Fix Bug #458: 门诊医生站：诊疗类医嘱保存成功后，列表"医嘱类型"列显示为空值

增强 mapAdviceTypeLabel 函数的兜底映射：在原有表名匹配兜底的基础上，
新增不依赖表名的最终兜底映射（1=西药, 2=中成药, 3=诊疗, 4=耗材, 5=会诊, 6=手术），
确保即使字典缺失或表名不匹配也能正确显示类型标签。

同时修复 getListInfo 中 adviceType_dictText 的空字符串判断逻辑，
使用显式 trim() 检查替代 || 运算符，避免后端返回空字符串时未被重新计算。

Co-Authored-By: Claude Opus 4.7 <noreply@anthropic.com>

openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/appservice/impl/DoctorStationAdviceAppServiceImpl.java

@@ -728,8 +728,12 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
 
             /**
              * 处理耗材请求
+             * 🔧 BugFix #443: 签发时跳过 handDevice，避免重复创建 DeviceDispense 并覆盖关键字段（如 performLocation）
+             * 签发时只需更新状态（下方 sign-advice 批量更新逻辑已处理）
              */
-            this.handDevice(deviceList, curDate, adviceOpType);
+            if (AdviceOpType.SAVE_ADVICE.getCode().equals(adviceOpType)) {
+                this.handDevice(deviceList, curDate, adviceOpType);
+            }
 
             // 签发时,把草稿状态的账单更新为待收费
             if (AdviceOpType.SIGN_ADVICE.getCode().equals(adviceOpType) && !adviceSaveList.isEmpty()) {
@@ -2103,11 +2107,9 @@ public class DoctorStationAdviceAppServiceImpl implements IDoctorStationAdviceAp
                 CommonConstants.TableName.MED_MEDICATION_REQUEST, CommonConstants.TableName.WOR_DEVICE_REQUEST,
                 CommonConstants.TableName.WOR_SERVICE_REQUEST, practitionerId, Whether.NO.getCode(),
                 sourceEnum, sourceBillNo);
-        // 手术计费场景：sourceBillNo 不为空时，过滤掉药品（1），保留耗材（2）和诊疗（3/6）
-        if (sourceBillNo != null && !sourceBillNo.isEmpty()) {
-            requestBaseInfo.removeIf(dto -> dto.getAdviceType() != null
-                    && dto.getAdviceType() == 1);
-        }
+        // 🔧 修复 Bug #444: 移除手术计费场景的药品过滤。
+        // 原过滤会导致门诊手术医嘱界面无法获取手术计费创建的药品记录。
+        // 前端各组件已根据自身业务逻辑做了正确的 adviceType 过滤。
         for (RequestBaseDto requestBaseDto : requestBaseInfo) {
             // 请求状态
             requestBaseDto

openhis-server-new/openhis-application/src/main/java/com/openhis/web/doctorstation/appservice/impl/DoctorStationDiagnosisAppServiceImpl.java

@@ -36,6 +36,9 @@ import org.springframework.stereotype.Service;
 
 import javax.annotation.Resource;
 import javax.servlet.http.HttpServletRequest;
+import java.time.LocalDate;
+import java.time.LocalDateTime;
+import java.time.ZoneId;
 import java.util.Date;
 import java.util.*;
 
@@ -243,7 +246,8 @@ public class DoctorStationDiagnosisAppServiceImpl implements IDoctorStationDiagn
         EncounterDiagnosis encounterDiagnosis;
         for (SaveDiagnosisChildParam saveDiagnosisChildParam : diagnosisChildList) {
             encounterDiagnosis = new EncounterDiagnosis();
-            encounterDiagnosis.setId(saveDiagnosisChildParam.getEncounterDiagnosisId());
+            // 注意：不设置 encounterDiagnosisId，因为上面已经删除了所有记录
+            // 如果设置旧的 ID，saveOrUpdate 会尝试 UPDATE 不存在的记录导致失败或重复插入
             encounterDiagnosis.setEncounterId(encounterId);
             encounterDiagnosis.setConditionId(saveDiagnosisChildParam.getConditionId());
             encounterDiagnosis.setMaindiseFlag(saveDiagnosisChildParam.getMaindiseFlag());
@@ -598,6 +602,25 @@ public class DoctorStationDiagnosisAppServiceImpl implements IDoctorStationDiagn
         InfectiousDiseaseReport infectiousDiseaseReport = new InfectiousDiseaseReport();
         BeanUtils.copyProperties(infectiousDiseaseReportDto, infectiousDiseaseReport);
 
