diff --git a/healthlink-his-server/healthlink-his-application/src/main/java/com/healthlink/his/web/inhospitalnursestation/appservice/impl/AdviceProcessAppServiceImpl.java b/healthlink-his-server/healthlink-his-application/src/main/java/com/healthlink/his/web/inhospitalnursestation/appservice/impl/AdviceProcessAppServiceImpl.java
index 611c04fdc..55ec4c0df 100755
--- a/healthlink-his-server/healthlink-his-application/src/main/java/com/healthlink/his/web/inhospitalnursestation/appservice/impl/AdviceProcessAppServiceImpl.java
+++ b/healthlink-his-server/healthlink-his-application/src/main/java/com/healthlink/his/web/inhospitalnursestation/appservice/impl/AdviceProcessAppServiceImpl.java
@@ -655,6 +655,7 @@ public class AdviceProcessAppServiceImpl implements IAdviceProcessAppService {
      * @return 操作结果
      */
     @Override
+    @Transactional(rollbackFor = Exception.class)
     public R<?> adviceCancel(AdviceExecuteParam adviceExecuteParam) {
         // 获取当前执行时间
         Date exeDate = DateUtils.getNowDate();
@@ -701,6 +702,7 @@ public class AdviceProcessAppServiceImpl implements IAdviceProcessAppService {
                     longMedDispensedList.add(medicationDispense);
                 } else if (DispenseStatus.EXECUTED.getValue().equals(medicationDispense.getStatusEnum())
                         || DispenseStatus.SUBMITTED.getValue().equals(medicationDispense.getStatusEnum())) {
+                    longMedDispensedList.add(medicationDispense);
                     longMedUndispenseList.add(medicationDispense);
                 }
             }
@@ -729,6 +731,7 @@ public class AdviceProcessAppServiceImpl implements IAdviceProcessAppService {
                     tempMedDispensedList.add(medicationDispense);
                 } else if (DispenseStatus.EXECUTED.getValue().equals(medicationDispense.getStatusEnum())
                         || DispenseStatus.SUBMITTED.getValue().equals(medicationDispense.getStatusEnum())) {
+                    tempMedDispensedList.add(medicationDispense);
                     tempMedUndispenseList.add(medicationDispense);
                 }
             }
@@ -876,7 +879,7 @@ public class AdviceProcessAppServiceImpl implements IAdviceProcessAppService {
         if (!longMedUndispenseList.isEmpty()) {
             // 排除已汇总的药品
             List<MedicationDispense> medicationDispenseList
-                    = tempMedUndispenseList.stream().filter(x -> x.getSummaryNo() == null).toList();
+                    = longMedUndispenseList.stream().filter(x -> x.getSummaryNo() == null).toList();
             medicationDispenseService
                     .removeByIds(medicationDispenseList.stream().map(MedicationDispense::getId).toList());
         }
diff --git a/healthlink-his-server/healthlink-his-application/src/main/java/com/healthlink/his/web/pharmacymanage/appservice/impl/InHospitalReturnMedicineAppServiceImpl.java b/healthlink-his-server/healthlink-his-application/src/main/java/com/healthlink/his/web/pharmacymanage/appservice/impl/InHospitalReturnMedicineAppServiceImpl.java
index 3e2f8bc4f..ee62e19a2 100755
--- a/healthlink-his-server/healthlink-his-application/src/main/java/com/healthlink/his/web/pharmacymanage/appservice/impl/InHospitalReturnMedicineAppServiceImpl.java
+++ b/healthlink-his-server/healthlink-his-application/src/main/java/com/healthlink/his/web/pharmacymanage/appservice/impl/InHospitalReturnMedicineAppServiceImpl.java
@@ -13,6 +13,7 @@ import jakarta.servlet.http.HttpServletRequest;
 
 import org.apache.commons.lang3.tuple.Pair;
 import org.springframework.stereotype.Service;
+import org.springframework.transaction.annotation.Transactional;
 
 import com.fasterxml.jackson.databind.JsonNode;
 import com.fasterxml.jackson.databind.node.ArrayNode;
@@ -227,6 +228,7 @@ public class InHospitalReturnMedicineAppServiceImpl implements IInHospitalReturn
      * @return 处理结果
      */
     @Override
+    @Transactional(rollbackFor = Exception.class)
     public R<?> medicineReturn(List<ReturnMedicineDto> medicineReturnList) {
         if (medicineReturnList == null || medicineReturnList.isEmpty()) {
             return R.ok();
@@ -249,6 +251,10 @@ public class InHospitalReturnMedicineAppServiceImpl implements IInHospitalReturn
         // 进销存参数
         List<SupplyItemDetailDto> supplyItemDetailList = new ArrayList<>();
 
+        // 记录未发药（无库存变动）的发药单ID
+        Set<Long> noInventoryUpdateMedIds = new HashSet<>();
+        Set<Long> noInventoryUpdateDevIds = new HashSet<>();
+
         // 处理退药
         // 获取药品退药id列表
         List<Long> medReturnIdList = new ArrayList<>();
@@ -278,6 +284,14 @@ public class InHospitalReturnMedicineAppServiceImpl implements IInHospitalReturn
                 throw new ServiceException("药品已退药，请勿重复退药");
             }
 
+            // 在更新退药单状态前，统计出实际没有发药（已发药数量为0/空）的退药单，避免后续加回库存和报错
+            for (MedicationDispense medicationDispense : refundMedList) {
+                if (medicationDispense.getDispenseQuantity() == null 
+                        || medicationDispense.getDispenseQuantity().compareTo(BigDecimal.ZERO) == 0) {
+                    noInventoryUpdateMedIds.add(medicationDispense.getId());
+                }
+            }
+
             // 更新退药单
             for (MedicationDispense medicationDispense : refundMedList) {
                 // 退药状态
@@ -291,20 +305,22 @@ public class InHospitalReturnMedicineAppServiceImpl implements IInHospitalReturn
                 // 退药人
                 medicationDispense.setPractitionerId(SecurityUtils.getLoginUser().getPractitionerId());
 
-                // 设置库存变更参数
-                SupplyItemDetailDto supplyItemDetailDto = new SupplyItemDetailDto();
-                for (MedicationRequest medicationRequest : refundMedRequestList) {
-                    // 根据退药id查询退药请求id（用于医保关联）
-                    if (medicationDispense.getMedReqId().equals(medicationRequest.getId())) {
-                        supplyItemDetailDto.setRequestId(medicationRequest.getRefundMedicineId());
+                // 设置库存变更参数（仅针对实际发过药的药品）
+                if (!noInventoryUpdateMedIds.contains(medicationDispense.getId())) {
+                    SupplyItemDetailDto supplyItemDetailDto = new SupplyItemDetailDto();
+                    for (MedicationRequest medicationRequest : refundMedRequestList) {
+                        // 根据退药id查询退药请求id（用于医保关联）
+                        if (medicationDispense.getMedReqId().equals(medicationRequest.getId())) {
+                            supplyItemDetailDto.setRequestId(medicationRequest.getRefundMedicineId());
+                        }
                     }
+                    supplyItemDetailDto.setItemTable(CommonConstants.TableName.MED_MEDICATION_DEFINITION)
+                        .setItemId(medicationDispense.getMedicationId()).setLotNumber(medicationDispense.getLotNumber());
+                    supplyItemDetailList.add(supplyItemDetailDto);
                 }
-                supplyItemDetailDto.setItemTable(CommonConstants.TableName.MED_MEDICATION_DEFINITION)
-                    .setItemId(medicationDispense.getMedicationId()).setLotNumber(medicationDispense.getLotNumber());
-                supplyItemDetailList.add(supplyItemDetailDto);
 
