Sideropenic chirwere namatare kushaikwa kupererwa neropa: zviratidzo, kurapwa

Iron - mumwe okunze, pasina iro muviri hadzikwanisi kuita. Kunyange zvakadaro, pane njodzi kutyora wenhumbi dzake kubva matambudziko akasiyana-siyana zvinokonzera uye muitiro. Chimwe chezvinhu zvinozivikanwa ndiyo simbi kushaikwa kupererwa neropa (Ida). Inogona kuva vose vana nevakuru, uye kunyange vakadzi vane pamuviri vari pangozi. Kupiwa vose rokuparadza rine chirwere, zvinokosha kuti uzive zvizere.

Chii chinorehwa yesimbi kushaikwa kupererwa neropa?

Asati kudzidza sideropenic chirwere nesimbi kushaikwa kupererwa, vanofanira kubata mudzi dambudziko chokuita kushaya chero maatomu akafanana. Izvi mhando kupererwa neropa chinhu pathological mamiriro dzinoratidzwa kuderera padanho Chizenga muropa nokuda kuoneka kushayiwa resimbi pamuviri. Chairo dhefisiti anozviratidza nokuda mitemo yayo chionekeso uye kuitwa, kana nokuda pathological kurasikirwa maatomu akafanana izvi.

Iron kushaikwa kupererwa neropa (aka sideropenic) hwakasiyana nemamwe anemias vakawanda kuti kana asingadi pane rutapudzo masero matsvuku eropa. Kazhinji hazvina chirwere mune vakadzi zera rokubereka, vakadzi vane pamuviri uye vana.

Zvinokonzera chirwere

Pakutanga vanofanira kuratidza zvinokonzera njodzi, izvo zvinogona kuitika kana simbi kukanganisika. Inosimudzira kunwa iron, iro rinoteverwa kupererwa neropa zvinogona kukonzerwa kudzokororwa pamuviri zhinji kumwedzi nguva nokukurumidza uye lactation panguva pubertantnogo kumwedzi. Vanhu vakura vanogona kukanganisa simbi Utilisation. Uyewo uwandu penga nokuda kokuchembera zvirwere zvakanyeverwa kupererwa neropa iri yekudyidzana kwakawedzera (diverticulosis ura, renal insufficiency, oncopathology, et unto.).

Vanonetseka yakadaro dambudziko sesimbi kushaikwa, zvakakosha uye pakuti mhosva, kana kuvhiringidzwa kubva Absorção de Água kuti chinhu ichi pamusoro erythrokaryocytes mwero (nokuda kukwana yaunodya nesimbi zvokudya). Sezvo zvinokonzera simbi kushaikwa kupererwa, zvine musoro kuti kurapa chero zvirwere kuti kukonzera kurasikirwa ropa. Izvi zvinogona ulcerated bundu uye pezvakaitwa ari nemudumbu, endometriosis, chisingaperi Mamota nevamwe. Mune zvisingawanzoitiki zviitiko, zvingava kuitwa kurasikirwa ropa kubva Meckel diverticulum pamusoro ura duku, apo munhu peptic urikanwi nokuda paumbwe hydrochloric asidhi uye peptin.

The zvinokonzera simbi kushaikwa kupererwa neropa anogona chokuita glomicheskimi mapundu mumapapu, pleura uye diaphragm, uyewo vari mesentery pamusoro ura uye mudumbu. mapundu aya, vane zvakananga chokuita nokuvhara arteries, anogona ulcerate uye kuva kwaibva ropa. ropa dzimwe nguva akasimbisa chokwadi panyaya nhaka kana akawana pulmonary siderosis, izvo rakaoma nokuda ropa. Somugumisiro iyi, simbi dziri mumuviri womunhu asunungurwa, ichiteverwa kubvisa zvemapapu yake chimiro hemosiderin pasina mukana tevera inoraswa. Kurasikirwa simbi iri weti chingava nokuda mubatanidzwa zvirwere zvakadai chisingaperi glomerulonephritis uye akava hemosiderosis chiedza, rine autoimmune mavambo.

