diff --git a/photo_review/auto_photo_review.py b/photo_review/auto_photo_review.py
index 9960999..a2832cf 100644
--- a/photo_review/auto_photo_review.py
+++ b/photo_review/auto_photo_review.py
@@ -458,10 +458,20 @@ def photo_review(pk_phhd, name):
     review_result['has_cost'] = bool(cost_result)
     # 三项资料缺页判断
     page_description = []
-    # todo:关键词需根据实际情况调整
-    discharge_key = ['入院诊断', '入院日期', '出院日期', '出院诊断', '入院情况', '诊疗经过', '出院情况', '出院医嘱']
-    if not all(key in discharge_text for key in discharge_key):
-        page_description.append('《出院记录》缺页')
+    discharge_key = {
+        '入院诊断': ['入院诊断'],
+        '入院情况': ['入院情况', '入院时情况', '入院时主要症状'],
+        '入院日期': ['入院日期', '入院时间'],
+        '诊疗经过': ['诊疗经过', '住院经过', '治疗经过'],
+        '出院诊断': ['出院诊断'],
+        '出院情况': ['出院情况', '出院时情况'],
+        '出院日期': ['出院日期', '出院时间'],
+        '出院医嘱': ['出院医嘱']
+    }
+    for discharge_item in discharge_key:
+        if not all(key in discharge_text for key in discharge_key[discharge_item]):
+            page_description.append(f"《出院记录》缺{discharge_item}")
+            break
 
     cost_missing_page = {}
     if cost_data['page_nums']: