diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/consultation/appservice/impl/ConsultationAppServiceImpl.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/consultation/appservice/impl/ConsultationAppServiceImpl.java
index f4549f3d..3405ddf7 100644
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/consultation/appservice/impl/ConsultationAppServiceImpl.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/consultation/appservice/impl/ConsultationAppServiceImpl.java
@@ -435,7 +435,15 @@ public class ConsultationAppServiceImpl implements IConsultationAppService {
             }
 
             // 判断是"取消提交"还是"作废"
-            if ("取消提交".equals(cancelReason) && ConsultationStatusEnum.SUBMITTED.getCode().equals(entity.getConsultationStatus())) {
+            if ("取消提交".equals(cancelReason)) {
+                // 状态校验：禁止已确认 (20)、已签名 (30)、已完成 (40) 的会诊申请取消提交
+                if (entity.getConsultationStatus() >= ConsultationStatusEnum.CONFIRMED.getCode()) {
+                    throw new IllegalArgumentException("当前状态不允许取消提交，只有已提交状态的会诊申请才能取消提交");
+                }
+                // 只有状态为 10(已提交) 才允许取消提交
+                if (!ConsultationStatusEnum.SUBMITTED.getCode().equals(entity.getConsultationStatus())) {
+                    throw new IllegalArgumentException("只有已提交状态的会诊申请才能取消提交");
+                }
                 // 取消提交：将状态从"已提交"改回"新开"
                 entity.setConsultationStatus(ConsultationStatusEnum.NEW.getCode());
                 entity.setConfirmingPhysician(null);
@@ -722,33 +730,42 @@ public class ConsultationAppServiceImpl implements IConsultationAppService {
                     (entity.getConsultationStatus() == ConsultationStatusEnum.SIGNED.getCode() || 
                      entity.getConsultationStatus() == ConsultationStatusEnum.COMPLETED.getCode())) {
                     
-                    // 查询所有已签名的医生（invited_status >= 3）
+                    // 查询所有已确认和已签名的医生（invited_status >= 2）
+                    // invited_status: 1-已提交，2-已确认，3-已签名
+                    List<ConsultationInvited> confirmedAndSignedPhysicians = invitedList.stream()
+                        .filter(inv -> inv.getInvitedStatus() != null && inv.getInvitedStatus() >= 2)
+                        .collect(Collectors.toList());
+                    
+                    // 查询所有已签名的医生（invited_status = 3）
                     List<ConsultationInvited> signedPhysicians = invitedList.stream()
                         .filter(inv -> inv.getInvitedStatus() != null && inv.getInvitedStatus() >= 3)
                         .collect(Collectors.toList());
                     
-                    if (!signedPhysicians.isEmpty()) {
-                        // 1. 会诊邀请参加医师：拼接所有已签名医生的"科室-姓名"
-                        String invitedPhysiciansText = signedPhysicians.stream()
+                    if (!confirmedAndSignedPhysicians.isEmpty()) {
+                        // 1. 会诊邀请参加医师：拼接所有已确认和已签名医生的"科室 - 姓名"
+                        String invitedPhysiciansText = confirmedAndSignedPhysicians.stream()
                             .map(inv -> inv.getInvitedDepartmentName() + "-" + inv.getInvitedPhysicianName())
                             .collect(Collectors.joining("、"));
                         dto.setInvitedPhysiciansText(invitedPhysiciansText);
                         
-                        // 2. 会诊意见：汇总所有已签名医生的意见
-                        String consultationOpinion = signedPhysicians.stream()
-                            .filter(inv -> StringUtils.hasText(inv.getConfirmOpinion()))
-                            .map(ConsultationInvited::getConfirmOpinion)
-                            .collect(Collectors.joining("\n"));
-                        dto.setConsultationOpinion(consultationOpinion);
-                        
-                        // 3. 所属医生、代表科室、签名医生、签名时间：使用第一个签名的医生
-                        ConsultationInvited firstSigned = signedPhysicians.get(0);
-                        dto.setAttendingPhysician(firstSigned.getInvitedPhysicianName());
-                        dto.setRepresentDepartment(firstSigned.getInvitedDepartmentName());
-                        dto.setSignPhysician(firstSigned.getInvitedPhysicianName());
-                        dto.setSignTime(firstSigned.getSignatureTime());
-                        
-                        log.info("填充会诊记录信息，已签名医生数：{}", signedPhysicians.size());
+                        // 2. 会诊意见：汇总所有已签名医生的意见（只有已签名医生才能填写意见）
+                        if (!signedPhysicians.isEmpty()) {
+                            String consultationOpinion = signedPhysicians.stream()
+                                .filter(inv -> StringUtils.hasText(inv.getConfirmOpinion()))
+                                .map(ConsultationInvited::getConfirmOpinion)
+                                .collect(Collectors.joining("\n"));
+                            dto.setConsultationOpinion(consultationOpinion);
+                            
+                            // 3. 所属医生、代表科室、签名医生、签名时间：使用第一个签名的医生
+                            ConsultationInvited firstSigned = signedPhysicians.get(0);
+                            dto.setAttendingPhysician(firstSigned.getInvitedPhysicianName());
+                            dto.setRepresentDepartment(firstSigned.getInvitedDepartmentName());
+                            dto.setSignPhysician(firstSigned.getInvitedPhysicianName());
+                            dto.setSignTime(firstSigned.getSignatureTime());
+                            
+                            log.info("填充会诊记录信息，已确认和已签名医生数：{}，已签名医生数：{}", 
+                                confirmedAndSignedPhysicians.size(), signedPhysicians.size());
+                        }
                     }
                 }
             }