diff --git a/openhis-ui-vue3/src/views/doctorstation/components/diagnosis/addDiagnosisDialog.vue b/openhis-ui-vue3/src/views/doctorstation/components/diagnosis/addDiagnosisDialog.vue
index 50982c23..299ccfae 100644
--- a/openhis-ui-vue3/src/views/doctorstation/components/diagnosis/addDiagnosisDialog.vue
+++ b/openhis-ui-vue3/src/views/doctorstation/components/diagnosis/addDiagnosisDialog.vue
@@ -143,7 +143,7 @@ function handleOpen() {
           ybNo: item.ybNo,
           syndromeGroupNo: item.syndromeGroupNo,
           verificationStatusEnum: 4,
-          medTypeCode: '11',
+          medTypeCode: item.medTypeCode || undefined,  // 使用已保存的值
           diagSrtNo: item.diagSrtNo,
           isExisting: true // 标记为已存在
         },
@@ -188,7 +188,7 @@ function handleOpen() {
                   ybNo: item.ybNo,
                   syndromeGroupNo: item.syndromeGroupNo,
                   verificationStatusEnum: item.verificationStatusEnum || 4,
-                  medTypeCode: item.medTypeCode || '11',
+                  medTypeCode: item.medTypeCode || undefined,  // 使用已保存的值
                   diagSrtNo: item.diagSrtNo,
                   isExisting: true // 标记为已存在
                 },
@@ -227,7 +227,7 @@ function handleClickRow(row) {
       ybNo: row.ybNo,
       syndromeGroupNo: timestamp.value,
       verificationStatusEnum: 4,
-      medTypeCode: '11',
+      medTypeCode: undefined,  // 不设默认值
       isExisting: false // 标记为新增
     });
     tcmDiagonsisList.value.push({
diff --git a/openhis-ui-vue3/src/views/doctorstation/components/diagnosis/diagnosis.vue b/openhis-ui-vue3/src/views/doctorstation/components/diagnosis/diagnosis.vue
index f6dbd040..bb1e4c03 100644
--- a/openhis-ui-vue3/src/views/doctorstation/components/diagnosis/diagnosis.vue
+++ b/openhis-ui-vue3/src/views/doctorstation/components/diagnosis/diagnosis.vue
@@ -36,26 +36,23 @@
                     </el-icon>
                   </el-button>
                 </template>
-                <el-popconfirm width="200" :hide-after="10" title="确认删除此常用诊断吗" placement="top-start"
-                  @confirm="deleteChild(data)">
-                  <template #reference>
-                    <el-button
-                      style="color: #000000"
-                      v-if="
-                        node.level === 2 &&
-                        node.parent.data.name != '常用' &&
-                        node.parent.data.name != '历史'
-                      "
-                      type="text"
-                      size="small"
-                      @click.stop=""
-                    >
-                      <el-icon>
-                        <Minus />
-                      </el-icon>
-                    </el-button>
-                  </template>
-                </el-popconfirm>
+                <template v-if="node.level === 2 && node.parent.data.name != '常用' && node.parent.data.name != '历史'">
+                  <el-popconfirm width="200" :hide-after="10" title="确认删除此常用诊断吗" placement="top-start"
+                    @confirm="deleteChild(data)">
+                    <template #reference>
+                      <el-button
+                        style="color: #000000"
+                        type="text"
+                        size="small"
+                        @click.stop=""
+                      >
+                        <el-icon>
+                          <Minus />
+                        </el-icon>
+                      </el-button>
+                    </template>
+                  </el-popconfirm>
+                </template>
               </span>
             </div>
           </template>
@@ -98,7 +95,7 @@
             <el-table-column label="诊断类型" align="center" prop="medTypeCode" width="180">
               <template #default="scope">
                 <el-form-item :prop="`diagnosisList.${scope.$index}.medTypeCode`" :rules="rules.medTypeCode">
-                  <el-select v-model="scope.row.medTypeCode" placeholder=" " style="width: 150px">
+                  <el-select v-model="scope.row.medTypeCode" placeholder="请选择" style="width: 150px" v-if="diag_type && diag_type.length > 0">
                     <el-option
                       v-for="item in diag_type"
                       :key="item.value"
@@ -106,6 +103,7 @@
                       :value="item.value"
                     />
                   </el-select>
+                  <span v-else style="color: #909399;">加载中...</span>
