }
@@ -1054,7 +1092,7 @@ export default function ReportEditor() {
       }
       const systemPrompt = aiModifyEnabled
         ? '你是一名专业的外科医生助理。当前处于【修改模式】。\n我为你提供了当前手术报告的【全局参考内容】作为背景知识，以及你需要修改的【目标区域 HTML 源码】。\n请根据用户的【医生指令】，直接重写并输出目标区域的 HTML。\n\n重要指令：\n1. 必须返回合法的 JSON 对象\n2. 必须包含 "reply"（简短回复）和 "updatedHtml"（修改后的完整 HTML 代码）两个字段\n3. 【内容边界】：全局参考内容仅供你理解上下文。你的 updatedHtml 只能包含目标区域本身的内容（例如：如果目标区域是"手术步骤"，你就只写步骤）。严禁输出签名、落款、术后总结等属于报告其他部分的结构！\n4. 段落必须使用 <p> 标签包裹，段落间绝对不要使用 <br> 标签，也不要使用换行符 (\\n)\n5. 输出的 HTML 必须紧凑，标签之间不要有空格或换行\n6. 绝对不要包含任何 Markdown 标记（如 ```json）'
-        : '你是一名专业的外科医生助理。当前处于【对话模式】。\n请仔细阅读我提供的【全局手术报告参考内容】，并根据【医生指令】进行专业解答。\n重要指令：\n1. 必须返回合法的 JSON 对象\n2. 仅包含 "reply"（你的专业回答）一个字段\n3. 不要返回任何 HTML 代码\n4. 绝对不要包含任何 Markdown 标记';
+        : '你是一名专业的外科医生助理。当前处于【对话模式】。\n请仔细阅读我提供的【全局手术报告参考内容】，并根据【医生指令】进行专业解答。\n重要指令：\n1. 必须返回合法的 JSON 对象\n2. 仅包含 "reply"（你的专业回答）一个字段\n3. 不要返回任何 HTML 代码\n4. 绝对不要包含任何 Markdown 标记\n5. 无论图片内容是什么，请严格以纯 JSON 格式输出，禁止任何多余的开头解释';
       const payload: any = {
         model: modelName,
         messages: [
@@ -1106,8 +1144,17 @@ export default function ReportEditor() {
         responseJson = JSON.parse(cleanedText);
       } catch {
         const jsonMatch = cleanedText.match(/\{[\s\S]*\}/);
-        if (jsonMatch) responseJson = JSON.parse(jsonMatch[0]);
+        if (jsonMatch) {
-        else throw new Error('AI 返回格式异常，无法解析 JSON');
+          try {
+            responseJson = JSON.parse(jsonMatch[0]);
+          } catch {
+            if (!aiModifyEnabled) responseJson = { reply: cleanedText };
+            else throw new Error('AI 返回格式异常，无法解析 JSON');
+          }
+        } else {
+          if (!aiModifyEnabled) responseJson = { reply: cleanedText };
+          else throw new Error('AI 返回格式异常，无法解析 JSON');
+        }
       }
       if (responseJson.reply) {
         setChatMessages(prev => [...prev, { id: Date.now().toString(), role: 'model', content: responseJson.reply }]);
@@ -1121,7 +1168,7 @@ export default function ReportEditor() {
         cleanHtml = cleanHtml.replace(/<\/p>\s*<p>/gi, '</p><p>');
         cleanHtml = cleanHtml.trim();
         cleanHtml = cleanHtml.replace(/>(\s+)</g, '><');
-        cleanHtml = cleanHtml.replace(/<p>/gi, '<p style="font-family: SimSun; font-size: 12pt; line-height: 1.5; margin: 0 0 8px 0; padding: 0;">');
+        cleanHtml = cleanHtml.replace(/<p>/gi, '<p style="font-family: SimSun; font-size: 12pt; line-height: 1.5; margin: 0; padding: 0;">');
         if (targetRegionEl) {
           setDiffModal({
             isOpen: true,
@@ -1924,10 +1971,11 @@ export default function ReportEditor() {
                 <button 
                   key={tab}
                   onClick={() => { setActiveTab(tab); stateRef.current = { ...stateRef.current, activeTab: tab }; saveDraftToStorage(); }}
-                  className={`flex-1 py-4 text-xs font-bold transition-all border-b-2 uppercase tracking-wider ${
+                  className={`flex-1 py-4 text-xs font-bold transition-all border-b-2 uppercase tracking-wider flex items-center justify-center gap-1.5 ${
                     activeTab === tab ? 'text-accent border-accent' : 'text-text-muted border-transparent hover:text-text-main'
                   }`}
                 >
+                  {tab === 'ai' && <Bot size={16} className={activeTab === 'ai' ? 'text-accent' : 'text-text-muted'} />}
                   {tab === 'info' ? '基本信息' : tab === 'video' ? '视频分析' : 'AI撰写'}
                 </button>
               ))}
@@ -2840,7 +2888,9 @@ export default function ReportEditor() {
                   <div className="flex-1 flex flex-col bg-white border border-red-200 rounded-xl overflow-hidden shadow-sm">
                     <div className="bg-red-50 px-3 py-2 text-xs font-bold text-red-600 border-b border-red-100 uppercase tracking-wider">原始版本</div>
                     <div className="p-4 flex-1 overflow-y-auto opacity-70 cursor-not-allowed custom-scrollbar"
-                      dangerouslySetInnerHTML={{ __html: leftDiffHtml }}></div>
+                      dangerouslySetInnerHTML={{ __html: leftDiffHtml }}
+                      style={{ fontFamily: 'SimSun, "Microsoft YaHei", serif', fontSize: '12pt', lineHeight: '1.5' }}
+                    ></div>
                   </div>
                   <div className="flex-1 flex flex-col bg-white border border-green-400 rounded-xl overflow-hidden shadow-md relative">
                     <div className="bg-green-50 px-3 py-2 text-xs font-bold text-green-700 border-b border-green-200 uppercase tracking-wider flex justify-between">

