diff --git a/src/views/trials/trials-panel/reading/dicoms/components/QuestionItem.vue b/src/views/trials/trials-panel/reading/dicoms/components/QuestionItem.vue
index 3ea9d642..476b07a2 100644
--- a/src/views/trials/trials-panel/reading/dicoms/components/QuestionItem.vue
+++ b/src/views/trials/trials-panel/reading/dicoms/components/QuestionItem.vue
@@ -337,11 +337,11 @@ export default {
       // if (parseInt(v) !== 5) {
       //   return
       // }
-      if (question.QuestionType === 49) {
-        this.$emit('setFormItemData', { key: question.Id, val: v })
-      }
+      
       if (question.Childrens.length > 0) {
         this.resetChild(question.Childrens)
+      }else{
+        this.$emit('setFormItemData', { key: question.Id, val: v })
       }
     },
     resetChild(obj) {
diff --git a/src/views/trials/trials-panel/reading/dicoms/components/Questions.vue b/src/views/trials/trials-panel/reading/dicoms/components/Questions.vue
index 2fbacd0e..056c9fe2 100644
--- a/src/views/trials/trials-panel/reading/dicoms/components/Questions.vue
+++ b/src/views/trials/trials-panel/reading/dicoms/components/Questions.vue
@@ -20,7 +20,7 @@
 
       <el-form-item v-if="readingTaskState < 2 && !isFirstChangeTask">
         <div style="text-align:right">
-          <el-button size="mini" :disabled="!questionFormChangeState" :type="questionFormChangeState ? 'primary' : null" @click="handleSave">{{ $t('common:button:save') }}</el-button>
+          <el-button size="mini" :disabled="!questionFormChangeState || (!formChanged && groupClassify > 0)" :type="questionFormChangeState || (!formChanged && groupClassify > 0) ? 'primary' : null" @click="handleSave">{{ $t('common:button:save') }}</el-button>
         </div>
       </el-form-item>
     </el-form>
@@ -79,7 +79,8 @@ export default {
       isBaseLineTask: false,
       criterionType: null,
       spleenInfo: null,
-      calculateSpleenStatus: ''
+      calculateSpleenStatus: '',
+      formChanged:false
     }
   },
   computed: {
@@ -323,6 +324,7 @@ export default {
             })
           }
         }
+        this.formChanged = false
       }).catch(() => {
         this.loading = false
       })
@@ -429,6 +431,7 @@ export default {
       DicomEvent.$emit('getMeasureData')
       this.calculateSpleenStatus = ''
       this.setSpleenCommentDisplay()
+      this.formChanged = true
     },
     locateAnnotation(obj) {
       const { Id } = obj
@@ -497,6 +500,7 @@ export default {
       if (this.isQulityIssues) {
         DicomEvent.$emit('questionFormChange', true)
       }
+      this.formChanged = true
     },
     getSpleenL() {
       var length = null
@@ -591,12 +595,14 @@ export default {
           this.removeAnnotation({ Id: this.spleenLengthId })
         }
       }
+      this.formChanged = true
     },
     setFormItemData(obj) {
       this.questionForm[obj.key] = obj.val
       if (obj.key === this.spleenStatusId) {
         this.setSpleenCommentDisplay()
       }
+      this.formChanged = true
     },
     isJSONString(str) {
       try {