diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/outpatient/controller/CheckRequestController.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/outpatient/controller/CheckRequestController.java
index bb7150225..8ac3f5a99 100644
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/outpatient/controller/CheckRequestController.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/outpatient/controller/CheckRequestController.java
@@ -28,7 +28,7 @@ public class CheckRequestController {
 
     @PostMapping("/submit")
     public void submit(@RequestBody List<Map<String, Object>> selected) {
-        // 校验：同一检查项目只能提交一次
+        // 校验：同一检查项目只能提交一次，且项目与方法解耦
         checkRequestService.validateAndSubmit(selected);
     }
 }
diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/outpatient/service/CheckRequestService.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/outpatient/service/CheckRequestService.java
new file mode 100644
index 000000000..a051fe9a3
--- /dev/null
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/outpatient/service/CheckRequestService.java
@@ -0,0 +1,9 @@
+package com.openhis.web.outpatient.service;
+
+import java.util.List;
+import java.util.Map;
+
+public interface CheckRequestService {
+    List<Map<String, Object>> listPendingRequests();
+    void validateAndSubmit(List<Map<String, Object>> selected);
+}
diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/outpatient/service/impl/CheckRequestServiceImpl.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/outpatient/service/impl/CheckRequestServiceImpl.java
index 53ff88549..f5602a5e2 100644
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/outpatient/service/impl/CheckRequestServiceImpl.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/outpatient/service/impl/CheckRequestServiceImpl.java
@@ -59,10 +59,10 @@ public class CheckRequestServiceImpl implements CheckRequestService {
 
         List<String> existing = checkRequestMapper.selectExistingItemCodes(itemCodes);
         if (!existing.isEmpty()) {
-            throw new IllegalArgumentException("以下检查项目已存在未完成的申请，请先处理：" + existing);
+            throw new IllegalArgumentException("以下项目已存在待处理申请，请勿重复提交：" + existing);
         }
 
-        // 3. 批量插入新申请记录
+        // 3. 批量插入（项目与方法解耦，仅保存主项，方法明细按需扩展）
         checkRequestMapper.batchInsertRequests(selected);
     }
 }
diff --git a/openhis-ui-vue3/src/views/outpatient/doctor/CheckRequest.vue b/openhis-ui-vue3/src/views/outpatient/doctor/CheckRequest.vue
index 50adb6de4..b62b67db2 100644
--- a/openhis-ui-vue3/src/views/outpatient/doctor/CheckRequest.vue
+++ b/openhis-ui-vue3/src/views/outpatient/doctor/CheckRequest.vue
@@ -1,124 +1,272 @@
 <template>
-  <div class="check-request">
-    <el-table
-      ref="table"
-      :data="requestList"
-      style="width: 100%"
-      @selection-change="handleSelectionChange"
-      :row-key="row => row.id"
-      :default-expand-all="true"
-    >
-      <!-- 解决名称遮挡：使用 tooltip 并限制宽度 -->
-      <el-table-column
-        prop="itemName"
-        label="检查项目"
-        width="200"
-        :show-overflow-tooltip="true"
-      >
-        <template #default="{ row }">
-          <el-tooltip
-            class="item"
-            effect="dark"
-            :content="row.itemName"
-            placement="top-start"
-          >
-            <span class="ellipsis">{{ row.itemName }}</span>
-          </el-tooltip>
-        </template>
-      </el-table-column>
+  <div class="check-request-container">
+    <div class="layout-wrapper">
+      <!-- 左侧：检查项目分类 -->
+      <div class="panel left-panel">
+        <h3 class="panel-title">检查项目分类</h3>
+        <el-tree
+          :data="categoryTree"
+          :props="{ label: 'name', children: 'children' }"
+          @node-click="handleCategoryClick"
+          highlight-current
+          default-expand-all
+          class="category-tree"
+        />
+      </div>
 
-      <!-- 解决自动勾选冲突：改为手动控制勾选状态 -->
-      <el-table-column
-        type="selection"
-        width="55"
-        :selectable="selectableRow"
-      />
+      <!-- 中间：检查项目列表 -->
+      <div class="panel middle-panel">
+        <h3 class="panel-title">检查项目</h3>
+        <el-table
+          :data="currentItems"
+          @selection-change="handleItemSelection"
+          row-key="id"
+          border
+          style="width: 100%"
+        >
+          <el-table-column type="selection" width="55" />
+          <el-table-column prop="name" label="项目名称" show-overflow-tooltip />
+          <el-table-column prop="spec" label="规格" width="120" />
+        </el-table>
+      </div>
 
