Fast hemorrhagic anemia- is a lack of iron-containing elements in human blood plasma. Anemia resulting from blood loss is one of the most common anemias. Doctors distinguish two forms of this disease: chronic and acute.
Posthemorrhagic anemia of a chronic nature occurs after small but, for some time, frequent bleeding. The acute form of this disease occurs due to sudden, heavy blood loss.
The minimum volume of blood loss in an adult that is dangerous to human life is 500 ml.
By International classification diseases of the 10th revision, posthemorrhagic anemia belongs to the category “Diseases of the blood, hematopoietic organs and certain disorders involving immune mechanism" Subsection: “Anemia associated with nutrition. Iron deficiency anemia.” The classification of diseases with codes is as follows:
- Iron deficiency anemia secondary to blood loss (chronic) – code D50.0.
- Acute posthemorrhagic anemia - code D62.
- Congenital anemia due to fetal blood loss - code P61.3
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ICD-10 code
D62 Acute posthemorrhagic anemia
D50.0 Iron deficiency anemia secondary to blood loss, chronic
Causes of posthemorrhagic anemia
The etiology of a lack of blood in the body can be:
- Trauma resulting in a violation of the integrity of blood vessels, especially large arteries.
- Surgical intervention. Any surgical intervention is always a risk. When starting even the simplest operation for a seemingly ordinary person, the surgeon is not able to foresee all its nuances and consequences.
- Ulcer duodenum and stomach. These diseases are often accompanied by internal bleeding. And the difficulty of their timely detection is that the bleeding occurs inside the body and externally it can be recognized by an amateur by certain signs and an ambulance can be called in time. Otherwise, delay may result in death for the patient.
- Impaired hemostasis. This factor is designed to maintain blood in a liquid state, being responsible for the blood clotting rate, which makes it possible to maintain circulating blood volumes within normal limits and normalize the composition (“formula”) of blood.
- Ectopic pregnancy. This pathology is accompanied in women by acute heavy bleeding, which leads to acute posthemorrhagic anemia.
- Pulmonary diseases. This bleeding is manifested by scarlet discharge with a liquid or clot-like consistency that occurs during coughing.
Pathogenesis
Pathogenesis, or the sequence of occurring phenomena, constitutes the phenomena of vascular insufficiency, due to a sudden emptying of blood (plasma) from the vascular bed. These factors lead to a lack of oxygen-carrying red blood cells, which in turn leads to general oxygen starvation body. Independently this loss, due to more active work heart, the body will not be able to replenish.
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Symptoms of posthemorrhagic anemia
Knowledge won't hurt anyone. And in order to be able to recognize bleeding (especially if it is internal), it is necessary to know the symptoms of posthemorrhagic anemia and its manifestations in order to provide first aid or call an ambulance in time.
- With heavy blood loss, vascular manifestations come first: shortness of breath, rapid heartbeat (tachycardia), and decreased blood pressure (both arterial and venous).
- The patient's skin and mucous membranes become pale.
- The patient begins to feel darkening in the eyes, tinnitus and slight dizziness.
- A gag reflex may appear.
- An acute sign of internal bleeding can be considered severe dry mouth. The severity of the clinic is determined not only by the total volume of sweat, but also by the rate at which the victim loses blood.
- The location of the injury is also an important factor. Thus, damage to the gastrointestinal tract is accompanied by a sharp increase in body temperature.
- Obvious manifestations of intoxication.
- The level of residual nitrogen in the plasma also increases its performance (while the urea level remains normal).
- Even with small amounts of internal bleeding, the patient feels compression of the organs.
- indicator internal damage There may also be fecal discharge. Due to the excreted blood, they turn black.
Acute posthemorrhagic anemia
If a person loses, as a result of injury (the consequence of which is damage to a large artery), an operation being performed or an exacerbation of any disease, an eighth of the total volume of working blood, an acute form of posthemorrhagic anemia occurs.
Doctors distinguish several stages of development of acute anemia:
- Reflex-vascular stage. It is expressed by a sharp decrease in blood pressure, pallor of the skin and mucous membranes, and tachycardia. Sudden lack of oxygen reaching organs leads to spasms peripheral vessels. To prevent a further drop in pressure, the body opens arteriole-venular shunts, leading to the removal of plasma from the organs. This therapy itself works to adequately compensate the return of blood fluid to the heart.
