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 01949a3b..98a72edd 100644
--- 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
@@ -737,6 +737,28 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
 
         List<String> medRequestIdList = new ArrayList<>();
         for (AdviceSaveDto adviceSaveDto : insertOrUpdateList) {
+            // 🔧 Bug Fix: 确保accountId不为null，与handleBoundDevices保持一致
+            if (adviceSaveDto.getAccountId() == null) {
+                // 尝试从患者就诊中获取默认账户ID（自费账户）
+                Account selfAccount = iAccountService.getSelfAccount(adviceSaveDto.getEncounterId());
+                if (selfAccount != null) {
+                    adviceSaveDto.setAccountId(selfAccount.getId());
+                } else {
+                    // 自动创建自费账户
+                    Account newAccount = new Account();
+                    newAccount.setPatientId(adviceSaveDto.getPatientId());
+                    newAccount.setEncounterId(adviceSaveDto.getEncounterId());
+                    newAccount.setContractNo(CommonConstants.BusinessName.DEFAULT_CONTRACT_NO);
+                    newAccount.setTypeCode(AccountType.PERSONAL_CASH_ACCOUNT.getCode());
+                    newAccount.setBalanceAmount(BigDecimal.ZERO);
+                    newAccount.setStatusEnum(AccountStatus.ACTIVE.getValue());
+                    newAccount.setEncounterFlag(Whether.YES.getValue());
+                    newAccount.setName(AccountType.PERSONAL_CASH_ACCOUNT.getInfo());
+                    Long newAccountId = iAccountService.saveAccountByRegister(newAccount);
+                    adviceSaveDto.setAccountId(newAccountId);
+                }
+            }
+            
             boolean firstTimeSave = false;// 第一次保存
             medicationRequest = new MedicationRequest();
             medicationRequest.setId(adviceSaveDto.getRequestId()); // 主键id
@@ -941,7 +963,29 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
             deviceChargeItem.setServiceId(deviceRequest.getId());
             deviceChargeItem.setProductTable(CommonConstants.TableName.ADM_DEVICE_DEFINITION);
             deviceChargeItem.setProductId(boundDevice.getDevActId());
-            deviceChargeItem.setAccountId(adviceSaveDto.getAccountId());
+            // 🔧 Bug Fix #281: 如果accountId为null，从就诊中获取账户ID，如果没有则自动创建
+            Long deviceAccountId = adviceSaveDto.getAccountId();
+            if (deviceAccountId == null) {
+                // 尝试从患者就诊中获取默认账户ID（自费账户）
+                Account selfAccount = iAccountService.getSelfAccount(adviceSaveDto.getEncounterId());
+                if (selfAccount != null) {
+                    deviceAccountId = selfAccount.getId();
+                } else {
+                    // 自动创建自费账户
+                    Account newAccount = new Account();
+                    newAccount.setPatientId(adviceSaveDto.getPatientId());
+                    newAccount.setEncounterId(adviceSaveDto.getEncounterId());
+                    newAccount.setContractNo(CommonConstants.BusinessName.DEFAULT_CONTRACT_NO);
+                    newAccount.setTypeCode(AccountType.PERSONAL_CASH_ACCOUNT.getCode());
+                    newAccount.setBalanceAmount(BigDecimal.ZERO);
+                    newAccount.setStatusEnum(AccountStatus.ACTIVE.getValue());
+                    newAccount.setEncounterFlag(Whether.YES.getValue());
+                    // 🔧 Bug Fix: 设置账户名称，避免数据库NOT NULL约束错误
+                    newAccount.setName(AccountType.PERSONAL_CASH_ACCOUNT.getInfo());
+                    deviceAccountId = iAccountService.saveAccountByRegister(newAccount);
+                }
+            }
+            deviceChargeItem.setAccountId(deviceAccountId);
             deviceChargeItem.setConditionId(adviceSaveDto.getConditionId());
             deviceChargeItem.setEncounterDiagnosisId(adviceSaveDto.getEncounterDiagnosisId());
             deviceChargeItem.setDispenseId(dispenseId);
@@ -1141,6 +1185,8 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
                         newAccount.setBalanceAmount(BigDecimal.ZERO);