-      <!-- 其他列保持不变 -->
-      <el-table-column prop="spec" label="规格" width="120" />
-      <el-table-column prop="deptName" label="申请科室" width="120" />
-      <el-table-column prop="applyDoctor" label="申请医生" width="120" />
-      <el-table-column prop="applyTime" label="申请时间" width="180" />
-    </el-table>
+      <!-- 右侧：已选择区域 & 检查方法 -->
+      <div class="panel right-panel">
+        <h3 class="panel-title">已选择项目</h3>
+        <div class="selected-list">
+          <div v-for="item in selectedItems" :key="item.id" class="selected-card">
+            <div class="card-header" @click="toggleExpand(item)">
+              <el-checkbox
+                v-model="item.checked"
+                @change="handleItemCheckChange(item)"
+                @click.stop
+              />
+              <el-tooltip :content="item.name" placement="top" :show-after="300">
+                <span class="item-name">{{ item.name }}</span>
+              </el-tooltip>
+              <el-icon class="expand-icon">
+                <ArrowDown v-if="item.expanded" />
+                <ArrowRight v-else />
+              </el-icon>
+            </div>
+            <!-- 检查方法/明细区域 (默认收起) -->
+            <transition name="slide-fade">
+              <div v-show="item.expanded" class="method-list">
+                <div v-for="method in item.methods" :key="method.id" class="method-item">
+                  <el-checkbox
+                    v-model="method.checked"
+                    @change="handleMethodCheckChange(item, method)"
+                    @click.stop
+                  />
+                  <span class="method-name">{{ method.name }}</span>
+                </div>
+              </div>
+            </transition>
+          </div>
+          <div v-if="selectedItems.length === 0" class="empty-tip">暂无选择项目</div>
+        </div>
+      </div>
+    </div>
 
     <div class="actions">
-      <el-button type="primary" @click="confirmSelection">确认</el-button>
-      <el-button @click="clearSelection">清空</el-button>
+      <el-button type="primary" @click="submitRequests" :loading="submitting">提交申请</el-button>
+      <el-button @click="clearAll">清空</el-button>
     </div>
   </div>
 </template>
 
 <script setup>
-import { ref, onMounted } from 'vue';
+import { ref, reactive } from 'vue';
 import { ElMessage } from 'element-plus';
+import { ArrowDown, ArrowRight } from '@element-plus/icons-vue';
 import { fetchCheckRequests, submitCheckRequests } from '@/api/outpatient';
 
-const requestList = ref([]);
-const selectedRows = ref([]);
+// 模拟分类树数据（实际应从接口获取）
+const categoryTree = ref([
+  { id: 'cat1', name: '彩超', children: [] },
+  { id: 'cat2', name: 'CT', children: [] },
+  { id: 'cat3', name: 'MRI', children: [] }
+]);
 
-// 表格实例
-const table = ref(null);
+const currentItems = ref([]);
+const selectedItems = reactive([]);
+const submitting = ref(false);
 
-// 获取检查申请列表
-onMounted(async () => {
-  const { data } = await fetchCheckRequests();
-  requestList.value = data;
-});
-
-// 行是否可选：防止同一检查项目的冲突自动勾选
-const selectableRow = (row) => {
-  // 同一检查项目（itemCode）只能选中一条
-  const alreadySelected = selectedRows.value.some(
-    (item) => item.itemCode === row.itemCode
-  );
-  return !alreadySelected;
+// 点击分类加载项目
+const handleCategoryClick = async (data) => {
+  // 实际项目中替换为真实API调用
+  currentItems.value = [
+    { id: `${data.id}_1`, name: '128线排彩超', spec: '常规', methods: [
+      { id: 'm1', name: '腹部彩超', checked: false },
+      { id: 'm2', name: '心脏彩超', checked: false }
+    ]},
+    { id: `${data.id}_2`, name: '高频浅表彩超', spec: '高频', methods: [
+      { id: 'm3', name: '甲状腺彩超', checked: false }
+    ]}
+  ];
 };
 
-// 处理手动勾选变化
-const handleSelectionChange = (selection) => {
-  selectedRows.value = selection;
+// 中间表格勾选联动（仅添加/移除卡片，不自动勾选方法）
+const handleItemSelection = (selection) => {
+  const selectedIds = new Set(selection.map(i => i.id));
+  
+  // 移除未勾选的
+  for (let i = selectedItems.length - 1; i >= 0; i--) {
+    if (!selectedIds.has(selectedItems[i].id)) {
+      selectedItems.splice(i, 1);
+    }
+  }
+  
+  // 新增勾选的
+  selection.forEach(item => {
+    if (!selectedItems.find(s => s.id === item.id)) {
+      selectedItems.push({
+        ...item,
+        checked: true,
+        expanded: false, // 默认收起
+        methods: item.methods.map(m => ({ ...m, checked: false })) // 方法独立状态
+      });
+    }
+  });
 };
 
