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<p>FHIR Transaction Bundle 主要解决这一类问题:</p> +<blockquote> +<p>假设你要创建一个 Patient，再创建一个属于这个患者的 Observation，两个必须同时成功或同时失败。用普通 REST API，你得先 POST Patient，拿到 ID，再 POST Observation，如果中间失败了还得自己回滚。FHIR 的 transaction 就是把这个流程标准化成类似数据库的事务操作或说是 “原子操作” ，整组操作要么全成功，要么全失败，而且可以在同一个 bundle 里直接引用还没创建的资源。</p> +</blockquote> +<p>transaction bundle 和 batch bundle 的区别是，batch 把多个请求一起提交，每个独立处理，一部分成功一部分失败是允许的。Transaction 是把所有请求当原子单元处理，任一失败则整体回滚。Medplum 文档说得很直接：batch 是独立处理，transaction 是原子处理。</p> +<p>然后看一个最基础的例子。同时创建 Patient 和 Observation，Observation 引用这个新建的 Patient：</p> +<figure class="highlight json"><table><tr><td class="gutter"><pre><span class="line">1</span><br><span class="line">2</span><br><span class="line">3</span><br><span class="line">4</span><br><span class="line">5</span><br><span class="line">6</span><br><span class="line">7</span><br><span class="line">8</span><br><span class="line">9</span><br><span class="line">10</span><br><span class="line">11</span><br><span class="line">12</span><br><span class="line">13</span><br><span class="line">14</span><br><span class="line">15</span><br><span class="line">16</span><br><span class="line">17</span><br><span class="line">18</span><br><span class="line">19</span><br><span class="line">20</span><br><span class="line">21</span><br><span class="line">22</span><br><span class="line">23</span><br><span class="line">24</span><br><span class="line">25</span><br><span class="line">26</span><br><span class="line">27</span><br><span class="line">28</span><br><span class="line">29</span><br><span class="line">30</span><br><span class="line">31</span><br></pre></td><td class="code"><pre><span class="line"><span class="punctuation">{</span></span><br><span class="line"> <span class="attr">"resourceType"</span><span class="punctuation">:</span> <span class="string">"Bundle"</span><span class="punctuation">,</span></span><br><span class="line"> <span class="attr">"type"</span><span class="punctuation">:</span> <span class="string">"transaction"</span><span class="punctuation">,</span></span><br><span class="line"> <span class="attr">"entry"</span><span class="punctuation">:</span> <span class="punctuation">[</span></span><br><span class="line"> <span class="punctuation">{</span></span><br><span class="line"> <span class="attr">"fullUrl"</span><span class="punctuation">:</span> <span class="string">"urn:uuid:patient-1"</span><span class="punctuation">,</span></span><br><span class="line"> <span class="attr">"request"</span><span class="punctuation">:</span> <span class="punctuation">{</span></span><br><span class="line"> <span class="attr">"method"</span><span class="punctuation">:</span> <span class="string">"POST"</span><span class="punctuation">,</span></span><br><span class="line"> <span class="attr">"url"</span><span class="punctuation">:</span> <span class="string">"Patient"</span></span><br><span class="line"> <span class="punctuation">}</span><span class="punctuation">,</span></span><br><span class="line"> <span class="attr">"resource"</span><span class="punctuation">:</span> <span class="punctuation">{</span></span><br><span class="line"> <span class="attr">"resourceType"</span><span class="punctuation">:</span> <span class="string">"Patient"</span><span class="punctuation">,</span></span><br><span class="line"> <span class="attr">"name"</span><span class="punctuation">:</span> <span class="punctuation">[</span><span class="punctuation">{</span> <span class="attr">"family"</span><span class="punctuation">:</span> <span class="string">"Doe"</span><span class="punctuation">,</span> <span class="attr">"given"</span><span class="punctuation">:</span> <span class="punctuation">[</span><span class="string">"Jane"</span><span class="punctuation">]</span> <span class="punctuation">}</span><span class="punctuation">]</span></span><br><span class="line"> <span class="punctuation">}</span></span><br><span class="line"> <span