diff --git a/openhis-ui-vue3/src/views/doctorstation/components/prescription/prescriptionlist.vue b/openhis-ui-vue3/src/views/doctorstation/components/prescription/prescriptionlist.vue
index 2dc7210b..7781f273 100644
--- a/openhis-ui-vue3/src/views/doctorstation/components/prescription/prescriptionlist.vue
+++ b/openhis-ui-vue3/src/views/doctorstation/components/prescription/prescriptionlist.vue
@@ -550,51 +550,36 @@
         </template>
       </el-table-column>
       <!-- <el-table-column label="序号" align="center" width="60" prop="sortNumber"> </el-table-column> -->
-      <el-table-column label="医嘱" align="center" prop="productName" width="400">
+      <!-- 医嘱类型列 -->
+      <el-table-column label="医嘱类型" align="center" width="120">
         <template #default="scope">
           <template v-if="getRowDisabled(scope.row)">
             <el-select
-              style="width: 35%; margin-right: 20px"
               v-model="scope.row.adviceType"
               :ref="'adviceTypeRef' + scope.$index"
-              @change="
-                (value) => {
-                  expandOrder = [];
-                  prescriptionList[scope.$index].adviceName = undefined;
-    
-                   // 直接更新查询参数
-                  adviceQueryParams.value.adviceType = value;
-                  adviceQueryParams.value.searchKey = '';
-    
-                  console.log('医嘱类型改变为:', value, '查询参数:', adviceQueryParams.value);
-    
-                 // 确保弹窗重新打开
-                  nextTick(() => {
-                    row.showPopover = true;
-                    handleFocus(scope.row, scope.$index);
-                  });
-                 }
-                "
-            >
+              @change="handleAdviceTypeChange(scope.row, scope.$index)"
+              placeholder="请选择"
+              style="width: 100%">
               <el-option
                 v-for="item in adviceTypeList"
                 :key="item.value"
                 :label="item.label"
                 :value="item.value"
-                @click="
-                  () => {
-                    prescriptionList[scope.$index].adviceType = item.value;
-                    prescriptionList[scope.$index].adviceType_dictText = item.label;
-                  }
-                "
               />
             </el-select>
+          </template>
+          <span v-else>{{ getAdviceTypeText(scope.row.adviceType) }}</span>
+        </template>
+      </el-table-column>
+      <!-- 项目列 -->
+      <el-table-column label="项目" align="center" prop="productName" width="280">
+        <template #default="scope">
+          <template v-if="getRowDisabled(scope.row)">
             <el-popover
               :popper-style="{ padding: '0' }"
               placement="bottom-start"
               :visible="scope.row.showPopover"
-              :width="1200"
-            >
+              :width="1200">
               <adviceBaseList
                 ref="adviceTableRef"
                 :popoverVisible="scope.row.showPopover"
@@ -605,24 +590,14 @@
               <template #reference>
                 <el-input
                   :ref="'adviceRef' + scope.$index"
-                  style="width: 50%"
                   v-model="scope.row.adviceName"
                   placeholder="请选择项目"
                   @input="handleChange"
                   @click="handleFocus(scope.row, scope.$index)"
                   @keyup.enter.stop="handleFocus(scope.row, scope.$index)"
-                  @keydown="
-                    (e) => {
-                      if (!scope.row.showPopover) return;
-                      // 拦截上下键和回车事件
-                      if (['ArrowUp', 'ArrowDown', 'Enter'].includes(e.key)) {
-                        e.preventDefault();
-                        // 传递事件到弹窗容器
-                        adviceTableRef.handleKeyDown(e);
-                      }
-                    }
-                  "
+                  @keydown="handleInputKeyDown(scope.row, $event)"
                   @blur="handleBlur(scope.row)"
+                  style="width: 100%"
                 />
               </template>
             </el-popover>
@@ -877,6 +852,15 @@ watch(
   },
   { immediate: true }
 );
+// 获取医嘱类别显示文本
+function getAdviceTypeText(adviceType) {
+  const typeMap = {
+    1: '西药中成药',
+    2: '耗材', 
+    3: '诊疗'
+  };
+  return typeMap[adviceType] || '未知';
+}
 function handleTotalAmount() {
   totalAmount.value = prescriptionList.value.reduce((accumulator, currentRow) => {
     if (currentRow.chargeStatus != 8) {
@@ -1119,9 +1103,11 @@ function selectAdviceBase(key, row) {
       prescriptionList.value[rowIndex.value].positionName = stock.locationName;
     }
   } else {
-    prescriptionList.value[rowIndex.value].orgId = JSON.parse(JSON.stringify(row)).positionId;
-    prescriptionList.value[rowIndex.value].unitPrice = row.priceList[0].price;
-  }
+  // 执行科室默认逻辑：优先使用诊疗项目维护的所属科室，如果没有则使用开单科室
+  const defaultOrgId = row.positionId || props.patientInfo.orgId;
+  prescriptionList.value[rowIndex.value].orgId = defaultOrgId;
+  prescriptionList.value[rowIndex.value].unitPrice = row.priceList[0].price;
+}
  expandOrder.value = [key];
   nextTick(() => {
     if (row.adviceType == 1) {
@@ -1515,9 +1501,11 @@ function setValue(row) {
         .toFixed(2);
     }
   } else {
-    prescriptionList.value[rowIndex.value].orgId = JSON.parse(JSON.stringify(row)).positionId;
-    prescriptionList.value[rowIndex.value].unitPrice = row.priceList[0].price;
-  }
+  // 执行科室默认逻辑：优先使用诊疗项目维护的所属科室，如果没有则使用开单科室
+  const defaultOrgId = row.positionId || props.patientInfo.orgId;
+  prescriptionList.value[rowIndex.value].orgId = defaultOrgId;
+  prescriptionList.value[rowIndex.value].unitPrice = row.priceList[0].price;
+}
 }
 
 // 组套保存