Professional Documents
Culture Documents
Bài 11. Điều Trị Thiếu Máu
Bài 11. Điều Trị Thiếu Máu
Bài 11. Điều Trị Thiếu Máu
THUC IU
TR THIU MU
T: DSH
LOGO
Thiu mu: phn loi v iu tr
Mc tiu:
Trnh by c khi nhim v phn loi nguyn nhn thiu mu theo hnh
thi
Tng hp hemoglobin
Nhu cu
Bng. Nhu cu st hng ngy ca ngi (mg/ngy)
PHN B ST TRONG C TH
Duodenum Dietary iron
(average, 1 - 2 mg
Utilization Utilization
per day)
Plasma
transferrin (TIBC)
(3 mg)
Bone
Muscle marrow
(myoglobin) Circulating (300 mg)
(300 mg) erythrocytes
Storage
iron (hemoglobin)
(Ferritin) (1,800 mg)
Fe2+ ;
D dy Fe3+ => Fe2+
Lng Mu
rut TB nm rut
+ glycoprotein
Ty xng
C, D tr(gan, Thi
(to HC)
enzym lch, ty) tr
75%
NGUYN NHN THIU ST
Mt mu
Gim hp thu st
CH NH
c tnh cp (tr em > ngi ln): chy mu d dy rut, try tim mch,
nhim acid chuyn ha, hn m, t vong
iu tr:
Loi b st khi ng tiu ha: gy nn, ty x
Tim deferoxamin
iu tr:
Ch nh:
Thiu mu c tnh ( B12 huyt < 100pg/ml, Schilling test < 5%) v
thiu mu do ct d dy, thiu mu hng cu to MCV > 100fL
Liu dng:
Khi u: IM 100-1000mcg/ngy hoc cch ngy trong 1-2 tun
(nu c rl thn kinh: dng trong 6 thng)
Ch nh:
Thiu mu do thiu acid folic (MCV > 100fL, nng acid folic
huyt gim)
Liu dng:
PO 1mg/ngy
ERYTHROPOEITIN (EFO)
Vai tr:
Ch nh:
c tnh:
Tng Hb, tng Hct, tng HA, huyt khi
ERYTHROPOEITIN (EFO)
Bng. Ch nh v ch iu tr ca Erythropoetin ti t hp
Thuc Nguyn nhn thiu mu
Do AIDS Do ha tr ung th Do suy thn
Epoetin alfa 100 IU/kg x 3 ln/tun, 150 IU x 3 ln/tun hoc 50IU x 3 ln/tun
p ng sau 8-12 40000IU/ln/tun, p ng
tun sau 2-8 tun
Darbopoetin alfa 2.25mcg/ln/tun IV, SC, 0.45 mcg/ln/tun IV,
p ng sau 2-8 tun SC, p ng sau 2-8
tun
* Ch nh ca vitamin B12, ngoi tr:
A. Thiu mu u sc
C. C th suy nhc, gi yu
C. Tch tr ch yu gan
A. St sulfat
B. St dextran
C. Acid folic
D. Cyanocobalamin
Cch s dng khng ng st II oxalat
A. Ung ngay sau ba n.
B. Ung vi nhiu nc.
C. Ung vi nc tr.
D. Ung vi nc un si ngui