儿童贫血全英收文ppt课件.pptVIP

Parenteral iron preparation A parenteral iron preparation (iron dextran) is an effective form of iron and is usually safe when given in a properly calculated dose, but the response to parenteral iron is no more rapid or complete than that obtained with proper oral administration of iron, unless malabsorption is a factor. Blood Transfusion With a severe anemia, immediate red blood cell transfusion may advisable, especially in cardiac failure or severe infection, but volume and speed of transfusion must be controlled well. We may transfuse, severely anemia children should be given only 2-3ml/kg of packed cells at any one time. If there is evidence of frank congestive failure, a modified exchange transfusion using fresh-packed RBCs should be considered. Iron therapy Notice : 3 points 1.Injection iron in danger 2.Reaction : 12-24h(irritability ↓,appetite ↑)--- 36-48h(erythroid hyperplasia )--- 48-72h(reticulocytosis↑)---5-7ds(peaking ) 2-3ws to reticulocytes 3.Times: 6-8ws Prevention 4 points— mother milk feeding specter food with iron – preterm infant Nutritional megaloblastic anemia Folic acid and vitamin B12 deficiency are primary causes of megaloblastic anemia. The clinical features include anemia， the decrease of red cell is more than that of HB， the volume of red cell is larger than normal. Causes 1.less intake 2.absorb abnormal 3.drug interactions 4.requirement increased Pathogenesis ? folic acid folic acid with 4 hydrate vitamin B12 DNA  Hb very large RBC Megaloblastic with Lot of Hb dihydrofolate reductase (THFA) VitaminB12 is importance in synthesis of nerve. deficiency of vitaminB12 can lead to discord of neurology psychology. In the macrocytic anemia produced by deficiency of vitamin B12, the symptoms an