diff --git a/IRaCIS.Core.Application/Service/Visit/VisitPlanService.cs b/IRaCIS.Core.Application/Service/Visit/VisitPlanService.cs
index 7f9477f02..8b2f94607 100644
--- a/IRaCIS.Core.Application/Service/Visit/VisitPlanService.cs
+++ b/IRaCIS.Core.Application/Service/Visit/VisitPlanService.cs
@@ -222,6 +222,9 @@ namespace IRaCIS.Application.Services
 
             var trial = (await _trialRepository.FirstOrDefaultAsync(t => t.Id == trialId)).IfNullThrowException();
 
+            //确认是否是首次确认
+            var initTrialVisitPlanConfirmed = trial.VisitPlanConfirmed;
+
             trial.VisitPlanConfirmed = true;
 
 
@@ -238,29 +241,35 @@ namespace IRaCIS.Application.Services
 
             #region 统一给Subject  增加访视任务
 
-            List<SubjectVisit> subjectVisits = new List<SubjectVisit>();
-
-            var addvisitStages = await _visitStageRepository.Where(x => !x.IsHaveFirstConfirmed && x.TrialId == trialId).ToListAsync();
-
-            foreach (var visitPlan in addvisitStages)
+            //首次确认时 IsHaveFirstConfirmed都为false  不需要给Subject 加访视
+            if (initTrialVisitPlanConfirmed)
             {
-                foreach (var subject in subjects)
+                List<SubjectVisit> subjectVisits = new List<SubjectVisit>();
+
+                var addvisitStages = await _visitStageRepository.Where(x => !x.IsHaveFirstConfirmed && x.TrialId == trialId).ToListAsync();
+
+                foreach (var visitPlan in addvisitStages)
                 {
-                    var addSv = _mapper.Map<SubjectVisit>(visitPlan);
-
-                    addSv.SubjectId = subject.Id;
-                    addSv.TrialId = subject.TrialId;
-                    addSv.SiteId = subject.SiteId;
-
-                    if (!await _subjectVisitRepository.AnyAsync(t => t.VisitStageId == visitPlan.Id && t.SubjectId == subject.Id))
+                    foreach (var subject in subjects)
                     {
-                        subjectVisits.Add(addSv);
+                        var addSv = _mapper.Map<SubjectVisit>(visitPlan);
+
+                        addSv.SubjectId = subject.Id;
+                        addSv.TrialId = subject.TrialId;
+                        addSv.SiteId = subject.SiteId;
+
+                        //再加一层保险，防止重复
+                        if (!await _subjectVisitRepository.AnyAsync(t => t.VisitStageId == visitPlan.Id && t.SubjectId == subject.Id))
+                        {
+                            subjectVisits.Add(addSv);
+                        }
                     }
                 }
+
+                await _subjectVisitRepository.AddRangeAsync(subjectVisits);
             }
 
-            await _subjectVisitRepository.AddRangeAsync(subjectVisits);
-
+         
             #endregion