diff --git a/openhis-ui-vue3/src/views/outpatient/examination/ExaminationApply.vue b/openhis-ui-vue3/src/views/outpatient/examination/ExaminationApply.vue
index ca65a4b52..633bca23c 100644
--- a/openhis-ui-vue3/src/views/outpatient/examination/ExaminationApply.vue
+++ b/openhis-ui-vue3/src/views/outpatient/examination/ExaminationApply.vue
@@ -1,177 +1,169 @@
 <template>
   <div class="examination-apply-container">
     <!-- 左侧：检查项目分类 -->
-    <div class="panel-left">
+    <div class="panel left-panel">
       <el-tree
-        class="exam-category-tree"
         :data="categoryTree"
-        :props="{ label: 'name', children: 'children' }"
         node-key="id"
+        highlight-current
         @node-click="handleCategoryClick"
+        class="category-tree"
       />
     </div>
 
     <!-- 中间：检查项目列表 -->
-    <div class="panel-middle">
-      <el-table :data="currentItems" border style="width: 100%" class="exam-item-list">
-        <el-table-column label="项目名称" prop="name" />
-        <el-table-column label="操作" width="100">
-          <template #default="{ row }">
-            <el-button type="primary" link @click="handleItemSelect(row)">选择</el-button>
-          </template>
-        </el-table-column>
-      </el-table>
+    <div class="panel middle-panel">
+      <div class="panel-title">检查项目</div>
+      <el-checkbox-group v-model="selectedItemIds" class="item-list">
+        <el-checkbox
+          v-for="item in currentItems"
+          :key="item.id"
+          :label="item.id"
+          class="item-checkbox"
+          @change="handleItemSelect(item)"
+        >
+          <!-- Bug #550 Fix 2: 清理冗余“套餐”字样 -->
+          {{ item.name.replace(/套餐/g, '') }}
+        </el-checkbox>
+      </el-checkbox-group>
     </div>
 
-    <!-- 右侧/下方：已选择区域 -->
-    <div class="panel-right">
-      <div class="selected-header">已选择项目</div>
-      <div class="selected-list">
-        <div
-          v-for="item in selectedItems"
-          :key="item.id"
-          class="selected-item-card"
-        >
-          <!-- 卡片头部：点击展开/收起 -->
-          <div class="card-header" @click="toggleExpand(item)">
-            <el-icon class="expand-icon">
-              <ArrowRight v-if="!item.expanded" />
-              <ArrowDown v-else />
-            </el-icon>
-            <!-- 修复 #550-2：去除“套餐”前缀，支持宽度自适应与完整提示 -->
-            <span class="item-name" :title="cleanName(item.name)">{{ cleanName(item.name) }}</span>
-            <el-button type="danger" link size="small" @click.stop="removeItem(item)">移除</el-button>
-          </div>
+    <!-- 右侧：已选择区域 -->
+    <div class="panel right-panel">
+      <div class="panel-title">已选择</div>
+      <div v-if="selectedGroups.length === 0" class="empty-tip">暂无选择项目</div>
+      
+      <!-- Bug #550 Fix 3 & 4: 结构化展示，默认收起，移除“项目套餐明细”标签 -->
+      <div v-for="group in selectedGroups" :key="group.itemId" class="selected-card">
+        <div class="card-header" @click="toggleExpand(group.itemId)">
+          <el-icon class="expand-icon">
+            <ArrowRight v-if="!group.expanded" />
+            <ArrowDown v-else />
+          </el-icon>
+          <!-- Bug #550 Fix 2: 宽度自适应/提示完整名称 -->
+          <el-tooltip :content="group.itemName" placement="top" :show-after="300">
+            <span class="item-name">{{ group.itemName }}</span>
+          </el-tooltip>
+        </div>
 
-          <!-- 修复 #550-3：默认收起，结构化展示明细，移除冗余“项目套餐明细”标签 -->
-          <div v-show="item.expanded" class="detail-section">
-            <div class="method-group">
-              <span class="group-label">检查方法</span>
-              <div class="method-list exam-method-list">
-                <el-checkbox
-                  v-for="method in item.methods"
-                  :key="method.id"
-                  v-model="method.checked"
-                  @change="onMethodChange(item, method)"
-                >
-                  {{ method.name }}
-                </el-checkbox>
-              </div>
-            </div>
+        <!-- 明细区域：严格遵循 项目 > 检查方法 层级 -->
+        <div v-show="group.expanded" class="details-panel">
+          <div class="method-section">
+            <span class="section-title">检查方法</span>
+            <!-- Bug #550 Fix 1: 独立解耦，不随项目勾选自动联动 -->
+            <el-checkbox-group
+              v-model="group.selectedMethods"
+              class="method-checkbox-group"
+              @change="handleMethodChange(group)"
+            >
+              <el-checkbox
+                v-for="method in group.methods"
+                :key="method.id"
+                :label="method.id"
+                class="method-checkbox"
+              >
+                {{ method.name }}
+              </el-checkbox>
+            </el-checkbox-group>
           </div>
         </div>
-        <el-empty v-if="selectedItems.length === 0" description="暂无已选项目" />
       </div>
     </div>
   </div>
 </template>
 
