diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/appservice/impl/DoctorStationDiagnosisAppServiceImpl.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/appservice/impl/DoctorStationDiagnosisAppServiceImpl.java
index d36440d28..11174386c 100755
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/appservice/impl/DoctorStationDiagnosisAppServiceImpl.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/appservice/impl/DoctorStationDiagnosisAppServiceImpl.java
@@ -261,8 +261,10 @@ public class DoctorStationDiagnosisAppServiceImpl implements IDoctorStationDiagn
             // 设置创建时间，避免数据库约束错误
             encounterDiagnosis.setCreateTime(new Date());
             iEncounterDiagnosisService.saveOrUpdate(encounterDiagnosis);
+            // 回写就诊诊断ID，供前端后续更新使用
+            saveDiagnosisChildParam.setEncounterDiagnosisId(encounterDiagnosis.getId());
         }
-        return R.ok(null, MessageUtils.createMessage(PromptMsgConstant.Common.M00002, new Object[] {"诊断"}));
+        return R.ok(saveDiagnosisParam, MessageUtils.createMessage(PromptMsgConstant.Common.M00002, new Object[] {"诊断"}));
     }
 
 
diff --git a/openhis-ui-vue3/src/views/inpatientDoctor/home/components/diagnosis/diagnosis.vue b/openhis-ui-vue3/src/views/inpatientDoctor/home/components/diagnosis/diagnosis.vue
index ed8637cf3..e50513b32 100755
--- a/openhis-ui-vue3/src/views/inpatientDoctor/home/components/diagnosis/diagnosis.vue
+++ b/openhis-ui-vue3/src/views/inpatientDoctor/home/components/diagnosis/diagnosis.vue
@@ -568,6 +568,11 @@ function handleMaindise(value, index) {
  * 保存诊断
  */
 function handleSaveDiagnosis() {
+  // 防止重复点击保存
+  if (isSaving.value) {
+    return;
+  }
+
   for (let index = 0; index < (form.value.diagnosisList || []).length; index++) {
     const item = form.value.diagnosisList[index];
     if (!item.diagSrtNo) {
@@ -600,7 +605,7 @@ function handleSaveDiagnosis() {
 
       // 步骤2：重新分配连续的序号（从1开始）
       sortedList.forEach((item, index) => {
-        item.diagSrtNo = index + 1; // 这里是关键！把“诊断排序”改成新顺序
+        item.diagSrtNo = index + 1; // 这里是关键！把”诊断排序”改成新顺序
       });
 
       // 步骤3：提交排序后的数据
@@ -610,12 +615,12 @@ function handleSaveDiagnosis() {
         diagnosisChildList: sortedList,
       }).then((res) => {
         if (res.code === 200) {
-          // 步骤4：更新本地数据，使用全新对象防止响应式问题
-          form.value.diagnosisList = sortedList.map(item => ({ ...item }));
-
           emits('diagnosisSave', false);
           proxy.$modal.msgSuccess('诊断已保存');
 
+          // 保存成功后从服务器重新加载数据，确保前后端数据一致
+          getList();
+
           // 食源性疾病逻辑
           isFoodDiseasesNew({ encounterId: props.patientInfo.encounterId }).then((res2) => {
             if (res2.code === 20 && res2.data) {