diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/controller/DoctorStationAdviceController.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/controller/DoctorStationAdviceController.java
index 6d39727c..6aa58de6 100644
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/controller/DoctorStationAdviceController.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/controller/DoctorStationAdviceController.java
@@ -53,7 +53,7 @@ public class DoctorStationAdviceController {
             @RequestParam(value = "pageSize", defaultValue = "10") Integer pageSize,
             @RequestParam(value = "categoryCode", required = false) String categoryCode) {
         return R.ok(iDoctorStationAdviceAppService.getAdviceBaseInfo(adviceBaseDto, searchKey, locationId,
-                adviceDefinitionIdParamList, organizationId, pageNo, pageSize, Whether.NO.getValue(), adviceTypes, null, categoryCode));
+                adviceDefinitionIdParamList, organizationId, pageNo, pageSize, null, adviceTypes, null, categoryCode));
     }
 
     /**
diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/controller/DoctorStationChineseMedicalController.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/controller/DoctorStationChineseMedicalController.java
index 5864da78..ac97cfc0 100644
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/controller/DoctorStationChineseMedicalController.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/controller/DoctorStationChineseMedicalController.java
@@ -118,7 +118,7 @@ public class DoctorStationChineseMedicalController {
             organizationId = SecurityUtils.getLoginUser().getOrgId();
         }
         return R.ok(iDoctorStationChineseMedicalAppService.getTcmAdviceBaseInfo(adviceBaseDto, searchKey, locationId,
-            adviceDefinitionIdParamList, organizationId, pageNo, pageSize, Whether.NO.getValue()));
+            adviceDefinitionIdParamList, organizationId, pageNo, pageSize, null));
     }
 
     /**
diff --git a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/dto/AdviceBaseDto.java b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/dto/AdviceBaseDto.java
index 0d548de3..47a075ea 100644
--- a/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/dto/AdviceBaseDto.java
+++ b/openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/dto/AdviceBaseDto.java
@@ -198,6 +198,7 @@ public class AdviceBaseDto {
     /**
      * 所属科室
      */
+    @JsonSerialize(using = ToStringSerializer.class)
     private Long orgId;
 
     /**
diff --git a/openhis-ui-vue3/src/views/basicmanage/ordersCombination/components/prescriptionlist.vue b/openhis-ui-vue3/src/views/basicmanage/ordersCombination/components/prescriptionlist.vue
index cf338672..48d343a2 100644
--- a/openhis-ui-vue3/src/views/basicmanage/ordersCombination/components/prescriptionlist.vue
+++ b/openhis-ui-vue3/src/views/basicmanage/ordersCombination/components/prescriptionlist.vue
@@ -819,7 +819,8 @@ function selectAdviceBase(key, row) {
       combinationList.value[rowIndex.value].positionName = stock.locationName;
     }
   } else {
-    combinationList.value[rowIndex.value].orgId = JSON.parse(JSON.stringify(row)).positionId;
+    // 🔧 修复执行科室逻辑：优先使用项目维护的所属科室(row.orgId)，其次使用positionId
+    combinationList.value[rowIndex.value].orgId = row.orgId || JSON.parse(JSON.stringify(row)).positionId;
     combinationList.value[rowIndex.value].unitPrice = row.priceList[0].price;
   }
   expandOrder.value = [key];
diff --git a/openhis-ui-vue3/src/views/clinicmanagement/bargain/component/prescriptionlist.vue b/openhis-ui-vue3/src/views/clinicmanagement/bargain/component/prescriptionlist.vue
index aa662dca..9101399f 100644
--- a/openhis-ui-vue3/src/views/clinicmanagement/bargain/component/prescriptionlist.vue
+++ b/openhis-ui-vue3/src/views/clinicmanagement/bargain/component/prescriptionlist.vue
@@ -702,7 +702,14 @@ async function selectAdviceBase(key, row) {
   };
 
   // 后续字段处理保持原样
-  prescriptionList.value[rowIndex.value].orgId = undefined;
+  // 🔧 修复执行科室逻辑：诊疗项目优先使用项目维护的所属科室(row.orgId)
+  // 如果所属科室为空，则回退到患者当前所在科室
+  if (row.adviceType === 3 && row.orgId) {
+    // 项目有所属科室，直接使用
+    prescriptionList.value[rowIndex.value].orgId = row.orgId;
+  } else {
+    prescriptionList.value[rowIndex.value].orgId = undefined;
+  }
   prescriptionList.value[rowIndex.value].dose = undefined;
   prescriptionList.value[rowIndex.value].unitCodeList = unitCodeList.value;
   prescriptionList.value[rowIndex.value].doseUnitCode =
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 bb239650..8d02ead1 100644
--- a/openhis-ui-vue3/src/views/doctorstation/components/prescription/prescriptionlist.vue
+++ b/openhis-ui-vue3/src/views/doctorstation/components/prescription/prescriptionlist.vue
@@ -3305,8 +3305,9 @@ function syncGroupFields(row) {
   }
   
