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Objective To explore the impact of metacognitive technology psychological intervention technology on perioperative school-age children′s psychological condition, designed to find an efficient, fast method to intervene preoperative psychological condition, to eliminate their fear of emotional,coping with stress reaction in the effective time. Methods A total of 70 cases of school-age children who were treated from December 2016 to March 2017 were selected randomly and divided into the experimental group (35 cases) and the control group (35 cases). Both groups performed routine preoperative,intraoperative and postoperative nursing,and the experimental group was performed by the special person on the basis of conventional care when waiting for the operation. The changes of the fear index were compared between two groups of patients(T1),preoperative waiting(T2),pre-anesthesia(T3) and one day after surgery(T4). Results The scores of T1,T2,T3 and T4 in the experimental group were 7.000,7.929,2.686,0.971.The scores of T1,T2,T3 and T4 in the control group were 6.929,7.543,8.286 and 3.400.There was no significant difference in the fear index between the two groups at time T1 and T2 (t=0.796, 1.627, P>0.05). The fear index of T3 and T4 was significantly lower than that in the control group. The difference was statistically significant (t=298.637, 400.463, P<0.05). Conclusions The metacognitive technique can significantly improve the psychological status of the children in perioperative school age,and improve the adaptability and tolerance of the children.
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Objective To investigate the influence of cognitive behavioral intervention on self efficacy and quality of life in patients with chronic hepatitis B (CHB).Methods 90 patients with chronic hepatitis B were randomly divided into cognitive behavioral intervention group and control group,45 cases in each group.The patients of the control group were treated with routine treatment,the intervention group was given cognitive behavior intervention on the basis of conventional treatment.The general self efficacy scale (GSEs) and SF-36 quantity form (SF-36) were used to evaluate the effects of intervention.Results Before the intervention,the GSES score and SF-36 scores of each dimension of the two groups had no statistically significant differences (all P ＞ 0.05).After intervention,the GSES scores of the intervention group was (22.53 ± 4.12) points,which was significantly higher than (17.82 ± 4.51)points of the control group,there was significant difference between the two groups (t =4.918,P ＜0.01).The dimensions of the intervention group SF-36 score[comprehensive health status (16.13 ± 2.04)points and physical function (17.73 ± 3.49) points,mental health (15.73 ± 2.69) points,role limitations (18.38 ± 2.78) points,social function (14.76 ± 2.96) points,physiological (15.89 ± 2.85) points,vitality and energy (19.18 ± 3.43) points,body pain (19.84 ± 3.78) points] were significantly increased,and compared with the control group [general health status (12.62 ± 2.15) points and physical function (13.18 ± 2.31) points,mental health (9.24 ± 3.54) points,role limitations (8.67 ± 3.47) points,social function (9.24 ± 2.42) points,physiological (8.67 ± 2.60) points,vitality and energy (10.64 ± 2.73) points,body pain (10.80 ± 2.40) points],the differences were statistically significant (t=6.896,8.863,9.189,17.309,9.287,12.046,11.645,14.937,all P＜0.05).Conclusion Cognitive behavioral intervention can significantly enhance the self-efficacy of patients with hepatitis B,and improve the quality of life of patients,it can be popularized in clinical work.
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Objective To summarize the experience in the diagnosis and management of insulinoma. Methods From January 1966 to December 2007, the clinical data of 131 patients with insulinoma were retrospectively analyzed. Results All the 131 cases had Whipple triad syndrome and 64 eases suffered from psychoneurosis symptoms. The fasting blood glucose or insultus blood glucose concentration of all the cases was lower than 2.8 mmol/L. The ratios of serum insulin to glucose were all higher than 0.3. Before operation, tumor was detected in 8 of 75 patients by B-us scan, and in 17 of 68 by CT, and in 5 of 10 by MRI. The intraoperative ultrasonography(IOUS) was applied in 44 eases, and tumor was found in 43 cases. Surgery included enucleation of insulinoma (88 cases), resection of the corpus and eauda of the pancreas (40 cases), duodenopancreatectomy (2 cases), and biopsy (1 case). The low blood glucose symptoms disappeared postoperatively in 130 cases. Pancreatic fistulae occurred in 20 cases, acute pancreatitis occurred in 32 cases. Conclusions Insulinoma can be diagnosed based on symptoms of Whipple triad and the ratio of serum insulin to glucose. Exploration and IOUS are the simple and effective methods to localize insulinoma.
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Objective To summarize the diagnosis and therapeutic experience of insulinoma in order to improve the surgical success rate and prognosis. Methods The clinical data of 138 patients with insulinoma from 1966 to 2007 were retrospectively analyzed. Results In this group of patients, hypoglycemia of different levels and Whipple triad were detected. 64 patients expressed different psychic symptom, 12 patients' psychic symptom were still present after blood glucose normalized after operation. Fasting serum insulin values in 88 patients were measured, and the insulin release index was higher than 0. 3. Before operation, tumor was detected in 8 of 75 patients by B-ultrasound scan, and in 17 of 68 patients by CT, and in 5 of 10 patients by MRI. The intra-operative B-ultrasound (IOUS) examination was applied in 44 cases, and 43 cases were successfully detected. The operations included enucleation of insulinoma (n=88) , resection of the body and tail of pancreass (n = 44) , pancreaticoduodenectomy (n=2) , and biopsy (n=1). The blood glucose symptoms normalized postoperatively in 132 patients. The blood glucose rebound in 110 patients, but blood glucose normalized within 2 weeks. After operation, 20 patients developed pancreatic fistula, 32 patients developed acute pancreatitis. Conclusions Insulinoma could be qualitatively diagnosed according to Whipple triad and the insulin release index. Operations with IOUS were simple and effective methods to localize the tumors. The only way to cure insulinoma was operation, and IOUS guided operation could avoid main pancreatic duct and vessel injury, decrease post-operative complications.