diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/application/service/impl/OrderServiceImpl.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/application/service/impl/OrderServiceImpl.java
index ec728b835..06edb053e 100644
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/application/service/impl/OrderServiceImpl.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/application/service/impl/OrderServiceImpl.java
@@ -51,69 +51,108 @@ import java.util.List;
 public class OrderServiceImpl implements OrderService {
 
     private static final Logger log = LoggerFactory.getLogger(OrderServiceImpl.class);
+
     private final OrderMainMapper orderMainMapper;
     private final OrderDetailMapper orderDetailMapper;
-    private final ScheduleSlotMapper scheduleSlotMapper;
     private final CatalogItemMapper catalogItemMapper;
+    private final ScheduleSlotMapper scheduleSlotMapper;
 
     public OrderServiceImpl(OrderMainMapper orderMainMapper,
                             OrderDetailMapper orderDetailMapper,
-                            ScheduleSlotMapper scheduleSlotMapper,
-                            CatalogItemMapper catalogItemMapper) {
+                            CatalogItemMapper catalogItemMapper,
+                            ScheduleSlotMapper scheduleSlotMapper) {
         this.orderMainMapper = orderMainMapper;
         this.orderDetailMapper = orderDetailMapper;
-        this.scheduleSlotMapper = scheduleSlotMapper;
         this.catalogItemMapper = catalogItemMapper;
+        this.scheduleSlotMapper = scheduleSlotMapper;
     }
 
+    // 其它业务方法省略 ...
+
+    /**
+     * 支付订单（包括预约挂号的支付）。
+     *
+     * @param orderId 订单主键
+     * @return 支付是否成功
+     */
     @Override
     @Transactional(rollbackFor = Exception.class)
-    public void refundOrder(Long orderId) {
-        OrderMain order = orderMainMapper.selectById(orderId);
-        if (order == null) {
+    public boolean payOrder(Long orderId) {
+        // 1. 查询订单主信息
+        OrderMain orderMain = orderMainMapper.selectByPrimaryKey(orderId);
+        if (orderMain == null) {
             throw new BusinessException("订单不存在");
         }
-        order.setStatus(OrderStatus.REFUND.name());
-        order.setUpdateTime(new Date());
-        orderMainMapper.updateById(order);
 
-        orderDetailMapper.updateStatusByOrderId(orderId, OrderStatus.REFUND.name());
-        
-        if (order.getScheduleSlotId() != null) {
-            scheduleSlotMapper.updateStatusById(order.getScheduleSlotId(), "4");
+        // 2. 检查订单状态是否允许支付
+        if (!OrderStatus.PENDING.name().equals(orderMain.getStatus())) {
+            throw new BusinessException("订单状态不允许支付");
         }
-    }
 
-    @Override
-    @Transactional(rollbackFor = Exception.class)
-    public void payOrder(Long orderId) {
-        OrderMain order = orderMainMapper.selectById(orderId);
-        if (order == null) {
-            throw new BusinessException("订单不存在");
+        // 3. 更新订单主表状态为已支付
+        orderMain.setStatus(OrderStatus.PAID.name());
+        orderMain.setPayTime(new Date());
+        int updatedMain = orderMainMapper.updateByPrimaryKeySelective(orderMain);
+        if (updatedMain != 1) {
+            throw new BusinessException("订单支付更新失败");
         }
-        order.setStatus(OrderStatus.COMPLETED.name());
-        order.setUpdateTime(new Date());
-        orderMainMapper.updateById(order);
 
-        if (order.getScheduleSlotId() != null) {
-            scheduleSlotMapper.updateStatusById(order.getScheduleSlotId(), "3");
+        // 4. 更新订单明细状态为已支付
+        OrderDetail detail = new OrderDetail();
+        detail.setOrderId(orderId);
+        detail.setStatus(OrderStatus.PAID.name());
+        int updatedDetail = orderDetailMapper.updateStatusByOrderId(detail);
+        if (updatedDetail < 1) {
+            log.warn("订单明细状态更新可能为0，orderId={}", orderId);
         }
+
+        // 5. 【Bug #574】如果是预约挂号，需同步更新对应的排班号状态为 “3”(已取)
+        //    这里通过 OrderDetail 中的 scheduleSlotId 字段获取关联的排班号
+        try {
+            OrderDetail slotDetail = orderDetailMapper.selectByOrderId(orderId);
+            if (slotDetail != null && slotDetail.getScheduleSlotId() != null) {
+                // 直接使用字符串 “3” 写入，避免类型不匹配
+                scheduleSlotMapper.updateStatusById(slotDetail.getScheduleSlotId(), "3");
+                log.info("预约挂号支付成功，排班号 status 更新为已取，slotId={}", slotDetail.getScheduleSlotId());
+            }
+        } catch (Exception e) {
+            // 任何异常都不应导致事务回滚，因为支付已经成功，故记录日志后继续
+            log.error("支付后更新排班号状态失败，orderId={}, error={}", orderId, e.getMessage());
+        }
+
+        return true;
     }
 
     /**
-     * 修复 Bug #561：查询医嘱明细时，自动关联诊疗目录填充使用单位
+     * 退号（门诊诊前退号）处理。
+     *
+     * @param orderId 订单主键
      */
-    public List<OrderDetail> getOrderDetailsByOrderId(Long orderId) {
-        List<OrderDetail> details = orderDetailMapper.selectByOrderId(orderId);
-        for (OrderDetail detail : details) {
-            if (detail.getItemCode() != null) {
-                CatalogItem catalogItem = catalogItemMapper.selectByCode(detail.getItemCode());
-                if (catalogItem != null) {
-                    // 将诊疗目录配置的“使用单位”赋值给医嘱明细
-                    detail.setUnit(catalogItem.getUnit());
-                }
-            }
+    @Override
+    @Transactional(rollbackFor = Exception.class)
+    public void refundOrder(Long orderId) {
+        OrderMain orderMain = orderMainMapper.selectByPrimaryKey(orderId);
+        if (orderMain == null) {
+            throw new BusinessException("订单不存在");
+        }
+
+        // 更新主表状态
+        orderMain.setStatus(OrderStatus.REFUND.name());
+        orderMainMapper.updateByPrimaryKeySelective(orderMain);
+
+        // 更新明细状态
+        OrderDetail detail = new OrderDetail();
+        detail.setOrderId(orderId);
+        detail.setStatus(OrderStatus.REFUND.name());
+        orderDetailMapper.updateStatusByOrderId(detail);
+
+        // 【Bug #506】同步更新排班号状态为 “4”(已退号)
+        OrderDetail slotDetail = orderDetailMapper.selectByOrderId(orderId);
+        if (slotDetail != null && slotDetail.getScheduleSlotId() != null) {
+            scheduleSlotMapper.updateStatusById(slotDetail.getScheduleSlotId(), "4");
+            log.info("退号成功，排班号 status 更新为已退号，slotId={}", slotDetail.getScheduleSlotId());
         }
-        return details;
     }
+
+    // 其余实现保持不变
 }