   // 同步执行科室
-  if (row.positionId || row.orgId) {
-    prescriptionList.value[rowIndex.value].orgId = row.positionId || row.orgId;
+  if (row.orgId || row.positionId) {
+    // 🔧 修复：优先使用项目所属科室(orgId)，其次positionId
+    prescriptionList.value[rowIndex.value].orgId = row.orgId || row.positionId;
   }
   
   // 同步皮试标记
@@ -3390,9 +3391,8 @@ function setValue(row) {
     showPopover: false, // 确保查询框关闭
   };
   console.log('[BugFix] setValue - prescriptionList[rowIndex].adviceType_dictText:', prescriptionList.value[rowIndex.value].adviceType_dictText);
-  // 🔧 Bug #218 修复：保留组套中的值，不要强制设为undefined
-  // 只有当值未定义时才使用默认值
-  prescriptionList.value[rowIndex.value].orgId = row.positionId || row.orgId;
+  // 🔧 修复执行科室逻辑：优先使用项目维护的所属科室(row.orgId)，其次使用positionId，最后回退到患者科室
+  prescriptionList.value[rowIndex.value].orgId = row.orgId || row.positionId || props.patientInfo?.orgId;
   prescriptionList.value[rowIndex.value].dose = row.dose || row.doseQuantity;
   prescriptionList.value[rowIndex.value].quantity = row.quantity || 1;
   prescriptionList.value[rowIndex.value].unitCodeList = unitCodeList.value;
@@ -3619,8 +3619,8 @@ function handleSaveGroup(orderGroupList) {
       unitCode: item.unitCode,
       unitCode_dictText: item.unitCodeName || '',
       statusEnum: 1,
-      // 🔧 Bug #218 修复：优先使用 item.positionId，其次使用 orderDetailInfos.positionId
-      orgId: item.positionId || item.orderDetailInfos?.positionId || mergedDetail.positionId,
+      // 🔧 修复执行科室逻辑：优先使用 orgId(所属科室)，其次 positionId
+      orgId: item.orderDetailInfos?.orgId || mergedDetail.orgId || item.positionId || item.orderDetailInfos?.positionId || mergedDetail.positionId,
       dbOpType: prescriptionList.value[rowIndex.value].requestId ? '2' : '1',
       conditionId: conditionId.value,
       conditionDefinitionId: conditionDefinitionId.value,
diff --git a/openhis-ui-vue3/src/views/inpatientDoctor/home/components/order/OrderForm.vue b/openhis-ui-vue3/src/views/inpatientDoctor/home/components/order/OrderForm.vue
index 1249c2e6..4834dbb8 100644
--- a/openhis-ui-vue3/src/views/inpatientDoctor/home/components/order/OrderForm.vue
+++ b/openhis-ui-vue3/src/views/inpatientDoctor/home/components/order/OrderForm.vue
@@ -395,11 +395,12 @@
                 clearable
                 v-model="row.orgId"
                 style="width: 200px"
-                :data="config.organization"
+                :data="orgTreeData"
                 :props="{ value: 'id', label: 'name', children: 'children' }"
                 value-key="id"
                 check-strictly
                 default-expand-all
+                :fallback-option="orgFallbackOption"
                 @change="handleOrgChange"
                 placeholder="请选择执行科室"
               />
@@ -422,7 +423,7 @@
 </template>
 
 <script setup lang="ts">
-import {getCurrentInstance, nextTick, onMounted, ref, watch} from 'vue';
+import {computed, getCurrentInstance, nextTick, onMounted, ref, watch} from 'vue';
 