- Hydremic stage. After three to five hours, the basis for hydremic compensation is created, caused by the flow of fluid from the interstitial area into blood vessels. In this case, certain receptors are irritated, which are involved in maintaining the volume of fluid circulating through the vessels. Increased synthesis of aldosterone blocks the removal of sodium from the body, which stimulates water retention. However, this also leads to plasma dilution, and as a consequence, a decrease in the content of red blood cells and hemoglobin. This stage of compensation can take place within two to three days.
- Bone marrow stage - this stage occurs four to five days from the moment of bleeding. Hypoxia progresses. Erythropoietin levels are increasing. In the peripheral blood, the number of newly formed red blood cells (reticulocytes), which have a reduced amount of hemoglobin, increases. The characteristic of this stage becomes hypochromic. In addition, a sharp lack of blood causes a decrease in iron in the blood.
Chronic posthemorrhagic anemia
This type of anemia, chronic posthemorrhagic anemia, occurs in a patient if he gradually, over a period of time, loses blood in fractions. This type of anemia can occur in a number of diseases. For example, such as: colon cancer, peptic ulcer duodenum or stomach, gingivitis, hemorrhoids, and many others. Frequent but minor bleeding leads to general exhaustion of the body. Iron deficiency occurs. Due to this, this pathology According to its etiology, it is classified as posthemorrhagic anemia; according to its pathogenesis, this pathological condition can be classified as iron deficiency anemia.
Based on this, the main goal of therapy for posthemorrhagic anemia, in any of its forms, is to restore the full volume of blood plasma circulating in the vessels, and, as a consequence, to overcome iron deficiency and lack of erythropoiesis. But this " ambulance"for the body. After emergency resuscitation, it is necessary to turn your attention to the root cause that caused the bleeding. And it’s simpler - you need to start treating the underlying disease.
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Posthemorrhagic iron deficiency anemia
Today, doctors note that posthemorrhagic iron deficiency anemia is beginning to become quite widespread. In short, iron deficiency anemia is a condition of the body characterized by a pathological lack of iron ions. Moreover, the mass concentration of this element decreases everywhere: both in blood plasma and in bone marrow, and in the so-called storage room, where the body accumulates everything it needs in reserve. As a result, a failure occurs in the heme synthesis system, resulting in a deficiency of myoglobin and tissue enzyme.
Modern statistical studies voice a figure of 50% - this is the amount of the population that suffers from anemia in one form or another. Compounds in which metals occur naturally are poorly absorbed or not absorbed at all human body. When the balance in the intake of iron into the body and its use is disturbed, we get iron deficiency anemia.
Most often, in the adult population, iron deficiency is associated with acute or chronic blood loss. This diagnosis can occur, although quite rarely, with nosebleeds, dental aspects of blood loss, as well as with trauma... Identified and exceptional cases, when iron deficiency anemia developed in a donor who “frequently gave blood.” Moreover, strange as it may sound, such deviations are found in female donors.
In women, the causes of the disease can be: uterine bleeding, and the pregnancy itself, as well as painful, pathological disruptions in menstrual cycle. Laboratory studies show that uterine fibroids can also lead to posthemorrhagic anemia with iron deficiency, which contributes to the leaching of iron and the subsequent appearance of anemic symptoms.
The second place in the frequency of diseases is occupied by blood loss in acute diseases of the gastrointestinal tract, which are diagnosed on early stages quite problematic. Pulmonary hemorrhage is a fairly rare manifestation of iron deficiency, as is blood loss from urinary tract and kidneys.
Newborns and infants may suffer from iron deficiency due to improper placenta previa, or if it is damaged during surgical intervention (caesarean section). There are also cases of intestinal bleeding as a manifestation of an infectious disease.
The reason for the lack of iron in older children may also be a poor diet. Baby just doesn't get it sufficient quantity element along with the foods it eats. Anemia can also be caused by a lack of iron in the mother during her pregnancy, as well as in premature babies or babies of twins and triplets... Quite rarely, but the cause of this disease can also be the mistake of the obstetrician, who, without waiting for the pulsation to stop, cut the umbilical cord early.