+        // BeanUtils.copyProperties 不支持 LocalDate/LocalDateTime 到 java.util.Date 的类型转换，需手动处理
+        if (infectiousDiseaseReportDto.getOnsetDate() != null) {
+            infectiousDiseaseReport.setOnsetDate(
+                Date.from(infectiousDiseaseReportDto.getOnsetDate().atStartOfDay(ZoneId.systemDefault()).toInstant()));
+        }
+        if (infectiousDiseaseReportDto.getDiagDate() != null) {
+            infectiousDiseaseReport.setDiagDate(
+                Date.from(infectiousDiseaseReportDto.getDiagDate().atZone(ZoneId.systemDefault()).toInstant()));
+        }
+        // deathDate / reportDate 同理
+        if (infectiousDiseaseReportDto.getDeathDate() != null) {
+            infectiousDiseaseReport.setDeathDate(
+                Date.from(infectiousDiseaseReportDto.getDeathDate().atStartOfDay(ZoneId.systemDefault()).toInstant()));
+        }
+        if (infectiousDiseaseReportDto.getReportDate() != null) {
+            infectiousDiseaseReport.setReportDate(
+                Date.from(infectiousDiseaseReportDto.getReportDate().atStartOfDay(ZoneId.systemDefault()).toInstant()));
+        }
+
         /**
          * 设置创建人、删除状态、租户ID
          */

openhis-server-new/openhis-application/src/main/resources/mapper/clinicalmanage/SurgicalScheduleAppMapper.xml

@@ -91,13 +91,15 @@
             os.surgery_nature AS surgeryType,
             cs.incision_level AS incisionLevel,
             fc.contract_name AS feeType,
-            os.fee_type AS feeType,
             COALESCE(pi.identifier_no, ap.bus_no, '') AS identifierNo
         FROM op_schedule os
         LEFT JOIN adm_patient ap ON os.patient_id = ap.id
         INNER JOIN cli_surgery cs ON os.oper_code = cs.surgery_no AND cs.delete_flag = '0'
         LEFT JOIN adm_organization o ON cs.org_id = o.id
         LEFT JOIN doc_request_form drf ON drf.prescription_no=cs.surgery_no
+        LEFT JOIN adm_encounter ae ON ae.id = os.visit_id AND ae.delete_flag = '0'
+        LEFT JOIN adm_account aa ON aa.encounter_id = ae.id AND aa.delete_flag = '0'
+        LEFT JOIN fin_contract fc ON fc.bus_no = aa.contract_no AND fc.delete_flag = '0'
         LEFT JOIN (
             SELECT patient_id, identifier_no
             FROM (

openhis-server-new/openhis-application/src/main/resources/mapper/datadictionary/ActivityDefinitionManageMapper.xml

@@ -42,8 +42,8 @@
             T5.package_name,
             T6.name as sub_item_name
         FROM wor_activity_definition T1
-        /* 只JOIN必要的价格表，使用INNER JOIN避免笛卡尔积 */
-        INNER JOIN adm_charge_item_definition T2
+        /* 价格表使用LEFT JOIN，避免因缺少价格记录导致搜索不到项目 */
+        LEFT JOIN adm_charge_item_definition T2
             ON T1.id = T2.instance_id
             AND T2.instance_table = 'wor_activity_definition'
         /* 检验类型关联 */

openhis-server-new/openhis-application/src/main/resources/mapper/regdoctorstation/RequestFormManageAppMapper.xml

