diff --git a/IRaCIS.Core.Application/Service/Reading/Dto/ReadingImageTaskViewModel.cs b/IRaCIS.Core.Application/Service/Reading/Dto/ReadingImageTaskViewModel.cs
index d0288c364..153e78ebb 100644
--- a/IRaCIS.Core.Application/Service/Reading/Dto/ReadingImageTaskViewModel.cs
+++ b/IRaCIS.Core.Application/Service/Reading/Dto/ReadingImageTaskViewModel.cs
@@ -1705,6 +1705,11 @@ namespace IRaCIS.Core.Application.Service.Reading.Dto
     {
         public Guid VisitTaskId { get; set; }
     }
+
+    public class SetSkipReadingCacheInDto
+    {
+        public Guid VisitTaskId { get; set; }
+    }
     public class GetNextTaskInDto
     {
 
diff --git a/IRaCIS.Core.Application/Service/Reading/ReadingImageTask/ReadingImageTaskService.cs b/IRaCIS.Core.Application/Service/Reading/ReadingImageTask/ReadingImageTaskService.cs
index fe00f7d4e..d67e162c0 100644
--- a/IRaCIS.Core.Application/Service/Reading/ReadingImageTask/ReadingImageTaskService.cs
+++ b/IRaCIS.Core.Application/Service/Reading/ReadingImageTask/ReadingImageTaskService.cs
@@ -22,6 +22,7 @@ using AutoMapper.QueryableExtensions;
 using IRaCIS.Application.Contracts;
 using IRaCIS.Core.Domain.Models;
 using Microsoft.Extensions.Options;
+using System.Linq;
 
 namespace IRaCIS.Application.Services
 {
@@ -2700,7 +2701,44 @@ namespace IRaCIS.Application.Services
             return ResponseOutput.Ok(true);
         }
 
+        /// <summary>
+        /// 清除跳过阅片的缓存
+        /// </summary>
+        /// <returns></returns>
+        [HttpPost]
+        public async Task<bool> ClearSkipReadingCache()
+        {
+            var clearSkipReadingCacheKey = _userInfo.Id.ToString() + "SkipReadingCache";
+            _provider.Remove(clearSkipReadingCacheKey);
+            return true;
+        }
 
+        /// <summary>
+        /// 设置跳过阅片的缓存
+        /// </summary>
+        /// <param name="inDto"></param>
+        /// <returns></returns>
+        [HttpPost]
+        public async Task<bool> SetSkipReadingCache(SetSkipReadingCacheInDto inDto )
+        {
+            var clearSkipReadingCacheKey = _userInfo.Id.ToString() + "SkipReadingCache";
+            var clearSkipReadingCache = _provider.Get<string>(clearSkipReadingCacheKey).Value;
+            if (clearSkipReadingCache == null|| clearSkipReadingCache==string.Empty)
+            {
+                List<Guid> cacheIds = new List<Guid>();
+                cacheIds.Add(inDto.VisitTaskId);
+
+                _provider.Set(clearSkipReadingCacheKey, JsonConvert.SerializeObject(cacheIds), TimeSpan.FromHours(24));
+            }
+            else
+            {
+                List<Guid>? cacheIds=JsonConvert.DeserializeObject<List<Guid>>(clearSkipReadingCache);
+                cacheIds.Add(inDto.VisitTaskId);
+                _provider.Set(clearSkipReadingCacheKey, JsonConvert.SerializeObject(cacheIds), TimeSpan.FromHours(24));
+            }
+
+            return true;
+        }
 
 
         /// <summary>
@@ -2728,6 +2766,19 @@ namespace IRaCIS.Application.Services
 
             var trialReadingCriterion = await _readingQuestionCriterionTrialRepository.FindAsync(trialReadingCriterionId ?? Guid.Empty);
 
