难治性消化道出血的定义并不明确，难治性消化道出血应包括：病因不明；病因难除或经内外科治疗难以控制出血；病人本身伴发高危合并症，病情复杂和危重；发病急、出血量大、病情凶险等4种情况。难治性消化道出血的诊断和治疗需要内科、外科以及介入科等多学科协作。

Diagnosis and treatment thinking of  refractory gastrointestinal bleeding        WANG Zhen-jun. Department of General Surgery, Beijing Chaoyang Hospital of Capital Medical University, Beijing 100020, China
Abstract    The definition of refractory gastrointestinal bleeding is equivocation. The purpose of the article is to summarize the features and basic principles of the treatment of refractory gastrointestinal bleeding through literature review. Refractory gastrointestinal bleeding can be divided into the following four situations: etiology unknown, knoun etiology buy refractory to treatment, patient with severe complication and acute massive gastrointestinal bleeding. Multidisciplinary collaboration including the department of endoscopy, surgery and intervention therapy is necessary for the succesful diagnosis and treatment of refractory gastrointestinal bleeding.