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 517a583d..347e2856 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
@@ -67,7 +67,7 @@
       <el-col :span="20" :xs="24">
         <div style="margin-bottom: 10px">
           <el-button type="primary" plain @click="handleAddDiagnosis()"> 新增诊断 </el-button>
-          <el-button type="primary" plain :loading="saveLoading" @click="handleSaveDiagnosis()"> 保存诊断 </el-button>
+          <el-button type="primary" plain @click="handleSaveDiagnosis()"> 保存诊断 </el-button>
           <!-- <el-button type="primary" plain @click="handleAddTcmDiagonsis()"> 中医诊断 </el-button> -->
           <el-button type="primary" plain @click="handleImport()"> 导入慢性病诊断 </el-button>
         </div>
@@ -169,7 +169,7 @@
 <script setup>
 import {getCurrentInstance} from 'vue'; // 添加 nextTick 导入
 import useUserStore from '@/store/modules/user';
-import { formatDateStr } from '@/utils/index';
+import { formatDateStr } from '@/utils';
 import {
   delEncounterDiagnosis,
   deleteDiagnosisBind,
@@ -191,7 +191,6 @@ import {ElMessage} from 'element-plus';
 // const diagnosisList = ref([]);
 const allowAdd = ref(false);
 const isSaving = ref(false);
-const saveLoading = ref(false);
 const tree = ref([]);
 const openDiagnosis = ref(false);
 const openAddDiagnosisDialog = ref(false);
@@ -288,10 +287,22 @@ function getList() {
         if (obj.diagSrtNo == null) {
           obj.diagSrtNo = '1';
         }
+        // 补充缺失的元数据字段
+        if (!obj.diagnosisDoctor) {
+          obj.diagnosisDoctor = props.patientInfo.practitionerName || props.patientInfo.doctorName || props.patientInfo.physicianName || userStore.name;
+        }
+        if (!obj.diagnosisTime) {
+          obj.diagnosisTime = item.diagnosisTime || getCurrentDate();
+        }
+        if (!obj.classification) {
+          obj.classification = item.typeName === '中医诊断' ? '中医' : '西医';
+        }
+        if (obj.longTermFlag == null) {
+          obj.longTermFlag = 0;
+        }
         return obj;
       });
       form.value.diagnosisList = datas;
-      // form.value.diagnosisList = res.data;
       emits('diagnosisSave', false);
     }
   });
@@ -307,13 +318,16 @@ function getList() {
             ybNo: item.ybNo,
             medTypeCode: item.medTypeCode,
             diagnosisDoctor: props.patientInfo.practitionerName || props.patientInfo.doctorName || props.patientInfo.physicianName || userStore.name,
-            diagnosisTime: formatDateStr(new Date(), 'YYYY/M/D HH:mm:ss')
+            diagnosisTime: item.diagnosisTime || getCurrentDate(),
+            diagSrtNo: item.diagSrtNo,
+            classification: '中医',
+            longTermFlag: item.longTermFlag || 0
           });
         });
-        
+
         // 将新数据添加到现有列表中
         form.value.diagnosisList.push(...newList);
-        
+
         // 重新排序整个列表
         form.value.diagnosisList.sort((a, b) => {
           const aNo = typeof a.diagSrtNo === 'number' ? a.diagSrtNo : 9999;
@@ -324,7 +338,7 @@ function getList() {
       emits('diagnosisSave', false);
     }
   });
-  
+
   getTree();
 }
 
@@ -341,11 +355,12 @@ function handleImport() {
   if (!props.patientInfo || !props.patientInfo.encounterId) {
     return;
   }
-  
+
   if (props.patientInfo.contractName != '自费') {
     // 获取患者慢性病信息
     getChronicDisease({ encounterId: props.patientInfo.encounterId }).then((res) => {
       if (res.data && res.data.length > 0) {
+        const currentDate = getCurrentDate();
         res.data.forEach((item, index) => {
           form.value.diagnosisList.push({
         ...item,
@@ -357,7 +372,10 @@ function handleImport() {
           iptDiseTypeCode: 2,
           diagnosisDesc: '',
           diagnosisDoctor: props.patientInfo.practitionerName || props.patientInfo.doctorName || props.patientInfo.physicianName || userStore.name,
-          diagnosisTime: formatDateStr(new Date(), 'YYYY/M/D HH:mm:ss'),
+          diagnosisTime: currentDate,
+          onsetDate: currentDate,
+          classification: '西医',
+          longTermFlag: 0,
           //添加 patientId
           patientId: props.patientInfo.patientId
         },
@@ -472,6 +490,7 @@ function handleAddDiagnosis() {
  * 添加诊断项
  */
 function addDiagnosisItem() {
+  const currentDate = getCurrentDate();
   form.value.diagnosisList.push({
     showPopover: false,
     name: undefined,
@@ -481,9 +500,10 @@ function addDiagnosisItem() {
     iptDiseTypeCode: 2,
     diagnosisDesc: '',
     diagnosisDoctor: props.patientInfo.practitionerName || props.patientInfo.doctorName || props.patientInfo.physicianName || userStore.name,
-    diagnosisTime: formatDateStr(new Date(), 'YYYY/M/D HH:mm:ss'),
-
-    // 新增这一行：为每个诊断项添加 patientId
+    diagnosisTime: currentDate,
+    classification: '西医',
+    onsetDate: currentDate,
+    longTermFlag: 0,
     patientId: props.patientInfo.patientId
   });
 