 interface Config {
   diagnosisName: string; // 仅用于显示
@@ -569,6 +570,54 @@ const handleCancel = () => {
 const handleNumberClick = (item: any) =>
   props.handlers.handleNumberClick(item, props.index, props.row);
 const handleOrgChange = (value: any) => props.handlers.handleOrgChange(value, props.index);
+
+// 🔧 关键修复：计算属性，确保当前行的 orgId 始终存在于树数据中
+// 当 orgId 不在科室树中时，注入一个临时节点，让 el-tree-select 能正确显示中文名称
+const orgTreeData = computed(() => {
+  const tree = props.config.organization || [];
+  const orgId = props.row?.orgId;
+  const orgName = props.row?.orgName || props.row?.positionName;
+  if (!orgId || !orgName) return tree;
+
+  // 检查 orgId 是否已在树中存在
+  const existsInTree = findOrgName(orgId);
+  if (existsInTree) return tree;
+
+  // 注入临时节点到树根层级
+  return [...tree, { id: String(orgId), name: orgName, children: [] }];
+});
+
+// 🔧 从 organization 树中根据 orgId 查找科室名称（供 fallback-option 使用）
+function findOrgName(orgId: any): string {
+  if (!orgId || !props.config.organization || props.config.organization.length === 0) return '';
+  const strId = String(orgId);
+  function walk(nodes: any[]): string {
+    if (!nodes) return '';
+    for (const node of nodes) {
+      if (String(node.id) === strId) return node.name;
+      // 模糊匹配：处理大 Long 精度丢失的情况
+      if (typeof node.id === 'string' && node.id.length >= 16 && strId.length >= 16
+          && node.id.substring(0, 15) === strId.substring(0, 15)) {
+        return node.name;
+      }
+      if (node.children) {
+        const found = walk(node.children);
+        if (found) return found;
+      }
+    }
+    return '';
+  }
+  return walk(props.config.organization);
+}
+
+// 🔧 el-tree-select 的 fallback-option：当 orgId 匹配不到树节点时，
+// 仍然显示对应的中文科室名称而非原始数字 ID
+// 优先从科室树查找，其次用 row 上保存的 orgName/positionName 兜底
+const orgFallbackOption = (value: any) => {
+  const name = findOrgName(value);
+  const fallbackName = props.row?.orgName || props.row?.positionName;
+  return { label: name || fallbackName || value, value };
+};
 const convertValues = () => props.handlers.convertValue('doseQuantity', props.row, props.index);
 const convertDoseValues = () => props.handlers.convertValue('dose', props.row, props.index);
 const calculateTotalPrice = () => props.handlers.calculateTotal('price', props.row, props.index);
diff --git a/openhis-ui-vue3/src/views/inpatientDoctor/home/components/order/index.vue b/openhis-ui-vue3/src/views/inpatientDoctor/home/components/order/index.vue
index b429bb5f..e0bf673b 100644
--- a/openhis-ui-vue3/src/views/inpatientDoctor/home/components/order/index.vue
+++ b/openhis-ui-vue3/src/views/inpatientDoctor/home/components/order/index.vue
@@ -593,29 +593,45 @@ function getListInfo(addNewRow) {
   }, 180);
   isAdding.value = false;
   expandOrder.value = [];
+  // 🔧 修复：先加载科室树，再处理处方数据
+  // 确保 resolveOrgId 在 organization 树已加载的情况下执行
+  // 避免因树为空导致 orgId 无法匹配，从而显示数字 ID 而非中文名称
+  const orgTreePromise = getOrgTree().then((res) => {
+    organization.value = res?.data?.records ?? res?.data ?? [];
+  });
   getPrescriptionList(patientInfo.value.encounterId).then((res) => {
     console.log('getListInfo==========>', JSON.stringify(res.data));
-
-    loadingInstance.close();
-    prescriptionList.value = res.data
-      .map((item) => {
-        const parsedContent = JSON.parse(item.contentJson);
-        return {
-          ...parsedContent,
-          ...item,
-          doseQuantity: parsedContent?.doseQuantity,
-          doseUnitCode_dictText: parsedContent?.doseUnitCode_dictText,
-          // 确保 therapyEnum 被正确设置，优先使用 contentJson 中的值
-          therapyEnum: String(parsedContent?.therapyEnum ?? item.therapyEnum ?? '1'),
-        };
-      })
-      .sort((a, b) => {
-        return new Date(b.requestTime) - new Date(a.requestTime);
-      });
-    getGroupMarkers(); // 更新标记
-    if (props.activeTab == 'prescription' && addNewRow) {
-      handleAddPrescription();
-    }
+    // 等待科室树加载完成后再处理处方数据，确保 resolveOrgId 能正确匹配
+    orgTreePromise.then(() => {
+      loadingInstance.close();
+      prescriptionList.value = res.data
+        .map((item) => {
+          const parsedContent = JSON.parse(item.contentJson);
+          return {
+            ...parsedContent,
+            ...item,
+            doseQuantity: parsedContent?.doseQuantity,
+            doseUnitCode_dictText: parsedContent?.doseUnitCode_dictText,
+            // 确保 therapyEnum 被正确设置，优先使用 contentJson 中的值
+            therapyEnum: String(parsedContent?.therapyEnum ?? item.therapyEnum ?? '1'),
+            // 🔧 修复：确保 orgId 为 String 类型，与 organization 树的 id 类型一致
+            // 关键：优先使用 item.positionId（后端 @JsonSerialize 保证精度），
+            // 而非 parsedContent.orgId（来自 JSON.parse，大 Long 可能精度丢失）
+            // 使用 resolveOrgId 从组织树中匹配正确的 String id
+            orgId: resolveOrgId(item.positionId || parsedContent?.orgId || item.orgId) || undefined,
+            // 🔧 修复：同时保存 orgName，当 orgId 在科室树中匹配不到时作为兜底显示
+            // 优先从科室树查找名称，其次用 positionName（后端已保存的科室名），最后用 contentJson 中的 orgName
+            orgName: findOrgName(item.positionId || parsedContent?.orgId || item.orgId) || item.positionName || parsedContent?.orgName || undefined,
+          };
+        })
+        .sort((a, b) => {
+          return new Date(b.requestTime) - new Date(a.requestTime);
+        });
+      getGroupMarkers(); // 更新标记
+      if (props.activeTab == 'prescription' && addNewRow) {
+        handleAddPrescription();
+      }
+    });
   });
   getContract({ encounterId: patientInfo.value.encounterId }).then((res) => {
     contractList.value = res.data;
@@ -796,6 +812,27 @@ function clickRowDb(row, column, event) {
   }
 }
 
