diff --git a/openhis-ui-vue3/src/layout/components/Settings/index.vue b/openhis-ui-vue3/src/layout/components/Settings/index.vue
index 7470cd056..f81c15c91 100755
--- a/openhis-ui-vue3/src/layout/components/Settings/index.vue
+++ b/openhis-ui-vue3/src/layout/components/Settings/index.vue
@@ -167,20 +167,20 @@ function handleNavType(val) {
 }
 
 /** 菜单导航设置 */
-watch(() => navType, val => {
-  if (val.value == 1) {
-    // 纯左侧菜单
+watch(() => navType.value, val => {
+  if (val == 1) {
+    // 纯左侧菜单：显示侧边栏，使用全部路由
     appStore.sidebar.opened = true
     appStore.toggleSideBarHide(false)
     permissionStore.setSidebarRouters(permissionStore.defaultRoutes)
   }
-  if (val.value == 2) {
-    // 混合菜单：顶部显示一级菜单，左侧显示子菜单
+  if (val == 2) {
+    // 混合菜单：顶部显示一级菜单，侧边栏由 TopNav activeRoutes 自动过滤
     appStore.sidebar.opened = true
     appStore.toggleSideBarHide(false)
-    permissionStore.setSidebarRouters(permissionStore.defaultRoutes)
+    // 保留当前 sidebarRouters，TopNav 组件会根据当前路由自动筛选
   }
-  if (val.value == 3) {
+  if (val == 3) {
     // 纯顶部菜单：隐藏侧边栏
     appStore.sidebar.opened = false
     appStore.toggleSideBarHide(true)
diff --git a/openhis-ui-vue3/src/layout/components/TopBar/index.vue b/openhis-ui-vue3/src/layout/components/TopBar/index.vue
index e42f28f55..213a457f1 100644
--- a/openhis-ui-vue3/src/layout/components/TopBar/index.vue
+++ b/openhis-ui-vue3/src/layout/components/TopBar/index.vue
@@ -1,68 +1,267 @@
 <template>
-  <el-menu class="topbar-menu" :ellipsis="false" :default-active="activeMenu" :active-text-color="theme" mode="horizontal">
-    <sidebar-item :key="route.path + index" v-for="(route, index) in topMenus" :item="route" :base-path="route.path" />
+  <el-menu
+    class="topbar-menu"
+    :default-active="activeMenu"
+    mode="horizontal"
+    :ellipsis="false"
+    :active-text-color="theme"
+    @select="handleSelect"
+  >
+    <template v-for="(item, index) in topMenus">
+      <template v-if="item.children && item.children.length > 0 && index < visibleNumber">
+        <el-sub-menu
+          :key="index"
+          :style="{'--theme': theme}"
+          :index="item.path"
+        >
+          <template #title>
+            <svg-icon
+              v-if="item.meta && item.meta.icon && item.meta.icon !== '#'"
+              :icon-class="item.meta.icon"
+            />
+            <span class="menu-title">{{ item.meta.title }}</span>
+          </template>
+          <template
+            v-for="(child, childIndex) in item.children"
+            :key="childIndex"
+          >
+            <el-menu-item :index="item.path + '/' + (child.path || '')">
+              <svg-icon
+                v-if="child.meta && child.meta.icon && child.meta.icon !== '#'"
+                :icon-class="child.meta.icon"
+              />
+              <template #title>
+                <span class="menu-title">{{ child.meta.title }}</span>
+              </template>
+            </el-menu-item>
+          </template>
+        </el-sub-menu>
+      </template>
+      <template v-else-if="index < visibleNumber">
+        <el-menu-item
+          :key="index"
+          :style="{'--theme': theme}"
+          :index="item.path"
+        >
+          <svg-icon
+            v-if="item.meta && item.meta.icon && item.meta.icon !== '#'"
+            :icon-class="item.meta.icon"
+          />
+          <template #title>
+            <span class="menu-title">{{ item.meta.title }}</span>
+          </template>
+        </el-menu-item>
+      </template>
+    </template>
 