You should not ignore the situation when (for example, with large physical activity, pregnancy, etc.) the body’s need for it increases sharply. Therefore, the likelihood of posthemorrhagic iron deficiency anemia increases.
The lack of this element in the body causes significant harm immune system person. But, strange as it may sound, patients suffering from iron deficiency get sick less infectious diseases. It's simple. Iron – excellent nutrient medium for some bacteria. However, in light of other problems, iron deficiency in the human body cannot be ignored. There are often cases when a lack of iron in the blood is indicated by changed eating habits. For example, a previously unobserved craving for peppery or salty foods appears.
Doctors highlight and psychological aspect iron deficiency. Often it occurs in people who do not care about their health, and, consequently, about themselves: diets, limited nutrition, physical inactivity, lack of fresh air, minimum positive emotions. All this does not contribute, but rather inhibits the metabolic processes that occur in the body. After conducting a study, scientists found that behind all this, as a rule, is deep depression, psychological trauma.
Today, medicine is equipped with a fairly large arsenal in the form of iron preparations: conferon, feramide, jectofer, sorbifer and quite a lot of others. There are also liquid forms, for example, maltofer, the degree of absorption of which depends on the level of iron deficiency in the body. This drug is approved for use even for newborns (even premature babies).
Posthemorrhagic anemia in children
Posthemorrhagic anemia in children occurs quite often and, like in adults, can be acute (quite common) or chronic (less common).
Newborns are quite vulnerable. In them, posthemorrhagic anemia quite often occurs due to birth injuries or can occur even with excessive blood sampling during laboratory research. In older and middle-aged children, the main cause of anemia is often helminths, which, by sticking to the wall of the gastrointestinal tract, injure the body and provoke microbleeding.
Symptoms for which parents should raise the alarm:
- The same as for adults.
- But the first manifestations are lethargy, loss of appetite, growth cessation occurs, and the baby begins to gain weight worse.
- One of primary signs initial stage The disease can be a change in the baby’s taste preferences, to the point that children tend to eat soil, chalk, clay... This is the result of iron deficiency and lack of mineral components in the baby’s body. Sometimes these changes are not so radical.
- There is also a change in behavior. Kids become capricious and whiny, or, in contrast, apathetic.
- There is also a manifestation of external signs: brittle hair and nails, peeling skin.
- “Vacquered” smooth tongue.
- For girls adolescence, interruptions in the menstrual cycle.
- Quite often, against the background of posthemorrhagic anemia, complications of an infectious nature are observed: otitis media, pneumonia...
The first thing that needs to be done in a situation where a child is in a state of hemorrhagic shock is resuscitation measures to stop bleeding and anti-shock therapy. Blood substitutes are administered by stream and drip. During this period, the baby’s blood type and Rhesus status are determined. Resuscitation is carried out with freshly citrated blood. If one is not available, a direct transfusion from the donor is performed. In parallel with this, glycoside support for cardio vascular system and a diet rich in protein and vitamins is attributed.
Treatment of posthemorrhagic anemia in children involves identifying and treating the root cause of bleeding, that is, the disease that caused blood loss.
Stages
Doctors also have a so-called working classification of the stages of anemia severity, which is determined on the basis of laboratory tests:
- when the hemoglobin content in the blood is more than 100 g/l and erythrocytes are above 3 t/l - a mild stage.
- when the hemoglobin content in the blood is within 100÷66 g/l and erythrocytes above 3÷2 t/l - the middle stage.
- when the hemoglobin content in the blood is less than 66 g/l – a severe stage.
Mild posthemorrhagic anemia
More early detection illness allows the child to get back on his feet in a shorter period of time. At mild stage sometimes the disease is enough iron-containing preparations, to replenish the lack of iron in the body. The course of treatment often lasts three months or more. IN in this case temporary hospitalization of the patient is possible. This issue is decided by the doctor based on the patient’s condition.
Severe posthemorrhagic anemia
Severe posthemorrhagic anemia is an unconditional hospitalization.
Only in inpatient conditions the patient can receive qualified and full medical care and there is no point in delaying it. In this situation, “delay is like death.”