-<script setup lang="ts">
-import { ref, reactive } from 'vue';
-import { ArrowRight, ArrowDown } from '@element-plus/icons-vue';
-import type { ElTree } from 'element-plus';
-
-// 模拟数据结构
-interface ExamMethod {
-  id: string;
-  name: string;
-  checked: boolean;
-}
-
-interface ExamItem {
-  id: string;
-  name: string;
-  methods: ExamMethod[];
-  expanded: boolean; // 修复 #550-3：默认收起状态
-}
+<script setup>
+import { ref, computed } from 'vue'
+import { ArrowRight, ArrowDown } from '@element-plus/icons-vue'
 
+// 模拟分类树数据（实际应从API获取）
 const categoryTree = ref([
-  { id: '1', name: '彩超', children: [] }
-]);
+  { id: 'c1', label: '彩超', children: [] }
+])
 
-const currentItems = ref<ExamItem[]>([
-  { id: '101', name: '128线排彩超套餐', methods: [{ id: 'm1', name: '常规扫描', checked: false }, { id: 'm2', name: '三维重建', checked: false }], expanded: false }
-]);
+const currentItems = ref([])
+const selectedItemIds = ref([])
+const selectedGroups = ref([])
 
-const selectedItems = reactive<ExamItem[]>([]);
+// 切换分类加载项目
+const handleCategoryClick = (data) => {
+  // 实际项目中此处调用API获取项目列表
+  currentItems.value = data.items || []
+}
 
-// 修复 #550-1：项目勾选与检查方法完全解耦，不触发任何自动联动
-const handleItemSelect = (item: ExamItem) => {
-  const exists = selectedItems.find(i => i.id === item.id);
-  if (!exists) {
-    // 深拷贝避免引用污染，默认 expanded: false
-    selectedItems.push({
-      ...item,
-      methods: item.methods.map(m => ({ ...m, checked: false })),
-      expanded: false
-    });
+// Bug #550 Fix 1: 解耦勾选逻辑。仅维护项目选中状态，绝不自动勾选检查方法
+const handleItemSelect = (item) => {
+  const isAdding = selectedItemIds.value.includes(item.id)
+  
+  if (isAdding) {
+    // 新增选中项：初始化独立状态，默认收起
+    const exists = selectedGroups.value.find(g => g.itemId === item.id)
+    if (!exists) {
+      selectedGroups.value.push({
+        itemId: item.id,
+        itemName: item.name.replace(/套餐/g, ''),
+        methods: item.methods || [],
+        selectedMethods: [], // 独立维护方法勾选状态
+        expanded: false      // Bug #550 Fix 4: 默认收起
+      })
+    }
+  } else {
+    // 取消选中：移除对应组
+    selectedGroups.value = selectedGroups.value.filter(g => g.itemId !== item.id)
   }
-};
+}
 
-// 修复 #550-2：清理冗余“套餐”字样
-const cleanName = (name: string) => {
-  return name.replace(/套餐/g, '').trim();
-};
+// 展开/收起明细
+const toggleExpand = (itemId) => {
+  const group = selectedGroups.value.find(g => g.itemId === itemId)
+  if (group) group.expanded = !group.expanded
+}
 
-// 修复 #550-3：展开/收起控制
-const toggleExpand = (item: ExamItem) => {
-  item.expanded = !item.expanded;
-};
-
-const removeItem = (item: ExamItem) => {
-  const idx = selectedItems.findIndex(i => i.id === item.id);
-  if (idx > -1) selectedItems.splice(idx, 1);
-};
-
-// 检查方法独立勾选逻辑，不反向影响父级项目
-const onMethodChange = (parent: ExamItem, method: ExamMethod) => {
-  // 仅记录方法状态，不触发父级联动或自动展开
-  console.log(`方法 ${method.name} 状态变更为: ${method.checked}`);
-};
-
-const handleCategoryClick = (data: any) => {
-  // 实际业务中此处应请求对应分类下的项目列表
-  console.log('切换分类:', data.name);
-};
+// 检查方法变更处理（仅记录或触发后续业务，不影响项目状态）
+const handleMethodChange = (group) => {
+  console.log(`项目 ${group.itemName} 的检查方法已更新:`, group.selectedMethods)
+  // 可在此处调用API同步方法选择状态
+}
 </script>
 
 <style scoped>
 .examination-apply-container {
   display: flex;
   gap: 16px;
-  padding: 16px;
   height: 100%;
-}
-
-.panel-left, .panel-middle, .panel-right {
-  background: #fff;
-  border-radius: 8px;
   padding: 12px;
-  box-shadow: 0 2px 8px rgba(0,0,0,0.05);
+  background: #fff;
 }
 