-                // 追溯码表相关处理
-                if (medicationDispense.getTraceNo() != null) {
+                // 追溯码表相关处理（仅针对实际发过药的药品）
+                if (!noInventoryUpdateMedIds.contains(medicationDispense.getId()) && medicationDispense.getTraceNo() != null) {
                     // 使用逗号分割追溯码并转换为List
                     String[] traceNoList = medicationDispense.getTraceNo().split(CommonConstants.Common.COMMA);
                     for (String item : traceNoList) {
@@ -345,7 +361,7 @@ public class InHospitalReturnMedicineAppServiceImpl implements IInHospitalReturn
             devReturnIdList =
                 returnDeviceList.stream().map(ReturnMedicineDto::getDispenseId).collect(Collectors.toList());
             // 获取退耗材请求id列表
-            List<Long> devRequestIdList = returnDeviceList.stream().map(ReturnMedicineDto::getRequestId).toList();
+            List<Long> devRequestIdList = returnDeviceList.stream().map(ReturnMedicineDto::getRequestId).collect(Collectors.toList());
             if (devReturnIdList.isEmpty()) {
                 throw new ServiceException("请选择要退的耗材");
             }
@@ -362,6 +378,15 @@ public class InHospitalReturnMedicineAppServiceImpl implements IInHospitalReturn
                 .anyMatch(x -> x.equals(DispenseStatus.REFUNDED.getValue()))) {
                 throw new ServiceException("耗材已退，请勿重复操作");
             }
+            
+            // 在更新退耗材单状态前，统计出实际没有发放（已发放数量为0/空）的退耗材单
+            for (DeviceDispense deviceDispense : refundDevList) {
+                if (deviceDispense.getDispenseQuantity() == null 
+                        || deviceDispense.getDispenseQuantity().compareTo(BigDecimal.ZERO) == 0) {
+                    noInventoryUpdateDevIds.add(deviceDispense.getId());
+                }
+            }
+            
             // 更新退耗材单状态
             for (DeviceDispense deviceDispense : refundDevList) {
                 // 退药时间
@@ -370,40 +395,20 @@ public class InHospitalReturnMedicineAppServiceImpl implements IInHospitalReturn
                 deviceDispense.setDispenseQuantity(deviceDispense.getQuantity());
                 // 退药状态
                 deviceDispense.setStatusEnum(DispenseStatus.REFUNDED.getValue());
-                // 设置库存变更参数
-                supplyItemDetailList
-                    .add(new SupplyItemDetailDto().setItemTable(CommonConstants.TableName.ADM_DEVICE_DEFINITION)
-                        .setItemId(deviceDispense.getDeviceDefId()).setLotNumber(deviceDispense.getLotNumber()));
-                // // 使用逗号分割追溯码并转换为List
-                // String[] traceNoList = deviceDispense.getTraceNo().split(CommonConstants.Common.COMMA);
-                // for (String item : traceNoList) {
-                // traceNoManage = new TraceNoManage();
-                // // 追溯码处理
-                // traceNoManage.setItemTable(CommonConstants.TableName.ADM_DEVICE_DEFINITION)
-                // // 项目id
-                // .setItemId(deviceDispense.getDeviceDefId())
-                // // 仓库类型
-                // .setLocationTypeEnum(LocationForm.PHARMACY.getValue())
-                // // 仓库
-                // .setLocationId(deviceDispense.getLocationId())
-                // // 产品批号
-                // .setLotNumber(deviceDispense.getLotNumber())
-                // // 追溯码
-                // .setTraceNo(item)
-                // // 追溯码状态
-                // .setStatusEnum(TraceNoStatus.IN.getValue())
-                // // 追溯码单位
-                // .setUnitCode(deviceDispense.getUnitCode())
-                // // 操作类型
-                // .setOperationType(SupplyType.RETURN_MEDICATION.getValue());
-                // traceNoManageList.add(traceNoManage);
-                // }
+                // 设置库存变更参数（仅针对实际发放过的耗材）
+                if (!noInventoryUpdateDevIds.contains(deviceDispense.getId())) {
+                    supplyItemDetailList
+                        .add(new SupplyItemDetailDto().setItemTable(CommonConstants.TableName.ADM_DEVICE_DEFINITION)
+                            .setItemId(deviceDispense.getDeviceDefId()).setLotNumber(deviceDispense.getLotNumber()));
+                }
             }
             deviceDispenseService.updateBatchById(refundDevList);
         }
 
         // 追溯码管理表数据追加
-        traceNoManageService.saveBatch(traceNoManageList);
+        if (!traceNoManageList.isEmpty()) {
+            traceNoManageService.saveBatch(traceNoManageList);
+        }
 
         // 处理退库存
         // 获取库存信息
@@ -424,6 +429,11 @@ public class InHospitalReturnMedicineAppServiceImpl implements IInHospitalReturn
                     BigDecimal minQuantity = BigDecimal.ZERO;
 
                     for (UnDispenseInventoryDto unDispenseInventoryDto : inventoryList) {
+                        // 过滤未实际发药/发耗材的项目，其库存不加回
+                        if (noInventoryUpdateMedIds.contains(unDispenseInventoryDto.getDispenseId())
+                                || noInventoryUpdateDevIds.contains(unDispenseInventoryDto.getDispenseId())) {
+                            continue;
+                        }
                         BigDecimal quantity = unDispenseInventoryDto.getQuantity();
                         if (!unDispenseInventoryDto.getDispenseUnit()
                             .equals(unDispenseInventoryDto.getInventoryUnitCode())) {
@@ -433,14 +443,19 @@ public class InHospitalReturnMedicineAppServiceImpl implements IInHospitalReturn
                         }
                         minQuantity = minQuantity.add(quantity);
                     }
-                    // 理论上不出bug的情况下以项目id，批号，仓库进行分组处理库存一定唯一所以get(0)
-                    // 设置待更新的库存信息
-                    inventoryItemList.add(new InventoryItem().setId(inventoryList.get(0).getInventoryId())
-                        .setQuantity(inventoryList.get(0).getInventoryQuantity().add(minQuantity)));
+                    // 只有当有需要恢复库存的药品/器材时才加回库存
+                    if (minQuantity.compareTo(BigDecimal.ZERO) > 0) {
+                        // 理论上不出bug的情况下以项目id，批号，仓库进行分组处理库存一定唯一所以get(0)
+                        // 设置待更新的库存信息
+                        inventoryItemList.add(new InventoryItem().setId(inventoryList.get(0).getInventoryId())
+                            .setQuantity(inventoryList.get(0).getInventoryQuantity().add(minQuantity)));
+                    }
                 }
             }
             // 库存更新
-            iInventoryItemService.updateBatchById(inventoryItemList);
+            if (!inventoryItemList.isEmpty()) {
+                iInventoryItemService.updateBatchById(inventoryItemList);
+            }
         } else {
             throw new ServiceException("请检查库存信息");
         }
@@ -497,13 +512,26 @@ public class InHospitalReturnMedicineAppServiceImpl implements IInHospitalReturn
                     }
                 }
             }
-            uploadFailedNoList = this.ybReturnIntegrated(medReturnIdList, null);
-            uploadFailedNoList = receiptApprovalAppService.ybInventoryIntegrated(supplyItemDetailList,
-                YbInvChgType.OTHER_OUT, DateUtils.getNowDate(), true);
-            if (uploadFailedNoList != null) {
-                returnMsg = "3506商品销售退货上传错误，错误项目编码" + uploadFailedNoList;
-            } else {
-                returnMsg = "3506商品销售退货上传成功";
+
+            // 仅对实际发过药（生成了收费记录且计费的）调用医保退货接口
+            List<Long> medReturnIdsForYb = medReturnIdList.stream()
+                .filter(id -> !noInventoryUpdateMedIds.contains(id))
+                .collect(Collectors.toList());
+            if (!medReturnIdsForYb.isEmpty()) {
+                uploadFailedNoList = this.ybReturnIntegrated(medReturnIdsForYb, null);
+                if (uploadFailedNoList != null) {
+                    returnMsg = "3506商品销售退货上传错误，错误项目编码" + uploadFailedNoList;
+                } else {
+                    returnMsg = "3506商品销售退货上传成功";
+                }
+            }
+
+            if (!supplyItemDetailList.isEmpty()) {
+                uploadFailedNoList = receiptApprovalAppService.ybInventoryIntegrated(supplyItemDetailList,
+                    YbInvChgType.OTHER_OUT, DateUtils.getNowDate(), true);
+                if (uploadFailedNoList != null) {
+                    returnMsg = (returnMsg != null ? returnMsg + "；" : "") + "医保进销存集成上传错误: " + uploadFailedNoList;
+                }
             }
         }
         // 返回退药成功信息
diff --git a/healthlink-his-server/healthlink-his-application/src/main/resources/mapper/pharmacymanage/InHospitalReturnMedicineAppMapper.xml b/healthlink-his-server/healthlink-his-application/src/main/resources/mapper/pharmacymanage/InHospitalReturnMedicineAppMapper.xml
index fc584ca84..4889a0762 100755
--- a/healthlink-his-server/healthlink-his-application/src/main/resources/mapper/pharmacymanage/InHospitalReturnMedicineAppMapper.xml
+++ b/healthlink-his-server/healthlink-his-application/src/main/resources/mapper/pharmacymanage/InHospitalReturnMedicineAppMapper.xml
@@ -2,11 +2,11 @@
 <!DOCTYPE mapper PUBLIC "-//mybatis.org//DTD Mapper 3.0//EN" "http://mybatis.org/dtd/mybatis-3-mapper.dtd">
 <mapper namespace="com.healthlink.his.web.pharmacymanage.mapper.InHospitalReturnMedicineAppMapper">
     <select id="selectEncounterInfoListPage" resultType="com.healthlink.his.web.pharmacymanage.dto.EncounterInfoDto">
-        SELECT ii.reception_time,
-               ii.start_time,
+        SELECT MAX(ii.reception_time) AS reception_time,
+               MAX(ii.start_time)     AS start_time,
                ii.encounter_id,
                ii.encounter_no,
-               ii.refund_enum,
+               MAX(ii.refund_enum)    AS refund_enum,
                ii.patient_name,
                ii.patient_wb_str,
                ii.patient_py_str,
@@ -15,11 +15,11 @@
                ii.birth_date,
                ii.department_name
         FROM (
-                 SELECT ae.reception_time,
+                 SELECT mmd.create_time AS reception_time,
                         ae.id           AS encounter_id,
                         ae.bus_no       AS encounter_no,
                         ae.tenant_id,
-                        ae.start_time,
+                        mmd.create_time AS start_time,
                         ae.class_enum,
                         mmd.status_enum AS refund_enum,
                         ap."name"       AS patient_name,
@@ -52,11 +52,11 @@
                         AND mmd.status_enum = #{refundStatus}
                     </if>
                  UNION
-                 SELECT ae.reception_time,
+                 SELECT wdd.create_time AS reception_time,
                         ae.id           AS encounter_id,
                         ae.bus_no       AS encounter_no,
                         ae.tenant_id,
-                        ae.start_time,
+                        wdd.create_time AS start_time,
                         ae.class_enum,
                         wdd.status_enum AS refund_enum,
                         ap."name"       AS patient_name,
@@ -90,7 +90,16 @@
                     </if>
              ) AS ii
             ${ew.customSqlSegment}
-        ORDER BY ii.reception_time DESC
+         GROUP BY ii.encounter_id,
+                  ii.encounter_no,
+                  ii.patient_name,
+                  ii.patient_wb_str,
+                  ii.patient_py_str,
+                  ii.id_card,
+                  ii.gender_enum,
+                  ii.birth_date,
+                  ii.department_name
+         ORDER BY reception_time DESC
     </select>
     <select id="selectReturnMedicineInfo"
             resultType="com.healthlink.his.web.pharmacymanage.dto.ReturnMedicineInfoDto">
diff --git a/healthlink-his-ui/src/patches/patch-deps-plugin.js b/healthlink-his-ui/src/patches/patch-deps-plugin.js
index 026032a5e..bebbc46f5 100644
--- a/healthlink-his-ui/src/patches/patch-deps-plugin.js
+++ b/healthlink-his-ui/src/patches/patch-deps-plugin.js
@@ -172,13 +172,13 @@ function getPatchedVxeTable() {
   // 修补 cell-click：在 dispatchEvent 前注入参数归一化
   code = code.replace(
     "dispatchEvent('cell-click', params, evnt);",
-    `params.row = params; params.column = params.column; dispatchEvent('cell-click', params, evnt);`
+    `var _orgRow = params.row; Object.assign(params, _orgRow); params.row = _orgRow; dispatchEvent('cell-click', params, evnt);`
   )
 