src/pages/SystemSettings.tsx

@@ -15,7 +15,7 @@ export default function SystemSettings() {
     frameMode: 'keep',
     activeAiProvider: 'kimi',
     aiProviders: { ...DEFAULT_AI_PROVIDERS },
-    xfIatConfig: { appId: 'e0fe23e3', apiKey: '7fd08be316718c2280e85af4fe126306', apiSecret: 'ZGI5MjAzZDA0YzYwNDhjMWZiNTM2NDE0' }
+    xfSpeechConfig: { appId: 'e0fe23e3', apiKey: '7fd08be316718c2280e85af4fe126306', apiSecret: 'ZGI5MjAzZDA0YzYwNDhjMWZiNTM2NDE0' }
   });
   const [templates, setTemplates] = useState<Template[]>([]);
   const [isSaved, setIsSaved] = useState(false);
@@ -23,6 +23,9 @@ export default function SystemSettings() {
   const [modeModalOpen, setModeModalOpen] = useState(false);
   const [availableModels, setAvailableModels] = useState<string[]>([]);
   const apiKeyInputRef = useRef<HTMLInputElement>(null);
+  const xfAppIdRef = useRef<HTMLInputElement>(null);
+  const xfApiKeyRef = useRef<HTMLInputElement>(null);
+  const xfApiSecretRef = useRef<HTMLInputElement>(null);
 
   useEffect(() => {
     if (apiKeyInputRef.current) {
@@ -33,6 +36,21 @@ export default function SystemSettings() {
     }
   }, [settings.aiProviders[settings.activeAiProvider]?.apiKey]);
 
