feat: 手术视频消耗、待确认与持久化改造

- 新增 Alembic 初始迁移、领域明细模型及归档持久化与重试链路\n- 拆分视频会话注册表、分类处理、推理时间窗聚合与流处理\n- 消耗日志：TSV/Markdown 含 top2/top3；item_id 优先产品编码；待确认记「待确认」行，语音确认后落正式行并更新汇总\n- 待确认时内存/DB 明细为占位行，确认后替换；拒绝时移除占位\n- 分类 probs 先 detach/cpu 再转 NumPy，修复 MPS/CUDA 上推理被静默跳过\n- 补充集成测试、归档与设备张量等单测

Made-with: Cursor

alembic/env.py

@@ -0,0 +1,66 @@
+"""Alembic environment.
+
+生产请用 `alembic upgrade head`；开发/测试可让 ``Settings.auto_create_schema`` 调用
+``init_db_schema()``。本文件读取 `app.config.settings`，把 asyncpg URL 转为同步
+`psycopg` URL 供 Alembic 使用（仅迁移期间）。
+"""
+
+from __future__ import annotations
+
+from logging.config import fileConfig
+
+from alembic import context
+from sqlalchemy import engine_from_config, pool
+
+from app.config import settings
+import app.db.models  # noqa: F401 - register ORM tables on Base.metadata
+from app.db.base import Base
+
+
+alembic_config = context.config
+
+if alembic_config.config_file_name is not None:
+    fileConfig(alembic_config.config_file_name)
+
+target_metadata = Base.metadata
+
+
+def _sync_database_url() -> str:
+    """把 asyncpg URL 转为同步 psycopg2 URL，避免 Alembic 强依赖 async 驱动。"""
+    url = settings.sqlalchemy_database_url
+    return url.replace("postgresql+asyncpg://", "postgresql+psycopg://", 1)
+
+
+def run_migrations_offline() -> None:
+    context.configure(
+        url=_sync_database_url(),
+        target_metadata=target_metadata,
+        literal_binds=True,
+        dialect_opts={"paramstyle": "named"},
+    )
+    with context.begin_transaction():
+        context.run_migrations()
+
+
+def run_migrations_online() -> None:
+    config_section = alembic_config.get_section(alembic_config.config_ini_section) or {}
+    config_section["sqlalchemy.url"] = _sync_database_url()
+    connectable = engine_from_config(
+        config_section,
+        prefix="sqlalchemy.",
+        poolclass=pool.NullPool,
+    )
+    with connectable.connect() as connection:
+        context.configure(
+            connection=connection,
+            target_metadata=target_metadata,
+            compare_type=True,
+        )
+        with context.begin_transaction():
+            context.run_migrations()
+
+
+if context.is_offline_mode():
+    run_migrations_offline()
+else:
+    run_migrations_online()

alembic/script.py.mako

@@ -0,0 +1,27 @@
+"""${message}
+
+Revision ID: ${up_revision}
+Revises: ${down_revision | comma,n}
+Create Date: ${create_date}
+
+"""
+from __future__ import annotations
+
+from typing import Sequence, Union
+
+from alembic import op
+import sqlalchemy as sa
+${imports if imports else ""}
+
+revision: str = ${repr(up_revision)}
+down_revision: Union[str, None] = ${repr(down_revision)}
+branch_labels: Union[str, Sequence[str], None] = ${repr(branch_labels)}
+depends_on: Union[str, Sequence[str], None] = ${repr(depends_on)}
+
+
+def upgrade() -> None:
+    ${upgrades if upgrades else "pass"}
+
+
+def downgrade() -> None:
+    ${downgrades if downgrades else "pass"}