   // 修补 current-change：在 dispatchEvent 前注入参数归一化
   code = code.replace(
     "dispatchEvent('current-change', Object.assign({ oldValue, newValue }, params), evnt);",
-    `var _ccp = Object.assign({ oldValue, newValue }, params); _ccp.newValue = _ccp; _ccp.oldValue = oldValue; dispatchEvent('current-change', _ccp, evnt);`
+    `var _ccp = Object.assign({ oldValue, newValue }, params); Object.assign(_ccp, newValue); _ccp.newValue = newValue; _ccp.oldValue = oldValue; dispatchEvent('current-change', _ccp, evnt);`
   )
 
   cachedVxeTable = code
diff --git a/healthlink-his-ui/src/views/clinicmanagement/returnDrug/index.vue b/healthlink-his-ui/src/views/clinicmanagement/returnDrug/index.vue
index 7157cf25b..321651162 100755
--- a/healthlink-his-ui/src/views/clinicmanagement/returnDrug/index.vue
+++ b/healthlink-his-ui/src/views/clinicmanagement/returnDrug/index.vue
@@ -52,40 +52,43 @@
           搜索
         </el-button>
       </div>
-      <vxe-table
-:row-config="{ isCurrent: true }"         :data="encounterList"
-        border
-        style="width: 100%"
-        height="calc(100vh - 300px)"
-        @cell-click="handleGetReturnDrugList"
-      >
-        <vxe-column
-          field="patientName"
-          align="center"
-          title="姓名"
-          width="130"
-          show-overflow
-        />
-        <vxe-column
-          field="genderEnum_enumText"
-          align="center"
-          title="性别"
-          show-overflow
-        />
-        <vxe-column
-          align="center"
-          width="140"
-          title="就诊日期"
-          show-overflow
+      <div style="flex: 1; overflow: hidden; margin-top: 10px;">
+        <vxe-table
+          :row-config="{ isCurrent: true }"
+          :data="encounterList"
+          border
+          style="width: 100%"
+          height="100%"
+          @cell-click="handleGetReturnDrugList"
         >
-          <template #default="scope">
-            {{
-              scope.row.receptionTime ? formatDateStr(scope.row.receptionTime, 'YYYY-MM-DD') : '-'
-            }}
-          </template>
-        </vxe-column>
-        <!-- <vxe-column title="状态" align="center" field="refundEnum_enumText" /> -->
-      </vxe-table>
+          <vxe-column
+            field="patientName"
+            align="center"
+            title="姓名"
+            width="130"
+            show-overflow
+          />
+          <vxe-column
+            field="genderEnum_enumText"
+            align="center"
+            title="性别"
+            show-overflow
+          />
+          <vxe-column
+            align="center"
+            width="140"
+            title="就诊日期"
+            show-overflow
+          >
+            <template #default="scope">
+              {{
+                scope.row.receptionTime ? formatDateStr(scope.row.receptionTime, 'YYYY-MM-DD') : '-'
+              }}
+            </template>
+          </vxe-column>
+          <!-- <vxe-column title="状态" align="center" field="refundEnum_enumText" /> -->
+        </vxe-table>
+      </div>
     </el-card>
 
