diff --git a/openhis-ui-vue3/src/views/surgicalschedule/index.vue b/openhis-ui-vue3/src/views/surgicalschedule/index.vue
index 6866d3d58..a65cd2cdf 100755
--- a/openhis-ui-vue3/src/views/surgicalschedule/index.vue
+++ b/openhis-ui-vue3/src/views/surgicalschedule/index.vue
@@ -1528,7 +1528,11 @@ function handleMedicalAdvice(row) {
   // 先清空旧数据
   temporaryBillingMedicines.value = []
   temporaryAdvices.value = []
-  temporarySigned.value = false // 🔧 重置签名状态
+  // 🔧 修复 Bug #446: 如果是同一 encounter 且已有提交的医嘱（有 requestId），保留签名状态
+  const hasSubmittedAdvices = temporaryAdvices.value.length > 0 &&
+    temporaryAdvices.value[0]?.originalMedicine?.encounterId === row.visitId &&
+    temporaryAdvices.value.some(a => a.originalMedicine?.requestId);
+  temporarySigned.value = hasSubmittedAdvices; // 修复：根据已有数据状态设置，而非盲目重置
   temporaryMedicalLoading.value = true // 🔧 新增：开始加载
 
   // 调用计费接口获取数据
diff --git a/openhis-ui-vue3/src/views/surgicalschedule/temporaryMedical.vue b/openhis-ui-vue3/src/views/surgicalschedule/temporaryMedical.vue
index 14b58b516..1da72293d 100755
--- a/openhis-ui-vue3/src/views/surgicalschedule/temporaryMedical.vue
+++ b/openhis-ui-vue3/src/views/surgicalschedule/temporaryMedical.vue
@@ -147,9 +147,10 @@
         <el-button class="cancel-btn" @click="handleCancel">取消</el-button>
         <el-button
           class="sign-btn"
+          :disabled="allItemsSubmitted"
           @click="handleSignAndSubmit"
         >
-          {{ isSigned ? '提交医嘱' : '一键签名并生成医嘱' }}
+          {{ allItemsSubmitted ? '已签发' : (isSigned ? '提交医嘱' : '一键签名并生成医嘱') }}
         </el-button>
       </div>
     </div>
@@ -310,6 +311,12 @@ const getMethodCodeDict = computed(() => {
   return dict
 })
 
+// 🔧 修复 Bug #446: 检查计费药品是否已全部提交（有 requestId），用于区分"首次签名"和"已提交重开"
+const allItemsSubmitted = computed(() => {
+  const meds = props.billingMedicines || []
+  return meds.length > 0 && meds.every(m => m.requestId)
+})
+
 // 响应式数据 - isSigned 从父组件传入的 prop 初始化
 const isSigned = ref(props.isSignedProp)