Kev tsis zoo vim tsis muaj oxygen yog paub rau ntau tus. Qhov tseeb yog tias rau lub neej ib txwm muaj, tag nrho cov ntaub so ntswg ntawm lub cev xav tau kev noj haus. Qhov no yog hais txog qhov txaus oxygen xav tau los ntawm cov hlwb. Qhov no yog qhov tseeb tshwj xeeb ntawm cov ntaub so ntswg ntawm lub hlwb thiab lub plawv. Kev tsis txaus ntawm oxygen rau cov hlwb yog pom nyob rau hauv anemia. Muaj ntau ntau yam ntawm no pathology. Ib txhia yog vim congenital defects, lwm tus yog tsim los ntawm ntau yam kab mob. Txawm li cas los xij, qhov ntsuas tseem ceeb rau txhua yam ntshav qab zib yog qhov tsis txaus ntawm hemoglobin hauv cov ntshav. Qhov tshwm sim ntawm cov kab mob no suav nrog pallor, kev hloov pauv hauv qhov chaw kuaj mob thiab lub cev hypoxia.
Dab tsi yog anemia?
Anemia yog ib yam kab mob ntawm cov kab mob hematopoietic uas tshwm sim los ntawm qhov tsis muaj hemoglobin. Nquag, cov protein no yuav tsum tau tswj hwm ntawm ib qib (120-140 g / l hauv cov poj niam, qhov taw qhia rau cov txiv neej yog 140-160). Hemoglobin deficiency tuaj yeem tshwm sim rau ntau yam laj thawj. Txawm hais tias vim li cas anemia tshwm sim, nws ua rau muaj mobhypoxia. Tom qab tag nrho, hemoglobin yog qhov tsim nyog rau kev hloov cov pa oxygen mus rau txhua lub cev thiab lub cev. Yog li, nws qhov tsis txaus ua rau qhov tseeb tias cov hlwb tsis muaj O2. Txhua hom kab mob ntshav qab zib muaj nws cov duab kho mob thiab cov ntaub ntawv kuaj mob. Tab sis qhov tsis txaus ntawm hemoglobin hauv cov ntshav yog ib txwm kuaj pom. Feem ntau, anemia yog xav tias muaj cov tsos mob xws li tawv nqaij daj ntseg thiab tsis muaj zog. Tus kab mob no muaj ntau heev ntawm cov poj niam cev xeeb tub. Kev txo qis me ntsis ntawm hemoglobin feem ntau tsis txaus ntshai thiab kho tau yooj yim nrog kev noj zaub mov thiab tshuaj. Kev mob ntshav qab zib hnyav tuaj yeem ua rau muaj kev puas tsuaj loj. Yog li ntawd, yuav tsum tau muab kev pab thaum muaj xwm ceev nrog nws.
YSeverity of anemia
Muaj 3 degrees ntawm qhov mob ntshav qab zib. Lawv txawv nyob rau hauv daim duab kho mob thiab txawv theem ntawm hemoglobin nyob rau hauv cov ntshav. Ntawm lawv:
- mob ntshav tsis txaus. Cov ntsiab lus ntawm hemoglobin nyob rau theem no yog 120-90 g / l. Pathology yog tus cwj pwm los ntawm cov teeb meem me me hemodynamic. Qee zaum, nws tsis tshwm sim txhua. Qee zaum muaj pallor, txo ntshav siab, nce plawv dhia, kiv taub hau.
- ntshav qab zib mob hnyav. Nyob rau theem no, tus nqi ntawm hemoglobin yog 90-70 g / L. Cov tsos mob tau tshaj tawm. Tej zaum yuav muaj qaug zog, nco thiab xav tsis meej, tsaug zog.
- ntshav qab zib mob hnyav tshwm sim thaum qib hemoglobin qis dua 70 g / l. Yog txaus ntshai rau lub cevxeev. Nws ua rau kev puas tsuaj ntawm tag nrho cov kab ke ua haujlwm vim hais tias tsis muaj oxygen.
Hom mob ntshav qab zib hnyav: kev faib tawm
mob ntshav qab zib hnyav tuaj yeem tiv thaiv keeb kwm yav dhau los ntawm ntau yam kab mob no. Xws li kev kuaj mob yog ua tsis hais txog qhov ua rau ua rau pathology. Cov txheej txheem tseem ceeb yog qhov tsis txaus hemoglobin - tsawg dua 70 g / l. Txawm li cas los xij, nws yog ib qho tseem ceeb kom paub qhov txawv ntawm ib hom ntshav qab zib los ntawm lwm tus. Tom qab tag nrho, kev xaiv ntawm txoj kev kho mob nyob ntawm qhov no. Kev faib tawm ntawm tus kab mob yog raws li nram no:
- Tsis muaj hemoglobin tshwm sim los ntawm cov hlau tsis txaus (IDA). Hom kab mob no muaj ntau dua li lwm tus. Nws yog tshwm sim los ntawm kev ua txhaum ntawm kev nqus hlau los yog kev noj me me ntawm cov khoom no nrog zaub mov.
- B12- deficiency mob hnyav anemia. Nws yog vim tsis muaj vitamin. Feem ntau hauv cov neeg mob gastritis.