                 </el-form-item>
               </template>
             </el-table-column>
@@ -507,7 +505,7 @@ function handleAddDiagnosis() {
         showPopover: false,
         name: undefined,
         verificationStatusEnum: 4,
-        medTypeCode: 11,  // Bug #151 修复：使用数字类型的字典值
+        medTypeCode: undefined,  // 新增时不设默认值，让用户选择
         diagSrtNo: maxSortNo + 1,
         iptDiseTypeCode: 2,
         diagnosisDesc: '',
@@ -578,6 +576,13 @@ function handleMaindise(value, index) {
 function handleSaveDiagnosis() {
   proxy.$refs.formRef.validate((valid) => {
     if (valid) {
+      // 验证诊断类型是否已选择
+      const emptyMedType = form.value.diagnosisList.find(d => !d.medTypeCode);
+      if (emptyMedType) {
+        proxy.$modal.msgWarning('请选择诊断类型');
+        return false;
+      }
+
       if (form.value.diagnosisList.length == 0) {
         proxy.$modal.msgWarning('诊断不能为空');
         return false;
@@ -718,7 +723,7 @@ form.value.diagnosisList.push({
     ybNo: data.ybNo,
     name: data.name,
     verificationStatusEnum: 4,
-    medTypeCode: 11,  // Bug #151 修复：使用数字类型的字典值，而非字符串'初诊诊断'
+    medTypeCode: undefined,  // 新增时不设默认值，让用户选择
     diagSrtNo: maxSortNo + 1,
     definitionId: data.definitionId,
     classification: '西医', // 默认为西医
diff --git a/openhis-ui-vue3/src/views/doctorstation/index.vue b/openhis-ui-vue3/src/views/doctorstation/index.vue
index a5519d6f..af9f3b3c 100644
--- a/openhis-ui-vue3/src/views/doctorstation/index.vue
+++ b/openhis-ui-vue3/src/views/doctorstation/index.vue
@@ -640,7 +640,38 @@ function handleLeave(encounterId) {
   });
 }
 
-function handleFinish(encounterId) {
+async function handleFinish(encounterId) {
+  // 完诊前验证诊断信息
+  try {
+    const diagnosisRes = await getEncounterDiagnosis(encounterId);
+    if (diagnosisRes.code === 200) {
+      const diagnosisList = diagnosisRes.data || [];
+
+      // 检查是否有诊断
+      if (diagnosisList.length === 0) {
+        proxy.$modal.msgWarning('请先添加诊断信息');
+        return;
+      }
+
+      // 检查诊断类型是否为空
+      const emptyMedType = diagnosisList.find(d => !d.medTypeCode);
+      if (emptyMedType) {
+        proxy.$modal.msgWarning('请选择诊断类型');
+        return;
+      }
+
+      // 检查是否有主诊断
+      if (!diagnosisList.some(d => d.maindiseFlag === 1)) {
+        proxy.$modal.msgWarning('请至少设置一条主诊断');
+        return;
+      }
+    }
+  } catch (error) {
+    console.error('获取诊断信息失败:', error);
+    proxy.$modal.msgWarning('获取诊断信息失败，请重试');
+    return;
+  }
+
   completeEncounter({ encounterId, firstEnum: firstEnum.value }).then((res) => {
     if (res.code == 200) {
       proxy.$modal.msgSuccess('操作成功');
diff --git a/openhis-ui-vue3/src/views/inpatientDoctor/home/components/diagnosis/addDiagnosisDialog.vue b/openhis-ui-vue3/src/views/inpatientDoctor/home/components/diagnosis/addDiagnosisDialog.vue
index 8b9c0b5c..90026fe0 100644
--- a/openhis-ui-vue3/src/views/inpatientDoctor/home/components/diagnosis/addDiagnosisDialog.vue
+++ b/openhis-ui-vue3/src/views/inpatientDoctor/home/components/diagnosis/addDiagnosisDialog.vue
@@ -153,7 +153,7 @@ function handleClickRow(row) {
       ybNo: row.ybNo,
       syndromeGroupNo: timestamp.value,
       verificationStatusEnum: 4,
-      medTypeCode: '11',
+      medTypeCode: undefined,  // 不设默认值
     });
     tcmDiagonsisList.value.push({
       conditionName: row.name,
diff --git a/openhis-ui-vue3/src/views/inpatientDoctor/home/components/diagnosis/diagnosis.vue b/openhis-ui-vue3/src/views/inpatientDoctor/home/components/diagnosis/diagnosis.vue
index 48fd7566..5b6e1c7d 100644
--- a/openhis-ui-vue3/src/views/inpatientDoctor/home/components/diagnosis/diagnosis.vue
+++ b/openhis-ui-vue3/src/views/inpatientDoctor/home/components/diagnosis/diagnosis.vue
@@ -415,7 +415,7 @@ function handleAddDiagnosis() {
         showPopover: false,
         name: undefined,
         verificationStatusEnum: 4,
-        medTypeCode: '11',
+        medTypeCode: undefined,  // 不设默认值
         diagSrtNo: form.value.diagnosisList.length + 1,
         iptDiseTypeCode: 2,
         diagnosisDesc: '',
@@ -632,7 +632,7 @@ function handleNodeClick(data) {
     ybNo: data.ybNo,
     name: data.name,
     verificationStatusEnum: 4,
-    medTypeCode: '11',
+    medTypeCode: undefined,  // 不设默认值
     diagSrtNo: form.value.diagnosisList.length + 1,
     definitionId: data.definitionId,
     diagnosisDoctor: props.patientInfo.practitionerName || props.patientInfo.doctorName || props.patientInfo.physicianName || userStore.name,