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實證醫學競賽 - PowerPoint PPT Presentation


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實證醫學競賽. 組別:第 B 組. 訂定 PICO. P: Patient with acute pancreatitis I :Pain control by Morphine C : Demerol O : S phincter of Oddi spasm. 資料庫來源. PubMed Ovid. 搜尋之關鍵字. Acute pancreatitis Morphine Demerol S phincter of Oddi spasm Motality Morbility.

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slide1

實證醫學競賽

組別:第 B 組

slide2
訂定 PICO

P: Patient with acute pancreatitis

I :Pain control by Morphine

C : Demerol

O : Sphincter of Oddispasm

slide3
資料庫來源

PubMed

Ovid

slide4
搜尋之關鍵字

Acute pancreatitis

Morphine

Demerol

Sphincter of Oddispasm

Motality

Morbility

slide5

DataBase: GASTROENTEROLOGY Vol. 96, No. 4, 2001

Search: Acute pancreatitis, Morphine, Demerol, Motality, Morbility

Limit : clinical trail

Result: 24

slide6
第一篇

出處:Narcotic Analgesic Effects on the Sphincter of Oddi: A Review of the Data and Therapeutic Implications in Treating Pancreatitis THE AMERICAN JOURNAL OF GASTROENTEROLOGY Vol. 96, No. 4, 2001

究設計: Systemic review of cohort studies

研究結果分析:

All narcotics increased biliary pressure, but morphine was associated with the largest elevation.

Endoscopic retrograde cholangiopancreatography with direct SO manometry demonstrated that the SO is exquisitely sensitive to all narcotics and that increase in biliary sphincter pressure is seen with higher doses of morphine.

結論:Morphine increase in biliary sphincter pressure

slide7
結論

Morphine increase in biliary sphincter pressure

slide8
訂定 PICO
  • P: Patient with acute pancreatitis
  • I :FOY (Gabexate mesilate )
  • C : Placebo
  • O : Mortality rate
slide10
搜尋之關鍵字
  • Acute pancreatitis
  • Gabexate mesilate
  • Motality
  • Morbility
  • Hospital day
slide12

DataBase: Hepatogastroenterology & World J Gastroenterol

  • Search: Acute pancreatitis, Gabexate mesilate, Motality, Morbility, Hospital day
  • Limit : clinical trail
  • Result: 26
slide14
第一篇
  • 出處:Prospective and randomized study of gabexate mesilate for the treatment of severe acute pancreatitis with organ dysfunction Hepatogastroenterology. 2000 Jul-Aug;47(34):1147-50.
  • 究設計:randomized study
  • 研究結果分析:
  • 52 patients with acute pancreatitis and organ dysfunction were enrolled.
  • 26 patients receiving intravenous gabexate mesilate infusion at a dose of 100 mg/hr for 7 days
  • The 7-day-mortality and 90-day-mortality rates were significantly reduced with gabexate mesilate therapy
  • 結論: early intravenous gabexate mesilate infusion results in improved survival in acute pancreatitis with organ dysfunction
slide15
第二篇

出處:Continuous regional arterial infusion therapy with gabexate

mesilate for severe acute pancreatitis World J Gastroenterol 2008 November 7; 14(41): 6382-6387

究設計:prospective study

研究結果分析:

18 patients diagnostic criteria for acute pancreatis, 9 patients underwent CRAI

Hospitalization significantly differed between the CRAI and non-CRAI groups, 53.3 ± 7.9 d and 87.4 ± 13.9 d (P values< 0.05)

結論: The present results suggest that CRAI

using gabexate mesilate was effective against acute pancreatis

slide17
結論

FOY 可以有效改善acute pancreatic 的愈後