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Causes Analysis of Hypopituitarism Patients of Below Standard of Treatment

Author: YuDongZuo
Tutor: SunZhongHua
School: Jilin University
Course: Clinical
Keywords: hypopituitarism treatment standard causes analysis
CLC: R584.2
Type: Master's thesis
Year: 2011
Downloads: 40
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Abstract


Hypopituitarism is a common endocrine system disease and the disease causes inappropriate secretion of hormone which will affect various systems deeply and threaten the patients’lives and health. Correct hormone replacement therapy may improve the patients’mental and physical activities, systemic metabolism and sexual function, and it may also prevent osteoporosis and is benefit for saving the patients’lives and improving their survival quality. At present, there is no corresponding guideline for hypopituitarism and large scale clinical controlled study, so it is very important to study its treatment situations and it worth to be paid more attention by medical workers.Objective:Compare the detailed situations hormone replacement therapy on target gland in the patients with hypopituitarism, investigate the reasons for treatment below a certain level and guide clinical decisions in the further.Materials and methods:50 hypopituitarism patients came in our hospital from 2008 to 2010 are included in this study. Inclusion criteria:(1) hypopituitarism is diagnosed according to disease history, clinical symptoms and signs and the results of pituitary and target gland hormone determination. (2) the age ranges from 20 to 60 years. (3) the course of disease ranges from 1 to 10 years. Exclusion criteria:(1) the patients have essential hypertension or secondary hypertension. (2) The patients have acute or chronic heart and kidney disease, consumptions or other systemic metabolic diseases. (3) Patients have many confounding factors. Study methods:observe the patients’treatment situations of hormone replacement therapy from adrenal gland, thyroid gland and gonad. Adrenal gland axis:take blood pressure, body mass index (BMI) and ions in blood as observation indicators. Thyroid gland axis:take FT4 as observation indicators. Gonad axis:take E2 (or T), secondary sexual character as the observation indicators. The treatment situation is determined below a certain level if the value of no less than one indicator is not in the reference range. Observation content:the detailed situations of hormone replacement therapy on target gland and record the reasons for treatment below a certain level by talking method. Statistical methods:SPSS 10.0 statistical software is applied to analyze the data, count data is expressed by relative number andX2 test is applied to compare the rate of paired data of multiple samples. If P<0.05, the results are considered to be significantly different.Results:(1) After the treatment on patients with hypopituitarism, the non-attainment rate of adrenal gland, thyroid gland and gonad function is given X2 test and the difference is significantly different (P<0.005). (2) In the treatment on patients with hypopituitarism, the non-taking rate of adrenal cortex hormones, thyroid hormones and sex hormones is givenX2 test and the difference is significantly different (P<0.005). (3) The reasons for treatment below a certain level include the patients not recognizing and paying more attention on the disease, many problems in the application of drugs, the economic limitations and incorrect review indicators.Conclusions:(1) After the treatment on patients with hypopituitarism, the non-attainment rate of gonad is highest, followed by that of thyroid gland and that of adrenal gland is the lowest. (2) In the treatment on patients with hypopituitarism, the non-taking rate of adrenal cortex hormones is lowest, followed by that of thyroid gland and that of gonad is highest. (3) The reasons for treatment below a certain level is influenced by various factors.Revelations:the improvement of attainment rate depends on the joint efforts of medical workers and patients:(1) Help the patients and their families have a correct understanding of the disease. Notice to them that the replacement drugs are the normal physiological demands and the changes of drug doses in different situations and drug effects and adverse reactions should be given close observation. (2) Enhance the monitoring and management of the patients with hypopituitarism in the process further and prevent the self drug-reduction or drug withdrawal. (3) Establish good doctor-patient relationship and improve the patient compliance. (4) Enhance the coping capacity of adverse reaction of related hormone and individual treatment plan should be given to special patients. (5) Medical workers should determine the selection of drugs and the indicators of drug efficacy. (6) Propose the government to establish the sound medical insurance system which will provide economic benefits to the patients having economic difficulties.

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CLC: > Medicine, health > Internal Medicine > Endocrine diseases and metabolic diseases > Pituitary and diencephalon - pituitary system diseases > Hypopituitarism
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