diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/dto/RequestBaseDto.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/dto/RequestBaseDto.java
index ad9a940d1..3007a9ebe 100755
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/dto/RequestBaseDto.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/dto/RequestBaseDto.java
@@ -127,6 +127,11 @@ public class RequestBaseDto {
      * 请求状态
      */
     private Integer statusEnum;
+    /**
+     * 退回原因
+     */
+    private String reasonText;
+
     private String statusEnum_enumText;
 
     /**
diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/inhospitalnursestation/appservice/impl/AdviceProcessAppServiceImpl.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/inhospitalnursestation/appservice/impl/AdviceProcessAppServiceImpl.java
index a86c601a5..b96d4ebc8 100755
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/inhospitalnursestation/appservice/impl/AdviceProcessAppServiceImpl.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/inhospitalnursestation/appservice/impl/AdviceProcessAppServiceImpl.java
@@ -415,13 +415,14 @@ public class AdviceProcessAppServiceImpl implements IAdviceProcessAppService {
         Date checkDate = new Date();
         if (!serviceRequestList.isEmpty()) {
             // 更新服务请求状态待发送
+            String backReason = performInfoList.get(0).getBackReason();
             serviceRequestService.updateDraftStatus(
-                    serviceRequestList.stream().map(PerformInfoDto::getRequestId).toList(), practitionerId, checkDate);
+                    serviceRequestList.stream().map(PerformInfoDto::getRequestId).toList(), practitionerId, checkDate, backReason);
         }
         if (!medRequestList.isEmpty()) {
             // 更新药品请求状态待发送
             medicationRequestService.updateDraftStatusBatch(
-                    medRequestList.stream().map(PerformInfoDto::getRequestId).toList(), practitionerId, checkDate);
+                    medRequestList.stream().map(PerformInfoDto::getRequestId).toList(), practitionerId, checkDate, backReason);
         }
         return R.ok(null, "退回成功");
     }
diff --git a/openhis-server-new/openhis-application/src/main/resources/mapper/doctorstation/DoctorStationAdviceAppMapper.xml b/openhis-server-new/openhis-application/src/main/resources/mapper/doctorstation/DoctorStationAdviceAppMapper.xml
index 8d5f78c65..ceda6b3c6 100755
--- a/openhis-server-new/openhis-application/src/main/resources/mapper/doctorstation/DoctorStationAdviceAppMapper.xml
+++ b/openhis-server-new/openhis-application/src/main/resources/mapper/doctorstation/DoctorStationAdviceAppMapper.xml
@@ -516,6 +516,7 @@
         T1.patient_id AS patient_id,
         'med_medication_definition' AS advice_table_name,
         T1.medication_id AS advice_definition_id
+        , T1.back_reason AS reason_text
         FROM med_medication_request AS T1
         LEFT JOIN med_medication_definition AS T2 ON T2.ID = T1.medication_id
         AND T2.delete_flag = '0'
@@ -577,6 +578,7 @@
         T1.patient_id AS patient_id,
         'med_medication_definition' AS advice_table_name,
         T3.ID AS advice_definition_id
+        , T2.back_reason AS reason_text
         FROM adm_charge_item AS T1
         INNER JOIN med_medication_request AS T2 ON T2.ID = T1.service_id AND T2.delete_flag = '0'
         LEFT JOIN med_medication_definition AS T3 ON T3.ID = T2.medication_id AND T3.delete_flag = '0'
@@ -640,6 +642,7 @@
         CI.patient_id AS patient_id,
         'adm_device_definition' AS advice_table_name,
         CI.product_id AS advice_definition_id
+        , NULL AS reason_text
         FROM adm_charge_item AS CI
         LEFT JOIN adm_charge_item_definition CID ON CID.id = CI.definition_id AND CID.delete_flag = '0'