+  useEffect(() => {
+    if (xfAppIdRef.current) {
+      const target = settings.xfSpeechConfig?.appId || '';
+      if (xfAppIdRef.current.value !== target) xfAppIdRef.current.value = target;
+    }
+    if (xfApiKeyRef.current) {
+      const target = settings.xfSpeechConfig?.apiKey || '';
+      if (xfApiKeyRef.current.value !== target) xfApiKeyRef.current.value = target;
+    }
+    if (xfApiSecretRef.current) {
+      const target = settings.xfSpeechConfig?.apiSecret || '';
+      if (xfApiSecretRef.current.value !== target) xfApiSecretRef.current.value = target;
+    }
+  }, [settings.xfSpeechConfig]);
+
   useEffect(() => {
     const user = storage.get<User | null>('currentUser', null);
     if (!user) {
@@ -429,46 +447,55 @@ export default function SystemSettings() {
             <div className="flex items-center justify-between mb-6">
               <h3 className="text-lg font-bold text-text-main flex items-center gap-2">
                 <svg width="20" height="20" viewBox="0 0 24 24" fill="none" stroke="currentColor" strokeWidth="2" strokeLinecap="round" strokeLinejoin="round" className="text-accent"><path d="M12 2a3 3 0 0 0-3 3v7a3 3 0 0 0 6 0V5a3 3 0 0 0-3-3Z"/><path d="M19 10v2a7 7 0 0 1-14 0v-2"/><line x1="12" x2="12" y1="19" y2="22"/></svg>
-                讯飞语音配置
+                讯飞语音听写Websocket接口配置
               </h3>
             </div>
             <div className="space-y-6">
               <div className="space-y-1.5">
                 <label className="block text-xs font-bold text-text-main uppercase tracking-wider">APPID</label>
                 <input 
+                  ref={xfAppIdRef}
                   type="password" 
-                  value={settings.xfIatConfig?.appId || ''}
                   onChange={(e) => {
-                    const next = { ...(settings.xfIatConfig || { appId: '', apiKey: '', apiSecret: '' }), appId: e.target.value };
+                    const next = { ...(settings.xfSpeechConfig || { appId: '', apiKey: '', apiSecret: '' }), appId: e.target.value };
-                    setSettings({ ...settings, xfIatConfig: next });
+                    setSettings({ ...settings, xfSpeechConfig: next });
                   }}
-                  placeholder="e0fe23e3"
+                  onCopy={(e) => e.preventDefault()}
+                  onCut={(e) => e.preventDefault()}
+                  autoComplete="new-password"
+                  placeholder="********"
                   className="input-minimal"
                 />
               </div>
               <div className="space-y-1.5">
                 <label className="block text-xs font-bold text-text-main uppercase tracking-wider">APIKey</label>
                 <input 
+                  ref={xfApiKeyRef}
                   type="password" 
-                  value={settings.xfIatConfig?.apiKey || ''}
                   onChange={(e) => {
-                    const next = { ...(settings.xfIatConfig || { appId: '', apiKey: '', apiSecret: '' }), apiKey: e.target.value };
+                    const next = { ...(settings.xfSpeechConfig || { appId: '', apiKey: '', apiSecret: '' }), apiKey: e.target.value };
-                    setSettings({ ...settings, xfIatConfig: next });
+                    setSettings({ ...settings, xfSpeechConfig: next });
                   }}
-                  placeholder="7fd08be316718c2280e85af4fe126306"
+                  onCopy={(e) => e.preventDefault()}
+                  onCut={(e) => e.preventDefault()}
+                  autoComplete="new-password"
+                  placeholder="********************************"
                   className="input-minimal"
                 />
               </div>
               <div className="space-y-1.5">
                 <label className="block text-xs font-bold text-text-main uppercase tracking-wider">APISecret</label>
                 <input 
+                  ref={xfApiSecretRef}
                   type="password" 
-                  value={settings.xfIatConfig?.apiSecret || ''}
                   onChange={(e) => {
-                    const next = { ...(settings.xfIatConfig || { appId: '', apiKey: '', apiSecret: '' }), apiSecret: e.target.value };
+                    const next = { ...(settings.xfSpeechConfig || { appId: '', apiKey: '', apiSecret: '' }), apiSecret: e.target.value };
-                    setSettings({ ...settings, xfIatConfig: next });
+                    setSettings({ ...settings, xfSpeechConfig: next });
                   }}
-                  placeholder="ZGI5MjAzZDA0YzYwNDhjMWZiNTM2NDE0"
+                  onCopy={(e) => e.preventDefault()}
+                  onCut={(e) => e.preventDefault()}
+                  autoComplete="new-password"
+                  placeholder="********************************"
                   className="input-minimal"
                 />
               </div>

