diff --git a/openhis-ui-vue3/src/views/inpatientDoctor/home/components/order/index.vue b/openhis-ui-vue3/src/views/inpatientDoctor/home/components/order/index.vue
index 3671cd6d..b8ab7936 100755
--- a/openhis-ui-vue3/src/views/inpatientDoctor/home/components/order/index.vue
+++ b/openhis-ui-vue3/src/views/inpatientDoctor/home/components/order/index.vue
@@ -1579,11 +1579,21 @@ function handleSaveGroup(orderGroupList) {
 
   let successCount = 0;
 
+  // 收集所有要添加的新行，最后统一 unshift 到数组开头（置顶显示）
+  const newRows = [];
+
   orderGroupList.forEach((item) => {
-    rowIndex.value = prescriptionList.value.length;
+    // 使用临时索引，先追加到末尾用于 setValue 填充
+    const tempIndex = prescriptionList.value.length;
+    prescriptionList.value[tempIndex] = {
+      uniqueKey: nextId.value++,
+      isEdit: false,
+      statusEnum: 1,
+    };
 
     if (!item) {
       console.warn('组套中的项目为空');
+      prescriptionList.value.splice(tempIndex, 1);
       return;
     }
 
@@ -1609,18 +1619,12 @@ function handleSaveGroup(orderGroupList) {
       therapyEnum: item.orderDetailInfos?.therapyEnum || '1',
     };
 
-    // 预初始化空行（组套项带预填值，设为 false 让明细字段在表格中直接展示）
-    prescriptionList.value[rowIndex.value] = {
-      uniqueKey: nextId.value++,
-      isEdit: false,
-      statusEnum: 1,
-    };
-
+    rowIndex.value = tempIndex;
     setValue(mergedDetail);
 
     // 创建新的处方项目
     const newRow = {
-      ...prescriptionList.value[rowIndex.value],
+      ...prescriptionList.value[tempIndex],
       patientId: patientInfo.value.patientId,
       encounterId: patientInfo.value.encounterId,
       accountId: accountId.value,
@@ -1639,12 +1643,12 @@ function handleSaveGroup(orderGroupList) {
       orgId: resolveOrgId(mergedDetail.orgId || patientInfo.value?.inHospitalOrgId) || '',
       // 🔧 修复：同时存储 orgName，确保树匹配不到时仍有中文名称可显示
       orgName: findOrgName(mergedDetail.orgId || patientInfo.value?.inHospitalOrgId) || mergedDetail.orgName || patientInfo.value?.inHospitalOrgName || '',
-      dbOpType: prescriptionList.value[rowIndex.value].requestId ? '2' : '1',
+      dbOpType: prescriptionList.value[tempIndex].requestId ? '2' : '1',
       conditionId: conditionId.value,
       conditionDefinitionId: conditionDefinitionId.value,
       encounterDiagnosisId: encounterDiagnosisId.value,
       diagnosisName: diagnosisName.value,
-      therapyEnum: prescriptionList.value[rowIndex.value]?.therapyEnum || mergedDetail.therapyEnum || '1',
+      therapyEnum: prescriptionList.value[tempIndex]?.therapyEnum || mergedDetail.therapyEnum || '1',
       // 🔧 修复：确保组套医嘱的 categoryEnum 被正确映射，防止后端 NPE
       categoryEnum: mergedDetail?.categoryEnum || mergedDetail?.categoryCode || item?.categoryCode,
     };
@@ -1663,11 +1667,13 @@ function handleSaveGroup(orderGroupList) {
     }
 
     newRow.contentJson = JSON.stringify(newRow);
-    prescriptionList.value[rowIndex.value] = newRow;
+    newRows.push(newRow);
     successCount++;
   });
-  
-  if (successCount > 0) {
+
+  // 统一添加到数组开头（置顶显示）
+  if (newRows.length > 0) {
+    prescriptionList.value.unshift(...newRows);
     proxy.$modal.msgSuccess(`成功添加 ${successCount} 个医嘱项`);
   }
 }