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find Author "邱实" 2 results
  • 大型医院医疗安全预防两级监管体系浅析

    【摘要】 建立从上而下和从下而上两级医疗安全预防管理模式,是大型医院预防医疗不良事件的重要措施与保证。通过对医疗安全预防管理机制和运行效果的探讨及总结,阐明了两级监管体系在发现、化解、降低各种医疗纠纷隐患及医疗风险中的有效性和作用,可供其他医疗机构参考借鉴。

    Release date:2016-09-08 09:27 Export PDF Favorites Scan
  • PPI versus H2RA for Both the Prevention of Bleeding and the Healing of Ulcer after ESD: A Meta-Analysis

    Objective To compare proton pump inhibitors (PPI) and H2 receptor antagonists (H2RA) for both the prevention of bleeding and the healing of ulcer after endoscopic submucosal dissection (ESD), so as to provide best evidence for treating ESD-induced ulcer in clinic. Methods Databases including PubMed, CENTRAL, EMbase, ISI Web of Knowledge, VIP, CNKI, CBM and WanFang Data were searched from the date of their establishment to October 26, 2012 to collect the randomized controlled trials (RCTs) about comparison of PPI and H2RA on the prevention of bleeding and the healing of ulcer after ESD. Meanwhile the references of the included studies were also retrieved manually. According to the inclusion and exclusion criteria, literature selection, data extraction and quality assessment were performed by four reviewers independently, and meta-analysis was performed using RevMan 5.1 software. Results A total of 6 studies involving 616 patients were included finally. The results of meta-analysis showed that: for the prevention of ulcer bleeding after ESD, PPI preceded H2RA apparently (OR=0.51, 95%CI 0.29 to 0.89, P=0.02), especially when the treatment course was 8-week (OR=0.43, 95%CI 0.22 to 0.82, P=0.01); but among the merged, 8-week and 4-week groups, there were no significant differences between PPI and H2RA in the healing of ESD-induced ulcer (OR=0.85, 95%CI 0.39 to 1.86, P=0.69; OR=1.33, 95%CI 0.28 to 6.27, P=0.72; OR=0.75, 95%CI 0.31 to 1.79, P=0.52). Conclusion PPI is superior to H2RA for the prevention of ulcer bleeding induced by ESD, but there is no significant difference between them in the healing of ulcer, so PPI is recommended to prevent ESD-induced ulcer bleeding in clinic. Due to the limitation of quantity and quality of the included studies, the safety of PPI has to be further proved by conducting more high quality, large scale and multicenter RCTs.

    Release date:2016-08-25 02:39 Export PDF Favorites Scan
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