class="punctuation">}</span><span class="punctuation">,</span></span><br><span class="line"> <span class="punctuation">{</span></span><br><span class="line"> <span class="attr">"fullUrl"</span><span class="punctuation">:</span> <span class="string">"urn:uuid:observation-1"</span><span class="punctuation">,</span></span><br><span class="line"> <span class="attr">"request"</span><span class="punctuation">:</span> <span class="punctuation">{</span></span><br><span class="line"> <span class="attr">"method"</span><span class="punctuation">:</span> <span class="string">"POST"</span><span class="punctuation">,</span></span><br><span class="line"> <span class="attr">"url"</span><span class="punctuation">:</span> <span class="string">"Observation"</span></span><br><span class="line"> <span class="punctuation">}</span><span class="punctuation">,</span></span><br><span class="line"> <span class="attr">"resource"</span><span class="punctuation">:</span> <span class="punctuation">{</span></span><br><span class="line"> <span class="attr">"resourceType"</span><span class="punctuation">:</span> <span class="string">"Observation"</span><span class="punctuation">,</span></span><br><span class="line"> <span class="attr">"status"</span><span class="punctuation">:</span> <span class="string">"final"</span><span class="punctuation">,</span></span><br><span class="line"> <span class="attr">"code"</span><span class="punctuation">:</span> <span class="punctuation">{</span> <span class="attr">"text"</span><span class="punctuation">:</span> <span class="string">"Body Weight"</span> <span class="punctuation">}</span><span class="punctuation">,</span></span><br><span class="line"> <span class="attr">"subject"</span><span class="punctuation">:</span> <span class="punctuation">{</span> <span class="attr">"reference"</span><span class="punctuation">:</span> <span class="string">"urn:uuid:patient-1"</span> <span class="punctuation">}</span><span class="punctuation">,</span></span><br><span class="line"> <span class="attr">"valueQuantity"</span><span class="punctuation">:</span> <span class="punctuation">{</span> <span class="attr">"value"</span><span class="punctuation">:</span> <span class="number">68</span><span class="punctuation">,</span> <span class="attr">"unit"</span><span class="punctuation">:</span> <span class="string">"kg"</span> <span class="punctuation">}</span></span><br><span class="line"> <span class="punctuation">}</span></span><br><span class="line"> <span class="punctuation">}</span></span><br><span class="line"> <span class="punctuation">]</span></span><br><span class="line"><span class="punctuation">}</span></span><br></pre></td></tr></table></figure> +<p>这里的关键是 <code>fullUrl</code> 和 <code>urn:uuid</code>。<code>fullUrl</code> 给 bundle 内还没创建的资源一个临时身份，其他资源通过这个 <code>urn:uuid</code> 引用它。服务端创建资源后会把内部引用替换成真实地址。</p> +<p>FHIR R4 规范对 transaction 有几个硬性规则，这些规则直接影响你怎么设计 bundle。</p> +<p>第一，原子性，要么全成功要么全失败。</p> +<p>第二，处理结果不依赖 entry 顺序。这是我踩坑的地方。不能把 transaction 当成"按顺序执行的脚本"。FHIR 明确规定了服务端处理顺序：先 DELETE，再 POST，再 PUT/PATCH，最后 GET 和解析条件引用。所以写 bundle 的时候不能依赖"先 A 再 B"这种逻辑。</p> +<p>第三，同一资源身份在一个 transaction 中只能出现一次。这是规范层面的限制，不是"可能出问题"，而是规范直接说 SHALL fail。</p> +<p>举个反面例子。我想在一个 transaction 里先 PATCH 一个资源补审计字段，再 DELETE 同一个资源：</p> +<figure class="highlight json"><table><tr><td class="gutter"><pre><span class="line">1</span><br><span class="line">2</span><br><span class="line">3</span><br><span class="line">4</span><br><span class="line">5</span><br><span class="line">6</span><br><span class="line">7</span><br><span class="line">8</span><br><span class="line">9</span><br><span class="line">10</span><br><span class="line">11</span><br><span class="line">12</span><br><span class="line">13</span><br></pre></td><td class="code"><pre><span class="line"><span class="punctuation">{</span></span><br><span class="line"> <span class="attr">"resourceType"</span><span class="punctuation">:</span> <span class="string">"Bundle"</span><span