         LEFT JOIN wor_device_request DR ON DR.id = CI.service_id AND DR.delete_flag = '0'
@@ -694,6 +697,7 @@
         T1.patient_id AS patient_id,
         'adm_device_definition' AS advice_table_name,
         T1.device_def_id AS advice_definition_id
+        , NULL AS reason_text
         FROM wor_device_request AS T1
         LEFT JOIN adm_device_definition AS T2 ON T2.ID = T1.device_def_id
         AND T2.delete_flag = '0'
@@ -750,6 +754,7 @@
          T1.patient_id AS patient_id,
         'wor_activity_definition' AS advice_table_name,
         T1.activity_id AS advice_definition_id
+        , T1.reason_text AS reason_text
          FROM wor_service_request AS T1
         LEFT JOIN wor_activity_definition AS T2
         ON T2.ID = T1.activity_id
diff --git a/openhis-server-new/openhis-domain/src/main/java/com/openhis/workflow/service/impl/ServiceRequestServiceImpl.java b/openhis-server-new/openhis-domain/src/main/java/com/openhis/workflow/service/impl/ServiceRequestServiceImpl.java
index be6db03fa..45add69da 100755
--- a/openhis-server-new/openhis-domain/src/main/java/com/openhis/workflow/service/impl/ServiceRequestServiceImpl.java
+++ b/openhis-server-new/openhis-domain/src/main/java/com/openhis/workflow/service/impl/ServiceRequestServiceImpl.java
@@ -197,9 +197,15 @@ public class ServiceRequestServiceImpl extends ServiceImpl<ServiceRequestMapper,
      * @param checkDate 校对时间
      */
     @Override
-    public void updateDraftStatus(List<Long> serviceRequestIdList, Long practitionerId, Date checkDate) {
-        baseMapper.update(new ServiceRequest().setStatusEnum(RequestStatus.DRAFT.getValue())
-                .setPerformerCheckId(SecurityUtils.getLoginUser().getPractitionerId()).setCheckTime(DateUtils.getNowDate()),
+    public void updateDraftStatus(List<Long> serviceRequestIdList, Long practitionerId, Date checkDate, String backReason) {
+        ServiceRequest updateEntity = new ServiceRequest()
+                .setStatusEnum(RequestStatus.DRAFT.getValue())
+                .setPerformerCheckId(SecurityUtils.getLoginUser().getPractitionerId())
+                .setCheckTime(DateUtils.getNowDate());
+        if (backReason != null && !backReason.isEmpty()) {
+            updateEntity.setReasonText(backReason);
+        }
+        baseMapper.update(updateEntity,
                 new LambdaUpdateWrapper<ServiceRequest>().in(ServiceRequest::getId, serviceRequestIdList)
                         .eq(ServiceRequest::getDeleteFlag, DelFlag.NO.getCode()));
     }
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 7ab3842bb..580054b09 100755
--- a/openhis-ui-vue3/src/views/doctorstation/components/prescription/prescriptionlist.vue
+++ b/openhis-ui-vue3/src/views/doctorstation/components/prescription/prescriptionlist.vue
@@ -1345,6 +1345,21 @@
             </span>
           </template>
         </el-table-column>
+        <el-table-column
+          label="退回原因"
+          align="center"
+          prop="reasonText"
+          width="160"
+        >
+          <template #default="scope">
+            <span
+              v-if="!scope.row.isEdit"
+              style="color: #e6a23c;"
+            >
+              {{ scope.row.reasonText || '-' }}
+            </span>
+          </template>
+        </el-table-column>
         <el-table-column
           label="诊断"
           align="center"
diff --git a/openhis-ui-vue3/src/views/inpatientNurse/medicalOrderProofread/components/prescriptionList.vue b/openhis-ui-vue3/src/views/inpatientNurse/medicalOrderProofread/components/prescriptionList.vue
index fd1fa92bc..fdb70695c 100755
--- a/openhis-ui-vue3/src/views/inpatientNurse/medicalOrderProofread/components/prescriptionList.vue
