diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/consultation/appservice/impl/ConsultationAppServiceImpl.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/consultation/appservice/impl/ConsultationAppServiceImpl.java
index 54007cda..15632f7a 100644
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/consultation/appservice/impl/ConsultationAppServiceImpl.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/consultation/appservice/impl/ConsultationAppServiceImpl.java
@@ -726,46 +726,65 @@ public class ConsultationAppServiceImpl implements IConsultationAppService {
                 dto.setInvitedList(invitedDtoList);
                 
                 
-                // 🎯 如果会诊已确认、已签名或已完成，填充会诊记录信息
+                // 🎯 如果会诊已确认、已签名或已完成，填充会诊记录信息（从会诊确认表中获取）
                 // 会诊状态：20=已确认，30=已签名，40=已完成
                 if (entity.getConsultationStatus() != null &&
                     entity.getConsultationStatus() >= ConsultationStatusEnum.CONFIRMED.getCode()) {
 
-                    // 查询所有已确认和已签名的医生（invited_status >= 20）
+                    // 查询会诊确认记录
+                    LambdaQueryWrapper<ConsultationConfirmation> confirmWrapper = new LambdaQueryWrapper<>();
+                    confirmWrapper.eq(ConsultationConfirmation::getConsultationRequestId, entity.getId());
+                    ConsultationConfirmation confirmation = consultationConfirmationMapper.selectOne(confirmWrapper);
+
+                    // 查询所有已确认和已签名的医生（invited_status >= 2）
                     List<ConsultationInvited> confirmedAndSignedPhysicians = invitedList.stream()
-                        .filter(inv -> inv.getInvitedStatus() != null && inv.getInvitedStatus() >= ConsultationStatusEnum.CONFIRMED.getCode())
+                        .filter(inv -> inv.getInvitedStatus() != null && inv.getInvitedStatus() >= 2)
                         .collect(Collectors.toList());
 
-                    // 查询所有已签名的医生（invited_status >= 30）
+                    // 查询所有已签名的医生（invited_status >= 3）
                     List<ConsultationInvited> signedPhysicians = invitedList.stream()
-                        .filter(inv -> inv.getInvitedStatus() != null && inv.getInvitedStatus() >= ConsultationStatusEnum.SIGNED.getCode())
+                        .filter(inv -> inv.getInvitedStatus() != null && inv.getInvitedStatus() >= 3)
                         .collect(Collectors.toList());
 
+                    if (confirmation != null) {
+                        // 1. 会诊确认参加医师：优先从确认表的confirming_physicians字段取值
+                        if (StringUtils.hasText(confirmation.getConfirmingPhysicians())) {
+                            dto.setInvitedPhysiciansText(confirmation.getConfirmingPhysicians());
+                        } else if (!confirmedAndSignedPhysicians.isEmpty()) {
+                            // 备用：从invitedList拼接
+                            String invitedPhysiciansText = confirmedAndSignedPhysicians.stream()
+                                .map(inv -> inv.getInvitedDepartmentName() + "-" + inv.getInvitedPhysicianName())
+                                .collect(Collectors.joining("、"));
+                            dto.setInvitedPhysiciansText(invitedPhysiciansText);
+                        }
+
+                        // 2. 会诊意见：优先从确认表取值
+                        if (StringUtils.hasText(confirmation.getConsultationOpinion())) {
+                            dto.setConsultationOpinion(confirmation.getConsultationOpinion());
+                        } else if (!confirmedAndSignedPhysicians.isEmpty()) {
+                            // 备用：从invitedList汇总
+                            String consultationOpinion = confirmedAndSignedPhysicians.stream()
+                                .filter(inv -> StringUtils.hasText(inv.getConfirmOpinion()))
+                                .map(ConsultationInvited::getConfirmOpinion)
+                                .collect(Collectors.joining("\n"));
+                            dto.setConsultationOpinion(consultationOpinion);
+                        }
+
+                        // 3. 签名医生、签名时间：从确认表取值
+                        dto.setSignPhysician(confirmation.getSignature());
+                        dto.setSignTime(confirmation.getSignatureDate());
+                    }
+
+                    // 4. 所属医生、代表科室：使用第一个确认的医生（向后兼容）
                     if (!confirmedAndSignedPhysicians.isEmpty()) {
-                        // 1. 会诊确认参加医师：拼接所有已确认和已签名医生的"科室 - 姓名"
-                        String invitedPhysiciansText = confirmedAndSignedPhysicians.stream()
-                            .map(inv -> inv.getInvitedDepartmentName() + "-" + inv.getInvitedPhysicianName())
-                            .collect(Collectors.joining("、"));
-                        dto.setInvitedPhysiciansText(invitedPhysiciansText);
-
-                        // 2. 会诊意见：汇总所有已确认医生的意见
-                        String consultationOpinion = confirmedAndSignedPhysicians.stream()
-                            .filter(inv -> StringUtils.hasText(inv.getConfirmOpinion()))
-                            .map(ConsultationInvited::getConfirmOpinion)
-                            .collect(Collectors.joining("\n"));
-                        dto.setConsultationOpinion(consultationOpinion);
-
-                        // 3. 所属医生、代表科室：使用第一个确认的医生
                         ConsultationInvited firstConfirmed = confirmedAndSignedPhysicians.get(0);
                         dto.setAttendingPhysician(firstConfirmed.getInvitedPhysicianName());
                         dto.setRepresentDepartment(firstConfirmed.getInvitedDepartmentName());
 
-                        // 4. 签名医生、签名时间：只有已签名医生才有
-                        if (!signedPhysicians.isEmpty()) {
-                            ConsultationInvited firstSigned = signedPhysicians.get(0);
-                            dto.setSignPhysician(firstSigned.getInvitedPhysicianName());
-                            dto.setSignTime(firstSigned.getSignatureTime());
-                        }
+                        log.info("填充会诊记录信息，已确认和已签名医生数：{}，已签名医生数：{}",
+                            confirmedAndSignedPhysicians.size(), signedPhysicians.size());
+                    }
+                }
 
                         log.info("填充会诊记录信息，已确认和已签名医生数：{}，已签名医生数：{}",
                             confirmedAndSignedPhysicians.size(), signedPhysicians.size());