-.panel-left { width: 20%; }
-.panel-middle { width: 40%; }
-.panel-right { width: 40%; display: flex; flex-direction: column; }
+.panel {
+  flex: 1;
+  border: 1px solid #e4e7ed;
+  border-radius: 4px;
+  padding: 12px;
+  overflow-y: auto;
+  display: flex;
+  flex-direction: column;
+}
 
-.selected-header {
-  font-weight: bold;
+.panel-title {
+  font-weight: 600;
   margin-bottom: 12px;
   padding-bottom: 8px;
-  border-bottom: 1px solid #eee;
+  border-bottom: 1px solid #ebeef5;
 }
 
-.selected-list {
-  flex: 1;
-  overflow-y: auto;
+.item-list, .method-checkbox-group {
+  display: flex;
+  flex-direction: column;
+  gap: 8px;
 }
 
-/* 修复 #550-2：卡片宽度自适应，名称超长省略并支持悬停提示 */
-.selected-item-card {
-  border: 1px solid #e4e7ed;
-  border-radius: 6px;
+.selected-card {
+  border: 1px solid #dcdfe6;
+  border-radius: 4px;
   margin-bottom: 10px;
   background: #fafafa;
+  overflow: hidden;
 }
 
 .card-header {
@@ -179,43 +171,46 @@ const handleCategoryClick = (data: any) => {
   align-items: center;
   padding: 10px;
   cursor: pointer;
-  user-select: none;
+  background: #f5f7fa;
+  transition: background 0.2s;
+}
+
+.card-header:hover {
+  background: #e9ecef;
 }
 
 .expand-icon {
   margin-right: 8px;
-  transition: transform 0.2s;
+  color: #909399;
 }
 
+/* Bug #550 Fix 2: 名称截断与自适应提示 */
 .item-name {
   flex: 1;
+  white-space: nowrap;
   overflow: hidden;
   text-overflow: ellipsis;
-  white-space: nowrap;
-  max-width: 100%;
-  font-weight: 500;
+  font-size: 14px;
+  color: #303133;
 }
 
-.detail-section {
-  padding: 0 10px 10px 28px;
-  border-top: 1px dashed #e4e7ed;
+.details-panel {
+  padding: 10px;
+  border-top: 1px solid #ebeef5;
   background: #fff;
 }
 
-.method-group {
-  margin-top: 8px;
-}
-
-.group-label {
-  font-size: 12px;
-  color: #909399;
-  margin-bottom: 6px;
+.section-title {
   display: block;
+  font-size: 13px;
+  color: #606266;
+  margin-bottom: 8px;
+  font-weight: 500;
 }
 
-.method-list {
-  display: flex;
-  flex-wrap: wrap;
-  gap: 12px;
+.empty-tip {
+  color: #909399;
+  text-align: center;
+  margin-top: 40px;
 }
 </style>
diff --git a/openhis-ui-vue3/tests/e2e/specs/bug-regression.spec.ts b/openhis-ui-vue3/tests/e2e/specs/bug-regression.spec.ts
index a61322372..66cd43cb0 100755
--- a/openhis-ui-vue3/tests/e2e/specs/bug-regression.spec.ts
+++ b/openhis-ui-vue3/tests/e2e/specs/bug-regression.spec.ts
@@ -43,4 +43,30 @@ describe('Bug Regression Tests', () => {
       cy.get('.detail-count').invoke('text').should('eq', summaryCount)
     })
   })
+
+  /**
+   * @bug550 @regression
+   * 验证门诊检查申请项目选择交互优化：解耦勾选、名称完整显示、明细默认收起及层级结构
+   */
+  it('Bug #550: 检查申请项目选择交互优化', () => {
+    cy.login('doctor1', '123456')
+    cy.visit('/outpatient/doctor/examination')
+
+    // 1. 展开彩超分类并勾选项目
+    cy.get('.category-tree').contains('彩超').click()
+    cy.get('.item-checkbox').contains('128线排').click()
+
+    // 2. 验证检查方法未自动勾选（解耦）
+    cy.get('.method-checkbox-group .el-checkbox').should('not.be.checked')
+
+    // 3. 验证已选卡片：无“套餐”前缀，名称完整或可悬停查看
+    cy.get('.selected-card').should('not.contain', '套餐')
+    cy.get('.selected-card .item-name').should('have.attr', 'title', '128线排')
+
+    // 4. 验证明细默认收起，且层级为 项目 > 检查方法
+    cy.get('.details-panel').should('not.be.visible')
+    cy.get('.card-header').first().click()
+    cy.get('.details-panel').should('be.visible')
+    cy.get('.method-section').should('exist')
+  })
 })