Dzimwe nguva zvinokonzera simbi kushaikwa kupererwa neropa chokuita simbi kurasikirwa pamwe neropa, zvine chokuita zvakananga kubata helminth dziri rakapinza muruoko intestinal kumadziro, zvichiita kukuvara uye, sezvo zvakaguma mikrokrovopoteri kuti zvingaita kuti pave Ida. Mukana uyu mhando kupererwa neropa ariko uye kuti vaya vaipa vanopa ropa kakawanda. Uye sezvo chimwe chikonzero ropa, vakafanirwa kuteerera, zvinokwanisika kuti kuona hemangioma pakati zvomukati.

The simbi mumuviri womunhu anogona havaratidzi kunyura nokuda duku bowel zvirwere, izvo kuitika pachiimbwa malabsorption chirwere dysbacteriosis ura uye diki ura resection. Kare, unogona kazhinji kusangana maonero kuti atrophic gastritis wakati akaderedza secretory basa, zvakanga zvakakodzera kuti funga sezvo chinokonzera simbi kushaikwa kupererwa neropa. Kutaura zvazviri, chirwere chakadai anokwanisa kupa chete webetsero simba.

The Isimba rakadini rinogona kubudiswa kushaikwa simbi (zvakavanzika, pasina kurapwa zviratidzo) anogona kuonekwa panguva nokukanganisika chechetere. Dzinoratidzwa kushayikwa kana kusavapo unopinza kuderera deposits ane microelement mwongo macrophages, izvo zvinogona kuoneka rinokosha ruvara. Zvinokosha kudzokorora kuti panguva ino, simbi kurasikirwa kunogona kuonekwa chete murabhoritari ezvinhu.

Chimwe chinhu, izvo anobvumira kuziva dhefisiti - zvinoderedza serum ferritin.

Zviratidzo mamirire esimbi-kushaikwa kupererwa neropa

To Zviratidzo vakanga nani kunzwisiswa, zvine musoro kuti vagovere chirongwa inotungamirwa redare kushayiwa 3 nzendo.

Achitaura wokutanga pachikuva, ndiko kuona mutengo kuti haisi achiperekedzwa yokuora zviratidzo. Zvinogona chete kuziva nokuda kuziva kwazvo radioactive simbi Absorção de Água muna nemudumbu uye uwandu hemosiderin, izvo zviri mu mwongo macrophages.

Danho rechipiri anganzi munhu Isimba rakadini rinogona kubudiswa simbi kukanganisika. It kunoratidzwa vasanyanye maekisesaizi kushivirira uye chinokosha kuneta. zviratidzo zvose izvi kunoratidza kusava simbi munyama zvakajeka nokuda vasanyanye wevasungwa resimbi tubhokisi makemikari. In mamiriro ichi, pezvakaitwa zviviri anowanikwa panguva: kuderedza ferritin nhanho mu erythrocytes uye serum, uyewo kushaya transferrin resimbi saturation.

Pasi Danho rechitatu zvakafanira kunzwisisa kunotoda kuratidzwa resimbi kushaikwa kupererwa neropa. The chikuru Zviratidzo izvi nguva inogona kunzi trophic kusagadzikana ganda, nzara, nevhudzi, sideropenic zviratidzo (kuneta uye utera), kukura tsandanyama simba, kupfupika mweya uye nezviratidzo chepfungwa uye cardiac kukundikana (achirira munzeve, dzungu, muchipfuva marwadzo, kufenda ).

By sideropenic zviratidzo panguva danho rechitatu unoshanda chido kudya choko -. Geophagy, dysuria, Urinary incontinence, achikurudzira kuti peturu kwakanaka, acetone, etc. With Panyaya geophagic, zviri kuwedzera simbi kushaikwa angava anoratidza kusava mumuviri magnesium uye zinc.

Richirondedzera vanhuwo zviratidzo resimbi kushaikwa, zvakakodzera kuteerera zviratidzo zvakadai muutera, kudya kurasikirwa, syncope, palpitations, kutemwa nomusoro, kushatirwa, pasi BP kuvheneka "nhunzi" pamberi, murombo hope usiku uye nehope masikati, zvishoma nezvishoma kuwedzera tembiricha, kuderera mune hanya uye ndangariro, uyewo tearfulness uye kutya.