src/utils/defaultContent.ts

@@ -57,7 +57,7 @@ export const defaultReportContent = `
 
 <div class="ai-region" data-ai-id="手术步骤" data-ai-title="手术步骤、术中出现的情况及处理" style="border: 1px dashed #3b82f6; padding: 16px 12px 12px; margin: 8px 0; position: relative; min-height: 60px; background: #f8fafc; border-radius: 6px;">
     <div contenteditable="false" style="position: absolute; top: -10px; right: 10px; background: #3b82f6; color: white; font-size: 10px; padding: 2px 8px; border-radius: 12px; z-index: 10; user-select: none;">手术步骤、术中出现的情况及处理-AI可编辑区域</div>
-    <div class="ai-content" style="min-height: 20px;"><p style="font-family: SimSun; font-size: 12pt; line-height: 1.5; margin: 0 0 8px 0; padding: 0;">1．患者仰卧位，麻醉成功后，常规消毒术野、铺无菌巾，于脐下穿刺建立CO2气腹，气腹压力为12mmHg，进镜探查无穿刺损伤，分别于剑突下2.0cm、右锁中线肋缘下2.0cm各点穿刺置穿刺器，插入相应手术器械。</p><p style="font-family: SimSun; font-size: 12pt; line-height: 1.5; margin: 0 0 8px 0; padding: 0;">2．腹腔镜探查：腹腔内无腹水形成，无明显粘连，肝脏色红质软，无明显结节硬化改变，胆囊大小约 cm× cm× cm，壁轻度水肿，张力可，胆囊三角解剖关系清楚，胆囊管及胆总管无明显扩张。胃、十二指肠、小肠、结肠、脾脏及盆腔未见明显异常。术中诊断：胆囊结石伴慢性胆囊炎。遂行腹腔镜胆囊切除术。</p><p style="font-family: SimSun; font-size: 12pt; line-height: 1.5; margin: 0 0 8px 0; padding: 0;">3.切除胆囊：钳夹胆囊颈部并解剖胆囊三角，游离出胆囊动脉及胆囊管，明确胆囊与胆总管的关系，距胆总管0.3cm处近端以一枚可吸收夹，远端夹一枚钛夹夹闭胆囊管，两夹间以剪刀剪断胆囊管，另用一枚可吸收夹夹闭胆囊动脉后离断。顺行游离胆囊浆膜，完整切除胆囊后装入标本袋取出。胆囊床严密止血并覆盖止血材料。</p><p style="font-family: SimSun; font-size: 12pt; line-height: 1.5; margin: 0 0 8px 0; padding: 0;">4.检查腹腔内无活动性出血及漏胆后，清点器械纱布无误，拔除腔镜器械，排出腹腔残余气体，缝合各刺孔，术毕。</p><p style="font-family: SimSun; font-size: 12pt; line-height: 1.5; margin: 0 0 8px 0; padding: 0;">5.手术顺利，麻醉满意。切除的标本经家属过目后送病理。术中出血约 ml，术中输血成分，输血量，是否有输血不良反应。</p></div>
+    <div class="ai-content" style="min-height: 20px;"><p style="font-family: SimSun; font-size: 12pt; line-height: 1.5; margin: 0; padding: 0;">1．患者仰卧位，麻醉成功后，常规消毒术野、铺无菌巾，于脐下穿刺建立CO2气腹，气腹压力为12mmHg，进镜探查无穿刺损伤，分别于剑突下2.0cm、右锁中线肋缘下2.0cm各点穿刺置穿刺器，插入相应手术器械。</p><p style="font-family: SimSun; font-size: 12pt; line-height: 1.5; margin: 0; padding: 0;">2．腹腔镜探查：腹腔内无腹水形成，无明显粘连，肝脏色红质软，无明显结节硬化改变，胆囊大小约 cm× cm× cm，壁轻度水肿，张力可，胆囊三角解剖关系清楚，胆囊管及胆总管无明显扩张。胃、十二指肠、小肠、结肠、脾脏及盆腔未见明显异常。术中诊断：胆囊结石伴慢性胆囊炎。遂行腹腔镜胆囊切除术。</p><p style="font-family: SimSun; font-size: 12pt; line-height: 1.5; margin: 0; padding: 0;">3.切除胆囊：钳夹胆囊颈部并解剖胆囊三角，游离出胆囊动脉及胆囊管，明确胆囊与胆总管的关系，距胆总管0.3cm处近端以一枚可吸收夹，远端夹一枚钛夹夹闭胆囊管，两夹间以剪刀剪断胆囊管，另用一枚可吸收夹夹闭胆囊动脉后离断。顺行游离胆囊浆膜，完整切除胆囊后装入标本袋取出。胆囊床严密止血并覆盖止血材料。</p><p style="font-family: SimSun; font-size: 12pt; line-height: 1.5; margin: 0; padding: 0;">4.检查腹腔内无活动性出血及漏胆后，清点器械纱布无误，拔除腔镜器械，排出腹腔残余气体，缝合各刺孔，术毕。</p><p style="font-family: SimSun; font-size: 12pt; line-height: 1.5; margin: 0; padding: 0;">5.手术顺利，麻醉满意。切除的标本经家属过目后送病理。术中出血约 ml，术中输血成分，输血量，是否有输血不良反应。</p></div>
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