@@ -560,17 +580,7 @@ function handleMaindise(value, index) {
 /**
  * 保存诊断
  */
-/**
- * 保存诊断
- */
-/**
- * 保存诊断
- */
-/**
- * 保存诊断
- */
-function handleSaveDiagnosis() {
-  if (saveLoading.value) return;
+async function handleSaveDiagnosis() {
   for (let index = 0; index < (form.value.diagnosisList || []).length; index++) {
     const item = form.value.diagnosisList[index];
     if (!item.diagSrtNo) {
@@ -581,7 +591,7 @@ function handleSaveDiagnosis() {
       break;
     }
   }
-  proxy.$refs.formRef.validate((valid) => {
+  proxy.$refs.formRef.validate(async (valid) => {
     if (valid) {
       if (form.value.diagnosisList.length === 0) {
         proxy.$modal.msgWarning('诊断不能为空');
@@ -591,48 +601,54 @@ function handleSaveDiagnosis() {
         return;
       }
 
-      saveLoading.value = true;
       // 设置保存标志，避免触发watch监听器
       isSaving.value = true;
 
-      // 步骤1：深拷贝并按 diagSrtNo 排序
-      const sortedList = [...form.value.diagnosisList].sort((a, b) => {
-        const aNo = typeof a.diagSrtNo === 'number' ? a.diagSrtNo : 9999;
-        const bNo = typeof b.diagSrtNo === 'number' ? b.diagSrtNo : 9999;
-        return aNo - bNo;
-      });
+      try {
+        // 步骤1：深拷贝并按 diagSrtNo 排序
+        const sortedList = [...form.value.diagnosisList].sort((a, b) => {
+          const aNo = typeof a.diagSrtNo === 'number' ? a.diagSrtNo : 9999;
+          const bNo = typeof b.diagSrtNo === 'number' ? b.diagSrtNo : 9999;
+          return aNo - bNo;
+        });
 
-      // 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
-      });
+        // 步骤2：转换日期格式为后端期望的格式
+        const diagnosisChildList = sortedList.map(item => ({
+          ...item,
+          onsetDate: item.onsetDate ? formatDateStr(item.onsetDate, 'YYYY/M/D HH:mm:ss') : null,
+          diagnosisTime: item.diagnosisTime ? formatDateStr(item.diagnosisTime, 'YYYY/M/D HH:mm:ss') : null
+        }));
+
+        // 步骤3：提交排序后的数据
+        const res = await saveDiagnosis({
+          patientId: props.patientInfo.patientId,
+          encounterId: props.patientInfo.encounterId,
+          diagnosisChildList: diagnosisChildList,
+        });
 
-      // 步骤3：提交排序后的数据
-      saveDiagnosis({
-        patientId: props.patientInfo.patientId,
-        encounterId: props.patientInfo.encounterId,
-        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 }));
-
+          // 步骤4：从服务器刷新数据，确保获取最新的诊断信息（避免重复记录）
+          await getList();
+          getTree();
           emits('diagnosisSave', false);
           proxy.$modal.msgSuccess('诊断已保存');
 
           // 食源性疾病逻辑
           isFoodDiseasesNew({ encounterId: props.patientInfo.encounterId }).then((res2) => {
-            if (res2.code === 20 && res2.data) {
+            if (res2.code === 200 && res2.data) {
               window.open(res2.data, '_blank');
             }
           });
         }
-      }).finally(() => {
-        saveLoading.value = false;
+      } catch (error) {
+        console.error('保存诊断失败:', error);
+        const errorMsg = error?.response?.data?.msg || error?.message || '保存诊断失败，请稍后重试';
+        proxy.$modal.msgError(errorMsg);
+      } finally {
         setTimeout(() => {
           isSaving.value = false;
         }, 100);
-      });
+      }
     }
   });
 }
@@ -692,6 +708,7 @@ function handleNodeClick(data) {
     proxy.$modal.msgWarning('该诊断项已存在');
     return;
   }
+  const currentDate = getCurrentDate();
   form.value.diagnosisList.push({
     ybNo: data.ybNo,
     name: data.name,
@@ -699,9 +716,12 @@ function handleNodeClick(data) {
     medTypeCode: undefined,
     diagSrtNo: form.value.diagnosisList.length + 1,
     definitionId: data.definitionId,
+    classification: '西医',
+    onsetDate: currentDate,
     diagnosisDoctor: props.patientInfo.practitionerName || props.patientInfo.doctorName || props.patientInfo.physicianName || userStore.name,
-    diagnosisTime: formatDateStr(new Date(), 'YYYY/M/D HH:mm:ss'),
-    // 添加 patientId
+    diagnosisTime: currentDate,
+    longTermFlag: 0,
+    selectedDiseases: data.ybNo ? [data.ybNo] : [],
     patientId: props.patientInfo.patientId
   });
   if (form.value.diagnosisList.length == 1) {