diff --git a/virtual-patient-model/src/main/java/com/supervision/model/ConfigDrug.java b/virtual-patient-model/src/main/java/com/supervision/model/ConfigDrug.java
index cb79bf09..3f5c3df3 100644
--- a/virtual-patient-model/src/main/java/com/supervision/model/ConfigDrug.java
+++ b/virtual-patient-model/src/main/java/com/supervision/model/ConfigDrug.java
@@ -63,7 +63,7 @@ public class ConfigDrug implements Serializable {
     private String skinTestFlag;
 
     /**
-     * 费用l
+     * 费用
      */
     private Integer costType;
 
diff --git a/virtual-patient-model/src/main/resources/mapper/ProcessMedicalMapper.xml b/virtual-patient-model/src/main/resources/mapper/ProcessMedicalMapper.xml
index af1d3ebe..5b70c30b 100644
--- a/virtual-patient-model/src/main/resources/mapper/ProcessMedicalMapper.xml
+++ b/virtual-patient-model/src/main/resources/mapper/ProcessMedicalMapper.xml
@@ -46,6 +46,8 @@
                pr.create_time            as createTime,
                pm.process_id            as processId,
                pm.disease_id            as diseaseId,
+               pm.patient_self_desc     as patientSelfDesc,
+               pm.operation_history      as operationHistory,
                mr.id                    as medicalRecId,
                mr.no                    as medicalRecNo,
                mr.patient_name          as patientName,
diff --git a/virtual-patient-web/src/main/java/com/supervision/service/impl/MedicalRecordServiceImpl.java b/virtual-patient-web/src/main/java/com/supervision/service/impl/MedicalRecordServiceImpl.java
index b44860e3..cfa2eb40 100644
--- a/virtual-patient-web/src/main/java/com/supervision/service/impl/MedicalRecordServiceImpl.java
+++ b/virtual-patient-web/src/main/java/com/supervision/service/impl/MedicalRecordServiceImpl.java
@@ -1,8 +1,10 @@
 package com.supervision.service.impl;
 
 import cn.hutool.core.bean.BeanUtil;
+import cn.hutool.core.collection.CollUtil;
 import cn.hutool.core.lang.Assert;
 import cn.hutool.core.util.StrUtil;
+import cn.hutool.json.JSONUtil;
 import com.supervision.model.Process;
 import com.supervision.model.ProcessMedical;
 import com.supervision.model.User;
@@ -52,12 +54,17 @@ public class MedicalRecordServiceImpl implements MedicalRecordService {
 
     @Override
     public boolean saveOrUpdateMedicalRecord(ProcessMedical processMedical) {
+        log.info(JSONUtil.toJsonStr(processMedical));
 
-        if (StrUtil.isEmpty(processMedical.getId())){
-            // 走新增逻辑
+        Assert.notEmpty(processMedical.getProcessId(),"流程id不为空");
+        List<ProcessMedical> list = processMedicalService.lambdaQuery().eq(ProcessMedical::getProcessId, processMedical.getProcessId()).list();
+        if (CollUtil.isEmpty(list)){
+            // 新增
             return saveMedicalRecord(processMedical);
         }
 
+        // 修改
+        processMedical.setId(CollUtil.getFirst(list).getId());
         return processMedicalService.updateById(processMedical);
     }