diff --git a/openhis-ui-vue3/src/views/outpatient/doctor/components/ExamItemSelector.vue b/openhis-ui-vue3/src/views/outpatient/doctor/components/ExamItemSelector.vue
new file mode 100644
index 000000000..ccd34b417
--- /dev/null
+++ b/openhis-ui-vue3/src/views/outpatient/doctor/components/ExamItemSelector.vue
@@ -0,0 +1,183 @@
+<template>
+  <div class="exam-item-selector">
+    <div class="selector-layout">
+      <!-- 左侧：检查项目分类 -->
+      <div class="panel category-panel">
+        <h4 class="panel-title">检查项目分类</h4>
+        <el-tree
+          :data="categoryTree"
+          node-key="id"
+          highlight-current
+          default-expand-all
+          @node-click="handleCategorySelect"
+        />
+      </div>
+
+      <!-- 中间：检查项目列表 -->
+      <div class="panel item-panel">
+        <h4 class="panel-title">检查项目</h4>
+        <el-checkbox-group v-model="selectedItemIds" @change="onItemChange" class="item-list">
+          <el-checkbox v-for="item in currentItems" :key="item.id" :label="item.id" class="item-checkbox">
+            {{ item.name }}
+          </el-checkbox>
+        </el-checkbox-group>
+      </div>
+
+      <!-- 右侧/下方：已选择区域 -->
+      <div class="panel selected-panel">
+        <h4 class="panel-title">已选择</h4>
+        <!-- 修复3：结构化展示 & 默认收起 -->
+        <el-collapse v-model="activeCollapseNames" accordion class="selected-collapse">
+          <el-collapse-item
+            v-for="group in selectedGroups"
+            :key="group.itemId"
+            :name="group.itemId"
+          >
+            <template #title>
+              <!-- 修复2：宽度自适应/提示完整名称，去除“套餐”前缀 -->
+              <el-tooltip :content="group.itemName" placement="top" :show-after="300">
+                <span class="group-title">{{ group.itemName }}</span>
+              </el-tooltip>
+            </template>
+            <div class="method-section">
+              <el-checkbox-group v-model="group.selectedMethodIds" @change="onMethodChange(group)">
+                <el-checkbox v-for="method in group.methods" :key="method.id" :label="method.id">
+                  {{ method.name }}
+                </el-checkbox>
+              </el-checkbox-group>
+            </div>
+          </el-collapse-item>
+        </el-collapse>
+      </div>
+    </div>
+  </div>
+</template>
+
+<script setup lang="ts">
+import { ref, computed } from 'vue'
+
+// 模拟数据结构 (实际应从API获取)
+interface CategoryNode { id: string; name: string; children?: ExamItem[] }
+interface ExamItem { id: string; name: string; methods?: ExamMethod[] }
+interface ExamMethod { id: string; name: string }
+
+const categoryTree = ref<CategoryNode[]>([
+  {
+    id: 'cat_1', name: '彩超', children: [
+      { id: 'item_1', name: '128线排套餐', methods: [{ id: 'm1', name: '常规' }, { id: 'm2', name: '三维' }] },
+      { id: 'item_2', name: '腹部彩超', methods: [{ id: 'm3', name: '常规' }] }
+    ]
+  }
+])
+
+const currentItems = ref<ExamItem[]>([])
+const selectedItemIds = ref<string[]>([])
+// 修复3：默认空数组，实现面板默认收起状态
+const activeCollapseNames = ref<string[]>([])
+
+// 已选数据映射：独立维护项目与方法状态
+const selectedDataMap = ref<Map<string, { id: string; name: string; methods: ExamMethod[]; selectedMethodIds: string[] }>>(new Map())
+
+// 计算属性：渲染已选择分组
+const selectedGroups = computed(() => {
+  return Array.from(selectedDataMap.value.values()).map(item => ({
+    itemId: item.id,
+    // 修复2：清理冗余“套餐”字样
+    itemName: item.name.replace(/套餐/g, ''),
+    methods: item.methods || [],
+    selectedMethodIds: item.selectedMethodIds || []
+  }))
+})
+
+// 分类点击
+const handleCategorySelect = (node: CategoryNode) => {
+  currentItems.value = node.children || []
+}
+
+// 修复1：项目勾选与检查方法解耦
+const onItemChange = (ids: string[]) => {
+  const added = ids.filter(id => !selectedItemIds.value.includes(id))
+  const removed = selectedItemIds.value.filter(id => !ids.includes(id))
+
+  // 处理新增项目
+  added.forEach(id => {
+    const item = currentItems.value.find(i => i.id === id)
+    if (item) {
+      selectedDataMap.value.set(id, {
+        id: item.id,
+        name: item.name,
+        methods: item.methods || [],
+        // 关键修复：不自动勾选关联方法，保持独立手动选择
+        selectedMethodIds: []
+      })
+    }
+  })
+
+  // 处理移除项目
+  removed.forEach(id => {
+    selectedDataMap.value.delete(id)
+  })
+
+  selectedItemIds.value = ids
+}
+
+// 方法独立勾选变更
+const onMethodChange = (group: { itemId: string; selectedMethodIds: string[] }) => {
+  const item = selectedDataMap.value.get(group.itemId)
+  if (item) {
+    item.selectedMethodIds = group.selectedMethodIds
+  }
+}
+</script>
+
+<style scoped>
+.exam-item-selector {
+  padding: 12px;
+  background: #fff;
+  border-radius: 4px;
+}
+.selector-layout {
+  display: flex;
+  gap: 12px;
+  height: 480px;
+}
+.panel {
+  flex: 1;
+  border: 1px solid #ebeef5;
+  border-radius: 4px;
+  padding: 10px;
+  overflow-y: auto;
+  background: #fafafa;
+}
+.panel-title {
+  margin: 0 0 10px 0;
+  font-size: 14px;
+  font-weight: 600;
+  color: #303133;
+}
+.item-list {
+  display: flex;
+  flex-direction: column;
+  gap: 8px;
+}
+.item-checkbox {
+  margin-right: 0;
+}
+.selected-collapse {
+  border: none;
+}
+.group-title {
+  max-width: 140px;
+  overflow: hidden;
+  text-overflow: ellipsis;
+  white-space: nowrap;
+  display: inline-block;
+  font-weight: 500;
+  color: #409eff;
+}
+.method-section {
+  padding: 8px 0 8px 16px;
+  border-left: 2px solid #e4e7ed;
+  margin-left: 4px;
+}
+</style>