diff --git a/virtual-patient-manage/src/main/java/com/supervision/manage/controller/medicalrec/MedicalRecManageController.java b/virtual-patient-manage/src/main/java/com/supervision/manage/controller/medicalrec/MedicalRecManageController.java
index 99ddcf3a..a1356555 100644
--- a/virtual-patient-manage/src/main/java/com/supervision/manage/controller/medicalrec/MedicalRecManageController.java
+++ b/virtual-patient-manage/src/main/java/com/supervision/manage/controller/medicalrec/MedicalRecManageController.java
@@ -120,7 +120,7 @@ public class MedicalRecManageController {
     @Operation(summary = "预导入疾病问题回答")
     @PostMapping("/preUploadMedicalAnswer")
     public MedicalAnswerVideoResVo uploadMedicalAnswer(@Parameter(name = "file", description = "文件") MultipartFile multipartFile,
-                                                       @Parameter(name = "medicalRecId", description = "病例id") String medicalRecId) throws Exception {
+                                                       @Parameter(name = "medicalRecId", description = "病例id") @RequestParam("medicalRecId")  String medicalRecId) throws Exception {
 
         return medicalRecManageService.preUploadMedicalAnswer(multipartFile, medicalRecId);
     }
@@ -135,15 +135,15 @@ public class MedicalRecManageController {
 
     @Operation(summary = "查询病例默认问题")
     @GetMapping("/queryMedicalDefaultAnswer")
-    public List<MedicalRecQaVO> queryMedicalDefaultAnswer(@Parameter(name = "medicalRecId", description = "病例id") String medicalRecId) {
+    public List<MedicalRecQaVO> queryMedicalDefaultAnswer(@Parameter(name = "medicalRecId", description = "病例id") @RequestParam("medicalRecId")  String medicalRecId) {
 
         return medicalRecManageService.queryMedicalDefaultAnswer(medicalRecId);
     }
 
 
     @Operation(summary = "修改病历状态,上线或下线病历",tags="v1.3新增")
-    @GetMapping("/updateMedicalStatus")
-    public Boolean updateMedicalStatus(@Parameter(name = "medicalRecId", description = "病例id") String medicalRecId,
+    @PostMapping("/updateMedicalStatus")
+    public Boolean updateMedicalStatus(@Parameter(name = "medicalRecId", description = "病例id") @RequestParam("medicalRecId")  String medicalRecId,
                                                     @Parameter(name = "status", description = "病历状态 0：未上线 1：上线") Integer status) {
 
         return medicalRecManageService.updateMedicalStatus(medicalRecId,status);
@@ -164,7 +164,7 @@ public class MedicalRecManageController {
 
     @Operation(summary = "查询虚拟病人电子病历信息",description = "可用于查询诊断依据",tags = "v1.3新增")
     @GetMapping("queryMedicalRecBaseInfo")
-    public MedicalRecInfoReVo queryMedicalRecBaseInfo(@Parameter(name = "medicalRecId", description = "病例id") String medicalRecId) {
+    public MedicalRecInfoReVo queryMedicalRecBaseInfo(@Parameter(name = "medicalRecId", description = "病例id") @RequestParam("medicalRecId") String medicalRecId) {
         return medicalRecManageService.queryMedicalRecBaseInfo(medicalRecId);
     }
 
@@ -176,7 +176,7 @@ public class MedicalRecManageController {
         return medicalRecManageService.batchUpdateMedicalRecPhysical(medicalRecPhysicalReqVoList);
     }
 
-    @Operation(summary = "更新病历关联的辅助检查信息",tags = "v1.3新增")
+    @Operation(summary = "批量更新病历关联的辅助检查信息",tags = "v1.3新增")
     @PostMapping("batchUpdateMedicalRecAncillary")
     public Boolean batchUpdateMedicalRecAncillary(@RequestBody List<MedicalRecAncillaryReqVo> medicalRecAncillaryReqVoList) {
 
@@ -193,7 +193,7 @@ public class MedicalRecManageController {
 
     @Operation(summary = "根据病历id查询疾病处置信息列表",tags = "v1.3新增")
     @GetMapping("/queryMedicalRecTreatmentPlanList")
-    public List<MedicalRecTreatmentPlanResVo> queryMedicalRecTreatmentPlanList(@Parameter(name = "medicalRecId", description = "病例id") String medicalRecId) {
+    public List<MedicalRecTreatmentPlanResVo> queryMedicalRecTreatmentPlanList(@Parameter(name = "medicalRecId", description = "病例id") @RequestParam("medicalRecId") String medicalRecId) {
 
         List<MedicalRecTreatmentPlanResVo> medicalRecTreatmentPlanList = medicalRecManageService.queryListByMedicalRecId(medicalRecId);
         // 前端大哥强烈要求把treatmentPlanId 转换为 firstMeasuresId
@@ -208,12 +208,13 @@ public class MedicalRecManageController {
     }
 
