diff --git a/openhis-ui-vue3/src/views/outpatient/exam/ExamApply.vue b/openhis-ui-vue3/src/views/outpatient/exam/ExamApply.vue
index 2a68947d4..3219d6e9c 100644
--- a/openhis-ui-vue3/src/views/outpatient/exam/ExamApply.vue
+++ b/openhis-ui-vue3/src/views/outpatient/exam/ExamApply.vue
@@ -58,51 +58,73 @@
 </template>
 
 <script setup lang="ts">
-import { ref, computed } from 'vue'
+import { ref } from 'vue'
 
-// 类型定义（实际项目中应从 API 或全局类型导入）
-interface ExamMethod { id: string; name: string; checked: boolean }
-interface ExamItem { id: string; name: string; checked: boolean; methods: ExamMethod[] }
-interface Category { id: string; name: string; children: ExamItem[] }
+// 类型定义
+interface Method {
+  id: string
+  name: string
+  checked: boolean
+}
 
-// 模拟数据源（实际应通过 API 获取）
+interface ExamItem {
+  id: string
+  name: string
+  checked: boolean
+  methods: Method[]
+}
+
+interface Category {
+  id: string
+  name: string
+  children?: Category[]
+  items?: ExamItem[]
+}
+
+// 状态初始化
 const categories = ref<Category[]>([])
-const currentCategory = ref<Category | null>(null)
-
-// 修复 Bug #550：默认收起状态，不预设任何展开项
+const currentItems = ref<ExamItem[]>([])
+const selectedItems = ref<ExamItem[]>([])
+// 修复：默认收起，不自动展开明细
 const activeCollapseNames = ref<string[]>([])
 
-const currentItems = computed(() => currentCategory.value?.children || [])
-
-const selectedItems = computed(() => {
-  const result: ExamItem[] = []
-  categories.value.forEach(cat => {
-    cat.children.forEach(item => {
-      if (item.checked) result.push(item)
-    })
-  })
-  return result
-})
-
+// 分类切换
 const handleCategorySelect = (node: Category) => {
-  currentCategory.value = node
+  currentItems.value = node.items || []
 }
 
-// 修复 Bug #550：项目勾选与检查方法完全解耦
-const handleItemCheck = (item: ExamItem) => {
-  // 仅切换项目自身的 checked 状态，绝不联动修改 item.methods
-  // 保持父子状态独立，由医生手动分别勾选
-}
-
-const handleMethodCheck = (sel: ExamItem, method: ExamMethod) => {
-  // 仅切换检查方法状态，不影响父级项目
-}
-
-// 修复 Bug #550：清理冗余“套餐”字样，避免名称遮挡
+// 修复：清理名称，去除冗余的“套餐”字样
 const cleanName = (name: string) => {
   if (!name) return ''
-  // 移除常见冗余前缀/后缀，保留核心业务名称
-  return name.replace(/(项目)?套餐(明细)?/g, '').trim()
+  return name.replace(/套餐/g, '').trim()
+}
+
+// 修复：项目勾选与检查方法解耦，仅维护已选列表，不联动勾选方法
+const handleItemCheck = (item: ExamItem) => {
+  if (item.checked) {
+    // 若未加入已选列表，则添加（方法默认未勾选）
+    if (!selectedItems.value.find(s => s.id === item.id)) {
+      selectedItems.value.push({
+        ...item,
+        methods: item.methods.map(m => ({ ...m, checked: false }))
+      })
+    }
+  } else {
+    // 取消勾选则从已选列表移除，并清理折叠状态
+    selectedItems.value = selectedItems.value.filter(s => s.id !== item.id)
+    activeCollapseNames.value = activeCollapseNames.value.filter(n => n !== item.id)
+  }
+}
+
+// 修复：检查方法独立控制，不反向影响父项目状态
+const handleMethodCheck = (parentItem: ExamItem, method: Method) => {
+  const sel = selectedItems.value.find(s => s.id === parentItem.id)
+  if (sel) {
+    const targetMethod = sel.methods.find(m => m.id === method.id)
+    if (targetMethod) {
+      targetMethod.checked = method.checked
+    }
+  }
 }
 </script>
 
@@ -111,46 +133,53 @@ const cleanName = (name: string) => {
   display: flex;
   flex-direction: column;
   gap: 16px;
-  padding: 16px;
   height: 100%;
+  padding: 16px;
 }
-
 .category-panel, .item-panel, .selected-panel {
-  width: 100%;
+  flex: 1;
+  overflow: auto;
 }
-
 .item-list {
-  max-height: 300px;
-  overflow-y: auto;
-}
-
-.item-row, .method-row {
   display: flex;
-  align-items: center;
-  padding: 8px 0;
+  flex-direction: column;
   gap: 8px;
 }
-
-/* 修复 Bug #550：名称超长时省略显示，配合 Tooltip 提示完整内容 */
-.item-name, .collapse-title {
+.item-row {
+  display: flex;
+  align-items: center;
+  gap: 8px;
+  padding: 4px 0;
+}
+/* 修复：名称自适应宽度，超长省略并支持悬浮提示 */
+.item-name {
+  flex: 1;
+  overflow: hidden;
+  text-overflow: ellipsis;
+  white-space: nowrap;
+  cursor: pointer;
+}
+.collapse-title {
+  font-weight: 500;
   overflow: hidden;
   text-overflow: ellipsis;
   white-space: nowrap;
   max-width: 100%;
-  display: inline-block;
-  cursor: default;
 }
-
 .method-container {
-  padding-left: 24px;
-  border-left: 2px solid #ebeef5;
-  margin-left: 4px;
+  padding: 8px 0 8px 24px;
+  border-left: 2px solid #e4e7ed;
+  margin-left: 8px;
+}
+.method-row {
+  display: flex;
+  align-items: center;
+  gap: 8px;
+  padding: 4px 0;
 }
-
 .empty-tip {
   color: #909399;
   text-align: center;
-  padding: 24px 0;
-  font-size: 14px;
+  padding: 20px 0;
 }
 </style>