- mob hnyav aplastic anemia. Nws yog hais txog congenital pathologies.
- Hemolytic anemia. Qhov no pathology yog suav hais tias yog ib tug kab mob autoimmune. Nws tuaj yeem yog congenital lossis kis tau.
- Qib Siab ntawm Fanconi anemia. Tus kab mob no yog hais txog qhov tsis xws luag hauv lub cev ntawm hematopoietic system.
mob ntshav qab zib: ua rau pathology
Nws tsim nyog nco ntsoov tias, tsis hais qib twg thiab ntau yam, anemia yeej tsis tshwm sim ntawm nws tus kheej, yam tsis muaj laj thawj. Txhawm rau txuas ntxiv nrog kev kho mob ntawm pathology, nws yog ib qho tsim nyog yuav tsum paub txog dab tsiua rau mob. Qhov hnyav hlau deficiency anemia yog feem ntau. Nws tshwm sim rau cov laj thawj hauv qab no:
- Tsis txaus cov khoom tsim nyog. Qhov no yog hais txog cov khoom noj uas muaj hlau. Cov khoom noj uas muaj cov ntsiab lus no yog nqaij, siab, pomegranate, txiv apples, thiab lwm yam.
- Impaired absorption ntawm hlau nyob rau hauv txoj hnyuv. Nws tshwm sim vim tsis muaj enzyme los yog vim muaj kab mob ntawm lub plab zom mov.
- Txhua hom ntshav poob. Yog li ntawd, nws yog ib qho tseem ceeb heev uas yuav tau sau cov keeb kwm gynecological (ntev sijhawm thiab ntau ntawm kev coj khaub ncaws), kom paub seb puas muaj hemorrhoids. Raws li qhov tshwm sim ntawm cov kab mob no, mob hnyav anemia feem ntau tshwm sim. Mob ntshav poob tuaj yeem tshwm sim nrog cov teeb meem ntawm peptic ulcer, daim siab cirrhosis, ectopic cev xeeb tub, zes qe menyuam apoplexy thiab cyst rupture.
- raug mob hnyav.
В12- deficiency anemia tshwm sim hauv cov kab mob ntawm lub plab (chronic atrophic gastritis), organ resection in oncological pathologies, perforated ulcer.
Lwm yam ua rau tsis muaj hemoglobin yog qhov tshwm sim ntawm qhov tshwm sim thiab qhov mob autoimmune ntawm cov kab mob liab hematopoietic, hemolysis (kev puas tsuaj) ntawm cov qe ntshav liab.
Mechanism of mob hnyav anemia
Vim li cas thiaj mob ntshav qab zib hnyav? Ua ntej tshaj plaws, qhov no tshwm sim yog tias tus neeg mob tsis pom qhov kev hloov pauv uas tshwm sim nrog qhov tsis txaus hemoglobin tsis txaus ntseeg. Tshwj xeeb tshaj yog feem ntau qhov tshwm sim no tuaj yeem pom hauv cov ntshav tsis txaus. Vimtib neeg lub cev tau siv los tas li "oxygen starvation", nws tau them nyiaj los ntawm ntau yam kev ua haujlwm (nce kev ua haujlwm plawv). IDA txhim kho vim tsis muaj hlau. Yog li ntawd, hemoglobin molecules tsis tsim nyob rau hauv tus nqi yuav tsum tau. Nrog B12-deficiency anemia, cov vitamins tsis nqus rau hauv plab hnyuv. Qhov no yog vim o los yog resection ntawm lub cev. Kev mob ntshav qab zib hnyav feem ntau pom muaj nyob rau hauv congenital hom kab mob no. Lawv tshwm sim los ntawm immaturity nrog hematopoiesis. Nyob rau tib lub sijhawm, muaj ntau cov ntaub so ntswg adipose pom hauv cov pob txha.
Kev nthuav qhia hauv kev mob ntshav siab hnyav
Thaum qib hemoglobin poob qis dua 70g / l, kuaj pom tus kab mob hnyav. Nyob rau hauv cov ntaub ntawv no, lub compensatory mechanisms ntawm lub cev tsis ua hauj lwm. Vim li no, qhov tsis muaj oxygen tau hnov hauv txhua lub tshuab ua haujlwm. Yog li ntawd, cov tsos mob hauv qab no tshwm sim:
- mob plees ntawm daim tawv nqaij.
- Kev ua txhaum ntawm kev nco qab. Hauv qhov mob hnyav heev, qaug zog thiab qaug zog tuaj yeem tshwm sim.
- Tuag ntshav siab.
- Npaj siab lub plawv dhia.
- kiv taub hau.
- qaug zog heev. Nyob rau hauv lub xeev no, ib tug neeg tsis tuaj yeem sawv ntawm txaj, thaum tsa lub taub hau, kiv taub hau, ua rau qaug zog.
- ua tsis taus pa.
Yog tias koj tsis muab kev pabcuam raws sijhawm, tej zaum yuav muaj kev ua txhaum ntawm kev ua haujlwm ntawm lub cev thiab lub cev. Hauv cov xwm txheej zoo li no feem ntaumuaj mob raum tsis ua hauj lwm, cardiogenic poob siab.
