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 df298f387..31ee811d9 100755
--- a/openhis-ui-vue3/src/views/doctorstation/components/prescription/prescriptionlist.vue
+++ b/openhis-ui-vue3/src/views/doctorstation/components/prescription/prescriptionlist.vue
@@ -3326,9 +3326,13 @@ function syncGroupFields(row) {
   }
   
   // 同步执行科室
+  // 🔧 Bug #455: 诊疗类医嘱(adviceType=3)不使用项目配置的执行科室，
+  // 避免配置ID不在机构树中导致显示原始ID，保持患者就诊科室即可
   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;
+    if (Number(row.adviceType) != 3) {
+      // 🔧 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
@@ -3412,8 +3416,11 @@ async 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 #455: 执行科室默认逻辑：使用positionId(诊疗执行科室配置) → 患者就诊科室，不再使用row.orgId(项目所属科室)
-  prescriptionList.value[rowIndex.value].orgId = row.positionId || props.patientInfo?.orgId;
+  // 🔧 Bug #455: 诊疗医嘱(adviceType=3)的执行科室默认使用患者就诊科室，
+  // 不使用positionId(诊疗目录配置的执行科室)，避免配置ID不在机构树中导致显示原始ID
+  if (Number(row.adviceType) != 3) {
+    prescriptionList.value[rowIndex.value].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;