+/**
+ * 🔧 从 organization 树中根据 orgId 查找科室名称
+ * 供 el-tree-select 的 fallback-option 使用
+ */
+function findOrgName(orgId) {
+  if (!orgId || !organization.value || organization.value.length === 0) return '';
+  const strId = String(orgId);
+  function walk(nodes) {
+    if (!nodes) return '';
+    for (const node of nodes) {
+      if (String(node.id) === strId) return node.name;
+      if (node.children) {
+        const found = walk(node.children);
+        if (found) return found;
+      }
+    }
+    return '';
+  }
+  return walk(organization.value);
+}
+
 function getFormConfig() {
   return {
     diagnosisName: diagnosisName.value,
@@ -934,7 +971,74 @@ function selectAdviceBase(key, row) {
 
 function getOrgList() {
   getOrgTree().then((res) => {
-    organization.value = res.data.records;
+    organization.value = res?.data?.records ?? res?.data ?? [];
+    // 🔧 修复：组织树加载完成后，重新解析所有医嘱行的orgId
+    // 确保orgId能匹配到树节点，解决精度丢失或类型不匹配的问题
+    resolveAllOrgIds();
+  });
+}
+
+/**
+ * 🔧 从 organization 树中查找正确的 String 类型 id
+ * 解决 JavaScript 大整数精度丢失问题：
+ * 当 orgId 为 Number 且超过 Number.MAX_SAFE_INTEGER 时，String() 转换会丢失精度
+ * 例：19072662242626273 (Long) → JS Number 19072662242626272 → String "19072662242626272" (错误)
+ * 通过在 organization 树中模糊匹配找到正确的 String id
+ */
+function resolveOrgId(rawOrgId) {
+  if (!rawOrgId) return undefined;
+  const strOrgId = String(rawOrgId);
+  
+  // 递归在树中查找匹配的节点
+  function findInTree(nodes) {
+    if (!nodes || !Array.isArray(nodes)) return null;
+    for (const node of nodes) {
+      // 精确匹配（正常情况：id 和 orgId 都是 String 且值一致）
+      if (String(node.id) === strOrgId) return String(node.id);
+      // 模糊匹配：精度丢失通常只影响最后1-2位数字
+      // 比较前15位是否相同（2^53 约 9007199254740992，共16位，前15位稳定）
+      // 🔧 修复：同时处理 Number 和 String 类型的精度丢失情况
+      // 场景1：rawOrgId 是 Number（JS已丢失精度），node.id 是正确 String
+      // 场景2：rawOrgId 是 String（从已丢失精度的 Number 转来），node.id 是正确 String
+      if (typeof node.id === 'string' && node.id.length >= 16 && strOrgId.length >= 16
+          && node.id.substring(0, 15) === strOrgId.substring(0, 15)) {
+        return String(node.id);
+      }
+      // 递归搜索子节点
+      if (node.children) {
+        const found = findInTree(node.children);
+        if (found) return found;
+      }
+    }
+    return null;
+  }
+  
+  const resolved = findInTree(organization.value);
+  if (!resolved) {
+    console.warn(`🔧 resolveOrgId 未匹配: rawOrgId=${rawOrgId}, type=${typeof rawOrgId}, strOrgId=${strOrgId}, treeSize=${organization.value?.length}`);
+  }
+  return resolved || strOrgId;
+}
+
+/**
+ * 🔧 组织树加载完成后，重新解析所有医嘱行的orgId
+ * 确保已有的医嘱行 orgId 能匹配到树节点
+ */
+function resolveAllOrgIds() {
+  if (!organization.value || organization.value.length === 0) return;
+  prescriptionList.value.forEach((row) => {
+    if (row.orgId && row.adviceType == 3) {
+      const resolved = resolveOrgId(row.orgId);
+      if (resolved !== String(row.orgId)) {
+        console.log(`🔧 orgId精度修复: ${row.orgId} → ${resolved} (${row.adviceName})`);
+        row.orgId = resolved;
+      }
+      // 🔧 修复：同步更新 orgName，确保科室树加载后能正确显示中文名称
+      const treeName = findOrgName(row.orgId);
+      if (treeName) {
+        row.orgName = treeName;
+      }
+    }
   });
 }
 