Zvinosimbisa sideropenic urwere

Zvakakosha kunzwisisa kuti simbi iri chezvinonhuwira makemikari akawanda. Nokuda kwechikonzero ichi, kana pane kushayikwa, kuti enzayemu basa ipfupi uye panguva dzose metabolic pezvakaitwa mumuviri anonetseka. Saka, sideropenic chirwere chinokonzera zviratidzo zvizhinji:

1. Skin kuchinja. Kana pane kushayikwa simbi, unogona kuonekwa peeling uye kuoma ganda, iyo pakupedzisira makatsemuka. The panowanikwa makatsemuka anogona emichindwe, makona muromo, uye kunyange tsoka horo. Hair pamwe mangwanani chirwere ichi musoro wachena, kuva pfava totadza kushingaira. Anenge ari kota wevarwere akatarisana pfava, rive dete uye transverse striations nzara. Tishu simbi kukanganisika Zviri chaizvoizvo migumisiro kushaya tishu makemikari.
2. Kuchinja tsandanyama hurongwa. Iron kushaikwa kunoguma achishayiwa makemikari uye myoglobin ari tsandanyama. Izvi zvinotungamirira kuneta uye kushaya simba. In kuyaruka, uyewo vana, kushaya redare makemikari chinokurwadzai ari kunonoka kwomuviri uye kukura. Nokuti kuti tsandanyama hurongwa simba, murwere anonzwa chakasimba uchida urinate, dzikatadza wakabata weti kana vachiseka uye vangakosora. Girls nesimbi kushaikwa kazhinji kugadzirisa bedwetting.

sideropenic urwere uyewo alters ari mucous membranes ari intestinal turakiti (makatsemuka pamakona mumuromo, chisina kutsetseka stomatitis, zvakawedzera susceptibility kuti mazino caries uye periodontal chirwere). Uyewo, pane kuchinja omumwe kunhuwirira. Ane chirwere chakadaro varwere vanotanga kuita kwakanaka shangu Polish, mafuta emotokari, peturu, gasi, naphthalene, acetone, akanyorova ivhu pashure mvura, varnishes.

Kuchinja kukanganisa kuravira. Zviri nechido chakasimba kuravidza nonfood zvigadzirwa akadai zino upfu, mukanyiwa mbishi, chando, jecha, ivhu, minced nyama, bota.

Zvakadaro chirwere sezvo sideropenic urwere, mucous anosiyana okumusoro kufema turakiti membranes. kuchinja kwakadaro kutungamirira kukudziri- atrophic rhinitis uye pharyngitis. Ruzhinji rwevanhu nesimbi Deficiency Syndrome anooneka yebhuruu sclera. Somugumisiro kutyora gidroskolirovaniya lysine atadze kushanda zvakanaka rikaitika nedanho collagen usage.

Kana simbi kushaikwa ari nengozi kuchinja zvirwere. Tiri kutaura achideredza kwevari zvimwe immunoglobulins, B-lysine, uye lysozyme. Uyewo, pane kukanganisa pamusoro phagocytic webasa neutrophils uye cellular kutapata.

Kana dambudziko yakadai sideropenic urwere, dziripowo nechitarisiko dystrophic nokuchinja nhengo dzomukati. Izvi zvinosanganisira yechipiri sideropenic myocardial neta neta. Kunoratidza pacharo nokusimbisa nenamo rokutanga panguva chakaderedzwa mutengo mwoyo uye kuwedzera miganhu percussion dullness.

Iron kushaikwa anogona kuchinja uye mamiriro ari zvomudumbu turakiti. Tiri kutaura zviratidzo zvakadai sideropenic dysphagia, chakaoma mucous membranes pakati yegurokuro uye zvichida kuparara. Varwere vanotanga kunzwa kunetseka pakuparadza usiku kana vachingotya vaneta. Dai kanganisa zvinyama afemeruke, zvichiita kuti zvishoma nezvishoma atrophy ari gastric mucosa, kukura atrophic gastritis umo. Sideropenic chirwere uye kungaita kuti kuderera kwemitambo gastric secretion, zvinogona kuguma ahilii.

Nei simbi kushaikwa kupererwa neropa vakadzi vane pamuviri?

In nevakadzi anotakura mwana, simbi kushaikwa kungava nokuda chitarisiko extragenital uye gynecological zvirwere vasati pamuviri, uyewo kumusoro kudiwa simbi panguva fetus.