     <!-- 右侧退药列表 -->
@@ -100,130 +103,132 @@
         </div>
       </template>
 
-      <el-button
-        type="primary"
-        :disabled="!selectedMedicines.length"
-        style="margin-bottom: 10px"
-        @click="handleReturnDrug(undefined)"
-      >
-        确认退药
-      </el-button>
-      <el-button
-        type="primary"
-        style="margin-bottom: 10px"
-        @click="handleScan()"
-      >
-        扫码
-      </el-button>
-      <vxe-table
-        ref="returnDrugRef"
-        :data="returDrugList"
-        style="width: 100%"
-        height="calc(100vh - 300px)"
-        border
-        :span-method="handelSpanMethod"
-        class="no-hover-table"
-        @select="handleSelection"
-        @checkbox-change="handelSelectRows"
-      >
-        <vxe-column
-          type="checkbox"
-          width="55"
-          align="center"
-        />
-        <vxe-column
-          field="itemName"
-          title="药品名称"
-          show-overflow
-          align="center"
-        />
-        <vxe-column
-          field="totalPrice"
-          title="总价"
-          width="100"
-          align="right"
-          header-align="center"
+      <div style="display: flex; gap: 10px; margin-bottom: 10px;">
+        <el-button
+          type="primary"
+          :disabled="!selectedMedicines.length"
+          @click="handleReturnDrug(undefined)"
         >
-          <template #default="scope">
-            {{ scope.row.totalPrice ? scope.row.totalPrice.toFixed(2) + ' 元' : '-' }}
-          </template>
-        </vxe-column>
-        <vxe-column
-          field="lotNumber"
-          title="批号"
-          width="180"
-          align="center"
-        />
-        <vxe-column
-          field="traceNo"
-          title="追溯码"
-          width="180"
-          align="center"
+          确认退药
+        </el-button>
+        <el-button
+          type="primary"
+          @click="handleScan()"
         >
-          <template #default="scope">
-            <el-input
-              v-model="scope.row.traceNo"
-              placeholder="请输入追溯码"
-            />
-          </template>
-        </vxe-column>
-        <vxe-column
-          field="reqStatus_enumText"
-          title="退药状态"
-          width="100"
-          align="center"
+          扫码
+        </el-button>
+      </div>
+      <div style="flex: 1; overflow: hidden; margin-bottom: 10px;">
+        <vxe-table
+          ref="returnDrugRef"
+          :data="returDrugList"
+          style="width: 100%"
+          height="100%"
+          border
+          :span-method="handelSpanMethod"
+          class="no-hover-table"
+          @checkbox-all="handelSelectRows"
+          @checkbox-change="handelSelectRows"
         >
-          <template #default="scope">
-            {{ scope.row.refundEnum_enumText }}
-          </template>
-        </vxe-column>
-        <vxe-column
-          field="waitingQuantity"
-          title="退药数量"
-          width="100"
-          align="center"
-        >
-          <template #default="scope">
-            <span>{{
-              scope.row.quantity
-                ? Math.abs(scope.row.quantity) + ' ' + scope.row.unitCode_dictText
-                : '0' + ' ' + scope.row.unitCode_dictText
-            }}</span>
-          </template>
-        </vxe-column>
-        <vxe-column
-          field="doctorName"
-          title="开单医生"
-          align="center"
-          width="180"
-        />
-        <vxe-column
-          title="操作"
-          width="100"
-          align="center"
-          fixed="right"
-        >
-          <template #default="scope">
-            <el-popconfirm
-              width="150"
-              hide-after="10"
-              title="操作确认"
-              placement="top-start"
-              @confirm="handleReturnDrug(scope.row)"
-            >
-              <template #reference>
-                <el-button
-                  type="primary"
-                  link
-                  :disabled="scope.row.refundEnum != 16"
-                >
-                  退药
-                </el-button>
-              </template>
-            </el-popconfirm>
-          </template>
-        </vxe-column>
-      </vxe-table>
+          <vxe-column
+            type="checkbox"
+            width="55"
+            align="center"
+          />
+          <vxe-column
+            field="itemName"
+            title="药品名称"
+            show-overflow
+            align="center"
+          />
+          <vxe-column
+            field="totalPrice"
+            title="总价"
+            width="100"
+            align="right"
+            header-align="center"
+          >
+            <template #default="scope">
+              {{ scope.row.totalPrice ? scope.row.totalPrice.toFixed(2) + ' 元' : '-' }}
+            </template>
+          </vxe-column>
+          <vxe-column
+            field="lotNumber"
+            title="批号"
+            width="180"
+            align="center"
+          />
+          <vxe-column
+            field="traceNo"
+            title="追溯码"
+            width="180"
+            align="center"
+          >
+            <template #default="scope">
+              <el-input
+                v-model="scope.row.traceNo"
+                placeholder="请输入追溯码"
+              />
+            </template>
+          </vxe-column>
+          <vxe-column
+            field="reqStatus_enumText"
+            title="退药状态"
+            width="100"
+            align="center"
+          >
+            <template #default="scope">
+              {{ scope.row.refundEnum_enumText }}
+            </template>
+          </vxe-column>
+          <vxe-column
+            field="waitingQuantity"
+            title="退药数量"
+            width="100"
+            align="center"
+          >
+            <template #default="scope">
+              <span>{{
+                scope.row.quantity
+                  ? Math.abs(scope.row.quantity) + ' ' + scope.row.unitCode_dictText
+                  : '0' + ' ' + scope.row.unitCode_dictText
+              }}</span>
+            </template>
+          </vxe-column>
+          <vxe-column
+            field="doctorName"
+            title="开单医生"
+            align="center"
+            width="180"
+          />
+          <vxe-column
+            title="操作"
+            width="100"
+            align="center"
+            fixed="right"
+          >
+            <template #default="scope">
+              <el-popconfirm
+                width="150"
+                hide-after="10"
+                title="操作确认"
+                placement="top-start"
+                @confirm="handleReturnDrug(scope.row)"
+              >
+                <template #reference>
+                  <el-button
+                    type="primary"
+                    link
+                    :disabled="scope.row.refundEnum != 16"
+                  >
+                    退药
+                  </el-button>
+                </template>
+              </el-popconfirm>
+            </template>
+          </vxe-column>
+        </vxe-table>
+      </div>
 
       <!-- 底部操作栏 -->
       <div class="footer">
@@ -288,7 +293,7 @@ function initOptions() {
   });
 }
 
-function handleGetReturnDrugList(row) {
+function handleGetReturnDrugList({ row }) {
   encounterId.value = row.encounterId;
   getReturnDrugList({
     encounterId: row.encounterId,
@@ -363,7 +368,7 @@ function handleReturnDrug(row) {
         };
       });
   } else {
-    saveList = proxy.$refs.returnDrugRef.getSelectionRows().map((item) => {
+    saveList = proxy.$refs.returnDrugRef.getCheckboxRecords().map((item) => {
       return {
         requestId: item.requestId,
         dispenseId: item.dispenseId,
@@ -387,31 +392,22 @@ function handleReturnDrug(row) {
   });
 }
 
-// 选择框改变时的处理
-function handleSelection(selection, row) {
-  const isSelected = selection.some((item) => item.dispenseId === row.dispenseId);
-  returDrugList.value
-    .filter((item) => {
-      return item.requestId == row.requestId;
-    })
-    .forEach((row) => {
-      proxy.$refs['returnDrugRef'].toggleCheckboxRow(row, isSelected);
-    });
+function handelSelectRows({ checked, row }) {
+  if (row) {
+    returDrugList.value
+      .filter((item) => item.requestId == row.requestId)
+      .forEach((r) => {
+        proxy.$refs['returnDrugRef'].setCheckboxRow(r, checked);
+      });
+  }
   nextTick(() => {
-    selectedMedicines.value = proxy.$refs['returnDrugRef'].getSelectionRows();
+    selectedMedicines.value = proxy.$refs['returnDrugRef'].getCheckboxRecords();
     totalAmount.value = selectedMedicines.value.reduce((accumulator, currentRow) => {
       return accumulator + (currentRow.totalPrice || 0);
     }, 0);
   });
 }
 
-function handelSelectRows(selection) {
-  selectedMedicines.value = selection;
-  totalAmount.value = selectedMedicines.value.reduce((accumulator, currentRow) => {
-    return accumulator + (currentRow.totalPrice || 0);
-  }, 0);
-}
-
 // 根据 requestId 合并相同行的方法（只合并药品名称和总价列）
 function handelSpanMethod({ row, column, rowIndex, columnIndex }) {
   // 定义需要合并的列索引
@@ -465,7 +461,7 @@ function handelSpanMethod({ row, column, rowIndex, columnIndex }) {
 <style lang="scss" scoped>
 .container {
   display: flex;
-  height: 90vh;
+  height: calc(100vh - 150px);
   gap: 16px;
   padding: 16px;
   background: #f0f2f5;
@@ -474,10 +470,24 @@ function handelSpanMethod({ row, column, rowIndex, columnIndex }) {
 .patient-list {
   width: 600px;
   flex-shrink: 0;
+  height: 100%;
+  display: flex;
+  flex-direction: column;
 }
 
 .refund-list {
   flex: 1;
+  height: 100%;
+  display: flex;
+  flex-direction: column;
+}
+
+:deep(.el-card__body) {
+  flex: 1;
+  display: flex;
+  flex-direction: column;
+  overflow: hidden;
+  padding: 16px;
 }
 
 .patient-item {
diff --git a/healthlink-his-ui/src/views/doctorstation/components/surgery/surgeryApplication.vue b/healthlink-his-ui/src/views/doctorstation/components/surgery/surgeryApplication.vue
index 8d67c3208..c726cae48 100755
--- a/healthlink-his-ui/src/views/doctorstation/components/surgery/surgeryApplication.vue
+++ b/healthlink-his-ui/src/views/doctorstation/components/surgery/surgeryApplication.vue
@@ -1,4 +1,4 @@
-<!--
+<!--
  * @Description: 门诊手术申请
 -->
 <template>
@@ -339,9 +339,11 @@
               <el-select
                 v-model="form.surgeryName"
                 filterable
+                remote
                 reserve-keyword
                 placeholder="请输入关键词搜索手术"
-                :filter-method="filterSurgery"
+                :remote-method="remoteSearchSurgery"
+                :loading="surgeryLoading"
                 style="width: 100%"
                 @change="handleSurgeryChange"
               >
@@ -414,9 +416,11 @@
                   <el-select
                     v-model="scope.row.surgeryName"
                     filterable
+                    remote
                     reserve-keyword
                     placeholder="搜索次要手术"
-                    :filter-method="filterSurgery"
+                    :remote-method="remoteSearchSurgery"
+                    :loading="surgeryLoading"
                     style="width: 100%"
                     @change="(val) => handleSecondarySurgeryChange(val, scope.row)"
                   >
@@ -1344,6 +1348,8 @@ function remoteSearchSurgery(query) {
 function doSearchSurgery(query) {
   surgeryLoading.value = true
   getDiagnosisTreatmentList({
+    categoryCode: '24',
+    statusEnum: 2,
     searchKey: query || '',
     pageNo: 1,
     pageSize: 100
@@ -1438,10 +1444,13 @@ function filterAnesthesia(query) {
 