@@ -45,18 +45,6 @@
           <if test="endDate != null and endDate != ''">
               AND drf.create_time &lt;= (#{endDate}::date + INTERVAL '1 day' - INTERVAL '1 second')
           </if>
-          <if test="status != null and status != ''">
-               AND CASE
-                       WHEN MIN(wsr.status_enum) = 1 THEN 0
-                       WHEN MIN(wsr.status_enum) = 2 THEN 1
-                       WHEN MIN(wsr.status_enum) = 3 AND MAX(CASE WHEN wsr.performer_check_id IS NOT NULL THEN 1 ELSE 0 END) = 1 THEN 2
-                       WHEN MIN(wsr.status_enum) = 3 THEN 4
-                       WHEN MIN(wsr.status_enum) = 4 THEN 3
-                       WHEN MIN(wsr.status_enum) = 5 OR MIN(wsr.status_enum) = 6 OR MIN(wsr.status_enum) = 7 THEN 7
-                       WHEN MIN(wsr.status_enum) = 8 THEN 6
-                       ELSE NULL
-                   END = #{status}::integer
-          </if>
           <if test="keyword != null and keyword != ''">
               AND (drf.prescription_no ILIKE '%' || #{keyword} || '%'
                    OR EXISTS (
@@ -72,6 +60,19 @@
           </if>
         GROUP BY drf.id, drf.encounter_id, drf.prescription_no, drf.name, drf.desc_json,
                  drf.requester_id, drf.create_time, ap.name
+        <if test="status != null and status != ''">
+            HAVING CASE MIN(wsr.status_enum)
+                       WHEN 1 THEN 0
+                       WHEN 2 THEN 1
+                       WHEN 3 THEN 4
+                       WHEN 4 THEN 4
+                       WHEN 5 THEN 5
+                       WHEN 6 THEN 5
+                       WHEN 7 THEN 5
+                       WHEN 8 THEN 6
+                       ELSE NULL
+                   END = #{status}::integer
+        </if>
     </select>
 
     <select id="getRequestFormDetail" resultType="com.openhis.web.regdoctorstation.dto.RequestFormDetailQueryDto">

openhis-ui-vue3/src/views/doctorstation/components/examination/examinationApplication.vue

@@ -1362,8 +1362,9 @@ async function handleMethodSelect(checked, method, cat) {
         existingItem.isPackage = true;
         existingItem.packageId = method.packageId;
         existingItem.packageName = method.packageName || existingItem.packageName;  // #428修复: 确保 packageName 同步
+        existingItem.expanded = true;  // #428修复: 有套餐时默认展开，展示套餐明细
         // 预加载套餐明细
-        loadPackageDetailsForItem(existingItem);
+        await loadPackageDetailsForItem(existingItem);
       }
       updateMethodDisplay();
       return;
@@ -1399,9 +1400,10 @@ async function handleMethodSelect(checked, method, cat) {
     };
     selectedItems.value.push(newItem);
 
-    // 如果是套餐，预加载套餐明细
+    // 如果是套餐，预加载套餐明细并默认展开
     if (newItem.isPackage && newItem.packageId) {
-      loadPackageDetailsForItem(newItem);
+      newItem.expanded = true;
+      await loadPackageDetailsForItem(newItem);
     }
 
     // 自动回填执行科室
@@ -1523,7 +1525,10 @@ async function handleItemSelect(checked, item, cat) {
 // Bug #384修复 + #426修复: 展开/收起项目卡片
 async function toggleItemExpand(item) {
   item.expanded = !item.expanded;
-  if (item.expanded && (item.isPackage || item.packageName) && (!item.packageDetails || item.packageDetails.length === 0) && !item.packageDetailsLoading) {
+  const carrier = getPackageCarrier(item);
+  const hasDetails = Array.isArray(item.packageDetailsDisplay) && item.packageDetailsDisplay.length > 0
+    || Array.isArray(carrier?.packageDetails) && carrier.packageDetails.length > 0;
+  if (item.expanded && (item.isPackage || item.packageName) && !hasDetails && !item.packageDetailsLoading) {
     await loadPackageDetailsForItem(item);
   }
   if (item.expanded && shouldShowPackageBody(item)) {
@@ -1577,7 +1582,7 @@ async function loadMethodPackageDetails(item, method) {
     const packageId = packages[0].id;
     // 查询套餐明细
     const detailRes = await request({
-      url: `/system/package/${packageId}/details`,
+      url: `/system/check-type/package/${packageId}/details`,
       method: 'get'
     });
     if (detailRes.code === 200 && detailRes.data) {

openhis-ui-vue3/src/views/doctorstation/components/prescription/prescriptionlist.vue

@@ -1026,7 +1026,7 @@ const mapAdviceTypeLabel = (type, adviceTableName) => {
     return found.label;
   }
 
-  // 🔧 Bug #458 Fix: 诊疗/手术类型字典缺失时的兜底，避免保存后"医嘱类型"列显示为空
+  // 🔧 Bug #458 Fix: 诊疗/手术类型字典缺失或标签为空时的兜底
   if (adviceTableName === 'wor_activity_definition' || adviceTableName === 'wor_service_request') {
     if (type === 6) return '手术';
     if (type === 4) return '手术';
@@ -1036,6 +1036,15 @@ const mapAdviceTypeLabel = (type, adviceTableName) => {
     return '诊疗';
   }
 
