目的　分析临床极重的危重型溃疡性结肠炎 (UC)的诊断、治疗和预后。方法　搜集近 18年UC ,参考国外分型标准 ,拟订诊断标准 ,分出危重型 :①血性腹泻≥ 9次 /d ;②体温≥ 38°C ;③脉搏90次 /min以上 ;④血红蛋白 <90 g/L ;⑤血浆白蛋白≤ 30 g/L ;⑥明显营养障碍或严重中毒症状。具备 3/ 6条属危重型。结果　 40例重症UC中危重型 2 7例。腹泻、便血、体重下降、发热、贫血频率分别为 10 0 %、10 0 %、92 %、82 %及 82 %。均为全结肠或广泛性结肠炎。并发休克 3例 ,肠穿孔 1例。 2 4例皮质激素治疗 ,最终手术 9例。 3例死亡。结论　危重型属UC重中之重 ,预后差 ,需特别监护、强化内科治疗 ,1周后无效者原则上立即手术 Objective To analyze the diagnosis, treatment and prognosis of critically ill clinical ulcerative colitis (UC). Methods Collecting UC for nearly 18 years, referring to the classification criteria of foreign countries, formulating the diagnostic criteria to distinguish the critical types: ① bloody diarrhea ≥ 9 times / d; ② body temperature ≥ 38 ° C; ③ pulse more than 90 beats / min; ④ hemoglobin <90 g / L; ⑤ plasma albumin ≤ 30 g / L; ⑥ significant nutritional disorders or severe symptoms of poisoning. With 3/6 is a dangerous type. Results 40 cases of severe UC in critically ill 27 cases. Diarrhea, blood in the stool, weight loss, fever and anemia were 10%, 100%, 92%, 82% and 82%, respectively. All colon or extensive colitis. Complicated shock in 3 cases, intestinal perforation in 1 case. 24 cases of corticosteroid treatment, the final surgery in 9 cases. 3 died. Conclusions The critical type is the most important UC, the prognosis is poor, requiring special supervision, to strengthen the medical treatment, one week after the invalid in principle, immediately surgery