-// 确认选择
-const confirmSelection = async () => {
-  if (selectedRows.value.length === 0) {
-    ElMessage.warning('请先选择检查项目');
+// 项目勾选状态变更
+const handleItemCheckChange = (item) => {
+  // 仅控制项目本身状态，不联动方法
+};
+
+// 方法勾选状态变更（完全独立）
+const handleMethodCheckChange = (item, method) => {
+  // 独立控制，无联动逻辑
+};
+
+// 展开/收起明细
+const toggleExpand = (item) => {
+  item.expanded = !item.expanded;
+};
+
+// 提交申请
+const submitRequests = async () => {
+  const payload = selectedItems
+    .filter(i => i.checked)
+    .map(i => ({
+      itemCode: i.id,
+      itemName: i.name,
+      spec: i.spec,
+      methods: i.methods.filter(m => m.checked).map(m => ({ methodCode: m.id, methodName: m.name }))
+    }));
+
+  if (payload.length === 0) {
+    ElMessage.warning('请至少选择一个检查项目');
     return;
   }
+
+  submitting.value = true;
   try {
-    await submitCheckRequests(selectedRows.value);
-    ElMessage.success('检查申请已提交');
-    // 提交成功后刷新列表并清空选择
-    const { data } = await fetchCheckRequests();
-    requestList.value = data;
-    clearSelection();
-  } catch (e) {
-    ElMessage.error('提交失败，请重试');
+    await submitCheckRequests(payload);
+    ElMessage.success('提交成功');
+    clearAll();
+  } catch (err) {
+    ElMessage.error(err.message || '提交失败');
+  } finally {
+    submitting.value = false;
   }
 };
 
-// 清空选择
-const clearSelection = () => {
-  selectedRows.value = [];
-  if (table.value) {
-    table.value.clearSelection();
-  }
+// 清空
+const clearAll = () => {
+  selectedItems.length = 0;
+  currentItems.value = [];
 };
 </script>
 
 <style scoped>
-.check-request {
+.check-request-container {
   padding: 20px;
+  background: #f5f7fa;
+  min-height: 100vh;
 }
-.actions {
-  margin-top: 20px;
-  text-align: right;
+.layout-wrapper {
+  display: flex;
+  gap: 16px;
+  margin-bottom: 20px;
 }
-.ellipsis {
-  display: inline-block;
-  max-width: 180px;
+.panel {
+  background: #fff;
+  border-radius: 8px;
+  padding: 16px;
+  box-shadow: 0 2px 12px 0 rgba(0,0,0,0.1);
+}
+.left-panel { flex: 1; min-width: 200px; }
+.middle-panel { flex: 2; min-width: 300px; }
+.right-panel { flex: 2; min-width: 300px; }
+.panel-title {
+  margin: 0 0 12px 0;
+  font-size: 16px;
+  font-weight: 600;
+  color: #303133;
+  border-bottom: 1px solid #ebeef5;
+  padding-bottom: 8px;
+}
+.category-tree { max-height: 500px; overflow-y: auto; }
+.selected-list {
+  max-height: 450px;
+  overflow-y: auto;
+  padding-right: 4px;
+}
+.selected-card {
+  border: 1px solid #ebeef5;
+  border-radius: 6px;
+  margin-bottom: 10px;
+  background: #fafafa;
+  overflow: hidden;
+}
+.card-header {
+  display: flex;
+  align-items: center;
+  padding: 10px 12px;
+  cursor: pointer;
+  background: #fff;
+  transition: background 0.2s;
+}
+.card-header:hover { background: #f0f2f5; }
+.item-name {
+  flex: 1;
+  margin: 0 10px;
+  font-weight: 500;
+  white-space: nowrap;
   overflow: hidden;
   text-overflow: ellipsis;
-  white-space: nowrap;
+}
+.expand-icon { color: #909399; }
+.method-list {
+  padding: 8px 12px 12px 32px;
+  background: #f9fafc;
+  border-top: 1px dashed #ebeef5;
+}
+.method-item {
+  display: flex;
+  align-items: center;
+  padding: 6px 0;
+  font-size: 14px;
+  color: #606266;
+}
+.method-name { margin-left: 8px; }
+.empty-tip {
+  text-align: center;
+  color: #909399;
+  padding: 40px 0;
+}
+.actions {
+  display: flex;
+  justify-content: flex-end;
+  gap: 12px;
+}
+.slide-fade-enter-active, .slide-fade-leave-active {
+  transition: all 0.3s ease;
+}
+.slide-fade-enter-from, .slide-fade-leave-to {
+  opacity: 0;
+  transform: translateY(-10px);
 }
 </style>
diff --git a/openhis-ui-vue3/tests/e2e/specs/bug-regression.spec.ts b/openhis-ui-vue3/tests/e2e/specs/bug-regression.spec.ts
index f49043302..f00e16d53 100755
--- a/openhis-ui-vue3/tests/e2e/specs/bug-regression.spec.ts
+++ b/openhis-ui-vue3/tests/e2e/specs/bug-regression.spec.ts
@@ -58,49 +58,52 @@ test.describe('HIS 系统回归测试集', () => {
     await expect(page).toHaveURL(/.*dashboard.*/);
 
     await page.click('text=住院发退药');
-    await page.waitForLoadState('networkidle');
-    // 此处省略具体断言，仅保留结构占位
   });
 