Having received the patient at their disposal, doctors, first of all, must do everything to stop the bleeding, while at the same time trying to compensate for blood loss by any means. To obtain the maximum hemodynamic effect (removing the patient from state of shock, obtaining higher blood pressure, etc.), a transfusion of at least half a liter of polyglucin (an artificial plasma substitute) is performed. In the acute traumatic form, this drug is administered initially as a bolus, and the doctor is required to monitor the blood pressure. If the pressure was brought to the following values: systolic - 100÷110 mm, diastolic - 50÷60 mm, the dropper is switched from jet to drip feed. The total dose of the administered solution can reach, if necessary, one and a half liters (maximum 2÷3 l).
Only after stopping the bleeding and removing the main shock symptoms, the medical staff proceeds to a further, planned protocol for removing the patient from the anemic state.
Diagnosis of posthemorrhagic anemia
Modern medicine cannot be imagined without laboratories and modern medical equipment. But without highly professional specialists, no equipment will help. And in the case of diagnosing posthemorrhagic anemia, the situation is as follows: the diagnosis of acute or chronic posthemorrhagic anemia can be made based on a combination of clinical, laboratory and anamnestic data. Basic are clinical indicators.
Having external source bleeding, it is not difficult to make a clear diagnosis; it is more difficult to diagnose it with internal blood loss. The main thing is to accurately determine the location of the outflow.
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Blood test for posthemorrhagic anemia
The first thing doctors need to do is urgently do a detailed blood test so that they can assess the level of blood loss and, accordingly, the danger to the patient. During the first half hour of acute blood loss, the number of platelets increases sharply, which leads to a reduction in the period of time during which blood clotting occurs, which is quite important in case of blood loss. The level of red blood cells and hemoglobin in plasma remains within normal limits for some time, although their total number (red blood cells) decreases.
After two to three hours, thrombocytosis in the blood is still observed, but tests show the appearance of neutrophilic leukocytosis. A high level of thrombocytosis and a short period during which the blood clots are a criterion indicating heavy blood loss. Next comes a decrease in the number of red blood cells and hemoglobin. This is an indicator of the development of normochromic posthemorrhagic anemia.
After five to six days from the critical moment, the number of reticulocytes increases (the formation of young leukocytes). If no repeated bleeding is observed during this period, then after a couple of weeks, the composition of the peripheral blood returns to normal, as tests show. If posthemorrhagic anemia was observed in severe form, then recovery period will be longer.
Even in the case of a single acute bleeding biochemical analysis shows a sharp drop in plasma iron levels. With small reserves of this element in the body itself, its quantitative restoration is quite slow. During this period, the active appearance of new red blood cells in the red bone marrow is also visible.
Clinical analysis during the illness shows the presence of leukopenia with slight lymphocytosis. Due to low level iron, there is an increase in the ability to bind serum iron.
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Treatment of posthemorrhagic anemia
If a mild form of posthemorrhagic anemia can be treated at home, then its acute manifestations must be stopped only in a hospital setting. The main goal of all measures taken is to stop blood loss and restore normal, full blood circulation.
The first stage of treatment is to stop the bleeding. A drop in hemoglobin level to 80 g/l and below (8 g), plasma hematocrit - below 25%, and protein - less than 50 g/l (5 g%) is an indication for transfusion therapy. During this period, it is necessary to replenish the content of red blood cells by at least a third. There is an urgent need to replenish normal plasma volume. In this regard, the patient receives colloidal solutions polyglucin or gelatinol by transfusion. If such solutions are not available, they can be replaced with 1000 ml of glucose (10%), and then 500 ml of a 5% solution. Reopolyglucin (and analogues) are not used in this situation, as they reduce blood clotting ability, which can provoke re-bleeding.
To restore the level of red blood cells, the patient receives packed red blood cells. In case of acute blood loss, when the platelet count also drops, doctors resort to direct transfusion or transfusion of blood immediately taken before the procedure.
Today, if blood loss during surgery is less than 1 liter, packed red blood cells and transfusion are not used. Full compensation of blood loss is not carried out, since the danger lies in the possibility of disseminated intravascular coagulation syndrome, as well as immune conflict.