class="punctuation">,</span></span><br><span class="line"> <span class="attr">"type"</span><span class="punctuation">:</span> <span class="string">"transaction"</span><span class="punctuation">,</span></span><br><span class="line"> <span class="attr">"entry"</span><span class="punctuation">:</span> <span class="punctuation">[</span></span><br><span class="line"> <span class="punctuation">{</span></span><br><span class="line"> <span class="attr">"request"</span><span class="punctuation">:</span> <span class="punctuation">{</span> <span class="attr">"method"</span><span class="punctuation">:</span> <span class="string">"PATCH"</span><span class="punctuation">,</span> <span class="attr">"url"</span><span class="punctuation">:</span> <span class="string">"Observation/obs-1"</span> <span class="punctuation">}</span><span class="punctuation">,</span></span><br><span class="line"> <span class="attr">"resource"</span><span class="punctuation">:</span> <span class="punctuation">{</span> <span class="attr">"resourceType"</span><span class="punctuation">:</span> <span class="string">"Parameters"</span> <span class="punctuation">}</span></span><br><span class="line"> <span class="punctuation">}</span><span class="punctuation">,</span></span><br><span class="line"> <span class="punctuation">{</span></span><br><span class="line"> <span class="attr">"request"</span><span class="punctuation">:</span> <span class="punctuation">{</span> <span class="attr">"method"</span><span class="punctuation">:</span> <span class="string">"DELETE"</span><span class="punctuation">,</span> <span class="attr">"url"</span><span class="punctuation">:</span> <span class="string">"Observation/obs-1"</span> <span class="punctuation">}</span></span><br><span class="line"> <span class="punctuation">}</span></span><br><span class="line"> <span class="punctuation">]</span></span><br><span class="line"><span class="punctuation">}</span></span><br></pre></td></tr></table></figure> +<p>这个 bundle 从规范层面就不合法。原因有两个：一是服务端不会按你写的顺序处理，DELETE 先于 PATCH；二是同一个资源 <code>Observation/obs-1</code> 在 transaction 里出现了两次，构成身份重叠，规范要求失败。</p> +<p>再说 DELETE。FHIR 的 DELETE 不是物理删除。从普通读取角度看，资源返回 410 Gone；从搜索角度看，资源不再出现；但如果服务端维护版本历史，<code>_history</code> 里仍然有记录，而且删除本身会形成一个"被标记为 deleted 的特殊历史版本"。规范还提到被删除的资源可以通过后续 PUT update “bring back to life”。</p> +<p>这对审计设计有直接影响。如果想把删除审计写在主资源的 extension 里（比如 deletedBy、deletedAt），就不能用一个 transaction 搞定，因为同一个资源不能既 PATCH 又 DELETE。你得接受两步法：先更新资源写审计信息，再执行 DELETE。代价是多出一个预删除版本，但好处是审计信息确实留在了主资源历史里。</p> +<p>什么时候该用 transaction？比如多资源必须原子操作的场景，资源间存在内部引用的场景，希望服务端负责一致性边界的场景。</p> +<p>什么时候不该用？比如只是想减少 HTTP 请求次数的，用 batch；bundle 太大事务太重的，某些资源本来就适合异步处理的。</p> +<h2 id="参考资料"><a class="header-anchor" href="#参考资料">¶</a>参考资料</h2> +<ul> +<li>FHIR R4 RESTful API<br> +<a target="_blank" rel="noopener" href="https://hl7.org/fhir/R4/http.html">https://hl7.org/fhir/R4/http.html</a></li> +<li>FHIR R4 Transaction Processing Rules<br> +<a target="_blank" rel="noopener" href="https://hl7.org/fhir/R4/http.html#transaction">https://hl7.org/fhir/R4/http.html#transaction</a></li> +<li>FHIR R4 Delete Interaction<br> +<a target="_blank" rel="noopener" href="https://hl7.org/fhir/R4/http.html#delete">https://hl7.org/fhir/R4/http.html#delete</a></li> +<li>Medplum: FHIR Batch Requests<br> +<a target="_blank" rel="noopener" href="https://www.medplum.com/docs/fhir-datastore/fhir-batch-requests">https://www.medplum.com/docs/fhir-datastore/fhir-batch-requests</a></li> +</ul> + +</div> + +<script> + window.onload = detectors(); +</script> + <div class="post-footer"> + <div class="h-line-primary"></div> + <nav class="post-nav"> + <div class="prev-item"> + + <div class="icon arrow-left"></div> + <div class="post-link"> + <a href="/2026/03/16/Nginx-%E5%89%8D%E5%90%8E%E7%AB%AF%E5%90%8C%E5%9F%9F%E5%88%86%E6%B5%81/">Prev</a> + </div> + + </div> + <div class="next-item"> + + <div class="icon arrow-right"></div> + <div 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