diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/appservice/impl/DoctorStationAdviceAppServiceImpl.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/appservice/impl/DoctorStationAdviceAppServiceImpl.java
index ec72e987..0f0a8b21 100755
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/appservice/impl/DoctorStationAdviceAppServiceImpl.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/appservice/impl/DoctorStationAdviceAppServiceImpl.java
@@ -912,7 +912,9 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
         ChargeItem chargeItem;
         // 新增 + 修改
         // 🔧 BugFix: 如果 requestId 不为空说明是已存在的医嘱，需要更新，即使 dbOpType 不匹配也应该包含进来
+        // 🔧 BugFix #454: 排除删除操作，避免误入insertOrUpdateList
         List<AdviceSaveDto> insertOrUpdateList = medicineList.stream()
+                .filter(e -> !DbOpType.DELETE.getCode().equals(e.getDbOpType()))
                 .filter(e -> (DbOpType.INSERT.getCode().equals(e.getDbOpType())
                         || DbOpType.UPDATE.getCode().equals(e.getDbOpType())
                         || e.getRequestId() != null))
@@ -1358,7 +1360,9 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
         ChargeItem chargeItem;
         // 新增 + 修改
         // 🔧 BugFix: 如果 requestId 不为空说明是已存在的医嘱，需要更新，即使 dbOpType 不匹配也应该包含进来
+        // 🔧 BugFix #454: 排除删除操作，避免误入insertOrUpdateList
         List<AdviceSaveDto> insertOrUpdateList = deviceList.stream()
+                .filter(e -> !DbOpType.DELETE.getCode().equals(e.getDbOpType()))
                 .filter(e -> (DbOpType.INSERT.getCode().equals(e.getDbOpType())
                         || DbOpType.UPDATE.getCode().equals(e.getDbOpType())
                         || e.getRequestId() != null))
@@ -1673,7 +1677,9 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
         ChargeItem chargeItem;
         // 新增 + 修改
         // 🔧 BugFix: 如果 requestId 不为空说明是已存在的医嘱，需要更新，即使 dbOpType 不匹配也应该包含进来
+        // 🔧 BugFix #454: 排除删除操作，避免误入insertOrUpdateList触发执行科室校验
         List<AdviceSaveDto> insertOrUpdateList = activityList.stream()
+                .filter(e -> !DbOpType.DELETE.getCode().equals(e.getDbOpType()))
                 .filter(e -> (DbOpType.INSERT.getCode().equals(e.getDbOpType())
                         || DbOpType.UPDATE.getCode().equals(e.getDbOpType())
                         || e.getRequestId() != null))