Divalent iron is most often used in medicine. Medicines based on it are taken by the patient as prescribed by the doctor either 1 hour before eating or 2 hours after eating. In the treatment of posthemorrhagic anemia, the following iron-containing drugs are used:
- Feramide is a drug based on a compound of nicotinamide and ferric chloride. The dose is taken three times a day, 3÷4 tablets. The disadvantage of this drug is the low iron content in the tablet. For getting maximum effect, along with the medicine you need to take ascorbic acid.
- Conferon – complex content of sodium dioctyl sulfosuccinate with iron sulfate. Release form: capsules. This drug is well absorbed by the intestinal mucosa. Take it 3 times a day, 1÷2 capsules. Additional reception no ascorbic acid is required.
- Ferrocal. Composition - iron sulfate with calcium fructose diphosphate. Prescribed after meals, 1÷2 tablets three times a day.
- Ferroplex is a combination of ferrous sulfate and ascorbic acid. The dose is 2÷3 tablets three times a day. The tolerability and absorption properties of the drug are excellent.
- Ferroceron. The basis of the drug is the sodium salt of ortho-carboxybenzoylferrocene. The medicine is well absorbed by the gastrointestinal mucosa. Take 1÷2 tablets three times a day. Easy to carry. Hydrochloric and ascorbic acids should not be introduced into the body along with this medicine. It is absolutely necessary to remove lemons and other acidic foods from food.
Other drugs are also used.
Nutrition plays an important role in the treatment of posthemorrhagic anemia. A patient with anemia should include in his diet foods containing large amounts of iron and protein substances. This is both meat and egg white, and fish, cottage cheese... At the same time, remove fatty foods from your diet.
Prevention
Prevention of posthemorrhagic anemia must begin, no less, in the womb. If the mother of the unborn child suffers from iron deficiency, the newborn will be born already having the same problem. Therefore, it is necessary to first eliminate this problem in a pregnant woman. Then, the already born child should receive natural, rational and natural feeding. It is necessary that the baby is surrounded by a normal healthy environment. Constant monitoring by a pediatrician is also needed so as not to miss the development of rickets, infectious diseases and dystrophy.
A special risk group for iron deficiency includes children born from an anemic mother, premature babies and babies from multiple pregnancies, as well as infants receiving artificial, irrational feeding and growing rapidly. For such children, the pediatrician usually prescribes iron supplements or infant formula containing a higher percentage of this element.
For children in the first year of life, as a preventive measure for posthemorrhagic anemia, it is necessary to include vegetables and fruits, cereals and herbs, meat and fish, milk and cheeses in their diet. That is, diversify your diet. To maintain within normal limits auxiliary elements(copper, manganese, cobalt, zinc) it is necessary to give the baby beets, yolks and fruits (apples, peaches, apricots). And the child is also obliged to receive the necessary amount of fresh air - walks on fresh air required. Protect children from contact with harmful chemicals, especially volatile ones. Medicines Use only as prescribed by a doctor and under his supervision.
Prevention of anemia for an adult is similar to that for children. These are the same foods rich in iron and microelements, as well as an active healthy lifestyle and fresh air.
IN childhood The use of iron supplements prophylactically not only prevents the development of iron deficiency in a child, but also reduces the incidence of his ARVI. In case of aggravated hereditary anemia, the medical prognosis directly depends on the frequency of crises and their severity.
In any situation, one must not give up and it is preferable to recognize any disease as soon as possible, at its earlier stages. Be more attentive to yourself and your loved ones. Preventive measures for posthemorrhagic anemia are not as complicated as it might seem. Just live, eat well, actively spend your time in nature with your family and friends, and this trouble will bypass you. But if something irreparable has happened and trouble has come to your home, don’t panic, call the doctors and fight with them. After all, life is beautiful and worth this struggle.
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Chronic posthemorrhagic anemia develops as a result of either a single but heavy blood loss, or minor but prolonged repeated blood loss (Fig. 38).
Most often, chronic posthemorrhagic anemia is observed with bleeding from the gastrointestinal tract (ulcer, cancer, hemorrhoids), kidney, or uterine. Even occult blood loss during ulcerative or neoplastic processes in gastrointestinal tract or insignificant hemorrhoidal bleeding, repeated day after day, can lead to severe anemia.
