患者男,49岁,因腹胀8d,头晕,呕棕褐色液体并黑便1 d急诊入院。2d前患者突感头晕、恶心,呕鲜红色胃内容物约800ml,呕吐后腹胀减轻,但头晕加重。患者有“胃溃疡”病史16年。入院体检：体温36．4℃,心率85次/min,呼吸21次/min,血压110/60 mmHg(1mmHg=0．133 kPa),神清,精神差,自主体位,浅表淋巴结不大,睑结膜色淡,口唇轻度发绀。入院诊断：上消化道大出血。为明确病因查胃镜 Male, 49 years old, due to bloating 8d, dizzy, vomiting tan liquid and black 1 d emergency admission. 2d before the patient suddenly felt dizzy, nausea, vomiting red stomach content of about 800ml, vomiting, reduce bloating, but increased dizziness. Patients have a history of “gastric ulcer” for 16 years. Admission physical examination: body temperature 36.4 ℃, heart rate 85 beats / min, breathing 21 times / min, blood pressure 110/60 mmHg (1mmHg = 0.133kPa), Shen Qing, poor spirit, autonomic position, superficial lymph nodes, Membrane pale conjunctiva, lips mild cyanosis. Admission diagnosis: upper gastrointestinal bleeding. To clear the cause of gastroscopy