                         newAccount.setStatusEnum(AccountStatus.ACTIVE.getValue());
                         newAccount.setEncounterFlag(Whether.YES.getValue());
+                        // 🔧 Bug Fix: 设置账户名称，避免数据库NOT NULL约束错误
+                        newAccount.setName(AccountType.PERSONAL_CASH_ACCOUNT.getInfo());
                         accountId = iAccountService.saveAccountByRegister(newAccount);
                     }
                 }
@@ -1222,6 +1268,28 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
         }
 
         for (AdviceSaveDto adviceSaveDto : insertOrUpdateList) {
+            // 🔧 Bug Fix: 确保accountId不为null
+            if (adviceSaveDto.getAccountId() == null) {
+                // 尝试从患者就诊中获取默认账户ID（自费账户）
+                Account selfAccount = iAccountService.getSelfAccount(adviceSaveDto.getEncounterId());
+                if (selfAccount != null) {
+                    adviceSaveDto.setAccountId(selfAccount.getId());
+                } else {
+                    // 自动创建自费账户
+                    Account newAccount = new Account();
+                    newAccount.setPatientId(adviceSaveDto.getPatientId());
+                    newAccount.setEncounterId(adviceSaveDto.getEncounterId());
+                    newAccount.setContractNo(CommonConstants.BusinessName.DEFAULT_CONTRACT_NO);
+                    newAccount.setTypeCode(AccountType.PERSONAL_CASH_ACCOUNT.getCode());
+                    newAccount.setBalanceAmount(BigDecimal.ZERO);
+                    newAccount.setStatusEnum(AccountStatus.ACTIVE.getValue());
+                    newAccount.setEncounterFlag(Whether.YES.getValue());
+                    newAccount.setName(AccountType.PERSONAL_CASH_ACCOUNT.getInfo());
+                    Long newAccountId = iAccountService.saveAccountByRegister(newAccount);
+                    adviceSaveDto.setAccountId(newAccountId);
+                }
+            }
+            
             // 🔧 Bug Fix #238: 诊疗项目执行科室非空校验
             if (adviceSaveDto.getAdviceType() != null && adviceSaveDto.getAdviceType() == 3) {
                 Long effectiveOrgId = adviceSaveDto.getEffectiveOrgId();
diff --git a/openhis-ui-vue3/src/views/doctorstation/components/prescription/prescriptionlist.vue b/openhis-ui-vue3/src/views/doctorstation/components/prescription/prescriptionlist.vue
index 227e49fe..a84cdbbe 100644
--- a/openhis-ui-vue3/src/views/doctorstation/components/prescription/prescriptionlist.vue
+++ b/openhis-ui-vue3/src/views/doctorstation/components/prescription/prescriptionlist.vue
@@ -261,6 +261,7 @@
                   <div class="form-group">
                     <el-form-item label="给药途径：" prop="methodCode" class="required-field" data-prop="methodCode">
                       <el-select v-model="scope.row.methodCode" placeholder="给药途径" clearable filterable
+                        style="width: 150px"
                         :ref="(el) => (inputRefs.methodCode = el)" @keyup.enter.prevent="
                           () => {
                             if (scope.row.methodCode) {
@@ -341,6 +342,7 @@
                               " />
                         </template>
                       </el-select>
+                      <span v-if="scope.row.unitCode_dictText" class="unit-text">{{ scope.row.unitCode_dictText }}</span>
                     </el-form-item>
                     <!-- 🔧 Bug #273 拆零比提示 -->
                     <span v-if="scope.row.partPercent !== null && scope.row.partPercent !== undefined && scope.row.partPercent - 1 > 0 && scope.row.unitCode !== scope.row.minUnitCode" 
@@ -732,7 +734,7 @@
               size="small"
             />
             <span style="margin: 0 2px; font-size: 12px;">天</span>
-            <el-select v-model="scope.row.methodCode" size="small" style="width: 65px" placeholder="用法">
+            <el-select v-model="scope.row.methodCode" size="small" style="width: 120px" placeholder="用法">
               <el-option v-for="item in method_code" :key="item.value" :label="item.label" :value="item.value" />
             </el-select>
           </template>