Zvakawanda zvinogona kuwanikwa kwezvirwere zvakadai kupererwa neropa. Iron kushayiwa vakadzi vane pamuviri, ave mutemo, akakudziridza nokuda kwezvikonzero zvinotevera:

• ataurwa pamusoro ekstragenital'nye chirwere zvirwere (mwoyo chirwere, duodenal urikanwi uye dumbu, atrophic gastritis, renal kukundikana, helminthic infestations, zvirwere chiropa, zvirwere kuti achiperekedzwa epistaxis, uye Mamota);
• kukanganisa yomukadzi muviri zvakasiyana makemikari uye mishonga yokuuraya zvipembenene, zvinokwanisa kuita tunodzivisa Absorção de Água resimbi;
• vachiberekwa kushaikwa;
• Zvirwere esimbi Absorção de Água kwacho (chirwere pfungwa nomuviri zvemwana asati, enteritis, resection pamusoro bowel duku, intestinal dysbiosis);
• Kudya kunaka, zvisina kukwanisa kupa hurukuro yacho zvisaririra chinhu mumuviri iri raida uwandu.

Iron kushayiwa muvana

Mumazana nguva pamuviri mumuviri mwana paumbwe chikuru Kuronga zvisaririra chinhu ropa. Zvisinei, chinonyanya kushingaira simbi kukurukura nokudzokorora placental midziyo inogona kuonekwa wechitatu trimester. In mwana hwenguva refu zvinoitika kwevari nayo pamuviri anofanira akaenzana 400 MG. Muchiitiko chino, avo vana vakaberekwa asati kutsvakwa izwi, chakarurama ichi rukasafashukira pamusoro 100 MG.

Zvinokosha kufunga nezvokuti kuti mukaka ine zvakakwana izvi zvisaririra chingaita mumuviri replenishment mwana wacho asati 4 months zera. Naizvozvo, kana zvinondiremera mangwanani kumisa achiyamwa, mwana anogona kukura simbi kukanganisika. The zvinokonzera simbi kushaikwa kupererwa neropa mune vana vanogona chokuita pamuviri kumwedzi. Tiri kutaura siyana zvinotapukira amai pavanenge vakazvitakura, mangwanani uye kunopera toxicosis uye hypoxia syndrome. Kwadzinoita simbi kuparadzwa arege zvinhu zvakadai vakawanda pamuviri kana fetus ropa chirwere, chisingaperi simbi kushaikwa kupererwa panguva pamuviri, uye uterine-placental kubuda ropa.

The ngozi iri intrapartum nguva hombe ropa pakukurukura uye rokusamhanyira rokusunga netambo. Panyaya post-Natal nguva, Panguva iyi esimbi kushaikwa kunogona kuva mhedzisiro yacho nokukurumidza mwero ikure mwana, mangwanani arumurwa mhou wose kuti mukaka uye zvirwere, izvo achiperekedzwa intestinal Absorção de Água.

A bvunzo ropa kuziva Ida

nzira iyi nechirwere kunodiwa kuti kuona kwakaderedza kwevari Chizenga uye masero matsvuku eropa. Inogona kushandiswa kuziva hemolytic kupererwa neropa uye simbi kushaikwa, nokuramba ari morphological unhu masero matsvuku eropa uye masero matsvuku eropa rakachengetwa.

Kana ari naIda ropa kemisitiri zvichaita hazvo kuderera mune wevasungwa pamusoro serum ferritin, ikawanda TIBC, achideredza wevasungwa pamusoro serum simbi uye yekudyidzana zvishoma pane dzose transferrin saturation Data chero maatomu akafanana.

Zvakakosha kuziva kuti zuva chokuendesa ari kuongorora havagoni kunwa doro. Hazvina zvakafanira kudya kwemaawa 8 vasati chirwere anobvumirwa mvura yakachena chete pasina gasi.

differential kuongorora chirwere

Muchiitiko chino, kubatsira zvikuru nechirwere chirwere anokwanisa nhoroondo. Iron kushaikwa kupererwa neropa kazhinji anova pamusoro pakanyorwa nezvimwe zvirwere, saka kuti mashoko kwaizova zvikuru kubatsira. Kana differential nzira nechirwere resimbi kushaikwa kupererwa, zvinonzi kuitwa neavo zvirwere zvinogona kukonzera simbi kukanganisika. Nokudaro thalassemia kunoratidzwa kurapwa uye rabhoritari zviratidzo shemoliza erythrocytes (wakakurisa chirwatata saizi, vakawedzera kwevari kunanga bilirubin, hypochromic kupererwa neropa, reticulocytosis uye yakakwirira simbi tigutsikane muna panosvikira mabhuku uye ropa serum).