-    <el-sub-menu index="more" class="el-sub-menu__hide-arrow" v-if="moreRoutes.length > 0">
+    <el-sub-menu
+      v-if="topMenus.length > visibleNumber"
+      :style="{'--theme': theme}"
+      index="more"
+    >
       <template #title>
         <span>更多菜单</span>
       </template>
-      <sidebar-item :key="route.path + index" v-for="(route, index) in moreRoutes" :item="route" :base-path="route.path" />
+      <template
+        v-for="(item, index) in topMenus"
+        :key="index"
+      >
+        <template v-if="item.children && item.children.length > 0 && index >= visibleNumber">
+          <el-sub-menu :index="item.path">
+            <template #title>
+              <svg-icon
+                v-if="item.meta && item.meta.icon && item.meta.icon !== '#'"
+                :icon-class="item.meta.icon"
+              />
+              <span class="menu-title">{{ item.meta.title }}</span>
+            </template>
+            <template
+              v-for="(child, childIndex) in item.children"
+              :key="childIndex"
+            >
+              <el-menu-item :index="item.path + '/' + (child.path || '')">
+                <svg-icon
+                  v-if="child.meta && child.meta.icon && child.meta.icon !== '#'"
+                  :icon-class="child.meta.icon"
+                />
+                <template #title>
+                  <span class="menu-title">{{ child.meta.title }}</span>
+                </template>
+              </el-menu-item>
+            </template>
+          </el-sub-menu>
+        </template>
+        <template v-else-if="index >= visibleNumber">
+          <el-menu-item :index="item.path">
+            <svg-icon
+              v-if="item.meta && item.meta.icon && item.meta.icon !== '#'"
+              :icon-class="item.meta.icon"
+            />
+            <template #title>
+              <span class="menu-title">{{ item.meta.title }}</span>
+            </template>
+          </el-menu-item>
+        </template>
+      </template>
     </el-sub-menu>
   </el-menu>
 </template>
 
 <script setup>
-import SidebarItem from '../Sidebar/SidebarItem'
-import useAppStore from '@/store/modules/app'
-import useSettingsStore from '@/store/modules/settings'
-import usePermissionStore from '@/store/modules/permission'
+import {constantRoutes} from "@/router"
+import {isHttp} from "@/utils/validate"
+import useAppStore from "@/store/modules/app"
+import useSettingsStore from "@/store/modules/settings"
+import usePermissionStore from "@/store/modules/permission"
+
+const visibleNumber = ref(5)
+const currentIndex = ref(null)
+const hideList = ['/index', '/user/profile']
 
-const route = useRoute()
 const appStore = useAppStore()
 const settingsStore = useSettingsStore()
 const permissionStore = usePermissionStore()
+const route = useRoute()
+const router = useRouter()
 
-const sidebarRouters = computed(() => permissionStore.sidebarRouters)
 const theme = computed(() => settingsStore.theme)
-const device = computed(() => appStore.device)
-const activeMenu = computed(() => {
-  const { meta, path } = route
-  if (meta.activeMenu) {
-    return meta.activeMenu
-  }
-  return path
+const routers = computed(() => permissionStore.topbarRouters)
+
+const topMenus = computed(() => {
+  let menus = []
+  routers.value.map((menu) => {
+    if (menu.hidden !== true) {
+      if (menu.path === "/") {
+        menus.push(menu.children[0])
+      } else {
+        menus.push(menu)
+      }
+    }
+  })
+  return menus
 })
 
-const visibleNumber = ref(5)
-const topMenus = computed(() => {
-  return permissionStore.sidebarRouters.filter((f) => !f.hidden).slice(0, visibleNumber.value)
+const childrenMenus = computed(() => {
+  let children = []
+  routers.value.map((rt) => {
+    for (let item in rt.children) {
+      if (rt.children[item].parentPath === undefined) {
+        if (rt.path === "/") {
+          rt.children[item].path = "/" + rt.children[item].path
+        } else {
+          if (!isHttp(rt.children[item].path)) {
+            rt.children[item].path = rt.path + "/" + rt.children[item].path
+          }
+        }
+        rt.children[item].parentPath = rt.path
+      }
+      children.push(rt.children[item])
+    }
+  })
+  return constantRoutes.concat(children)
 })
-const moreRoutes = computed(() => {
-  return permissionStore.sidebarRouters.filter((f) => !f.hidden).slice(visibleNumber.value)
+
+const activeMenu = computed(() => {
+  const path = route.path
+  let activePath = path
+  if (path !== undefined && path.lastIndexOf("/") > 0 && hideList.indexOf(path) === -1) {
+    const tmpPath = path.substring(1, path.length)
+    activePath = "/" + tmpPath.substring(0, tmpPath.indexOf("/"))
+    if (!route.meta.link) {
+      appStore.toggleSideBarHide(false)
+    }
+  } else if (!route.children) {
+    activePath = path
+    appStore.toggleSideBarHide(true)
+  }
+
+  let isChildRoute = false
+  for (const item of routers.value) {
+    if (item.children && item.children.length > 0) {
+      const childRoute = item.children.find(child => (item.path + '/' + (child.path || '')) === path)
+      if (childRoute) {
+        isChildRoute = true
+        activePath = item.path
+        break
+      }
+    }
+  }
+
+  activeRoutes(activePath)
+  return activePath
 })
+
 function setVisibleNumber() {
   const width = document.body.getBoundingClientRect().width / 3
   visibleNumber.value = Math.max(1, parseInt(width / 85))
 }
 
