diff --git a/IRaCIS.Core.Application/Service/Reading/Dto/ReadingMedicalReviewDto.cs b/IRaCIS.Core.Application/Service/Reading/Dto/ReadingMedicalReviewDto.cs
index 6e6f39f1d..224cf8a45 100644
--- a/IRaCIS.Core.Application/Service/Reading/Dto/ReadingMedicalReviewDto.cs
+++ b/IRaCIS.Core.Application/Service/Reading/Dto/ReadingMedicalReviewDto.cs
@@ -259,6 +259,8 @@ namespace IRaCIS.Core.Application.Service.Reading.Dto
 
         public MedicalReviewAuditState AuditState { get; set; }
 
+        public bool IsSendMsg { get; set; }
+
         /// <summary>
         /// 是否关闭
         /// </summary>
@@ -355,6 +357,9 @@ namespace IRaCIS.Core.Application.Service.Reading.Dto
         /// 是否关闭
         /// </summary>
         public bool IsClosedDialog { get; set; }
+
+
+        public bool IsSendMsg { get; set; }
     }
 
     public class ReadingMedicineQuestion 
diff --git a/IRaCIS.Core.Application/Service/Reading/ReadingMedicalReviewService.cs b/IRaCIS.Core.Application/Service/Reading/ReadingMedicalReviewService.cs
index ad0a31800..ad8a11eb3 100644
--- a/IRaCIS.Core.Application/Service/Reading/ReadingMedicalReviewService.cs
+++ b/IRaCIS.Core.Application/Service/Reading/ReadingMedicalReviewService.cs
@@ -73,7 +73,7 @@ namespace IRaCIS.Core.Application.Service
             medicalReviewInfo.ArmEnum = taskInfo.ArmEnum;
             medicalReviewInfo.IsClosedDialog = medicalReviewInfo.MedicalReviewInfo.IsClosedDialog;
             medicalReviewInfo.AuditState = medicalReviewInfo.MedicalReviewInfo.AuditState;
-
+            medicalReviewInfo.IsSendMsg = medicalReviewInfo.MedicalReviewInfo.IsSendMsg;
 
             #region 取任务
             if (medicalReviewInfo.IsReadingTaskViewInOrder)
@@ -251,16 +251,17 @@ namespace IRaCIS.Core.Application.Service
             {
                 IsHaveQuestion = inDto.IsHaveQuestion,
                 Questioning = inDto.Questioning,
-              
+                IsSendMsg= inDto.IsSendDialog && inDto.IsHaveQuestion,
                 AuditAdviceEnum = inDto.AuditAdviceEnum,
              
                 SaveConclusionTime=DateTime.Now,
               
             });
 
-            if(inDto.IsSendDialog)
+            var medicalReview = await _taskMedicalReviewRepository.Where(x => x.Id == inDto.TaskMedicalReviewId).FirstNotNullAsync();
+            if (inDto.IsSendDialog&& !medicalReview.IsSendMsg&& inDto.IsHaveQuestion)
             {
-                var medicalReview = await _taskMedicalReviewRepository.Where(x => x.Id == inDto.TaskMedicalReviewId).FirstNotNullAsync();
+              
                 await _readingMedicalReviewDialogRepository.AddAsync(new ReadingMedicalReviewDialog()
                 {
                     AuditAdviceEnum = inDto.AuditAdviceEnum,
diff --git a/IRaCIS.Core.Domain/Allocation/TaskMedicalReview.cs b/IRaCIS.Core.Domain/Allocation/TaskMedicalReview.cs
index e257d2440..0910e84cd 100644
--- a/IRaCIS.Core.Domain/Allocation/TaskMedicalReview.cs
+++ b/IRaCIS.Core.Domain/Allocation/TaskMedicalReview.cs
@@ -142,9 +142,14 @@ namespace IRaCIS.Core.Domain.Models
 		public string FileName { get; set; } = string.Empty;
 
 
-		public List<ReadingMedicalReviewDialog> ReadingMedicalReviewDialogList { get; set; } 
+		public List<ReadingMedicalReviewDialog> ReadingMedicalReviewDialogList { get; set; }
 
 
+	    /// <summary>
+		/// 是否发送消息
+		/// </summary>
+		public bool IsSendMsg { get; set; } = false;
+
 
 
 	}