diff --git a/sa-admin/src/main/java/net/lab1024/sa/admin/module/app/medicalrecord/service/MedicalRecordService.java b/sa-admin/src/main/java/net/lab1024/sa/admin/module/app/medicalrecord/service/MedicalRecordService.java
index ba20502..2a5ac87 100644
--- a/sa-admin/src/main/java/net/lab1024/sa/admin/module/app/medicalrecord/service/MedicalRecordService.java
+++ b/sa-admin/src/main/java/net/lab1024/sa/admin/module/app/medicalrecord/service/MedicalRecordService.java
@@ -509,10 +509,20 @@ public class MedicalRecordService {
             return ResponseDTO.userErrorParam("最后一次人工肝治疗后检测时间必须在入院和出院时间之间");
         }
 
-        for (DpmsAddForm dpma : dpmas) {
+        for (int i = 0; i < dpmas.size(); i++) {
+            DpmsAddForm dpma = dpmas.get(i);
             LocalDateTime treatTime = dpma.getTreatTime();
-            if (treatTime.isBefore(admissionTime) || treatTime.isAfter(dischargeTime)) {
-                return ResponseDTO.userErrorParam("人工肝治疗时间必须在入院和出院时间之间");
+
+            if (dpmas.size() > 1) {
+                // 多次治疗：必须严格在入院和出院之间（不能等于）
+                if (!treatTime.isAfter(admissionTime) || !treatTime.isBefore(dischargeTime)) {
+                    return ResponseDTO.userErrorParam("第 " + (i + 1) + " 次人工肝治疗时间必须在入院和出院时间之间");
+                }
+            } else {
+                // 只有一次治疗：允许等于入院或出院时间
+                if (treatTime.isBefore(admissionTime) || treatTime.isAfter(dischargeTime)) {
+                    return ResponseDTO.userErrorParam("人工肝治疗时间必须在入院和出院时间之间（允许为同一天）");
+                }
             }
         }