Abstract: Objective:To investigate the feasibility, efficacy, and safety of transjugular intrahepatic portosystemic shunt(TIPS) in the treatment of acute upper gastrointestinal bleeding induced by portal hypertension and evaluate its clinical application value. Method:Seventy-eight patients with the diagnosis of upper gastrointestinal bleeding induced by cirrhotic portal hypertension in the Weifang People's Hospital from April 2015 to March 2017 were included. The patients were randomized divided into the observation group and the control group by using the random number table, with 39 cases in each group. The observation group received TIPS surgery, while the control group underwent splenectomy and pericardial devascularization. Follow up for 1 year, the preoperative and postoperative hemodynamic indexes, liver function and coagulation function indexes of the two groups were compared. The rebleeding rate within 1 year after operation, and the perioperative and postoperative complication rates were compared between the two groups. Result:The patients in both groups received the corresponding operation. There was no perioperative death in the observation group, 1 patient of the control group died because of massive necrosis of the small intestine induced by portal vein thrombosis. The portal vein diameter(PVD) of the observation group was significantly smaller than that of the control group, the portal vein pressure(PVP) and the portal venous blood flow were significantly decreased compared with the control group(P<0.05). and the portal vein velocity(PVV) was significantly faster than that of the control group(P<0.05). The levels of AST, ALT and TBIL in the observation group were lower than those in the control group(P<0.05), while the PT and APTT in the observation group were not significantly different from those in the control group(P>0.05). In the observation group, rebleeding occurred in 3 patients, respectively in the 4, 6, 11 months after operation. 1 patient was cured by endoscopic ligation and the other 2 patients were cured by conservative treatment; 6 patients developed hepatic encephalopathy of grade II or above within 1 year after operation; 2 patients died because of liver failure respectively in the 3, 8 months after operation. In the control group, rebleeding occurred in 2 patients, respectively in the 2, 5 months after operation. Both of them were cured by endoscopic ligation; Hepatic encephalopathy of grade II or above occurred in 5 patients after operation; 1 patient died because of liver failure in the 5 month after operation. There was no significant difference in rebleeding rate, perioperative and postoperative complications between the two groups(P>0.05).Conclusion:TIPS can significantly improve the hemodynamic indexes and liver function of patients. Compared with the traditional operation method, TIPS makes less trauma, possesses significant effect and high safety, which is worthy of the further clinical application.