DISEASES OF THE BLOOD SYSTEM : POSTHEMORRHAGIC ANEMIA CHRONIC (ANAEMIA POSTHAEMORRHAGICA CHRONICA) - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention
Etiology. A number of diseases accompanied by repetitive small blood loss: gastric ulcer and duodenal ulcer, stomach cancer, hemorrhoids, tumors of the female genital organs (fibroma, myoma of the uterus, and others), hemorrhagic diathesis.
The pathogenesis. Depending on the functional characteristics of haematopoiesis as a result of blood loss there either regenerative or hyporegenerative anemia. Gipoplasticheskaya type of anemia is observed only when the condition complicating the course of posthemorrhagic anemia infection (sepsis), intoxication, individual characteristics of the reactivity of the patient's body.
Symptoms. Pallor of the skin and visible mucous membranes. Headaches, General weakness. Cardiovascular system due to the reduced mass of blood on the soil of chronic blood loss detects the number of violations increased cardiac activity (increased heart rate), shortness of breath, increased heart size to the left, which is associated with fatty infiltration of the heart muscle. Functional systolic murmur best heard at the apex of the heart and pulmonary artery. The lowering of the percentage of hemoglobin and the number of erythrocytes per unit volume of blood characterizes chloronema. Color index is equal to 0.5 or even lower. Regenerative phenomena, depending on the type of anemia, manifested in varying degrees. Aniso and poikilocytes blurred expressed. The number of cells close to the norm; immediately after blood loss is observed neutrophilic leukocytosis. Anemia with leukopenia indicate the severity of disease (hyporegenerative type of anemia).
For. Anemia can be more light on the current (regenerative) and harder treatable with greater severity (hyporegenerative and gipoplasticskie form of anemia).
Recognition on the basis of a thorough examination of the patient and diagnosis of the underlying disease.
The prediction is closely related to the type of anemia. Believe that developing on the soil of external blood loss anemia recover slower than internal blood loss, as in the latter case, necessary to repair the blood of the plastic mass used by the body. This provision is conditional, as the main role in the development and outcomes of anemia are the individual characteristics of the organism and the nature of the main disease.
Destruction of reasons blood loss (ligation of hemorrhoids, remove tumors of the female genital organs, and others), blood transfusion as a means of preoperative preparation.
While in regenerative forms of anemia by removing the cause anemia, in most cases, comes complete cure, when hyporegenerative and gipoplasticheskaya anemia necessary energetic therapy. In the first place - the iron treatment. If within the next 2 to 3 weeks under the influence of the iron is not marked shift, you should resort to the combined treatment with vitamin C with hepatic diet (up to 200 g per day). As a substitution therapy in particularly stubborn, not amenable to drug therapy cases it is advisable to apply a blood transfusion (up to 200 - 300 ml again with pauses for at least 4 to 6 days). Beautiful effect will give the transfusion of concentrated mass of erythrocytes in a dose of 100 - 200 ml - re 2 - 3 times a week. Patients shows protein food (meat)and vitamins as vegetables and fruits. Depending on the severity of anemia and course of the main disease it is recommended that one or another mode (mild, moderate or severe), bed content. Shows treatment in Kislovodsk, Zheleznovodsk, Yessentuki (in the last two - in violation of the secretory function of the stomach).