diff --git a/yudao-module-inspect/yudao-module-inspect-biz/src/main/java/cn/iocoder/yudao/module/inspect/controller/admin/inspectpatient/InspectPatientController.java b/yudao-module-inspect/yudao-module-inspect-biz/src/main/java/cn/iocoder/yudao/module/inspect/controller/admin/inspectpatient/InspectPatientController.java
index 1ee63bd..fef03ae 100644
--- a/yudao-module-inspect/yudao-module-inspect-biz/src/main/java/cn/iocoder/yudao/module/inspect/controller/admin/inspectpatient/InspectPatientController.java
+++ b/yudao-module-inspect/yudao-module-inspect-biz/src/main/java/cn/iocoder/yudao/module/inspect/controller/admin/inspectpatient/InspectPatientController.java
@@ -1628,11 +1628,10 @@ public class InspectPatientController {
     @ApiAccessLog(operateType = EXPORT)
     public void exportPatientExcel(@Valid InspectPatientPageReqVO pageReqVO,
                                    HttpServletResponse response) throws IOException {
-        pageReqVO.setPageSize(PageParam.PAGE_SIZE_NONE);
-        List<InspectPatientDO> list = patientService.getPatientPage(pageReqVO).getList();
+        // 直接获取需要的字段数据，优化查询性能
+        List<InspectPatientExcelVO> list = patientService.getPatientForExcel(pageReqVO);
         // 导出 Excel
-        ExcelUtils.write(response, "患者信息.xls", "数据", InspectPatientExcelVO.class,
-                BeanUtils.toBean(list, InspectPatientExcelVO.class));
+        ExcelUtils.write(response, "患者信息.xls", "数据", InspectPatientExcelVO.class, list);
     }
 
     @GetMapping("/createPatientInspectDataReport")
diff --git a/yudao-module-inspect/yudao-module-inspect-biz/src/main/java/cn/iocoder/yudao/module/inspect/service/inspectpatient/InspectPatientService.java b/yudao-module-inspect/yudao-module-inspect-biz/src/main/java/cn/iocoder/yudao/module/inspect/service/inspectpatient/InspectPatientService.java
index b35c354..dbe6c56 100644
--- a/yudao-module-inspect/yudao-module-inspect-biz/src/main/java/cn/iocoder/yudao/module/inspect/service/inspectpatient/InspectPatientService.java
+++ b/yudao-module-inspect/yudao-module-inspect-biz/src/main/java/cn/iocoder/yudao/module/inspect/service/inspectpatient/InspectPatientService.java
@@ -103,6 +103,14 @@ public interface InspectPatientService {
      */
     PageResult<InspectPatientDO> getPatientPage(InspectPatientPageReqVO pageReqVO);
 
+    /**
+     * 获取患者信息用于Excel导出
+     *
+     * @param pageReqVO 分页查询
+     * @return 包含导出所需字段的患者信息列表
+     */
+    List<InspectPatientExcelVO> getPatientForExcel(InspectPatientPageReqVO pageReqVO);
+
     //根据条码获取患者信息
     InspectPatientDO getPatientOfMedicalSn(String medicalSn);
     //验证身份证号是否存在
diff --git a/yudao-module-inspect/yudao-module-inspect-biz/src/main/java/cn/iocoder/yudao/module/inspect/service/inspectpatient/InspectPatientServiceImpl.java b/yudao-module-inspect/yudao-module-inspect-biz/src/main/java/cn/iocoder/yudao/module/inspect/service/inspectpatient/InspectPatientServiceImpl.java
index 9b623d6..9f4f45c 100644
--- a/yudao-module-inspect/yudao-module-inspect-biz/src/main/java/cn/iocoder/yudao/module/inspect/service/inspectpatient/InspectPatientServiceImpl.java
+++ b/yudao-module-inspect/yudao-module-inspect-biz/src/main/java/cn/iocoder/yudao/module/inspect/service/inspectpatient/InspectPatientServiceImpl.java
@@ -942,4 +942,75 @@ public class InspectPatientServiceImpl implements InspectPatientService {
             e.printStackTrace();
         }
     }
+
+    @Override
+    public List<InspectPatientExcelVO> getPatientForExcel(InspectPatientPageReqVO pageReqVO) {
+        // 构建查询条件，只查询Excel导出需要的字段
+        LambdaQueryWrapper<InspectPatientDO> queryWrapper = new LambdaQueryWrapper<>();
+        queryWrapper.select(
+                InspectPatientDO::getMedicalSn,
+                InspectPatientDO::getPName,
+                InspectPatientDO::getGender,
+                InspectPatientDO::getCardId,
+                InspectPatientDO::getPhoneNum,
+                InspectPatientDO::getDomicileaddress,
+                InspectPatientDO::getIsprint
+        );
+
+        // 添加筛选条件
+        if (pageReqVO.getMedicalSn() != null) {
+            queryWrapper.eq(InspectPatientDO::getMedicalSn, pageReqVO.getMedicalSn());
+        }
+        // 检查大写字段，如果为空则尝试通过getter方法获取小写字段
+        String patientName = null;
+        // 使用反射尝试获取pname字段（如果存在）
+        try {
+            if (pageReqVO.getPName() != null) {
+                patientName = pageReqVO.getPName();
+            } else {
+                java.lang.reflect.Method method = pageReqVO.getClass().getMethod("getPname");
+                if (method != null) {
+                    Object result = method.invoke(pageReqVO);
+                    if (result != null) {
+                        patientName = result.toString();
+                    }
+                }
+            }
+        } catch (Exception e) {
+            // 忽略反射异常
+        }
+
+        if (patientName != null && !patientName.isEmpty()) {
+            queryWrapper.like(InspectPatientDO::getPName, patientName);
+        }
+        if (pageReqVO.getGender() != null) {
+            queryWrapper.eq(InspectPatientDO::getGender, pageReqVO.getGender());
+        }
+        if (pageReqVO.getCardId() != null) {
+            queryWrapper.eq(InspectPatientDO::getCardId, pageReqVO.getCardId());
+        }
+        if (pageReqVO.getPhoneNum() != null) {
+            queryWrapper.eq(InspectPatientDO::getPhoneNum, pageReqVO.getPhoneNum());
+        }
+        if (pageReqVO.getStatus() != null) {
+            queryWrapper.eq(InspectPatientDO::getStatus, pageReqVO.getStatus());
+        }
+        if (pageReqVO.getIsprint() != null) {
+            queryWrapper.eq(InspectPatientDO::getIsprint, pageReqVO.getIsprint());
+        }
+        if (pageReqVO.getPrintTimeRange() != null && pageReqVO.getPrintTimeRange().length > 1) {
+            queryWrapper.between(InspectPatientDO::getPrinttime,
+                    pageReqVO.getPrintTimeRange()[0],
+                    pageReqVO.getPrintTimeRange()[1]);
+        }
+
+        // 按ID降序排序
+        queryWrapper.orderByDesc(InspectPatientDO::getId);
+
+        // 查询数据
+        List<InspectPatientDO> patientList = patientMapper.selectList(queryWrapper);
+
+        // 转换为Excel VO对象
+        return BeanUtils.toBean(patientList, InspectPatientExcelVO.class);
+    }
 }
\ No newline at end of file