diff --git a/healthlink-his-mobile/src/views/PatientList.vue b/healthlink-his-mobile/src/views/PatientList.vue
index c07e31d8f..82de476f4 100644
--- a/healthlink-his-mobile/src/views/PatientList.vue
+++ b/healthlink-his-mobile/src/views/PatientList.vue
@@ -1,52 +1,79 @@
 <template>
   <div class="patient-list">
-    <div class="search-bar"><input v-model="searchText" placeholder="搜索患者姓名/床号..." class="search-input" /></div>
-    <div v-if="loading" class="loading">加载中...</div>
-    <div v-for="p in displayPatients" :key="p.id" class="patient-card" @click="$router.push(`/mobile/patient-detail/${p.id}`)">
-      <div class="patient-avatar" :class="'level-' + p.nursingLevel">{{ p.name?.charAt(0) }}</div>
+    <div class="search-bar">
+      <input v-model="searchText" placeholder="搜索患者姓名/床号..." class="search-input" @input="onSearch" />
+    </div>
+    <div v-if="loading" class="loading">
+      <div class="loading-spinner"></div>
+      <span>加载中...</span>
+    </div>
+    <div v-for="p in patients" :key="p.patientId || p.id" class="patient-card" @click="goDetail(p)">
+      <div class="patient-avatar" :class="'level-' + (p.nursingLevel || 3)">{{ (p.patientName || p.name || '?').charAt(0) }}</div>
       <div class="patient-info">
-        <div class="patient-name">{{ p.name }} <span class="bed">{{ p.bedNo }}床</span></div>
-        <div class="patient-diag">{{ p.diagnosis || '暂无诊断' }}</div>
-        <div class="patient-tags"><span class="tag" :class="'level-' + p.nursingLevel">{{ p.nursingLevel }}级护理</span><span v-if="p.gender" class="tag">{{ p.gender }}</span></div>
+        <div class="patient-name">{{ p.patientName || p.name || '未知患者' }} <span class="bed">{{ p.bedNo || p.locationName || '' }}</span></div>
+        <div class="patient-diag">{{ p.primaryDiagnosisName || p.diagnosis || '暂无诊断' }}</div>
+        <div class="patient-tags">
+          <span class="tag" :class="'level-' + (p.nursingLevel || 3)">{{ (p.nursingLevel || 3) }}级护理</span>
+          <span v-if="p.gender" class="tag">{{ p.gender }}</span>
+          <span v-if="p.age" class="tag">{{ p.age }}岁</span>
+        </div>
       </div>
     </div>
-    <div v-if="!loading && displayPatients.length === 0" class="empty">暂无患者</div>
+    <div v-if="!loading && patients.length === 0" class="empty">暂无患者</div>
+    <div v-if="!loading && hasMore" class="load-more" @click="loadMore">加载更多</div>
   </div>
 </template>
 
 <script setup>
-import { ref, onMounted, computed } from 'vue'
+import { ref, onMounted } from 'vue'
+import { useRouter } from 'vue-router'
 import { ElMessage } from 'element-plus'
 import { nursingApi } from '../api'
 
+const router = useRouter()
 const patients = ref([])
 const loading = ref(false)
 const searchText = ref('')
-const displayPatients = computed(() => searchText.value ? patients.value.filter(p => p.name?.includes(searchText.value) || p.bedNo?.includes(searchText.value)) : patients.value)
+const pageNo = ref(1)
+const pageSize = 20
+const hasMore = ref(true)
 
-const loadPatients = async () => {
+const loadPatients = async (reset = false) => {
+  if (reset) { pageNo.value = 1; patients.value = []; hasMore.value = true }
   loading.value = true
   try {
-    const res = await nursingApi.getPatientList({})
-    patients.value = res.data?.list || res.data?.records || res.data?.rows || res.data || []
-  } catch (e) { ElMessage.error('加载患者列表失败') } finally { loading.value = false }
+    const params = { pageNo: pageNo.value, pageSize: pageSize }
+    if (searchText.value) params.searchKey = searchText.value
+    const res = await nursingApi.getPatientList(params)
+    const list = res.data?.list || res.data?.records || res.data?.rows || res.data || []
+    if (reset) { patients.value = list } else { patients.value.push(...list) }
+    hasMore.value = list.length >= pageSize
+  } catch (e) { console.error('加载失败:', e) } finally { loading.value = false }
 }
 
-onMounted(loadPatients)
+const onSearch = () => { loadPatients(true) }
+const loadMore = () => { pageNo.value++; loadPatients(false) }
+const goDetail = (p) => { router.push(`/mobile/patient-detail/${p.patientId || p.id}`) }
+
+onMounted(() => loadPatients(true))
 </script>
 
 <style scoped>
 .search-bar { padding: 8px 0; }
 .search-input { width: 100%; padding: 10px 16px; border: 1px solid #ddd; border-radius: 20px; font-size: 15px; outline: none; background: #fff; }
 .search-input:focus { border-color: #1890ff; }
-.loading { text-align: center; padding: 20px; color: #999; }
+.loading { text-align: center; padding: 20px; color: #999; display: flex; align-items: center; justify-content: center; gap: 8px; }
+.loading-spinner { width: 20px; height: 20px; border: 2px solid #1890ff; border-top-color: transparent; border-radius: 50%; animation: spin 0.8s linear infinite; }
+@keyframes spin { to { transform: rotate(360deg); } }
 .patient-card { background: #fff; border-radius: 8px; padding: 12px; margin-bottom: 8px; display: flex; align-items: center; gap: 12px; box-shadow: 0 1px 3px rgba(0,0,0,0.08); }
-.patient-avatar { width: 44px; height: 44px; border-radius: 50%; display: flex; align-items: center; justify-content: center; font-size: 18px; font-weight: 600; color: #fff; }
+.patient-avatar { width: 44px; height: 44px; border-radius: 50%; display: flex; align-items: center; justify-content: center; font-size: 18px; font-weight: 600; color: #fff; flex-shrink: 0; }
 .level-1 { background: #f5222d; } .level-2 { background: #fa8c16; } .level-3 { background: #52c41a; }
-.patient-name { font-weight: 600; font-size: 15px; }
-.bed { color: #999; font-size: 13px; }
-.patient-diag { color: #666; font-size: 13px; margin: 2px 0; }
-.patient-tags { display: flex; gap: 6px; }
-.tag { font-size: 11px; padding: 2px 6px; border-radius: 4px; }
+.patient-info { flex: 1; min-width: 0; }
+.patient-name { font-weight: 600; font-size: 15px; white-space: nowrap; overflow: hidden; text-overflow: ellipsis; }
+.bed { color: #999; font-size: 13px; margin-left: 4px; }
+.patient-diag { color: #666; font-size: 13px; margin: 2px 0; white-space: nowrap; overflow: hidden; text-overflow: ellipsis; }
+.patient-tags { display: flex; gap: 6px; flex-wrap: wrap; }
+.tag { font-size: 11px; padding: 2px 6px; border-radius: 4px; background: #f5f5f5; }
+.load-more { text-align: center; padding: 12px; color: #1890ff; font-size: 14px; cursor: pointer; }
 .empty { text-align: center; padding: 40px; color: #999; }
 </style>