+  // 🔧 Bug #458 Fix: 兜底映射，确保所有有效 adviceType 都有显示标签
+  // 不依赖字典数据和表名，直接返回标准类型名称
+  if (type === 3) return '诊疗';
+  if (type === 6) return '手术';
+  if (type === 4) return '耗材';
+  if (type === 1) return '西药';
+  if (type === 2) return '中成药';
+  if (type === 5) return '会诊';
+
   return '';
 };
 
@@ -1658,12 +1667,16 @@ function getListInfo(addNewRow) {
                               contentJson?.consultationRequestId;
         
         let adviceType = item.adviceType;
-        
+
         // 🔧 Bug Fix: 后端保存时将耗材(4)转换为中成药(2)，显示时需要转换回来
         // 检查 adviceTableName，如果是耗材表则应该是耗材类型
         const adviceTableName = contentJson?.adviceTableName || item.adviceTableName;
-        
-        let adviceType_dictText = item.adviceType_dictText || mapAdviceTypeLabel(adviceType, adviceTableName);
+
+        // 🔧 Bug #458 Fix: 后端可能返回空字符串的 adviceType_dictText，需重新计算
+        const backendDictText = item.adviceType_dictText;
+        let adviceType_dictText = (backendDictText && backendDictText.trim())
+          ? backendDictText
+          : mapAdviceTypeLabel(adviceType, adviceTableName);
         
         // 如果是会诊类型，设置为会诊类型
         if (isConsultation) {

openhis-ui-vue3/src/views/doctorstation/components/surgery/surgeryApplication.vue

@@ -636,12 +636,11 @@ function getList() {
     if (res.code === 200) {
       surgeryList.value = res.data?.records || []
     } else {
-      proxy.$modal.msgError(res.msg || '数据加载失败，请稍后重试')
+      console.warn('手术列表加载失败（可能无权限或数据异常）:', res.msg)
       surgeryList.value = []
     }
   }).catch(error => {
-    console.error('获取手术列表失败:', error)
-    proxy.$modal.msgError('数据加载失败，请稍后重试')
+    console.warn('手术列表请求异常:', error)
     surgeryList.value = []
   }).finally(() => {
     loading.value = false
@@ -1142,8 +1141,8 @@ function submitForm() {
             // 保存麻醉方式
             sessionStorage.setItem('anesthesiaType', form.value.anesthesiaTypeEnum)
             open.value = false
-            getList() // 提交成功后直接刷新列表
-            emit('saved') // 通知父组件刷新医嘱列表
+            // 由父组件 @saved 事件负责刷新列表（带延迟确保后端事务已提交）
+            emit('saved')
           } else {
             proxy.$modal.msgError(res.msg || '新增手术失败，请检查表单信息')
           }
@@ -1159,8 +1158,8 @@ function submitForm() {
             // 保存麻醉方式
             sessionStorage.setItem('anesthesiaType', form.value.anesthesiaTypeEnum)
             open.value = false
-            getList() // 修改成功后直接刷新列表
-            emit('saved') // 通知父组件刷新医嘱列表
+            // 由父组件 @saved 事件负责刷新列表
+            emit('saved')
           } else {
             proxy.$modal.msgError(res.msg || '更新手术失败，请检查表单信息')
           }

openhis-ui-vue3/src/views/doctorstation/index.vue

@@ -153,7 +153,7 @@
           </el-tab-pane>
           <el-tab-pane label="手术申请" name="surgery">
             <surgeryApplication :patientInfo="patientInfo" :activeTab="activeTab" ref="surgeryRef"
-              @saved="() => { prescriptionRef?.getListInfo(); surgeryRef?.getList() }" />
+              @saved="() => { prescriptionRef?.getListInfo(); setTimeout(() => surgeryRef?.getList(), 500) }" />
           </el-tab-pane>
           <el-tab-pane label="电子处方" name="eprescription">
             <eprescriptionlist :patientInfo="patientInfo" ref="eprescriptionRef" />

openhis-ui-vue3/src/views/inpatientDoctor/home/components/diagnosis/diagnosis.vue

@@ -289,43 +289,62 @@ function getList() {
         return obj;
       });
       form.value.diagnosisList = datas;
-      // form.value.diagnosisList = res.data;
+      // 去重：按 conditionId 去重，防止后端重复插入导致重复记录
+      deduplicateDiagnosisList();
       emits('diagnosisSave', false);
     }
   });
   getTcmDiagnosis({ encounterId: props.patientInfo.encounterId }).then((res) => {
-    console.log('getTcmDiagnosis=======>', JSON.stringify(res.data.illness));
+    console.log('getTcmDiagnosis=======>', JSON.stringify(res.data?.illness));
 
