男性，65岁。上腹隐痛，乏力伴食欲减退，间 断解黑便半年余，体重下降约10kg。今日突然 呕吐暗红色血，量约200ml。查体：上腹部饱 满，轻压痛，肝脾未触及，无移动性浊音。诊断一经明确，治疗方案宜采取

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