+++ b/openhis-ui-vue3/src/views/inpatientNurse/medicalOrderProofread/components/prescriptionList.vue
@@ -226,6 +226,44 @@
       />
     </div>
   </div>
+  <!-- 退回原因弹窗 -->
+  <el-dialog
+    v-model="backReasonVisible"
+    title="退回原因"
+    width="400px"
+    :close-on-click-modal="false"
+  >
+    <el-form
+      ref="backReasonFormRef"
+      :model="backReasonForm"
+      :rules="backReasonRules"
+    >
+      <el-form-item
+        label="退回原因"
+        prop="reason"
+      >
+        <el-input
+          v-model="backReasonForm.reason"
+          type="textarea"
+          :rows="4"
+          placeholder="请输入退回原因（必填）"
+          maxlength="500"
+          show-word-limit
+        />
+      </el-form-item>
+    </el-form>
+    <template #footer>
+      <el-button @click="backReasonVisible = false">
+        取消
+      </el-button>
+      <el-button
+        type="primary"
+        @click="confirmCancel"
+      >
+        确定退回
+      </el-button>
+    </template>
+  </el-dialog>
 </template>
 <script setup>
 import {ref, computed, getCurrentInstance} from 'vue';
@@ -239,6 +277,9 @@ const prescriptionList = ref([]);
 const deadline = ref(formatDateStr(new Date(), 'YYYY-MM-DD') + ' 23:59:59');
 const type = ref(null);
 const { proxy } = getCurrentInstance();
+const backReasonVisible = ref(false);
+const backReasonForm = ref({ reason: '' });
+const backReasonFormRef = ref(null);
 const loading = ref(false);
 const chooseAll = ref(false);
 const selectionTrigger = ref(0);
@@ -438,24 +479,39 @@ function handleCheck() {
 function handleCancel() {
   let list = getSelectRows();
   if (list.length > 0) {
-    // 校验已发药的医嘱不允许退回
     let dispensedItems = list.filter(item => item.dispenseStatus === 4);
     if (dispensedItems.length > 0) {
       proxy.$message.error('该药品已由药房发放，请先执行退药处理，不可直接退回');
       return;
     }
-    cancel(list).then((res) => {
-      if (res.code == 200) {
-        proxy.$modal.msgSuccess(res.msg);
-        handleGetPrescription();
-      }
-    });
-    console.log(list, 'list');
+    // 显示退回原因弹窗
+    backReasonForm.value.reason = '';
+    backReasonVisible.value = true;
   } else {
     proxy.$message.warning('请先选择医嘱信息');
   }
 }
 
+/** 确定退回 — 从弹窗获取原因后调用API */
+function confirmCancel() {
+  if (!backReasonForm.value.reason.trim()) {
+    proxy.$message.warning('请输入退回原因');
+    return;
+  }
+  let list = getSelectRows();
+  let requestList = list.map(item => ({
+    ...item,
+    backReason: backReasonForm.value.reason.trim()
+  }));
+  cancel(requestList).then((res) => {
+    if (res.code == 200) {
+      proxy.$modal.msgSuccess(res.msg);
+      handleGetPrescription();
+    }
+  });
+  backReasonVisible.value = false;
+}
+
 function getSelectRows() {
   // 获取选中的医嘱信息
   let list = [];
diff --git a/sql/迁移记录-DB变更记录/20260529_fix_BUG#613_add_column_back_reason.sql b/sql/迁移记录-DB变更记录/20260529_fix_BUG#613_add_column_back_reason.sql
new file mode 100644
index 000000000..e50ff420f
--- /dev/null
+++ b/sql/迁移记录-DB变更记录/20260529_fix_BUG#613_add_column_back_reason.sql
@@ -0,0 +1,17 @@
+-- Bug #613: 医嘱退回流程 — med_medication_request 表缺少退回原因字段
+-- 退回原因必填（NOT NULL），前端弹窗 + 后端都做校验
+DO $$
+BEGIN
+    IF NOT EXISTS (
+        SELECT 1 FROM information_schema.columns 
+        WHERE table_name = 'med_medication_request' AND column_name = 'back_reason'
+    ) THEN
+        ALTER TABLE med_medication_request ADD COLUMN back_reason VARCHAR(500) NOT NULL DEFAULT '';
+        COMMENT ON COLUMN med_medication_request.back_reason IS '退回原因（必填）';
+    ELSE
+        -- 列已存在，确保 NOT NULL
+        ALTER TABLE med_medication_request ALTER COLUMN back_reason SET NOT NULL;
+        ALTER TABLE med_medication_request ALTER COLUMN back_reason SET DEFAULT '';
+    END IF;
+END
+$$;