diff --git a/app/Services/PatientCaseService.php b/app/Services/PatientCaseService.php
index 9cace7b..c91c069 100644
--- a/app/Services/PatientCaseService.php
+++ b/app/Services/PatientCaseService.php
@@ -16,6 +16,7 @@ use App\Model\PatientFamilyHealth;
 use App\Model\PatientFamilyPersonal;
 use App\Model\User;
 use App\Model\UserDoctor;
+use Hyperf\DbConnection\Db;
 use Hyperf\Redis\Redis;
 
 /**
@@ -473,6 +474,16 @@ class PatientCaseService  extends BaseService
             return fail();
         }
 
+        // 获取病例信息
+        $params = array();
+        $params['order_inquiry_id'] = $order_inquiry_id;
+        $order_inquiry_case = OrderInquiryCase::getOne($params);
+        if (empty($order_inquiry_case)) {
+            return fail();
+        }
+
+        $order_inquiry_case = $order_inquiry_case->toArray();
+
         // 初始字段定义
         $fields = [
             "relation", // 与患者关系（1:本人 2:父母 3:爱人 4:子女 5:亲戚 6:其他 ）
@@ -505,6 +516,8 @@ class PatientCaseService  extends BaseService
             "chemical_compound_describe", // 化合物描述
         ];
 
+        Db::beginTransaction();
+
         try {
             $redis = $this->container->get(Redis::class);
             $redis_key = "patient_family_inquiry_case_unfilled_fields_" . $order_inquiry_id;
@@ -515,19 +528,46 @@ class PatientCaseService  extends BaseService
 
             // 患者病例字段
             $case_fields = [];
+
+            // 修改字段
+            $order_inquiry_case_data = [];
+
             foreach ($request_params['fields'] as $key => $value){
                 if (!in_array($key,$fields)){
                     if ($key != "order_inquiry_id"){
+                        Db::rollBack();
                         return fail(HttpEnumCode::HTTP_ERROR,"存在非法数据");
                     }
                 }
 
+                if ($value === ""){
+                    continue;
+                }
+
+                // 判断修改数据
+                if (array_key_exists($key,$order_inquiry_case)){
+                    if ($order_inquiry_case[$key] == null){
+                        $order_inquiry_case_data[$key] = $value;
+                    }
+                }
+
                 $case_fields[$key] = $value;
             }
 
-            $case_fields = json_encode($case_fields,JSON_UNESCAPED_UNICODE);
+            // 存储至问诊病例中
+            if (!empty($order_inquiry_case_data)){
+                $params = array();
+                $params['inquiry_case_id'] = $order_inquiry_case['inquiry_case_id'];
+                $res = OrderInquiryCase::edit($params,$order_inquiry_case_data);
+                if (!$res){
+                    Db::rollBack();
+                    return fail();
+                }
+            }
 
             // 发送im消息
+            $case_fields = json_encode($case_fields,JSON_UNESCAPED_UNICODE);
+
             $imService = new ImService();
             $imService->CaseUnfilledFieldsToDoctor($order_inquiry,$doctor['user_id'],$user_info['user_id'],$case_fields);
 
@@ -545,7 +585,10 @@ class PatientCaseService  extends BaseService
             }else{
                 $redis->del($redis_key);
             }
+
+            Db::commit();
         }catch (\Throwable $e){
+            Db::rollBack();
             return fail();
         }