Tuesday, June 23, 2020

Prevention and treatment of iron deficiency anemia

Iron deficiency anemia (IDA) is a small cell hypochromic anemia and other abnormalities caused by the body's lack of iron demand and supply, resulting in iron deficiency in the body. IDA is the most common type of anemia. Its incidence is significantly higher in developing countries, economically underdeveloped regions, and infants, young children, and women of childbearing age. Iron deficiency is mainly related to the following factors: insufficient supplementary food supplementation in infants and young children, partial eclipse in adolescents, excessive menstrual flow in women / multiple pregnancy / lactation and certain pathological factors (such as major gastrectomy, chronic blood loss, chronic diarrhea, atrophic gastritis) And hookworm infections, etc.) etc.

1. Clinical manifestations

1. Common manifestations are dizziness, headache, dazzling, fatigue and panic throughout the body, and most of them are obvious after activities (such as brisk walking, going up stairs, etc.), and can be improved under rest.

2. Poor appetite, tinnitus, insomnia, memory loss, poor concentration, anorexia, adolescents will affect academic performance, and infants and young children will have intellectual developmental disorders.

3. The face is pale, the nail bed is pale, and the nails in severe cases are tarnished, brittle and cracked, flattened, and even concave in a spoon shape (spoon-shaped nail). Stomatitis, glossitis, chapped corners, difficulty swallowing, dry hair, and shedding.

Second, check

1. Blood routine: small cell hypochromic anemia, early platelet rise may occur, severe cases may appear white blood cells, platelet decline.

2. Serum iron and ferritin were low, total iron binding capacity was normal or increased, and transferrin saturation decreased.

3. Bone marrow examination: Bone marrow hyperplasia is active or significantly active, mainly erythroid hyperplasia, iron staining shows negative external iron, internal iron reduction, bone marrow iron staining is the gold standard for the diagnosis of iron deficiency anemia.

3. Treatment

1. Cause treatment: remove the cause of iron deficiency as much as possible. For example, anemia caused by nutritional deficiencies in infants, young people and pregnant women should actively improve the diet structure. Patients with multiple menstruation should be adjusted for menstruation; those with parasitic infections should be deworming treatment; chronic blood loss caused by gastrointestinal diseases should be actively treated.

2. Iron supplement therapy: oral iron is preferred, such as ferrous succinate, polysaccharide iron complex, ferrous fumarate and other iron agents. It is recommended to take it after a meal to reduce gastrointestinal reactions. Eating milk and tea will inhibit the absorption of iron. Try to stagger it for 2 hours. The iron usually needs to be supplemented for 3-4 months. Oral iron can not be tolerated, or patients with stomach surgery have poor iron absorption, intravenous iron can be used.

4. Dietary guidance

1. It is not advisable to eat more irritating food, limit alcohol, and correct partial eating habits.

2. Pay attention to eating foods rich in iron and folic acid, such as green vegetables, eggs, meat, fish, fruits, etc., and ensure sufficient protein and rich vitamins.

5. Guidance on rest activities

1. Patients with anemia due to lack of oxygen should pay attention to rest, not heavy physical activity, to avoid syncope.

2. According to the degree of anemia and the symptoms of anemia, appropriate physical exercise can be carried out as appropriate, such as walking slowly, Tai Chi, not vigorous exercise.

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