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實證醫學競賽

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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實證醫學競賽

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  1. 實證醫學競賽 組別：第 B 組

  2. 訂定 PICO P: Patient with acute pancreatitis I :Pain control by Morphine C : Demerol O : Sphincter of Oddispasm

  3. 資料庫來源 PubMed Ovid

  4. 搜尋之關鍵字 Acute pancreatitis Morphine Demerol Sphincter of Oddispasm Motality Morbility

  5. DataBase: GASTROENTEROLOGY Vol. 96, No. 4, 2001 Search: Acute pancreatitis, Morphine, Demerol, Motality, Morbility Limit : clinical trail Result: 24

  6. 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

  7. 結論 Morphine increase in biliary sphincter pressure

  8. 訂定 PICO • P: Patient with acute pancreatitis • I :FOY (Gabexate mesilate ) • C : Placebo • O : Mortality rate

  9. 資料庫來源 • PubMed

  10. 搜尋之關鍵字 • Acute pancreatitis • Gabexate mesilate • Motality • Morbility • Hospital day

  11. 搜尋之歷程 • PubMed

  12. DataBase: Hepatogastroenterology & World J Gastroenterol • Search: Acute pancreatitis, Gabexate mesilate, Motality, Morbility, Hospital day • Limit : clinical trail • Result: 26

  13. 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

  14. 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

  15. 結論 FOY 可以有效改善acute pancreatic 的愈後

  16. 參考資料：證據等級和臨床建議

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