儿科学之小儿贫血课件.pptVIP

Anemia in childhood (小儿贫血) Dept. of pediatrics 李圭华; Teaching purpose;Features of hematopoiesis in children;;Features of hematopoiesis in children;Hematopoesis in bone marrow; When hematopoietic demand increases, liver, spleen and lymph nodes come back to the Status to produce blood cells, hepatomegaly（肝肿大） and splenomegaly（脾肿大） appears, and maybe there are immature erythrocytes and granulocytes in circulating blood. Extramedullary hemopoiesis is the specific phenomena only appearing in infant and toddler. ;Features of blood in children;Erythrocyte and hemoglobin ;;Leucocyte count;%;Morphological classification of anemia;　　　　　　　　　Blood routine Hypochromic microcytic Macrocytic Normocytic （Hb↓＞RBC↓） （Hb↓＜RBC↓) （Hb↓ =RBC↓） IDA （缺铁性贫血） megaloblastic 　 acute bleeding Thalassemia 　　　　　Vit B12↓↓ hemolytic anemia sideroblastic anemia folic acid ↓ 　aplastic anemia Chronic infection most of secondary anemia ;Age ;Nutritional iron deficiency anemia (IDA) 营养性缺铁性贫血; Zhou, male, 10 months old. Paleness in face and lips for 4 mons. His facial expression became more and more pale since 6 months of age. Without fever and bleeding. He was premature birth at 33 weeks of gestational age and fed with Mothers milk only. ;PE: Pallor. no jaundice and hemorrhagic spots in skin and sclera; Bilateral submandibular lymph nodes are 0.8×0.8cm. Breath sounds in lungs are distinct; there are no rhonchi and moist rale. HR 100/min.There is II/VI systolic murmur in precordial region. The liver and spleen enlarge to 4 cm and 3 cm below lower costa margin respectively.;Blood routine test;questions;answer;questions;answer;etiology;questions;Smear of Blood ;Bone marrow ;Bone marrow ex