alembic/versions/0001_initial.py

@@ -0,0 +1,119 @@
+"""initial schema: surgery_final_results / surgery_result_details / voice_confirmation_audits
+
+Revision ID: 0001_initial
+Revises:
+Create Date: 2026-04-23
+
+对应 `app.db.models` 中的三张表，与 `init_db_schema()` 的 ``Base.metadata.create_all``
+等价，作为生产环境 `alembic upgrade head` 的初始版本。
+"""
+
+from __future__ import annotations
+
+from typing import Sequence, Union
+
+import sqlalchemy as sa
+from alembic import op
+
+
+revision: str = "0001_initial"
+down_revision: Union[str, None] = None
+branch_labels: Union[str, Sequence[str], None] = None
+depends_on: Union[str, Sequence[str], None] = None
+
+
+def upgrade() -> None:
+    op.create_table(
+        "surgery_final_results",
+        sa.Column("surgery_id", sa.String(length=6), primary_key=True),
+        sa.Column(
+            "completed_at",
+            sa.DateTime(timezone=True),
+            server_default=sa.text("CURRENT_TIMESTAMP"),
+            nullable=False,
+        ),
+    )
+
+    op.create_table(
+        "surgery_result_details",
+        sa.Column("id", sa.Integer(), primary_key=True, autoincrement=True),
+        sa.Column(
+            "surgery_id",
+            sa.String(length=6),
+            sa.ForeignKey(
+                "surgery_final_results.surgery_id", ondelete="CASCADE"
+            ),
+            nullable=False,
+            index=True,
+        ),
+        sa.Column("item_id", sa.String(length=256), nullable=False),
+        sa.Column("item_name", sa.String(length=256), nullable=False),
+        sa.Column("quantity", sa.Integer(), nullable=False),
+        sa.Column("doctor_id", sa.String(length=128), nullable=False),
+        sa.Column("recorded_at", sa.DateTime(timezone=True), nullable=False),
+        sa.Column(
+            "source", sa.String(length=32), nullable=False, server_default="vision"
+        ),
+    )
+    op.create_index(
+        op.f("ix_surgery_result_details_surgery_id"),
+        "surgery_result_details",
+        ["surgery_id"],
+        unique=False,
+    )
+
+    op.create_table(
+        "voice_confirmation_audits",
+        sa.Column("id", sa.Integer(), primary_key=True, autoincrement=True),
+        sa.Column("surgery_id", sa.String(length=6), nullable=False, index=True),
+        sa.Column(
+            "confirmation_id", sa.String(length=128), nullable=False, index=True
+        ),
+        sa.Column("status", sa.String(length=32), nullable=False),
+        sa.Column("audio_object_key", sa.String(length=512), nullable=True),
+        sa.Column("audio_content_type", sa.String(length=128), nullable=True),
+        sa.Column("audio_size_bytes", sa.Integer(), nullable=True),
+        sa.Column("audio_sha256", sa.String(length=64), nullable=True),
+        sa.Column("asr_text", sa.String(length=2048), nullable=True),
+        sa.Column("resolved_label", sa.String(length=256), nullable=True),
+        sa.Column("options_snapshot_json", sa.Text(), nullable=True),
+        sa.Column("error_message", sa.String(length=1024), nullable=True),
+        sa.Column(
+            "created_at",
+            sa.DateTime(timezone=True),
+            server_default=sa.text("CURRENT_TIMESTAMP"),
+            nullable=False,
+        ),
+    )
+    op.create_index(
+        op.f("ix_voice_confirmation_audits_surgery_id"),
+        "voice_confirmation_audits",
+        ["surgery_id"],
+        unique=False,
+    )
+    op.create_index(
+        op.f("ix_voice_confirmation_audits_confirmation_id"),
+        "voice_confirmation_audits",
+        ["confirmation_id"],
+        unique=False,
+    )
+
+
+def downgrade() -> None:
+    op.drop_index(
+        op.f("ix_voice_confirmation_audits_confirmation_id"),
+        table_name="voice_confirmation_audits",
+    )
+    op.drop_index(
+        op.f("ix_voice_confirmation_audits_surgery_id"),
+        table_name="voice_confirmation_audits",
+    )
+    op.drop_table("voice_confirmation_audits")
+
+    op.drop_index(
+        op.f("ix_surgery_result_details_surgery_id"),
+        table_name="surgery_result_details",
+    )
+    op.drop_table("surgery_result_details")
+
+    op.drop_table("surgery_final_results")