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

app/services/surgery_pipeline.py

@@ -4,7 +4,10 @@ from __future__ import annotations
 
 import base64
 
+from sqlalchemy.ext.asyncio import async_sessionmaker
+
 from app.database import AsyncSessionLocal
+from app.domain.consumption import SurgeryConsumptionStored
 from app.repositories.surgery_results import SurgeryResultRepository
 from app.schemas import (
     PendingConfirmationOption,
@@ -18,6 +21,20 @@ from app.services.voice_resolution import VoiceConfirmationService, VoiceResolve
 from app.surgery_errors import SurgeryPipelineError
 
 
+def _stored_to_response(rows: list[SurgeryConsumptionStored]) -> list[SurgeryConsumptionDetail]:
+    """领域对象 → HTTP DTO 的单向转换，仅在返回给客户端的边界调用。"""
+    return [
+        SurgeryConsumptionDetail(
+            item_id=r.item_id,
+            item_name=r.item_name,
+            qty=r.qty,
+            doctor_id=r.doctor_id,
+            timestamp=r.timestamp,
+        )
+        for r in rows
+    ]
+
+
 class SurgeryPipeline:
     """协调开录、停录与算法产出。路由仅在子系统确认后返回 HTTP 200。"""
 
@@ -27,10 +44,12 @@ class SurgeryPipeline:
         *,
         result_repository: SurgeryResultRepository,
         voice_confirmation: VoiceConfirmationService,
+        session_factory: async_sessionmaker | None = None,
     ) -> None:
         self._sessions = sessions
         self._repo = result_repository
         self._voice = voice_confirmation
+        self._session_factory: async_sessionmaker = session_factory or AsyncSessionLocal
 
     async def start_recording(
         self,
@@ -72,13 +91,16 @@ class SurgeryPipeline:
         """进行中：返回内存明细；已结束：返回数据库最终结果；持久化失败时回退内存归档。"""
         live = self._sessions.live_consumption_if_active(surgery_id)
         if live is not None:
-            return live
-        async with AsyncSessionLocal() as session:
+            return _stored_to_response(live)
+        async with self._session_factory() as session:
             async with session.begin():
                 persisted = await self._repo.load_final_details(session, surgery_id)
         if persisted is not None:
-            return persisted
-        return self._sessions.archived_consumption_fallback(surgery_id)
+            return _stored_to_response(persisted)
+        archived = self._sessions.archived_consumption_fallback(surgery_id)
+        if archived is not None:
+            return _stored_to_response(archived)
+        return None
 
     async def get_pending_confirmation_for_client(
         self, surgery_id: str