diff --git a/openhis-server-new/sql/20260115_add_table_triage_queue_item.sql b/openhis-server-new/sql/20260115_add_table_triage_queue_item.sql
index f2253a22c..a7a158d1c 100755
--- a/openhis-server-new/sql/20260115_add_table_triage_queue_item.sql
+++ b/openhis-server-new/sql/20260115_add_table_triage_queue_item.sql
@@ -13,7 +13,7 @@ CREATE TABLE IF NOT EXISTS triage_queue_item (
     patient_name     VARCHAR(255),
     healthcare_name  VARCHAR(255),
     practitioner_name VARCHAR(255),
-    status           VARCHAR(50)  NOT NULL, -- WAITING/CALLING/SKIPPED/COMPLETED
+    status           INTEGER      NOT NULL DEFAULT 0, -- 分诊队列状态: 0=WAITING(等待), 10=CALLING(叫号中), 20=IN_CLINIC(诊中), 30=COMPLETED(已完成), 40=SKIPPED(已跳过)
     queue_order      INTEGER      NOT NULL,
     create_time      TIMESTAMP,
     update_time      TIMESTAMP,
diff --git a/openhis-server-new/sql/bug_400_fix_triage_queue_item_status_type.sql b/openhis-server-new/sql/bug_400_fix_triage_queue_item_status_type.sql
new file mode 100644
index 000000000..7289a8241
--- /dev/null
+++ b/openhis-server-new/sql/bug_400_fix_triage_queue_item_status_type.sql
@@ -0,0 +1,30 @@
+-- Bug #400 修复：triage_queue_item.status 字段类型修正
+-- 原 DDL 将 status 定义为 VARCHAR(50)，但 Java 实体 TriageQueueItem.status 为 Integer 类型，
+-- 应用层使用 TriageQueueStatus 枚举值（0/10/20/30/40）写入，类型不匹配导致 MyBatis-Plus
+-- 无法正确映射 status 字段，完诊时 status 更新为 30 失败。
+--
+-- 注意：必须在后端实际连接的 schema 中执行（dev=hisdev, test=histest, prd=hisprd）
+-- 执行前请先确认：SET search_path TO hisdev; （或对应的 schema）
+
+-- 1. 先将已有的字符串值转换为对应的整数值
+-- 如果之前写入的是枚举 code（如 'waiting'、'completed'），需要先转换
+UPDATE triage_queue_item
+SET status = CASE
+    WHEN status IN ('0', 'waiting', 'WAITING') THEN 0
+    WHEN status IN ('10', 'calling', 'CALLING') THEN 10
+    WHEN status IN ('20', 'in-clinic', 'IN_CLINIC', 'in-clinic') THEN 20
+    WHEN status IN ('30', 'completed', 'COMPLETED') THEN 30
+    WHEN status IN ('40', 'skipped', 'SKIPPED') THEN 40
+    WHEN status IN ('50', 'refunded', 'REFUNDED') THEN 50
+    WHEN status IN ('60', 'follow', 'FOLLOW') THEN 60
+    ELSE 0
+END
+WHERE status IS NOT NULL AND status !~ '^[0-9]+$';
+
+-- 2. 修改字段类型为 INTEGER
+ALTER TABLE triage_queue_item
+    ALTER COLUMN status TYPE INTEGER USING status::INTEGER;
+
+-- 3. 设置默认值
+ALTER TABLE triage_queue_item
+    ALTER COLUMN status SET DEFAULT 0;