@@ -1000,6 +1104,9 @@ function handleNumberClick(item, index, row) {
 // 选择执行科室处理
 function handleOrgChange(value, index) {
   prescriptionList.value[index].positionId = value;
+  prescriptionList.value[index].orgId = value;
+  // 🔧 修复：同步保存 orgName，确保树匹配不到时仍有中文名称可显示
+  prescriptionList.value[index].orgName = findOrgName(value) || '';
 }
 
 /**
@@ -1090,11 +1197,11 @@ function handleSave() {
     // 保存签发按钮
     isSaving.value = true;
     console.log('签发处方参数：', {
-      organizationId: patientInfo.value.orgId,
+      organizationId: patientInfo.value.inHospitalOrgId,
       adviceSaveList: list,
     });
     savePrescriptionSign({
-      organizationId: patientInfo.value.orgId,
+      organizationId: patientInfo.value.inHospitalOrgId,
       regAdviceSaveList: list,
     })
       .then((res) => {
@@ -1391,7 +1498,14 @@ function setValue(row) {
     ...prevRow,
     ...baseRow,
     uniqueKey: currentUniqueKey, // 确保 uniqueKey 不被覆盖
-    orgId: row.adviceType != 3 ? undefined : JSON.parse(JSON.stringify(row)).positionId,
+    // 🔧 修复执行科室逻辑：
+    // 1. 非诊疗类型(adviceType!=3)不需要执行科室，设为undefined
+    // 2. 诊疗类型优先使用项目维护的所属科室(row.orgId)，其次positionId
+    // 3. 如果都为空，回退到患者当前所在科室(patientInfo.orgId)
+    // 4. 使用 resolveOrgId 从组织树中匹配正确的 String id，解决大 Long 精度丢失问题
+    orgId: row.adviceType != 3 ? undefined : (resolveOrgId(row.orgId || row.positionId || patientInfo.value?.inHospitalOrgId) || ''),
+    // 🔧 修复：同时保存 orgName，当 orgId 在科室树中匹配不到时作为兜底显示
+    orgName: row.adviceType != 3 ? undefined : (findOrgName(row.orgId || row.positionId || patientInfo.value?.inHospitalOrgId) || row.orgName || patientInfo.value?.inHospitalOrgName || ''),
     dose: undefined,
     unitCodeList: unitCodeList.value,
     doseUnitCode: row.doseUnitCode,
@@ -1487,7 +1601,9 @@ function handleSaveGroup(orderGroupList) {
       unitCode: item.unitCode,
       unitCode_dictText: item.unitCodeName || '',
       statusEnum: 1,
-      orgId: item.orderDetailInfos?.positionId || mergedDetail.positionId,
+      orgId: resolveOrgId(item.orderDetailInfos?.orgId || mergedDetail.orgId || patientInfo.value?.inHospitalOrgId) || '',
+      // 🔧 修复：同时保存 orgName，确保树匹配不到时仍有中文名称可显示
+      orgName: findOrgName(item.orderDetailInfos?.orgId || mergedDetail.orgId || patientInfo.value?.inHospitalOrgId) || item.orderDetailInfos?.orgName || mergedDetail.orgName || patientInfo.value?.inHospitalOrgName || '',
       dbOpType: prescriptionList.value[rowIndex.value].requestId ? '2' : '1',
       conditionId: conditionId.value,
       conditionDefinitionId: conditionDefinitionId.value,