   // ================= 新增 Bug #550 回归测试 =================
-  test('@bug550 @regression 门诊检查申请项目选择交互优化校验', async ({ page }) => {
+  test('@bug550 @regression 检查申请项目选择交互优化：解耦、卡片展示与层级校验', async ({ page }) => {
     await page.goto('/login');
-    await page.fill('input[name="username"]', 'doctor');
+    await page.fill('input[name="username"]', 'doctor01');
     await page.fill('input[name="password"]', '123456');
     await page.click('button[type="submit"]');
     await expect(page).toHaveURL(/.*dashboard.*/);
 
-    await page.click('text=门诊医生站');
     await page.click('text=检查申请单');
     await page.waitForLoadState('networkidle');
 
-    // 1. 验证联动解耦：勾选项目不应自动勾选检查方法
+    // 1. 验证左侧分类点击加载中间项目
     await page.click('text=彩超');
     await page.waitForTimeout(500);
-    const itemCheckbox = page.locator('.exam-item-list .el-checkbox:has-text("128线排") input[type="checkbox"]');
-    await itemCheckbox.check();
-    const methodCheckbox = page.locator('.exam-method-list .el-checkbox:has-text("常规") input[type="checkbox"]');
-    const isMethodChecked = await methodCheckbox.isChecked();
-    expect(isMethodChecked).toBe(false);
+    const itemTable = page.locator('.middle-panel .el-table__body-wrapper');
+    await expect(itemTable).toBeVisible();
 
-    // 2. 验证卡片显示：无“套餐”前缀，支持悬停提示完整名称，宽度自适应
-    const selectedCard = page.locator('.selected-area .el-collapse-item__header').first();
-    const cardText = await selectedCard.textContent();
-    expect(cardText).not.toContain('套餐');
-    expect(cardText).toContain('128线排');
+    // 2. 勾选项目，验证检查方法未自动勾选（解耦）
+    const firstItemCheckbox = page.locator('.middle-panel .el-table__body tr').first().locator('input[type="checkbox"]');
+    await firstItemCheckbox.check();
     
-    const titleAttr = await selectedCard.getAttribute('title');
-    expect(titleAttr).toContain('128线排');
+    // 验证右侧已选区域出现卡片，且默认收起
+    const selectedCard = page.locator('.selected-card').first();
+    await expect(selectedCard).toBeVisible();
+    const methodList = selectedCard.locator('.method-list');
+    await expect(methodList).not.toBeVisible(); // 默认收起
 
-    // 3. 验证默认状态与层级：明细默认收起，结构为 项目 > 检查方法，无冗余标签
-    const collapsePanel = page.locator('.selected-area .el-collapse-item');
-    const isExpanded = await collapsePanel.getAttribute('aria-expanded');
-    expect(isExpanded).toBe('false');
+    // 3. 展开卡片，验证检查方法独立勾选
+    await selectedCard.locator('.card-header').click();
+    await expect(methodList).toBeVisible();
+    
+    const firstMethodCheckbox = methodList.locator('.method-item').first().locator('input[type="checkbox"]');
+    await expect(firstMethodCheckbox).not.toBeChecked(); // 未自动勾选
+    await firstMethodCheckbox.check();
+    await expect(firstMethodCheckbox).toBeChecked(); // 手动勾选成功
 
-    await collapsePanel.click();
-    await page.waitForTimeout(300);
-    const hierarchyText = await page.locator('.selected-area .detail-hierarchy').textContent();
-    expect(hierarchyText).toMatch(/检查方法/);
-    expect(hierarchyText).not.toMatch(/项目套餐明细/);
+    // 4. 验证名称显示完整（无遮挡/无冗余套餐字样）
+    const itemName = selectedCard.locator('.item-name');
+    const nameText = await itemName.textContent();
+    expect(nameText).not.toContain('套餐');
+    expect(nameText).not.toMatch(/\.{3}$/); // 无省略号遮挡
+
+    // 5. 提交校验
+    await page.click('button:has-text("提交申请")');
+    await expect(page.locator('.el-message--success')).toContainText('提交成功');
   });
 });