diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/appservice/impl/DoctorStationAdviceAppServiceImpl.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/appservice/impl/DoctorStationAdviceAppServiceImpl.java
index 0cbd3d1e..10feadbd 100644
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/appservice/impl/DoctorStationAdviceAppServiceImpl.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/appservice/impl/DoctorStationAdviceAppServiceImpl.java
@@ -16,9 +16,11 @@ import com.core.common.utils.SecurityUtils;
 import com.core.common.utils.StringUtils;
 import com.core.web.util.TenantOptionUtil;
 import com.openhis.administration.domain.Account;
-import com.openhis.administration.service.IAccountService;
 import com.openhis.administration.domain.ChargeItem;
+import com.openhis.administration.domain.Encounter;
+import com.openhis.administration.service.IAccountService;
 import com.openhis.administration.service.IChargeItemService;
+import com.openhis.administration.service.IEncounterService;
 import com.openhis.common.constant.CommonConstants;
 import com.openhis.common.constant.PromptMsgConstant;
 import com.openhis.common.enums.*;
@@ -106,6 +108,9 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
     @Resource
     RedisCache redisCache;
 
+    @Resource
+    IEncounterService iEncounterService;
+
     // 缓存 key 前缀
     private static final String ADVICE_BASE_INFO_CACHE_PREFIX = "advice:base:info:";
     // 缓存过期时间（小时）
@@ -480,6 +485,30 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
             Long organizationId = adviceSaveParam.getOrganizationId();
             // 医嘱分类信息
             List<AdviceSaveDto> adviceSaveList = adviceSaveParam.getAdviceSaveList();
+            
+            // 🔧 Bug Fix: 校验并补全patientId（如果为null，从encounter查询获取）
+            for (AdviceSaveDto adviceSaveDto : adviceSaveList) {
+                // 首先检查encounterId是否为null
+                if (adviceSaveDto.getEncounterId() == null) {
+                    log.error("encounterId为null，无法保存医嘱");
+                    return R.fail(null, "就诊信息不完整，请重新选择患者后再试");
+                }
+                
+                // 如果patientId为null，尝试从encounter获取
+                if (adviceSaveDto.getPatientId() == null) {
+                    // 从就诊记录中获取patientId
+                    Encounter encounter = iEncounterService.getById(adviceSaveDto.getEncounterId());
+                    if (encounter != null && encounter.getPatientId() != null) {
+                        adviceSaveDto.setPatientId(encounter.getPatientId());
+                        log.info("自动补全patientId: encounterId={}, patientId={}", 
+                                adviceSaveDto.getEncounterId(), encounter.getPatientId());
+                    } else {
+                        log.error("无法获取patientId: encounterId={}", adviceSaveDto.getEncounterId());
+                        return R.fail(null, "无法获取患者信息，请重新选择患者");
+                    }
+                }
+            }
+            
             // 药品
             List<AdviceSaveDto> medicineList = adviceSaveList.stream()
                     .filter(e -> ItemType.MEDICINE.getValue().equals(e.getAdviceType())).collect(Collectors.toList());
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 8b973667..08c9b9ab 100644
--- a/openhis-ui-vue3/src/views/doctorstation/components/prescription/prescriptionlist.vue
+++ b/openhis-ui-vue3/src/views/doctorstation/components/prescription/prescriptionlist.vue
@@ -674,6 +674,7 @@
               :controls="false"
               style="width: 60px"
               size="small"
+              @change="calculateTotalPrice(scope.row, scope.$index)"
             />
             <span style="margin-left: 4px">{{ scope.row.unitCode_dictText }}</span>
           </template>
@@ -2154,6 +2155,13 @@ function handleSave(prescriptionId) {
       finalAccountId = null;
     }
     
+    // 🔧 Bug Fix: 校验患者信息完整性
+    if (!props.patientInfo || !props.patientInfo.patientId || !props.patientInfo.encounterId) {
+      console.error('患者信息不完整:', props.patientInfo);
+      proxy.$modal.msgError('患者信息不完整，请重新选择患者后再试');
+      return;
+    }
+    
     saveList.forEach((item) => {
       item.patientId = props.patientInfo.patientId;
       item.encounterId = props.patientInfo.encounterId;
@@ -2686,6 +2694,13 @@ function handleSaveBatch(prescriptionId) {
     return;
   }
 
+  // 🔧 Bug Fix: 校验患者信息完整性
+  if (!props.patientInfo || !props.patientInfo.patientId || !props.patientInfo.encounterId) {
+    console.error('患者信息不完整:', props.patientInfo);
+    proxy.$modal.msgError('患者信息不完整，请重新选择患者后再试');
+    return;
+  }
+
   // --- 【修改开始：优先使用选中行】 ---
 
   // 1. 获取表格当前选中的行
@@ -2785,6 +2800,8 @@ function handleSaveBatch(prescriptionId) {
 
         return {
           ...item,
+          patientId: props.patientInfo.patientId,
+          encounterId: props.patientInfo.encounterId,
           adviceType: saveAdviceType,
           dbOpType: item.requestId ? '2' : '1',
           isSaved: true,