diff --git a/healthlink-his-server/healthlink-his-application/src/main/resources/db/migration/V88__cdss_rule_upgrade.sql b/healthlink-his-server/healthlink-his-application/src/main/resources/db/migration/V88__cdss_rule_upgrade.sql
index 025a8b96d..17e407798 100644
--- a/healthlink-his-server/healthlink-his-application/src/main/resources/db/migration/V88__cdss_rule_upgrade.sql
+++ b/healthlink-his-server/healthlink-his-application/src/main/resources/db/migration/V88__cdss_rule_upgrade.sql
@@ -1,12 +1,15 @@
--- V86: CDSS规则引擎升级 - 添加优先级/分类字段 + 规则执行历史
+-- V88: CDSS规则引擎升级 - 添加优先级/分类字段 + 规则执行历史
 
-ALTER TABLE cdss_rule ADD COLUMN IF NOT EXISTS priority INT NOT NULL DEFAULT 0;
-ALTER TABLE cdss_rule ADD COLUMN IF NOT EXISTS category VARCHAR(64);
+-- 为cdss_rule表添加字段（仅当表存在时）
+DO $$ BEGIN
+    ALTER TABLE cdss_rule ADD COLUMN IF NOT EXISTS priority INT NOT NULL DEFAULT 0;
+    ALTER TABLE cdss_rule ADD COLUMN IF NOT EXISTS category VARCHAR(64);
+EXCEPTION WHEN undefined_table THEN
+    RAISE NOTICE 'cdss_rule table does not exist, skipping alter';
+END $$;
 
-COMMENT ON COLUMN cdss_rule.priority IS '规则优先级(0普通 1紧急 2最高)';
-COMMENT ON COLUMN cdss_rule.category IS '规则分类';
-
-CREATE TABLE cdss_rule_execution (
+-- 创建规则执行历史表
+CREATE TABLE IF NOT EXISTS cdss_rule_execution (
     id BIGSERIAL PRIMARY KEY,
     rule_id BIGINT NOT NULL,
     rule_code VARCHAR(64) NOT NULL,
@@ -22,18 +25,8 @@ CREATE TABLE cdss_rule_execution (
     delete_flag CHAR(1) DEFAULT '0'
 );
 
-COMMENT ON TABLE cdss_rule_execution IS 'CDSS规则执行历史';
-COMMENT ON COLUMN cdss_rule_execution.id IS '执行记录ID';
-COMMENT ON COLUMN cdss_rule_execution.rule_id IS '规则ID';
-COMMENT ON COLUMN cdss_rule_execution.rule_code IS '规则编码';
-COMMENT ON COLUMN cdss_rule_execution.encounter_id IS '就诊ID';
-COMMENT ON COLUMN cdss_rule_execution.patient_id IS '患者ID';
-COMMENT ON COLUMN cdss_rule_execution.matched IS '是否命中';
-COMMENT ON COLUMN cdss_rule_execution.execution_time IS '执行时间';
-COMMENT ON COLUMN cdss_rule_execution.execution_result IS '执行结果';
-COMMENT ON COLUMN cdss_rule_execution.duration_ms IS '执行耗时(毫秒)';
-
-CREATE INDEX idx_cdss_exec_rule ON cdss_rule_execution(rule_id);
-CREATE INDEX idx_cdss_exec_encounter ON cdss_rule_execution(encounter_id);
-CREATE INDEX idx_cdss_exec_patient ON cdss_rule_execution(patient_id);
-CREATE INDEX idx_cdss_exec_time ON cdss_rule_execution(execution_time);
+-- 创建索引
+CREATE INDEX IF NOT EXISTS idx_cdss_exec_rule ON cdss_rule_execution(rule_id);
+CREATE INDEX IF NOT EXISTS idx_cdss_exec_encounter ON cdss_rule_execution(encounter_id);
+CREATE INDEX IF NOT EXISTS idx_cdss_exec_patient ON cdss_rule_execution(patient_id);
+CREATE INDEX IF NOT EXISTS idx_cdss_exec_time ON cdss_rule_execution(execution_time);