     @Operation(summary = "批量修改处置计划",description = "列表修改或者删除数据保存后把现有数据传递过来",tags = "v1.3新增")
-    @PutMapping("/batchUpdateMedicalRecTreatmentPlan")
-    public boolean batchUpdateMedicalRecTreatmentPlan(@RequestBody List<MedicalRecTreatmentPlanReqVo> medicalRecTreatmentPlanReqVoList) {
+    @PostMapping("/batchUpdateMedicalRecTreatmentPlan")
+    public boolean batchUpdateMedicalRecTreatmentPlan(@Parameter(name = "medicalRecId", description = "病例id") @RequestParam("medicalRecId") String medicalRecId,
+            @RequestBody List<MedicalRecTreatmentPlanReqVo> medicalRecTreatmentPlanReqVoList) {
         // 适配前端传入数据
         medicalRecTreatmentPlanReqVoList.forEach(medicalRecTreatmentPlanReqVo ->
                 medicalRecTreatmentPlanReqVo.setTreatmentPlanId(medicalRecTreatmentPlanReqVo.getFirstMeasuresId()));
-        return medicalRecManageService.batchUpdateMedicalRecTreatmentPlan(medicalRecTreatmentPlanReqVoList);
+        return medicalRecManageService.batchUpdateMedicalRecTreatmentPlan(medicalRecId,medicalRecTreatmentPlanReqVoList);
 
     }
 }
diff --git a/virtual-patient-manage/src/main/java/com/supervision/manage/service/MedicalRecManageService.java b/virtual-patient-manage/src/main/java/com/supervision/manage/service/MedicalRecManageService.java
index c40e729a..53c75a1d 100644
--- a/virtual-patient-manage/src/main/java/com/supervision/manage/service/MedicalRecManageService.java
+++ b/virtual-patient-manage/src/main/java/com/supervision/manage/service/MedicalRecManageService.java
@@ -4,7 +4,6 @@ import com.baomidou.mybatisplus.core.metadata.IPage;
 import com.supervision.manage.pojo.vo.*;
 import com.supervision.vo.manage.MedicalRecTreatmentPlanResVo;
 import com.supervision.model.Disease;
-import com.supervision.model.DiseaseAncillary;
 import com.supervision.vo.manage.*;
 import jakarta.servlet.http.HttpServletResponse;
 import org.springframework.web.multipart.MultipartFile;
@@ -65,6 +64,7 @@ public interface MedicalRecManageService {
 
     Boolean batchUpdateMedicalRecAncillary(List<MedicalRecAncillaryReqVo> medicalRecAncillaryReqVoList);
 
-    boolean batchUpdateMedicalRecTreatmentPlan(List<MedicalRecTreatmentPlanReqVo> medicalRecTreatmentPlanReqVoList);
+    boolean batchUpdateMedicalRecTreatmentPlan(String medicalRecId,
+            List<MedicalRecTreatmentPlanReqVo> medicalRecTreatmentPlanReqVoList);
 
 }
diff --git a/virtual-patient-manage/src/main/java/com/supervision/manage/service/MedicalRecTreatmentPlanManageService.java b/virtual-patient-manage/src/main/java/com/supervision/manage/service/MedicalRecTreatmentPlanManageService.java
index 9e12c587..8545306d 100644
--- a/virtual-patient-manage/src/main/java/com/supervision/manage/service/MedicalRecTreatmentPlanManageService.java
+++ b/virtual-patient-manage/src/main/java/com/supervision/manage/service/MedicalRecTreatmentPlanManageService.java
@@ -15,5 +15,5 @@ public interface MedicalRecTreatmentPlanManageService {
 
     MedicalRecTreatmentPlan saveTreatmentPlan(MedicalRecTreatmentPlanReqVo medicalTreatmentPlan);
 
-    boolean batchUpdateTreatmentPlan(List<MedicalRecTreatmentPlanReqVo> medicalRecTreatmentPlanReqVoList);
+    boolean batchUpdateTreatmentPlan(String medicalRecId,List<MedicalRecTreatmentPlanReqVo> medicalRecTreatmentPlanReqVoList);
 }
diff --git a/virtual-patient-manage/src/main/java/com/supervision/manage/service/impl/MedicalRecAncillaryManageServiceImpl.java b/virtual-patient-manage/src/main/java/com/supervision/manage/service/impl/MedicalRecAncillaryManageServiceImpl.java
index 8b41085a..48ed678c 100644
--- a/virtual-patient-manage/src/main/java/com/supervision/manage/service/impl/MedicalRecAncillaryManageServiceImpl.java
+++ b/virtual-patient-manage/src/main/java/com/supervision/manage/service/impl/MedicalRecAncillaryManageServiceImpl.java
@@ -32,7 +32,7 @@ public class MedicalRecAncillaryManageServiceImpl implements MedicalRecAncillary
         if (CollUtil.isEmpty(medicalRecAncillaries)){
             return;
         }
-        medicalRecAncillaryService.saveBatch(medicalRecAncillaries);
+        medicalRecAncillaryService.updateBatchById(medicalRecAncillaries);
     }
 