+function handleSelect(key, keyPath) {
+  currentIndex.value = key
+  const rt = routers.value.find(item => item.path === key)
+  if (isHttp(key)) {
+    window.open(key, "_blank")
+  } else {
+    let isChildRoute = false
+    let parentRoute = null
+
+    for (const item of routers.value) {
+      if (item.children && item.children.length > 0) {
+        const childRoute = item.children.find(child => (item.path + '/' + (child.path || '')) === key)
+        if (childRoute) {
+          isChildRoute = true
+          parentRoute = item
+          break
+        }
+      }
+    }
+
+    if (isChildRoute) {
+      router.push({ path: key })
+      appStore.toggleSideBarHide(true)
+    } else if (!rt || !rt.children) {
+      const routeMenu = childrenMenus.value.find(item => item.path === key)
+      if (routeMenu && routeMenu.query) {
+        let query = JSON.parse(routeMenu.query)
+        router.push({ path: key, query: query })
+      } else {
+        router.push({ path: key })
+      }
+      appStore.toggleSideBarHide(true)
+    } else {
+      activeRoutes(key)
+      appStore.toggleSideBarHide(false)
+    }
+  }
+}
+
+function activeRoutes(key) {
+  let routes = []
+  if (childrenMenus.value && childrenMenus.value.length > 0) {
+    childrenMenus.value.map((item) => {
+      if (key == item.parentPath || (key == "index" && "" == item.path)) {
+        routes.push(item)
+      }
+    })
+  }
+  if (routes.length > 0) {
+    permissionStore.setSidebarRouters(routes)
+  } else {
+    appStore.toggleSideBarHide(true)
+  }
+  return routes
+}
+
 onMounted(() => {
+  setVisibleNumber()
   window.addEventListener('resize', setVisibleNumber)
 })
 onBeforeUnmount(() => {
   window.removeEventListener('resize', setVisibleNumber)
 })
-
-onMounted(() => {
-  setVisibleNumber()
-})
 </script>
 
 <style lang="scss">
-/* menu item */
-.topbar-menu.el-menu--horizontal .el-submenu__title, .topbar-menu.el-menu--horizontal .el-menu-item {
-  padding: 0 10px !important;
-}
-
 .topbar-menu.el-menu--horizontal > .el-menu-item {
   float: left;
   height: 50px !important;
@@ -72,28 +271,35 @@ onMounted(() => {
   margin: 0 10px !important;
 }
 
-.el-sub-menu.is-active .svg-icon, .el-menu-item.is-active .svg-icon + span, .el-sub-menu.is-active .svg-icon + span, .el-sub-menu.is-active .el-sub-menu__title span {
-  color: v-bind(theme);
+.topbar-menu.el-menu--horizontal > .el-menu-item.is-active,
+.topbar-menu.el-menu--horizontal > .el-sub-menu.is-active > .el-sub-menu__title {
+  border-bottom: 2px solid #{'var(--theme)'} !important;
+  color: #303133;
 }
 
-/* sub-menu item */
 .topbar-menu.el-menu--horizontal > .el-sub-menu .el-sub-menu__title {
   float: left;
+  height: 50px !important;
   line-height: 50px !important;
   color: #303133 !important;
-  margin: 0 15px -3px!important;
+  padding: 0 5px !important;
+  margin: 0 10px !important;
+}
+
+.topbar-menu.el-menu--horizontal > .el-menu-item:not(.is-disabled):focus,
+.topbar-menu.el-menu--horizontal > .el-menu-item:not(.is-disabled):hover,
+.topbar-menu.el-menu--horizontal > .el-sub-menu .el-sub-menu__title:hover {
+  background-color: #ffffff !important;
+}
+
+.topbar-menu .svg-icon {
+  margin-right: 4px;
 }
 
-/* topbar more arrow */
 .topbar-menu .el-sub-menu .el-sub-menu__icon-arrow {
   position: static;
+  vertical-align: middle;
   margin-left: 8px;
   margin-top: 0px;
-  display: block !important;
-}
-
-/* menu__title el-menu-item */
-.topbar-menu.el-menu--horizontal .el-sub-menu__title, .topbar-menu.el-menu--horizontal .el-menu-item {
-  height: 60px;
 }
 </style>
diff --git a/openhis-ui-vue3/src/layout/index.vue b/openhis-ui-vue3/src/layout/index.vue
index fa8e472cf..2dbf35a71 100755
--- a/openhis-ui-vue3/src/layout/index.vue
+++ b/openhis-ui-vue3/src/layout/index.vue
@@ -16,7 +16,7 @@
       <TopBar v-if="topNav === 2 || topNav === 3" />
       <!-- 内容区 -->
       <div
-        :class="{ 'hasTagsView': needTagsView, 'sidebar-hidden': sidebar.hide }"
+        :class="{ 'hasTagsView': needTagsView, 'sidebar-hidden': sidebar.hide, 'has-topbar': topNav === 2 || topNav === 3 }"
         class="content-wrapper"
       >
         <!-- 标签栏 -->
@@ -149,6 +149,10 @@ defineExpose({
   box-sizing: border-box;
 }
 
+.has-topbar .fixed-header {
+  top: 100px;
+}
+
 .sidebar-hidden {
   .fixed-header {
     left: 0 !important;