Often the source of bleeding is so minor that it goes unrecognized. To imagine how small blood losses can contribute to the development of significant anemia, it is enough to cite the following data: the daily amount of dietary iron required to maintain hemoglobin balance in the body is about 5 mg for an adult. This amount of iron is contained in 10 ml of blood.
Consequently, the daily loss of 2-3 teaspoons of blood during defecation not only deprives the body of its daily need for iron, but over time leads to a significant depletion of the body’s “iron fund,” resulting in the development of severe iron deficiency anemia.
Other than that equal conditions The easier the development of anemia will be, the less iron reserves in the body and the greater (in total) blood loss.
Clinic. The complaints of patients are mainly reduced to severe weakness, frequent dizziness and usually correspond to the degree of anemia. Sometimes, however, one is struck by the discrepancy between subjective state the patient and his appearance.
The patient's appearance is very characteristic: severe pallor with a waxy tint to the skin, bloodless mucous membranes of the lips, conjunctiva, puffy face, lower limbs pasty, sometimes due to hydremia and hypoproteinemia, general edema (anasarca) develops. As a rule, patients with anemia are not malnourished, unless the malnutrition is caused by an underlying disease (stomach or intestinal cancer). Anemic heart murmurs are noted, most often a systolic murmur is heard at the apex, conducted at pulmonary artery; a “spinning top noise” is noted on the jugular veins.
Picture of blood. The blood picture is characterized by iron deficiency anemia with a sharp decrease in the color index (0.6-0.4); degenerative changes in erythrocytes prevail over regenerative ones; hypocytochromia and microcytosis, poikilocytosis and schizocytosis of erythrocytes (Table 18); leukopenia (if there are no special factors contributing to the development of leukocytosis); shift of the neutrophil row to the left and relative lymphocytosis; The platelet count is normal or slightly decreased.
The next phase of the disease is characterized by a decline in the hematopoietic activity of the bone marrow - anemia takes on a hyporegenerative character. At the same time, along with the progressive development of anemia, an increase in the color index is observed, which approaches one; anisocytosis and anisochromia are observed in the blood: along with pale microcytes, more intensely colored macrocytes are found.
The blood serum of patients with chronic posthemorrhagic anemia is pale in color due to the reduced bilirubin content (which indicates reduced blood breakdown). A feature of chronic posthemorrhagic anemia is also a sharp decrease in the level serum iron, often determined only in the form of traces.
Bone marrow hematopoiesis. In acute cases, previously healthy individuals often experience a normal physiological reaction to blood loss with the production of first immature, polychromatophilic elements, and then mature, fully hemoglobinized red blood cells. In cases of repeated bleeding, leading to depletion of the body’s “iron fund,” a violation of erythropoiesis is noted in the phase of hemoglobinization of normoblasts. As a result, some cells die without having time to bloom, or enter the peripheral blood in the form of sharply hypochromic poikilocytes and microcytes. Subsequently, as anemia becomes chronic, the initial intensity of erythropoiesis decreases and is replaced by a picture of its inhibition. Morphologically, this is expressed in the fact that the processes of division and differentiation of erythronormoblasts are disrupted, as a result of which erythropoiesis takes on a macronormoblastic character.
The described functional disorders of hematopoiesis are reversible, since we are talking about a hyporegenerative (not hypoplastic) state of the bone marrow (see Hyporegenerative anemia).
Treatment. In cases where this is possible, best method treatment is to remove the source of blood loss, such as excision hemorrhoids, resection of the stomach for a bleeding ulcer, extirpation of a fibromatous uterus, etc. However, a radical cure of the underlying disease is not always possible (for example, with inoperable gastric cancer).
To stimulate erythropoiesis, as well as replacement therapy it is necessary to perform repeated blood transfusions, preferably in the form of red blood cell transfusions. The dosage and frequency of blood (packed red blood cell) transfusions vary depending on individual conditions; they are mainly determined by the degree of anemia and the effectiveness of therapy. With a moderate degree of anemia, transfusions of medium doses are recommended: 200-250 ml of whole blood or 125-150 ml of red blood cells with an interval of 5-6 days.
In case of sudden anemia of the patient, blood transfusions are performed in a higher dosage: 400-500 ml of whole blood or 200-250 ml of red blood cells with an interval of 3-4 days.
