目的比较上消化道出血急诊内镜检查及止血的即刻止血率、再出血发生率及住院死亡率．方法上消化道出血４８６例，分为两组，Ａ组为１９９１年底以前出血者（ｎ＝２０９），Ｂ组为１９９２年以后出血者（ｎ＝２７７）．两组大出血发生率无显著差别．Ｂ组出血后２４ｈ内行急诊检查者明显多于Ａ组（Ｐ＜００１）．结果Ｂ组急性胃粘膜损伤出血（９７％）多于Ａ组（５３％），原因不明出血者（４３％）少于Ａ组（９６％）．经过治疗，Ｂ组出血控制率（９４４％）高于Ａ组（６０３％），再出血率（９４％）低于Ａ组（１５８％），住院死亡率（２８％）低于Ａ组（１０１％）．结论急诊内镜检查可提高出血病因诊断率，配合有效的止血措施，可提高止血率和降低住院死亡率 Objective To compare the immediate hemostasis rate, rebleeding rate and in-hospital mortality rate of emergency endoscopy and hemostasis of upper gastrointestinal bleeding. Methods 486 cases of upper gastrointestinal bleeding, divided into two groups, group A bleeding before the end of 1991 (n = 209), group B bleeding after 1992 (n = 277). No significant difference in the incidence of major bleeding between the two groups. The number of emergency examinations within 24 hours after bleeding in group B was significantly more than that in group A (P <001). Results Acute gastric mucosal injury in group B was more severe (97%) than in group A (5.3%), and the cause of unidentified hemorrhage (43%) was less than that in group A (96%). After treatment, the bleeding control rate (944%) in group B was higher than that in group A (603%), the rate of rebleeding was lower (94%) than that in group A (158%),  8%) than in group A (101%). Conclusion Emergency endoscopy can improve the diagnosis of hemorrhage etiology, with effective measures to stop bleeding can increase the rate of hemostasis and reduce hospital mortality