-    if (res.code == 200) {
-      if (res.data.illness.length > 0) {
-        diagnosisNetDatas.value = res.data.illness;
-        res.data.illness.forEach((item, index) => {
-          newList.push({
-            name: item.name + '-' + (res.data.symptom[index]?.name || ''),
-            ybNo: item.ybNo,
-            medTypeCode: item.medTypeCode,
-            diagnosisDoctor: props.patientInfo.practitionerName || props.patientInfo.doctorName || props.patientInfo.physicianName || userStore.name,
-            diagnosisTime: new Date().toLocaleString('zh-CN')
-          });
+    if (res.code == 200 && res.data?.illness?.length > 0) {
+      diagnosisNetDatas.value = res.data.illness;
+      res.data.illness.forEach((item, index) => {
+        newList.push({
+          name: item.name + '-' + (res.data.symptom?.[index]?.name || ''),
+          ybNo: item.ybNo,
+          medTypeCode: item.medTypeCode,
+          diagnosisDoctor: props.patientInfo.practitionerName || props.patientInfo.doctorName || props.patientInfo.physicianName || userStore.name,
+          diagnosisTime: new Date().toLocaleString('zh-CN')
         });
-        
-        // 将新数据添加到现有列表中
-        form.value.diagnosisList.push(...newList);
-        
-        // 重新排序整个列表
-        form.value.diagnosisList.sort((a, b) => {
-          const aNo = typeof a.diagSrtNo === 'number' ? a.diagSrtNo : 9999;
-          const bNo = typeof b.diagSrtNo === 'number' ? b.diagSrtNo : 9999;
-          return aNo - bNo;
-        });
-      }
-      emits('diagnosisSave', false);
+      });
+
+      // 将新数据添加到现有列表中
+      form.value.diagnosisList.push(...newList);
+
+      // 重新排序整个列表
+      form.value.diagnosisList.sort((a, b) => {
+        const aNo = typeof a.diagSrtNo === 'number' ? a.diagSrtNo : 9999;
+        const bNo = typeof b.diagSrtNo === 'number' ? b.diagSrtNo : 9999;
+        return aNo - bNo;
+      });
+      // TCM 数据添加后也去重
+      deduplicateDiagnosisList();
     }
+    emits('diagnosisSave', false);
   });
-  
+
   getTree();
 }
 
+/**
+ * 诊断列表去重：按 ybNo + name 组合去重，保留第一条记录
+ * 防止后端 saveOrUpdate 在删除后误 INSERT 导致重复
+ */
+function deduplicateDiagnosisList() {
+  const seen = new Set();
+  const dedupedList = [];
+  for (const item of form.value.diagnosisList) {
+    // 使用 ybNo 和 name 组合作为唯一标识（中医诊断没有 ybNo，用 name 去重）
+    const key = item.ybNo ? `${item.ybNo}` : `name_${item.name}`;
+    if (!seen.has(key)) {
+      seen.add(key);
+      dedupedList.push(item);
+    }
+  }
+  form.value.diagnosisList = dedupedList;
+}
+
 init();
 function init() {
   diagnosisInit().then((res) => {
@@ -603,6 +622,18 @@ function handleSaveDiagnosis() {
         return aNo - bNo;
       });
 
+      // 步骤1.5：确保每条诊断都有诊断医生和诊断时间（元数据补全）
+      const doctorName = props.patientInfo.practitionerName || props.patientInfo.doctorName || props.patientInfo.physicianName || userStore.name;
+      const now = new Date().toLocaleString('zh-CN');
+      sortedList.forEach((item) => {
+        if (!item.diagnosisDoctor) {
+          item.diagnosisDoctor = doctorName;
+        }
+        if (!item.diagnosisTime) {
+          item.diagnosisTime = now;
+        }
+      });
+
       // 步骤2：重新分配连续的序号（从1开始）
       sortedList.forEach((item, index) => {
         item.diagSrtNo = index + 1; // 这里是关键！把”诊断排序”改成新顺序

openhis-ui-vue3/src/views/medicationmanagement/requisitionManagement/requisitionManagement/index.vue

