1.Pre-operative assessment of the disease, blood count, CD4+ T lymphocytes, viral load check in recent years, and the presence of associated opportunistic infections and exclusion of associated tumors. Make good preoperative preparation, decide the indications for surgery, timing and size of surgery. Predict the complications. 2, preoperative antiviral treatment, efficacy and determine whether there is drug resistance, detection of antiviral treatment for drug side effects, not taking antiviral drugs due to surgical disease found HIV infection, to meet the criteria for taking drugs, non-emergency surgery is recommended elective preoperative drug treatment for a period of time, until the virus is not detected, CD4 + > 200 to perform surgery, tumor patients or other patients with a deadline for surgery, while antiviral treatment If CD4+<200, surgery should not be delayed for too long, and the risks of surgery should be informed. Patients with abdominal surgery requiring perioperative fasting: preoperative measurement of CD4+ T lymphocytes and viral load to determine the immune status and the presence of drug resistance. HIV/AIDS combined with acute surgical diseases: CD4+>200 with clear indications for surgery should be decisively operated, CD4+<200 especially <100, then comprehensive judgment of the condition and vital signs, especially for patients who have been for a long time, to judge the process of treatment, pay attention to close observation of changes in the condition, intensive conservative treatment such as unobstructed gastrointestinal decompression and anti-infection and supportive treatment, if there is no improvement in a short period of time, non-operative treatment cannot be used. If there is no improvement and aggravation, non-surgical procedures cannot save the life, then we should refer to surgery, and surgery under supportive therapy should simply solve the main problem. Acute abdomen should exclude AIDS-induced gastroenteritis peritonitis mesenteric lymphadenitis lactic acidosis tuberculosis obstruction, etc. We have encountered two cases of acute abdominal pain due to lactic acidosis caused by stavudine, two cases of upper gastrointestinal perforation and one case of abdominal tuberculosis obstruction cured by active conservative treatment, a young patient with upper gastrointestinal perforation, not timely gastrointestinal decompression, probably perforated roughly abdominal contamination, CD4+ T lymphocytes <100, referred to our department after the symptoms of poisoning is more serious, recommended emergency surgery, the family refused, and then abandoned treatment back to He died 2 days later from generalized infectious toxic shock. 3, tuberculosis is a common opportunistic infection of AIDS, combined with acute surgical disease, considering the low immunity is more likely to cause the spread of tuberculosis, at the same time do not know whether drug resistance, before and after the operation recommended intensive anti-tuberculosis treatment plus 2-3 second-line drugs to ensure effective control of tuberculosis, while strengthening anti-infection and supportive therapy.