Nzira kurapwa

Kuti tikunde dambudziko akadai kusava simbi muropa, zvakakodzera nounyanzvi kuswedera pakupora nzira. Mumwe murwere anofanira kuonekwa munhu kusvika, zvimwe zvinodiwa nenhanho kunyatsoshanda kuti kuchirapa kupindira kuti asvike zvakaoma.

Kana zvakadaro dambudziko sedare kushayiwa mumuviri, kurapwa zvikurukuru kunosanganisira kugara pedyo chinhu chinokurwadzai kupererwa neropa. Nokururamiswa ezvinhu iyi mishonga unoitawo basa yavaipora kwacho.

Attention inofanira kubhadharwa uye kudya kunovaka. Rokugoverwa Ida varwere zvinofanira kuverengerwa zvinogadzirwa kuti ane heme simbi. Izvi tsuro nyama, veal, nyama. Usakanganwa succinic, cucumber uye ascorbic acid. Zadza simbi kushaikwa kuchabatsira kushandiswa Mishonga faibha, calcium, oxalate, uye polyphenols (Sou mapuroteni, tii, kofi, chocolate, mukaka).

Achitaura zvinodhaka kurapwa misoro muudzame, zvinokosha kuziva kuti zvinodhaka simbi vari ushandiswe mwero kubva 1.5 kusvika 2 months. Mushure HB pamwero riri normalized, kuratidzwa Nokuraramisa kurapa vachishandisa hafu-mishonga kwevhiki 4-6.

Iron zvokuwedzera nokuti kupererwa neropa uchigamuchirwa yakavakirwa 100-200 MG / zuva. Mushure chipimo chemushonga ipfupi kuti 30-60 d (2-4 months). The kupfuura mukurumbira zvinosanganisira zvinotevera zvinodhaka: "Tardiferon", "Maltofer", "Totem", "Ferropleks", "Sorbifer", "Ferrum naAmareki". Kazhinji, mishonga rinoitwa pamberi kudya. The anosiyiwa ndivo varwere vari panoonekwa gastritis uye maronda. Mishonga-dzataurwa pamusoro havagoni kunwa zvigadzirwa, akakwanisa kusunga simbi (mukaka, tii, kofi). Zvikasadaro, avo nomugumisiroi ruchabviswa. Zvinofanira Pakutanga kungwarira mhembwewo divi maturo, izvo anokwanisa kubudisa zvinowedzera iron kuti kupererwa neropa (kureva zvasviba ruvara mazino). Kutya kwakadaro maitiro hakusi zvakakodzera. Kana nemigumisiro yokurapwa, zvinogona kukonzera gastro-intestinal zvinetso (kupatira, abdominal marwadzo), uye svoto.

Nzira inokosha kutungamirira zvinodhaka nesimbi kushaikwa - mukati. Asi kune intestinal zvirwere, umo kwakakanganiswa kubvisa kwacho dzakaratidza parenteral yaitonga.

dziviriro

Kazhinji, kushandisa kurapwa pavadzidzisi vanokwanisa kugadzirisa simbi kukanganisika. Kunyange zvakadaro, chirwere anokwanisa recur zvakare uye kukudziridza (kashoma). Kuti tidzivise kuwedzera ikoko, kudiwa kudzivirirwa resimbi kushaikwa kupererwa neropa. Izvi zvinoreva wegore negore kudzora parameters kunotoda kurapwa pachisara ropa, kukurumidza kubviswa zvose zvinokonzera kurasikirwa neropa uye kudya kunovaka. Vaya vari pangozi, chiremba wako anogona mishonga kugamuchira kugadzirira zvakafanira kuti chokudzivirira zvinangwa.

Zviri pachena kuti kushaya simbi muropa - iri dambudziko chakakomba zvikuru. Izvi zvinogona kusimbisa nhoroondo mishonga ipi. Iron kushaikwa kupererwa, zvisinei worudzii muchitsungirira mubvunzo, inonyatsoratidza ane chirwere chaizvo zvinoparadza. Naizvozvo, kana zviratidzo kushaya ichi zvisaririra chaikosha chokutanga chinodiwa kuti chiremba uye kurapwa mune nenguva nenzira.