@@ -1131,15 +1131,15 @@ function handleLocationClick(item, row, index) {
     .then((res) => {
       const list = res.data || [];
       const d = pickBestOrgQuantityRow(list);
-      const strictOk = d && Number(d.orgQuantity ?? 0) > 0;
-      if (strictOk) {
+
+      // 严格批号查询有库存（orgQuantity > 0）
+      if (d && Number(d.orgQuantity ?? 0) > 0) {
         applyFromDto(d, false);
-        if (Number(r.totalQuantity) <= 0) {
-          proxy.$message.warning('仓库数量为0，无法调用！');
-        }
         persistStore();
         return;
       }
+
+      // 严格查询无库存或数量为0 → 回退到非严格查询（查同仓库其他批号）
       if (lotTrimmed) {
         return runGet(false).then((res2) => {
           const list2 = res2.data || [];
@@ -1157,6 +1157,8 @@ function handleLocationClick(item, row, index) {
           persistStore();
         });
       }
+
+      // 没有指定批号，直接提示
       r.totalQuantity = 0;
       r.price = 0;
       proxy.$message.warning('仓库数量为0，无法调用！');

openhis-ui-vue3/src/views/surgicalschedule/index.vue

@@ -1535,8 +1535,8 @@ function handleMedicalAdvice(row) {
   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
-  getPrescriptionList(row.visitId).then((res) => {
+  // 调用计费接口获取数据（使用手术计费来源参数，匹配 surgery billing 创建的记录）
+  getPrescriptionList(row.visitId, 6, row.operCode).then((res) => {
     console.log('=== 拉取计费数据返回结果 ===', res)
     if (res.code === 200 && res.data) {
       // 🔧 修复：显示所有药品请求数据，不管有没有计费项目
@@ -1741,27 +1741,39 @@ function handleTemporaryMedicalSubmit(data) {
       }
     })
     
-    // 🔧 修复 Bug #445: 使用稳定的字段组合匹配已提交项目，而不是依赖可能为空的 requestId/chargeItemId
-    // 构建已提交项目的匹配键集合（药品名称 + 规格 + 数量）
-    const submittedKeys = new Set(
-      (data.temporaryAdvices || [])
-        .map(a => {
-          const om = a.originalMedicine || {}
-          const name = om.medicineName || om.adviceName || om.advice_name || a.adviceName || ''
-          const spec = om.specification || om.volume || ''
-          const qty = om.quantity || 0
-          return `${name}|||${spec}|||${qty}`
-        })
-        .filter(k => k !== '|||0') // 过滤掉空项
-    )
+    // 🔧 修复 Bug #445: 使用稳定可靠的字段组合匹配已提交项目，从已生成列表中剔除待生成项
+    // 匹配键：优先使用 chargeItemId（后端费用项目ID，最可靠），其次使用 名称+规格+数量 组合
+    const submittedKeys = new Set()
+    const submittedChargeIds = new Set()
 
-    if (submittedKeys.size > 0) {
+    ;(data.temporaryAdvices || []).forEach(a => {
+      const om = a.originalMedicine || {}
+      // 收集 chargeItemId（最可靠的匹配标识）
+      if (om.chargeItemId) {
+        submittedChargeIds.add(om.chargeItemId)
+      }
+      // 构建名称+规格+数量的匹配键（用于无 chargeItemId 的兜底匹配）
+      // 注意：originalMedicine 中的名称字段是 adviceName（来自 billingMedicines.map 时的字段）
+      const name = om.medicineName || om.adviceName || om.advice_name || a.adviceName || ''
+      const spec = om.specification || om.volume || ''
+      const qty = om.quantity || 0
+      if (name) {
+        submittedKeys.add(`${name}|||${spec}|||${qty}`)
+      }
+    })
+
+    if (submittedChargeIds.size > 0 || submittedKeys.size > 0) {
       temporaryBillingMedicines.value = (temporaryBillingMedicines.value || []).filter(m => {
-        const key = `${m.medicineName || ''}|||${m.specification || ''}|||${m.quantity || 0}`
+        // 优先用 chargeItemId 匹配
+        if (m.chargeItemId && submittedChargeIds.has(m.chargeItemId)) {
+          return false
+        }
+        // 兜底用 名称+规格+数量 匹配
+        const key = `${m.medicineName || m.adviceName || ''}|||${m.specification || m.volume || ''}|||${m.quantity || 0}`
         return !submittedKeys.has(key)
       })
     } else {
-      // 如果没有任何匹配键，清空待生成列表（所有项目都已提交）
+      // 如果没有任何匹配标识，清空待生成列表（保守策略：认为所有项目都已提交）
       temporaryBillingMedicines.value = []
     }