     @Override
diff --git a/virtual-patient-manage/src/main/java/com/supervision/manage/service/impl/MedicalRecManageServiceImpl.java b/virtual-patient-manage/src/main/java/com/supervision/manage/service/impl/MedicalRecManageServiceImpl.java
index df20ddf4..d5c01346 100644
--- a/virtual-patient-manage/src/main/java/com/supervision/manage/service/impl/MedicalRecManageServiceImpl.java
+++ b/virtual-patient-manage/src/main/java/com/supervision/manage/service/impl/MedicalRecManageServiceImpl.java
@@ -577,11 +577,9 @@ public class MedicalRecManageServiceImpl implements MedicalRecManageService {
     }
 
     @Override
-    public boolean batchUpdateMedicalRecTreatmentPlan(List<MedicalRecTreatmentPlanReqVo> medicalRecTreatmentPlanReqVoList) {
-        if (CollUtil.isEmpty(medicalRecTreatmentPlanReqVoList)){
-            return false;
-        }
-        return medicalRecTreatmentPlanManageService.batchUpdateTreatmentPlan(medicalRecTreatmentPlanReqVoList);
+    public boolean batchUpdateMedicalRecTreatmentPlan(String medicalRecId,
+                                                        List<MedicalRecTreatmentPlanReqVo> medicalRecTreatmentPlanReqVoList) {
+        return medicalRecTreatmentPlanManageService.batchUpdateTreatmentPlan(medicalRecId,medicalRecTreatmentPlanReqVoList);
     }
 
     private void saveMedicalRecAssert(MedicalRecInfoReVo reqVO){
diff --git a/virtual-patient-manage/src/main/java/com/supervision/manage/service/impl/MedicalRecTreatmentPlanManageServiceImpl.java b/virtual-patient-manage/src/main/java/com/supervision/manage/service/impl/MedicalRecTreatmentPlanManageServiceImpl.java
index d010093f..a0cc48ff 100644
--- a/virtual-patient-manage/src/main/java/com/supervision/manage/service/impl/MedicalRecTreatmentPlanManageServiceImpl.java
+++ b/virtual-patient-manage/src/main/java/com/supervision/manage/service/impl/MedicalRecTreatmentPlanManageServiceImpl.java
@@ -100,20 +100,17 @@ public class MedicalRecTreatmentPlanManageServiceImpl implements MedicalRecTreat
 
     @Override
     @Transactional(rollbackFor = Exception.class)
-    public boolean batchUpdateTreatmentPlan(List<MedicalRecTreatmentPlanReqVo> medicalRecTreatmentPlanReqVoList) {
+    public boolean batchUpdateTreatmentPlan(String medicalRecId,List<MedicalRecTreatmentPlanReqVo> medicalRecTreatmentPlanReqVoList) {
 
+        Assert.notEmpty(medicalRecId,"病历id不允许为空");
         medicalRecTreatmentPlanReqVoList.forEach(diseaseTreatmentPlan -> Assert.notEmpty(diseaseTreatmentPlan.getId(),"id不允许为空"));
 
+        // 清空数据
+        medicalRecTreatmentPlanService.lambdaUpdate().eq(MedicalRecTreatmentPlan::getMedicalRecId,medicalRecId).remove();
+        medicalRecTreatmentPlanDrugService.lambdaUpdate().eq(MedicalRecTreatmentPlanDrug::getMedicalRecId,medicalRecId).remove();
+
+        //批量保存
         for (MedicalRecTreatmentPlanReqVo medicalRecTreatmentPlanReqVo : medicalRecTreatmentPlanReqVoList) {
-            // 删除该条记录
-            String id = medicalRecTreatmentPlanReqVo.getId();
-            MedicalRecTreatmentPlan medicalRecTreatmentPlan = medicalRecTreatmentPlanService.getById(id);
-            if (Objects.nonNull(medicalRecTreatmentPlan)){
-                medicalRecTreatmentPlanService.removeById(id);
-                medicalRecTreatmentPlanDrugService.lambdaUpdate()
-                        .eq(MedicalRecTreatmentPlanDrug::getMedicalRecTreatmentPlanId,medicalRecTreatmentPlan.getId()).remove();
-            }
-            // 重新保存
             medicalRecTreatmentPlanReqVo.setId(null);
             this.saveTreatmentPlan(medicalRecTreatmentPlanReqVo);
         }