目的 探讨急性荨麻疹伴消化道大出血的临床特征及诊治。方法 回顾分析2例在治疗过程中出现消化道 大出血的急性荨麻疹患儿的临床资料，并复习相关文献。结果 例1男性患儿11岁，例2女性患儿2岁10个月，均表现为 皮疹、腹痛、呕血、黑便。经治疗后，例1皮疹基本消退，例2残留少许斑片状皮疹；但仍均有不同程度贫血，胃镜均提示消 化性溃疡。2例患儿均出现上消化道大出血，例1经药物治疗、介入治疗、外科急诊手术后仍不能有效止血，后继发弥散性 血管内凝血及多器官功能衰竭死亡；例2经内科治疗、介入治疗及外科手术治疗后出血停止。结论 急性荨麻疹易并发消 化道大出血，经药物、内镜下止血及手术治疗，出血可得到有效控制，否则易发生严重并发症。

Objective To explore the clinical characteristics, diagnosis and treatment of acute urticaria with gastrointestinal hemorrhage in children. Methods The clinical data of acute urticaria with massive gastrointestinal hemorrhage during treatment in 2 cases were analyzed retrospectively, and the related literature was reviewed. Results Case 1 was an 11 -year-old boy and case 2 was a 2 -year- and 10 -month-old girl. Both of them presented with rash, abdominal pain, hematemesis and melena. After treatment, the rash basically subsided in case 1 and a little patchy rash remained in case 2 . However, both patients still had anemia of different degrees, and gastroscopy showed peptic ulcer. Both children suffered from massive gastrointestinal hemorrhage. Case 1 failed to stop bleeding effectively after drug treatment, interventional treatment and emergency surgery, and later died of secondary disseminated intravascular coagulation and multiple organ failure; case 2 stopped bleeding after medical treatment, interventional treatment and surgical treatment. Conclusions Acute urticaria is vulnerable to be complicated with massive gastrointestinal hemorrhage. After drugs, endoscopic hemostasis and surgical treatments, the bleeding can be effectively controlled. If not, serious complications are prone to occur.