diff --git a/IRaCIS.Core.Application/Service/Visit/VisitPlanService.cs b/IRaCIS.Core.Application/Service/Visit/VisitPlanService.cs
index 933b96207..3e03b794c 100644
--- a/IRaCIS.Core.Application/Service/Visit/VisitPlanService.cs
+++ b/IRaCIS.Core.Application/Service/Visit/VisitPlanService.cs
@@ -234,19 +234,23 @@ namespace IRaCIS.Application.Services
 
             var addvisitStages = await _visitStageRepository.Where(x => !x.IsHaveFirstConfirmed && x.TrialId == trialId).ToListAsync();
 
-            addvisitStages.ForEach(visitPlan =>
+            foreach (var visitStage in addvisitStages)
             {
-                subjects.ForEach(subject =>
+                foreach (var item in collection)
                 {
                     var addSv = _mapper.Map<SubjectVisit>(visitPlan);
 
                     addSv.SubjectId = subject.Id;
                     addSv.TrialId = subject.TrialId;
                     addSv.SiteId = subject.SiteId;
-                   
-                    subjectVisits.Add(addSv);
-                });
-            });
+
+                    if (!await _subjectVisitRepository.AnyAsync(t => t.VisitStageId == visitPlan.Id && t.SubjectId == subject.Id))
+                    {
+                        subjectVisits.Add(addSv);
+                    }
+                }
+            }
+        
             await _subjectVisitRepository.AddRangeAsync(subjectVisits);
 
             //访视计划 整体状态变更为 确认