 // 加载手术和麻醉全量数据供本地过滤
 function loadSurgeryAndAnesthesiaOptions() {
+  // 1. 初始加载前 100 个启用状态的手术项目，供下拉菜单默认展示，避免全量加载 10,102 条数据导致卡顿
   getDiagnosisTreatmentList({
+    categoryCode: '24',
+    statusEnum: 2,
     searchKey: '',
     pageNo: 1,
-    pageSize: 1000
+    pageSize: 100
   }).then(res => {
     let data = []
     if (res.data && res.data.records) {
@@ -1455,14 +1464,34 @@ function loadSurgeryAndAnesthesiaOptions() {
       (item.categoryCode === '24' || item.categoryCode_dictText === '手术') &&
       (item.statusEnum === 2 || item.statusEnum_enumText === '启用' || !item.statusEnum)
     )
+    surgeryNameList.value = allSurgeryItems.value
+  }).catch(error => {
+    console.error('加载手术选项失败:', error)
+  })
+
+  // 2. 加载全部启用状态的麻醉项目（麻醉数量较少，可以直接加载全部）
+  getDiagnosisTreatmentList({
+    categoryCode: '25',
+    statusEnum: 2,
+    searchKey: '',
+    pageNo: 1,
+    pageSize: 200
+  }).then(res => {
+    let data = []
+    if (res.data && res.data.records) {
+      data = res.data.records
+    } else if (res.data && Array.isArray(res.data)) {
+      data = res.data
+    } else if (res.records && Array.isArray(res.records)) {
+      data = res.records
+    }
     allAnesthesiaItems.value = data.filter(item =>
       (item.categoryCode === '25' || item.categoryCode_dictText === '麻醉') &&
       (item.statusEnum === 2 || item.statusEnum_enumText === '启用' || !item.statusEnum)
     )
-    surgeryNameList.value = allSurgeryItems.value
     anesthesiaNameList.value = allAnesthesiaItems.value
   }).catch(error => {
-    console.error('加载手术/麻醉选项失败:', error)
+    console.error('加载麻醉选项失败:', error)
   })
 }
 
@@ -1664,6 +1693,8 @@ function reset() {
   if (surgeryRef.value) {
     surgeryRef.value.resetFields()
   }
+  surgeryNameList.value = allSurgeryItems.value
+  anesthesiaNameList.value = allAnesthesiaItems.value
 }
 
 // 获取状态标签类型
diff --git a/healthlink-his-ui/src/views/drug/inpatientMedicationDispensing/components/ReturnDrug.vue b/healthlink-his-ui/src/views/drug/inpatientMedicationDispensing/components/ReturnDrug.vue
index 843ace9de..697f054a8 100755
--- a/healthlink-his-ui/src/views/drug/inpatientMedicationDispensing/components/ReturnDrug.vue
+++ b/healthlink-his-ui/src/views/drug/inpatientMedicationDispensing/components/ReturnDrug.vue
@@ -52,40 +52,43 @@
           搜索
         </el-button>
       </div>
-      <vxe-table
-:row-config="{ isCurrent: true }"         :data="encounterList"
-        border
-        style="width: 100%"
-        height="calc(100vh - 300px)"
-        @cell-click="handleGetReturnDrugList"
-      >
-        <vxe-column
-          field="patientName"
-          align="center"
-          title="姓名"
-          width="130"
-          show-overflow
-        />
-        <vxe-column
-          field="genderEnum_enumText"
-          align="center"
-          title="性别"
-          show-overflow
-        />
-        <vxe-column
-          align="center"
-          width="140"
-          title="就诊日期"
-          show-overflow
+      <div style="flex: 1; overflow: hidden; margin-top: 10px;">
+        <vxe-table
+          :row-config="{ isCurrent: true }"
+          :data="encounterList"
+          border
+          style="width: 100%"
+          height="100%"
+          @cell-click="handleGetReturnDrugList"
         >
-          <template #default="scope">
-            {{
-              scope.row.receptionTime ? formatDateStr(scope.row.receptionTime, 'YYYY-MM-DD') : '-'
-            }}
-          </template>
-        </vxe-column>
-        <!-- <vxe-column title="状态" align="center" field="refundEnum_enumText" /> -->
-      </vxe-table>
+          <vxe-column
+            field="patientName"
+            align="center"
+            title="姓名"
+            width="130"
+            show-overflow
+          />
+          <vxe-column
+            field="genderEnum_enumText"
+            align="center"
+            title="性别"
+            show-overflow
+          />
+          <vxe-column
+            align="center"
+            width="140"
+            title="就诊日期"
+            show-overflow
+          >
+            <template #default="scope">
+              {{
+                scope.row.receptionTime ? formatDateStr(scope.row.receptionTime, 'YYYY-MM-DD') : '-'
+              }}
+            </template>
+          </vxe-column>
+          <!-- <vxe-column title="状态" align="center" field="refundEnum_enumText" /> -->
+        </vxe-table>
+      </div>
     </el-card>
 
     <!-- 右侧退药列表 -->
@@ -100,130 +103,132 @@
         </div>
       </template>
 
-      <el-button
-        type="primary"
-        :disabled="!selectedMedicines.length"
-        style="margin-bottom: 10px"
-        @click="handleReturnDrug(undefined)"
-      >
-        确认退药
-      </el-button>
-      <el-button
-        type="primary"
-        style="margin-bottom: 10px"
-        @click="handleScan()"
-      >
-        扫码
-      </el-button>
-      <vxe-table
-        ref="returnDrugRef"
-        :data="returDrugList"
-        style="width: 100%"
-        height="calc(100vh - 300px)"
-        border
-        :span-method="handelSpanMethod"
-        class="no-hover-table"
-        @select="handleSelection"
-        @checkbox-change="handelSelectRows"
-      >
-        <vxe-column
-          type="checkbox"
-          width="55"
-          align="center"
-        />
-        <vxe-column
-          field="itemName"
-          title="药品名称"
-          show-overflow
-          align="center"
-        />
-        <vxe-column
-          field="totalPrice"
-          title="总价"
-          width="100"
-          align="right"
-          header-align="center"
+      <div style="display: flex; gap: 10px; margin-bottom: 10px;">
+        <el-button
+          type="primary"
+          :disabled="!selectedMedicines.length"
+          @click="handleReturnDrug(undefined)"
         >
-          <template #default="scope">
-            {{ scope.row.totalPrice ? scope.row.totalPrice.toFixed(2) + ' 元' : '-' }}
-          </template>
-        </vxe-column>
-        <vxe-column
-          field="lotNumber"
-          title="批号"
-          width="180"
-          align="center"
-        />
-        <vxe-column
-          field="traceNo"
-          title="追溯码"
-          width="180"
-          align="center"
+          确认退药
+        </el-button>
+        <el-button
+          type="primary"
+          @click="handleScan()"
         >
-          <template #default="scope">
-            <el-input
-              v-model="scope.row.traceNo"
-              placeholder="请输入追溯码"
-            />
-          </template>
-        </vxe-column>
-        <vxe-column
-          field="reqStatus_enumText"
-          title="退药状态"
-          width="100"
-          align="center"
+          扫码
+        </el-button>
+      </div>
+      <div style="flex: 1; overflow: hidden; margin-bottom: 10px;">
+        <vxe-table
+          ref="returnDrugRef"
+          :data="returDrugList"
+          style="width: 100%"
+          height="100%"
+          border
+          :span-method="handelSpanMethod"
+          class="no-hover-table"
+          @checkbox-all="handelSelectRows"
+          @checkbox-change="handelSelectRows"
         >
-          <template #default="scope">
-            {{ scope.row.refundEnum_enumText }}
-          </template>
-        </vxe-column>
-        <vxe-column
-          field="waitingQuantity"
-          title="退药数量"
-          width="100"
-          align="center"
-        >
-          <template #default="scope">
-            <span>{{
-              scope.row.quantity
-                ? Math.abs(scope.row.quantity) + ' ' + scope.row.unitCode_dictText
-                : '0' + ' ' + scope.row.unitCode_dictText
-            }}</span>
-          </template>
-        </vxe-column>
-        <vxe-column
-          field="doctorName"
-          title="开单医生"
-          align="center"
-          width="180"
-        />
-        <vxe-column
-          title="操作"
-          width="100"
-          align="center"
-          fixed="right"
-        >
-          <template #default="scope">
-            <el-popconfirm
-              width="150"
-              hide-after="10"
-              title="操作确认"
-              placement="top-start"
-              @confirm="handleReturnDrug(scope.row)"
-            >
-              <template #reference>
-                <el-button
-                  type="primary"
-                  link
-                  :disabled="scope.row.refundEnum != 16"
-                >
-                  退药
-                </el-button>
-              </template>
-            </el-popconfirm>
-          </template>
-        </vxe-column>
-      </vxe-table>
+          <vxe-column
+            type="checkbox"
+            width="55"
+            align="center"
+          />
+          <vxe-column
+            field="itemName"
+            title="药品名称"
+            show-overflow
+            align="center"
+          />
+          <vxe-column
+            field="totalPrice"
+            title="总价"
+            width="100"
+            align="right"
+            header-align="center"
+          >
+            <template #default="scope">
+              {{ scope.row.totalPrice ? scope.row.totalPrice.toFixed(2) + ' 元' : '-' }}
+            </template>
+          </vxe-column>
+          <vxe-column
+            field="lotNumber"
+            title="批号"
+            width="180"
+            align="center"
+          />
+          <vxe-column
+            field="traceNo"
+            title="追溯码"
+            width="180"
+            align="center"
+          >
+            <template #default="scope">
+              <el-input
+                v-model="scope.row.traceNo"
+                placeholder="请输入追溯码"
+              />
+            </template>
+          </vxe-column>
+          <vxe-column
+            field="reqStatus_enumText"
+            title="退药状态"
+            width="100"
+            align="center"
+          >
+            <template #default="scope">
+              {{ scope.row.refundEnum_enumText }}
+            </template>
+          </vxe-column>
+          <vxe-column
+            field="waitingQuantity"
+            title="退药数量"
+            width="100"
+            align="center"
+          >
+            <template #default="scope">
+              <span>{{
+                scope.row.quantity
+                  ? Math.abs(scope.row.quantity) + ' ' + scope.row.unitCode_dictText
+                  : '0' + ' ' + scope.row.unitCode_dictText
+              }}</span>
+            </template>
+          </vxe-column>
+          <vxe-column
+            field="doctorName"
+            title="开单医生"
+            align="center"
+            width="180"
+          />
+          <vxe-column
+            title="操作"
+            width="100"
+            align="center"
+            fixed="right"
+          >
+            <template #default="scope">
+              <el-popconfirm
+                width="150"
+                hide-after="10"
+                title="操作确认"
+                placement="top-start"
+                @confirm="handleReturnDrug(scope.row)"
+              >
+                <template #reference>
+                  <el-button
+                    type="primary"
+                    link
+                    :disabled="scope.row.refundEnum != 16"
+                  >
+                    退药
+                  </el-button>
+                </template>
+              </el-popconfirm>
+            </template>
+          </vxe-column>
+        </vxe-table>
+      </div>
 
