危重病人合并广泛胃肠道出血者,死亡率很高。本文报道了100例,平均年龄61.5岁,男女约半。列出6个容易出血的危险因子:肾功能衰竭、黄疸、持续低血压,呼吸衰竭、腹膜炎、腹外败血症等,其中肾衰竭及黄疽最易出血。100例随机分成预防及未加预防二组。病人禁食,均插鼻饲管,每12小时抽取胃液3次,以敏感 pH 试纸测试 pH,并识别有无上消化道出血。如胃液 pH≥3.5,每小时注入抗酸药30ml,pH<3.5,每次给60ml。抗酸药用 MylantaⅡ(一种镁盐,抗酸作用约为一般抗酸药的1倍)或氢氧化铝液。预防组51例给予抗酸药预防出血,平均每个病人有危险因子2.2个,出血2人(2%);未加预防组 Critically ill patients with extensive gastrointestinal bleeding, high mortality. This article reports 100 cases, the average age of 61.5 years old, about half of men and women. Six risk factors for hemorrhage were listed: renal failure, jaundice, persistent hypotension, respiratory failure, peritonitis, and extra-abdominal sepsis. Among them, renal failure and jaundice most often bleed. One hundred cases were randomly divided into two groups: prevention and no prevention. The patient was fasted and the nasogastric tube was inserted. The gastric fluid was taken 3 times every 12 hours, the pH was tested with a sensitive pH test paper and the presence or absence of upper gastrointestinal bleeding was identified. Such as gastric juice pH ≥ 3.5, hourly injection of antacids 30ml, pH <3.5, each time to 60ml. Antacids Mylanta II (a magnesium salt, antacid effect of about 1 times the general antacid) or aluminum hydroxide solution. In the prevention group, 51 patients were given antacid prophylaxis to prevent bleeding. On average, each patient had 2.2 risk factors and 2 bleeding patients (2%). No prevention group