Anemia thaum cev xeeb tub: nta
Anemia yog ib qho ntawm cov tsos mob uas cov poj niam cev xeeb tub feem ntau yws txog. Qhov no yog vim qhov tseeb tias, ntxiv rau niam lub cev, tus menyuam kuj xav tau cov pa oxygen. Vim tias qhov tshwm sim ntawm lub voj voog ntxiv ntawm cov ntshav ncig (placental), qhov txo qis hauv hemoglobin feem ntau pom. Yog li, tus nqi ib txwm muaj thaum cev xeeb tub yog 110 g / l. Nrog rau qhov poob qis hauv qib hemoglobin, yuav tsum tau muab kev pab sai. Ib qho mob hnyav ntawm cov poj niam cev xeeb tub yog qhov txaus ntshai tsis yog rau leej niam, tab sis kuj rau tus menyuam. Feem ntau, nws tshwm sim vim muaj teeb meem xws li placental abruption lossis spontaneous nchuav menyuam. Yog li ntawd, yog tias los ntshav los ntawm qhov chaw mos, koj yuav tsum hu rau tus kws kho mob tam sim ntawd.
Kev kuaj mob ntawm tus mob ntshav qab zib
Yuav kom kuaj tau "anemia", nws txaus los kuaj ntshav. Ib qho kev mob hnyav ntawm tus kab mob tau sau tseg thaum qib hemoglobin qis dua 70 g / l. Cov tsos mob tshwm sim yog pallor, txo ntshav siab, tachycardia, kiv taub hau, thiab syncope. Mob ntshav qab zib ntau feem ntau nrog ntshav poob. Txhawm rau txheeb xyuas qhov ua rau ntawm qhov txo qis hauv qib hemoglobin, nws yog ib qho tsim nyog yuav tsum tau ua ntau yam kev kuaj mob. Txhawm rau kuaj xyuas IDA, kuaj ntshav biochemical ua tiav. Nyob rau tib lub sijhawm, cov kev hloov pauv no tau pom raws li qhov txo qis hauv cov ntshav cov ntshav thiab nce hauv TI. Txhawm rau kuaj xyuas lwm hom kab mob ntshav qab zib, nws yog ib qho tsim nyog yuav tsum tau ua qhov kev soj ntsuam microscopic ntawm cov ntshav thiab cerebrospinal kua. Rau lub hom phiaj no, lumbar puncture yog ua.
Cov kab mob dab tsi txawv qhov mob ntshav qab zib hnyav?
Qee zaum, anemic syndrome tau pom nyob rau hauv cov kab mob ntawm cov kab mob hematopoietic thiab daim siab. Kev txo qis hauv hemoglobin nrog yuav luag txhua yam ntawm oncological pathologies. Qhov no yog qhov tseeb tshwj xeeb ntawm cov qog ntshav ntshav - leukemia. Lawv tuaj yeem paub qhov txawv ntawm cov ntshav liab los ntawm kev hloov pauv hauv lwm qhov ntsuas hauv KLA. Cov no suav nrog: qhov txo qis hauv qib ntawm platelets thiab leukocytes, acceleration ntawm ESR. Kuj tseem muaj qhov sib txawv ntawm daim duab kho mob (subfebrile kub, o ntawm cov qog nqaij hlav). Anemic syndrome muaj nyob rau hauv daim siab cirrhosis, kab mob siab ntev. Txhawm rau kuaj xyuas cov kab mob no, ultrasound ntawm lub plab kab noj hniav thiab kuaj tshwj xeeb yog kuaj.
Severe anemia: kho tus kab mob
Txawm hais tias ua rau muaj ntshav tsis txaus, mob ntshav qab zib hnyav yuav tsum tau txhaj ntshav lossis ntshav liab. Tsis tas li ntawd, kev kho mob yog nqa tawm. Yog tias qhov sib npaug ntawm electrolyte raug cuam tshuam, physiological saline, kev npaj muaj cov poov tshuaj raug tswj hwm. Yog hais tias qhov ua rau ntawm anemia yog los ntshav, yuav tsum tau phais xwm txheej ceev. Tsis tas li ntawd, kev kho tshuaj yog nqa tawm. Nrog lub hom phiaj hemostatic, sodium etamsylate, aminocaproic acid yog siv. Aplastic anemia yuav tsum tau hloov cov pob txha pob txha. Yog tias tsis muaj vitamin B tsis txaus yog qhov ua rau12 kev kho mob tas mus li.
Qhov tshwm sim ntawm anemiahnyav
Nco ntsoov txog kev phom sij tshwm sim los ntawm kev mob ntshav qab zib hnyav. Qhov tshwm sim ntawm tus mob no yog kev poob siab cardiogenic, mob raum tsis ua haujlwm, nrog rau kev ua haujlwm tsis zoo ntawm lwm cov kabmob tseem ceeb. Cov teeb meem no tuaj yeem ua rau tuag taus. Yog li ntawd, txawm tias los ntshav me me, koj yuav tsum sab laj nrog kws kho mob tam sim.