       <!-- 底部操作栏 -->
       <div class="footer">
@@ -289,7 +294,7 @@ function initOptions() {
   });
 }
 
-function handleGetReturnDrugList(row) {
+function handleGetReturnDrugList({ row }) {
   encounterId.value = row.encounterId;
   getReturnDrugList({
     encounterId: row.encounterId,
@@ -364,7 +369,7 @@ function handleReturnDrug(row) {
         };
       });
   } else {
-    saveList = proxy.$refs.returnDrugRef.getSelectionRows().map((item) => {
+    saveList = proxy.$refs.returnDrugRef.getCheckboxRecords().map((item) => {
       return {
         requestId: item.requestId,
         dispenseId: item.dispenseId,
@@ -388,31 +393,22 @@ function handleReturnDrug(row) {
   });
 }
 
-// 选择框改变时的处理
-function handleSelection(selection, row) {
-  const isSelected = selection.some((item) => item.dispenseId === row.dispenseId);
-  returDrugList.value
-    .filter((item) => {
-      return item.requestId == row.requestId;
-    })
-    .forEach((row) => {
-      proxy.$refs['returnDrugRef'].toggleCheckboxRow(row, isSelected);
-    });
+function handelSelectRows({ checked, row }) {
+  if (row) {
+    returDrugList.value
+      .filter((item) => item.requestId == row.requestId)
+      .forEach((r) => {
+        proxy.$refs['returnDrugRef'].setCheckboxRow(r, checked);
+      });
+  }
   nextTick(() => {
-    selectedMedicines.value = proxy.$refs['returnDrugRef'].getSelectionRows();
+    selectedMedicines.value = proxy.$refs['returnDrugRef'].getCheckboxRecords();
     totalAmount.value = selectedMedicines.value.reduce((accumulator, currentRow) => {
       return accumulator + (currentRow.totalPrice || 0);
     }, 0);
   });
 }
 
-function handelSelectRows(selection) {
-  selectedMedicines.value = selection;
-  totalAmount.value = selectedMedicines.value.reduce((accumulator, currentRow) => {
-    return accumulator + (currentRow.totalPrice || 0);
-  }, 0);
-}
-
 // 根据 requestId 合并相同行的方法（只合并药品名称和总价列）
 function handelSpanMethod({ row, column, rowIndex, columnIndex }) {
   // 定义需要合并的列索引
@@ -466,17 +462,31 @@ function handelSpanMethod({ row, column, rowIndex, columnIndex }) {
 <style lang="scss" scoped>
 .container {
   display: flex;
-  height: 80vh;
+  height: calc(100vh - 150px);
   gap: 16px;
 }
 
 .patient-list {
   width: 600px;
   flex-shrink: 0;
+  height: 100%;
+  display: flex;
+  flex-direction: column;
 }
 
 .refund-list {
   flex: 1;
+  height: 100%;
+  display: flex;
+  flex-direction: column;
+}
+
+:deep(.el-card__body) {
+  flex: 1;
+  display: flex;
+  flex-direction: column;
+  overflow: hidden;
+  padding: 16px;
 }
 
 .patient-item {
diff --git a/healthlink-his-ui/src/views/drug/inpatientMedicationDispensing/components/api.js b/healthlink-his-ui/src/views/drug/inpatientMedicationDispensing/components/api.js
index 76254dea2..9f77c5707 100755
--- a/healthlink-his-ui/src/views/drug/inpatientMedicationDispensing/components/api.js
+++ b/healthlink-his-ui/src/views/drug/inpatientMedicationDispensing/components/api.js
@@ -247,13 +247,13 @@ export function medicineMatch(data) {
   });
 }
 
-// ----------------------------------------------门诊退药接口----------------------------------------------------------------------
+// ----------------------------------------------住院退药接口----------------------------------------------------------------------
 /**
  * 获取患者列表
  */
 export function getList(queryParams) {
   return request({
-    url: '/pharmacy-manage/return-medicine/return-patient-page',
+    url: '/pharmacy-manage/inHospital-return-medicine/return-patient-page',
     method: 'get',
     params: queryParams,
   });
@@ -264,7 +264,7 @@ export function getList(queryParams) {
  */
 export function getReturnDrugList(params) {
   return request({
-    url: '/pharmacy-manage/return-medicine/medicine-return-list',
+    url: '/pharmacy-manage/inHospital-return-medicine/medicine-return-list',
     method: 'get',
     params: params,
   });
@@ -275,7 +275,7 @@ export function getReturnDrugList(params) {
  */
 export function returnDrug(data) {
   return request({
-    url: '/pharmacy-manage/return-medicine/medicine-return',
+    url: '/pharmacy-manage/inHospital-return-medicine/medicine-return',
     method: 'put',
     data: data,
   });
@@ -286,7 +286,7 @@ export function returnDrug(data) {
  */
 export function init() {
   return request({
-    url: '/pharmacy-manage/return-medicine/init',
+    url: '/pharmacy-manage/inHospital-return-medicine/init',
     method: 'get',
   });
 }
diff --git a/healthlink-his-ui/src/views/inpatientDoctor/home/components/diagnosis/diagnosis.vue b/healthlink-his-ui/src/views/inpatientDoctor/home/components/diagnosis/diagnosis.vue
index 5d3f762ce..b10c0bc7e 100755
--- a/healthlink-his-ui/src/views/inpatientDoctor/home/components/diagnosis/diagnosis.vue
+++ b/healthlink-his-ui/src/views/inpatientDoctor/home/components/diagnosis/diagnosis.vue
@@ -1,4 +1,4 @@
-<template>
+<template>
   <div>
     <el-row :gutter="24">
       <el-col
@@ -187,7 +187,7 @@
                     style="width: 150px"
                   >
                     <el-option
-                      v-for="item in diag_type"
+                      v-for="item in inpatient_diag_category"
                       :key="item.value"
                       :label="item.label"
                       :value="item.value"
@@ -423,7 +423,7 @@ const emits = defineEmits(['diagnosisSave']);
 const { proxy } = getCurrentInstance();
 const userStore = useUserStore();
 // 获取诊断类型字典（住院诊断类别）
-const { diag_type } = proxy.useDict('diag_type');
+const { inpatient_diag_category } = proxy.useDict('inpatient_diag_category');
 const rules = ref({
   name: [{ required: true, message: '请选择诊断', trigger: 'change' }],
   medTypeCode: [{ required: true, message: '请选择诊断类型', trigger: 'change' }],
diff --git a/healthlink-his-ui/src/views/inpatientDoctor/home/components/diagnosis/index.vue b/healthlink-his-ui/src/views/inpatientDoctor/home/components/diagnosis/index.vue
index 292cf5e72..618391a3f 100755
--- a/healthlink-his-ui/src/views/inpatientDoctor/home/components/diagnosis/index.vue
+++ b/healthlink-his-ui/src/views/inpatientDoctor/home/components/diagnosis/index.vue
@@ -95,7 +95,7 @@
                 style="width: 100%"
               >
                 <el-option
-                  v-for="item in diag_type"
+                  v-for="item in inpatient_diag_category"
                   :key="item.value"
                   :label="item.label"
                   :value="item.value"
@@ -324,7 +324,7 @@ const syndromeSearchkey = ref('')
 const syndromeList = ref([])
 