+
+            #region 跳过阅片
+            var clearSkipReadingCacheKey = _userInfo.Id.ToString() + "SkipReadingCache";
+            var clearSkipReadingCache = _provider.Get<string>(clearSkipReadingCacheKey).Value;
+            List<Guid> cacheSkipIds = new List<Guid>();
+            if (clearSkipReadingCache != null && clearSkipReadingCache != string.Empty)
+            {
+                cacheSkipIds = JsonConvert.DeserializeObject<List<Guid>>(clearSkipReadingCache);
+            }
+            #endregion
+
+
+
             if (inDto.VisitTaskId != null)
             {
                 task = await _visitTaskRepository.Where(x => x.Id == inDto.VisitTaskId).Select(x => new GetReadingTaskDto()
@@ -2746,6 +2797,7 @@ namespace IRaCIS.Application.Services
                 trialReadingCriterionId = task.TrialReadingCriterionId;
 
             }
+            // 有序
             else if (inDto.SubjectId != null && trialReadingCriterion.IsReadingTaskViewInOrder == ReadingOrder.InOrder)
             {
                 var subjectTaskList = (await _visitTaskService.GetSubjectReadingIQueryable(new GetReadingIQueryableInDto()
@@ -2766,14 +2818,22 @@ namespace IRaCIS.Application.Services
 
                 var subjectIndex = subjectTaskList.Where(x => x.SubjectId == inDto.SubjectId && x.SubjectCode == inDto.SubjectCode).Select(x => x.Index).FirstOrDefault();
 
-                var currentSubject = subjectTaskList.Where(x => x.Index >= subjectIndex && !x.ExistReadingApply).OrderBy(x => x.Index).FirstOrDefault();
+
+                var currentSubject = subjectTaskList.Where(x => x.Index >= subjectIndex && !x.ExistReadingApply)
+                    // 排除跳过的
+                    .Where(x=> x.UnReadCanReadTaskList.Select(y => y.Id).Except(cacheSkipIds).Count()>0)
+                    .OrderBy(x => x.Index).FirstOrDefault();
+
 
                 if (currentSubject == null)
                 {
                     throw new BusinessValidationFailedException(_localizer["ReadingImage_TaskFinish"], ApiResponseCodeEnum.CloseCurrentWindows);
                 }
 
-                task = currentSubject.UnReadCanReadTaskList.Select(x => new GetReadingTaskDto()
+                task = currentSubject.UnReadCanReadTaskList
+                    // 排除跳过的
+                    .Where(x=> !cacheSkipIds.Contains(x.Id))
+                    .Select(x => new GetReadingTaskDto()
                 {
                     ReadingCategory = x.ReadingCategory,
                     SubjectCode = currentSubject.SubjectCode,
@@ -2789,8 +2849,12 @@ namespace IRaCIS.Application.Services
 
 
             }
+            // 受试者无序
             else if (inDto.SubjectId != null && trialReadingCriterion.IsReadingTaskViewInOrder == ReadingOrder.SubjectRandom)
             {
+
+
+
                 var subjectTaskList = (await _visitTaskService.GetSubjectReadingIQueryable(new GetReadingIQueryableInDto()
                 {
                     TrialId = inDto.TrialId,
@@ -2802,6 +2866,11 @@ namespace IRaCIS.Application.Services
 
                 })).CurrentPageData;
 
+
+                subjectTaskList = subjectTaskList
+                 // 排除跳过的
+                 .Where(x => x.UnReadCanReadTaskList.Select(y => y.Id).Except(cacheSkipIds).Count() > 0).ToList();
+
                 if (subjectTaskList.Count() == 0)
                 {
                     throw new BusinessValidationFailedException(_localizer["ReadingImage_TaskFinish"], ApiResponseCodeEnum.CloseCurrentWindows);
@@ -2829,11 +2898,14 @@ namespace IRaCIS.Application.Services
 				}).FirstOrDefaultAsync();
 
 			}
+            // 完全随机
             else
             {
                 var query = _visitTaskRepository.Where(x => x.TrialId == inDto.TrialId && x.TrialReadingCriterionId == trialReadingCriterionId && x.ReadingTaskState != ReadingTaskState.HaveSigned && x.DoctorUserId == _userInfo.Id
                 && x.TrialReadingCriterionId == trialReadingCriterionId
-                && x.TaskState == TaskState.Effect);
+                && x.TaskState == TaskState.Effect)
+                    // 排除跳过的
+                 .Where(x => !cacheSkipIds.Contains(x.Id));
                 var count = await query.CountAsync();
                 if (count == 0)
                 {