上消化道出血（upper gastrointestinal bleeding, UGIB）是指源于十二指肠空肠连接处 Treitz 韧带（十二指肠悬韧带）近端的消化道失血。急性 UGIB 可以表现为多种形式，伴随或不伴随血流动力学损害，包括呕血、咖啡色呕吐物、鼻胃管引流出鲜血以及黑便。活动性极其高的 UGIB 患者很少出现便血（经直肠排出鲜血）。[1]Wilcox CM, Alexander LN, Cotsonis G. A prospective characterization of upper gastrointestinal hemorrhage presenting with hematochezia. Am J Gastroenterol. 1997 Feb;92(2):231-5.
http://www.ncbi.nlm.nih.gov/pubmed/9040197?tool=bestpractice.com
[2]Hwang JH, Fisher DA, Ben-Menachem T, et al. The role of endoscopy in the management of acute non-variceal upper GI bleeding. Gastrointest Endosc. 2012 Jun;75(6):1132-8.
https://www.giejournal.org/article/S0016-5107(12)00198-8/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/22624808?tool=bestpractice.com
引起上消化道出血的原因有很多，但在发达国家，出血通常继发于消化性溃疡病（peptic ulcer disease, PUD）、糜烂、食管炎或静脉曲张。
在美国，UGIB 每年导致 250,000 多人入院，死亡率高达 11%。[3]Abougergi MS, Travis AC, Saltzman JR. The in-hospital mortality rate for upper GI hemorrhage has decreased over 2 decades in the United States: a nationwide analysis. Gastrointest Endosc. 2014 Dec 5;81(4):882-8.e1.
http://www.ncbi.nlm.nih.gov/pubmed/25484324?tool=bestpractice.com
[4]Rosenstock SJ, Møller MH, Larsson H, et al. Improving quality of care in peptic ulcer bleeding: nationwide cohort study of 13,498 consecutive patients in the Danish Clinical Register of Emergency Surgery. Am J Gastroenterol. 2013 Sep;108(9):1449-57.
http://www.ncbi.nlm.nih.gov/pubmed/23732464?tool=bestpractice.com
在英国，UGIB 每年导致 70,000 多人入院，其中大多数为非静脉曲张性，死亡率为 10%。[5]Jairath V, Desborough MJ. Modern-day management of upper gastrointestinal haemorrhage. Transfus Med. 2015 Dec 28;25(6):351-7.
http://www.ncbi.nlm.nih.gov/pubmed/26707695?tool=bestpractice.com
[6]Siau K, Chapman W, Sharma N, et al. Management of acute upper gastrointestinal bleeding: an update for the general physician. J R Coll Physicians Edinb. 2017 Sep;47(3):218-30.
http://www.rcpe.ac.uk/sites/default/files/jrcpe_47_3_bhala.pdf
http://www.ncbi.nlm.nih.gov/pubmed/29465096?tool=bestpractice.com
通常，死亡继发于低血容量性休克。迅速的评估、血流动力学复苏以及适当的药物治疗和内镜干预是治疗的基础。