 // 获取诊断类型字典（住院诊断类别）
-const { diag_type } = proxy.useDict('diag_type')
+const { inpatient_diag_category } = proxy.useDict('inpatient_diag_category')
 
 const filteredSyndromeList = computed(() => {
   if (!syndromeSearchkey.value) {
diff --git a/healthlink-his-ui/src/views/inpatientDoctor/home/components/order/index.vue b/healthlink-his-ui/src/views/inpatientDoctor/home/components/order/index.vue
index 759cf69c6..560eb9b9c 100755
--- a/healthlink-his-ui/src/views/inpatientDoctor/home/components/order/index.vue
+++ b/healthlink-his-ui/src/views/inpatientDoctor/home/components/order/index.vue
@@ -362,7 +362,7 @@
                 :popper-style="{ padding: '0' }"
                 placement="bottom-start"
                 :visible="scope.row.showPopover"
-                :width="1200"
+                :width="950"
               >
                 <adviceBaseList
                   ref="adviceTableRef"
diff --git a/healthlink-his-ui/src/views/inpatientNurse/medicalOrderExecution/components/prescriptionList.vue b/healthlink-his-ui/src/views/inpatientNurse/medicalOrderExecution/components/prescriptionList.vue
index 5e9e04f04..346a004c1 100755
--- a/healthlink-his-ui/src/views/inpatientNurse/medicalOrderExecution/components/prescriptionList.vue
+++ b/healthlink-his-ui/src/views/inpatientNurse/medicalOrderExecution/components/prescriptionList.vue
@@ -1,4 +1,4 @@
-<template>
+<template>
   <div style="height: calc(100vh - 126px)">
     <div
       style="
@@ -7,6 +7,8 @@
         display: flex;
         align-items: center;
         justify-content: space-between;
+        overflow-x: auto;
+        overflow-y: hidden;
       "
     >
       <div style="display: flex; align-items: center; flex-wrap: nowrap; flex-shrink: 0">
@@ -83,7 +85,7 @@
           class="ml20"
           style="flex-shrink: 0"
           type="danger"
-          :disabled="props.exeStatus != 6"
+          :disabled="props.exeStatus != 6 || selectedCount === 0"
           plain
           @click="handleCancel"
         >
@@ -174,8 +176,8 @@
             :data="item"
             border
             :header-cell-style="{ background: '#eef9fd !important' }"
-            @checkbox-change="({ records, row }) => handleRowSelect(records, row, index)"
-            @checkbox-all="({ records }) => handleSelectAll(records, index)"
+            @checkbox-change="handleRowSelect"
+            @checkbox-all="handleSelectAll"
           >
             <vxe-column
               type="checkbox"
@@ -246,24 +248,24 @@
             >
               <template #default="scope">
                 <div
-                  v-for="(item, timeIndex) in scope.row.times"
+                  v-for="(timeItem, timeIndex) in scope.row.times"
                   :key="timeIndex"
                   style="padding-bottom: 5px"
                 >
-                  <span>{{ item }}</span>
+                  <span>{{ timeItem }}</span>
                   <el-checkbox-group
                     v-model="scope.row.checkedRates[timeIndex]"
                     style="display: inline-block; margin-left: 15px"
                   >
                     <el-checkbox
-                      v-for="(rateItem, rateIndex) in scope.row.rate[item]"
+                      v-for="(rateItem, rateIndex) in scope.row.rate[timeItem]"
                       :key="rateIndex"
                       :value="rateItem.rate"
                       border
                       size="small"
                       style="margin-right: 15px"
                       @change="
-                        (value) => handleRateChange(value, item, rateItem.rate, scope.row, rateItem)
+                        (value) => handleRateChange(value, timeItem, rateItem.rate, scope.row, rateItem)
                       "
                     >
                       {{ rateItem.rate }}
@@ -292,7 +294,7 @@ import {patientInfoList} from '../../components/store/patient.js';
 import {lotNumberMatch} from '@/api/public';
 import {formatDateStr} from '@/utils/index';
 import {RequestStatus} from '@/utils/medicalConstants';
-import {getCurrentInstance, nextTick, ref, provide} from 'vue';
+import {getCurrentInstance, nextTick, ref, provide, computed} from 'vue';
 
 /** 请求状态 → 医嘱状态映射表（开具/签发/校对） */
 const REQUEST_STATUS_DISPLAY = {
@@ -380,8 +382,9 @@ const therapyEnum = ref(undefined);
 const { proxy } = getCurrentInstance();
 const loading = ref(false);
 const chooseAll = ref(false);
-// 独立维护选中行ID集合，避免vxe-table内部selection状态异常导致联动全选
-const selectedRowIds = ref(new Set());
+// 独立维护选中行ID列表，避免vxe-table内部selection状态异常导致联动全选
+// 使用数组而非Set，确保Vue 3响应式系统能可靠追踪变更
+const selectedRowIds = ref([]);
 const props = defineProps({
   exeStatus: {
     type: Number,
@@ -393,6 +396,15 @@ const props = defineProps({
   },
 });
 
+const selectedCount = computed(() => selectedRowIds.value.length);
+
+function getTableRef(index) {
+  const tableRef = proxy.$refs['tableRef' + index];
+  if (!tableRef) return null;
+  return Array.isArray(tableRef) ? tableRef[0] : tableRef;
+}
+
+
 function handleRadioChange() {
   handleGetPrescription();
 }
@@ -414,7 +426,7 @@ function normalizeDayTimeHm(part) {
 function handleGetPrescription(skipAutoSelectAll = false) {
   if (patientInfoList.value.length > 0) {
     // 刷新前保存当前选中状态，刷新后恢复（用于执行/不执行后的列表更新）
-    const previousSelectedIds = skipAutoSelectAll ? new Set(selectedRowIds.value) : null;
+    const previousSelectedIds = skipAutoSelectAll ? [...selectedRowIds.value] : null;
     loading.value = true;
     let encounterIds = patientInfoList.value.map((i) => i.encounterId).join(',');
     getPrescriptionList({
@@ -585,14 +597,14 @@ function handleGetPrescription(skipAutoSelectAll = false) {
       if (skipAutoSelectAll && previousSelectedIds) {
         // 执行/不执行后刷新：只恢复父checkbox行选中，子checkbox保持未选中
         nextTick(() => {
-          selectedRowIds.value.clear();
+          selectedRowIds.value = [];
           prescriptionList.value.forEach((item, index) => {
-            const tableRef = proxy.$refs['tableRef' + index];
+            const tableRef = getTableRef(index);
             item.forEach((row) => {
-              if (previousSelectedIds.has(row.requestId)) {
-                selectedRowIds.value.add(row.requestId);
-                if (tableRef && tableRef[0]) {
-                  tableRef[0].setCheckboxRow([row], true);
+              if (previousSelectedIds.includes(row.requestId)) {
+                if (!selectedRowIds.value.includes(row.requestId)) selectedRowIds.value = [...selectedRowIds.value, row.requestId];
+                if (tableRef) {
+                  tableRef.setCheckboxRow([row], true);
                 }
               }
               // 清空子checkbox选中状态，避免刷新后自动勾选
@@ -622,7 +634,7 @@ function handleGetPrescription(skipAutoSelectAll = false) {
     });
   } else {
     prescriptionList.value = [];
-    selectedRowIds.value.clear();
+    selectedRowIds.value = [];
     loading.value = false;
     // proxy.$message.warning('请选择患者');
   }
@@ -749,7 +761,7 @@ function getSelectRows() {
   const list = [];
   prescriptionList.value.forEach((item) => {
     item.forEach((row) => {
-      if (selectedRowIds.value.has(row.requestId)) {
+      if (selectedRowIds.value.includes(row.requestId)) {
         list.push(row);
       }
     });
@@ -823,16 +835,16 @@ function handleRateChange(value, date, time, row, rateItem) {
 
 function handelSwicthChange(value) {
   prescriptionList.value.forEach((item, index) => {
-    const tableRef = proxy.$refs['tableRef' + index];
-    if (tableRef && tableRef[0]) {
+    const tableRef = getTableRef(index);
+    if (tableRef) {
       // 批量设置选中/取消选中（setCheckboxRow 显式设置，比 toggleCheckboxRow 更可靠）
-      tableRef[0].setCheckboxRow(item, value);
+      tableRef.setCheckboxRow(item, value);
       item.forEach((row) => {
         if (value) {
-          selectedRowIds.value.add(row.requestId);
+          if (!selectedRowIds.value.includes(row.requestId)) selectedRowIds.value = [...selectedRowIds.value, row.requestId];
           selectAllCheckboxesInRow(row);
         } else {
-          selectedRowIds.value.delete(row.requestId);
+          selectedRowIds.value = selectedRowIds.value.filter(id => id !== row.requestId);
           unselectAllCheckboxesInRow(row);
         }
       });
@@ -843,14 +855,14 @@ function handelSwicthChange(value) {
 // 默认选中全部行
 function defaultSelectAllRows() {
   // 清空并重建选中集合
-  selectedRowIds.value.clear();
+  selectedRowIds.value = [];
   prescriptionList.value.forEach((item, index) => {
-    const tableRef = proxy.$refs['tableRef' + index];
-    if (tableRef && tableRef[0]) {
+    const tableRef = getTableRef(index);
+    if (tableRef) {
       // 批量选中该表格的所有行（setCheckboxRow 显式设置选中状态，比 toggleCheckboxRow 更可靠）
-      tableRef[0].setCheckboxRow(item, true);
+      tableRef.setCheckboxRow(item, true);
       item.forEach((row) => {
-        selectedRowIds.value.add(row.requestId);
+        if (!selectedRowIds.value.includes(row.requestId)) selectedRowIds.value = [...selectedRowIds.value, row.requestId];
         // 同时选中该行内部的所有checkbox
         selectAllCheckboxesInRow(row);
       });
@@ -926,18 +938,18 @@ function checkAndToggleRowSelection(row) {
   prescriptionList.value.forEach((item, tableIndex) => {
     const rowIndex = item.findIndex((r) => r.requestId === row.requestId);
     if (rowIndex !== -1) {
-      const tableRef = proxy.$refs['tableRef' + tableIndex];
-      if (tableRef && tableRef[0]) {
+      const tableRef = getTableRef(tableIndex);
+      if (tableRef) {
         const isAllSelected = isAllCheckboxesSelected(row);
-        const isCurrentlySelected = selectedRowIds.value.has(row.requestId);
+        const isCurrentlySelected = selectedRowIds.value.includes(row.requestId);
 
         // 根据checkbox状态更新表格行选中状态（使用 setCheckboxRow 显式设置，避免 toggleCheckboxRow 翻转方向不确定）
         if (isAllSelected && !isCurrentlySelected) {
-          selectedRowIds.value.add(row.requestId);
-          tableRef[0].setCheckboxRow([row], true);
+          if (!selectedRowIds.value.includes(row.requestId)) selectedRowIds.value = [...selectedRowIds.value, row.requestId];
+          tableRef.setCheckboxRow([row], true);
         } else if (!isAllSelected && isCurrentlySelected) {
-          selectedRowIds.value.delete(row.requestId);
-          tableRef[0].setCheckboxRow([row], false);
+          selectedRowIds.value = selectedRowIds.value.filter(id => id !== row.requestId);
+          tableRef.setCheckboxRow([row], false);
         }
       }
     }
@@ -954,49 +966,39 @@ function findOriginalRow(requestId) {
   return null;
 }
 
-// 处理表格行选中事件
-function handleRowSelect(selection, row, tableIndex) {
-  // 回查原始行引用，避免修改 vxe-table 代理对象导致 el-checkbox 不更新
-  const originalRow = findOriginalRow(row.requestId);
-  if (!originalRow) return;
+// 处理表格行选中事件（不依赖事件参数，通过 getCheckboxRecords 查询真实状态）
+function handleRowSelect() {
+  // 从所有表格的内部状态获取当前选中行
+  const selectedIds = new Set();
+  prescriptionList.value.forEach((item, index) => {
+    const tableRef = getTableRef(index);
+    if (tableRef) {
+      tableRef.getCheckboxRecords().forEach((row) => {
+        selectedIds.add(row.requestId);
+      });
+    }
+  });
+  selectedRowIds.value = [...selectedIds];
 
-  const isSelected = selection.some((item) => item.requestId === row.requestId);
+  // 同步子checkbox状态
+  prescriptionList.value.forEach((item) => {
+    item.forEach((row) => {
+      const originalRow = findOriginalRow(row.requestId);
+      if (!originalRow) return;
+      if (selectedIds.has(row.requestId)) {
+        selectAllCheckboxesInRow(originalRow);
+      } else {
+        unselectAllCheckboxesInRow(originalRow);
+      }
+    });
+  });
 
-  if (isSelected) {
-    selectedRowIds.value.add(row.requestId);
-    // 选中行时，选中该行内部的所有checkbox
-    selectAllCheckboxesInRow(originalRow);
-  } else {
-    selectedRowIds.value.delete(row.requestId);
-    // 取消选中行时，取消选中该行内部的所有checkbox
-    unselectAllCheckboxesInRow(originalRow);
-  }
-
-  // 更新全选开关状态
   updateChooseAllStatus();
 }
 
-// 处理表格全选事件
-function handleSelectAll(selection, tableIndex) {
-  const tableData = prescriptionList.value[tableIndex];
-  if (!tableData) return;
-
-  if (selection.length > 0) {
-    // 全选时，选中所有行内部的所有checkbox
-    tableData.forEach((row) => {
-      selectedRowIds.value.add(row.requestId);
-      selectAllCheckboxesInRow(row);
-    });
-  } else {
-    // 取消全选时，取消选中所有行内部的所有checkbox
-    tableData.forEach((row) => {
-      selectedRowIds.value.delete(row.requestId);
-      unselectAllCheckboxesInRow(row);
-    });
-  }
-
-  // 更新全选开关状态
-  updateChooseAllStatus();
+// 处理表格全选事件（不依赖事件参数，通过 getCheckboxRecords 查询真实状态）
+function handleSelectAll() {
+  handleRowSelect();
 }
 
 // 更新全选开关状态
@@ -1004,7 +1006,7 @@ function updateChooseAllStatus() {
   let allSelected = true;
   prescriptionList.value.forEach((item) => {
     item.forEach((row) => {
-      if (!selectedRowIds.value.has(row.requestId)) {
+      if (!selectedRowIds.value.includes(row.requestId)) {
         allSelected = false;
       }
     });
diff --git a/healthlink-his-ui/src/views/inpatientNurse/medicalOrderExecution/index.vue b/healthlink-his-ui/src/views/inpatientNurse/medicalOrderExecution/index.vue
index 18318b138..55663a972 100755
--- a/healthlink-his-ui/src/views/inpatientNurse/medicalOrderExecution/index.vue
+++ b/healthlink-his-ui/src/views/inpatientNurse/medicalOrderExecution/index.vue
@@ -53,8 +53,8 @@
           <!-- 使用模板引用 -->
           <PrescriptionList
             :ref="(el) => setPrescriptionRef(el, tab.name)"
-            :exe-status="exeStatus"
-            :request-status="requestStatus"
+            :exe-status="tab.exeStatus"
+            :request-status="tab.requestStatus"
           />
         </el-tab-pane>
       </el-tabs>
@@ -79,10 +79,10 @@ const prescriptionRefs = ref({});
 
 // 定义处方列表tabs配置
 const prescriptionTabs = [
-  { label: '待执行', name: 'preparation' },
-  { label: '已执行', name: 'completed' },
-  { label: '不执行', name: 'stopped' },
-  { label: '取消执行', name: 'cancel' },
+  { label: '待执行', name: 'preparation', exeStatus: 1, requestStatus: RequestStatus.COMPLETED },
+  { label: '已执行', name: 'completed', exeStatus: 6, requestStatus: RequestStatus.COMPLETED },
+  { label: '不执行', name: 'stopped', exeStatus: 5, requestStatus: RequestStatus.COMPLETED },
+  { label: '已取消', name: 'cancel', exeStatus: 9, requestStatus: RequestStatus.CANCELLED },
 ];
 
 // 设置处方组件引用