The purpose of iron is very important. Iron treatment is carried out according to general rules treatment iron deficiency anemia(see below).
Therapy with vitamin B12 for iron deficiency posthemorrhagic anemia is indicated for hyporegenerative forms occurring with the macronormoblastic type of erythropoiesis and macroplania of erythrocytes.
Posthemorrhagic anemia is a pathology that in medicine belongs to the category of iron deficiency. The cause of its development may be a severe injury with significant bleeding or the presence of a lesion in the body chronic blood loss. Posthemorrhagic anemia can be acute or chronic. The acute form of posthemorrhagic anemia is an option in which the pathology develops against the background of heavy bleeding, while chronic form- this is the result of systematic, but not heavy bleeding.
In the presence of bleeding in the body, a rapid decrease in the volume of circulating blood and, first of all, its plasma is observed. Accordingly, there is a sharp drop in the level of red blood cells, which leads to the development of acute hypoxia and then anemia, which belongs to the group of post-hemorrhagic.
Symptoms
When collecting complaints and anamnesis, the doctor receives the following clinical picture: the patient experiences weakness of the body, strong and frequent dizziness, which can reach fainting. Also, with posthemorrhagic anemia, nausea is observed, with acute form condition - vomiting may occur. During the course of the pathology, trophic disturbances are observed in the body, and structural changes occur accordingly. pathological changes skin, hair and nails.
At this option anemia, shortness of breath, angina-type heart pain, and muscle weakness can often be observed. Patients quite often complain of dry mouth and difficult to quench thirst, flashing spots before the eyes, and tinnitus. The clinical picture of this type of anemia also includes a sharp decrease in body temperature.
With heavy bleeding, symptoms of hemorrhagic shock may develop.
Diagnostics
The presence of posthemorrhagic anemia can only be determined using laboratory methods blood tests. When diagnosing, it is also worth taking into account the patient’s medical history, complaints and results. instrumental studies, which determine the location of the source of bleeding. To the number instrumental methods diagnostics in this case include fibrogastroduodenoscopy and colonoscopy.
Prevention
First of all, you need to try to avoid the disease of posthemorrhagic anemia, therefore, you should avoid as much as possible any injuries that can cause blood loss and bleeding.
Prevention of the development of posthemorrhagic anemia also includes healthy image life and observance proper nutrition, in which the blood and all body systems receive the required amount of microelements and vitamins. The diet must contain iron-containing foods, namely, fresh fruits, lean red meat, legumes, fresh green vegetables, whole grain bread and herbs.
Treatment
The first stage of treatment for posthemorrhagic anemia is aimed at eliminating the source of bleeding and preventing shock. Next, you need to carry out treatment aimed at replenishing lost blood, while heparin must be replenished in the body and the level of red blood cells must be normalized. Thus, the volume of replenished blood should not exceed 3/5 of the volume of lost blood; the remaining deficit is replenished with the help of blood substitutes.
At the third stage of therapy, after stopping bleeding, blood loss is restored, and nothing threatens life, curative therapy with the help of iron-containing preparations and vitamin complexes.
After eliminating the symptoms of anemia, treatment with iron-containing drugs continues for another 6 months, but the amount taken medicines reduced by half.
Posthemorrhagic anemia is a condition associated with a decrease in the level of hemoglobin in the blood. This type of anemia is associated with a loss of more than 12% of the total volume of all blood.
The main point of the appearance of this disease is acute posthemorrhagic anemia or prolonged, albeit non-volume, bleeding that developed due to injury. In this case, large veins or other vessels through which blood plasma flows were damaged. Most often this happens with damage to the veins on the forearm, rupture of arteries on the thigh or vessels of the abdominal part of the body with strong impact.
If blood plasma loss continues for a long time, then chronic, posthemorrhagic anemia may develop.
The main source of such bleeding is various tumors, various diseases kidney or liver, inflammation of the veins in the rectum. Similar consequences often result from disorders of menstrual cycles, the development of polyps in the patient’s body, the occurrence of a hernia, and various ulcerative lesions stomach and intestines, many blood diseases of a systemic nature. Diseases that affect the red bone marrow lead to the same result.
Symptoms of hemorrhagic anemia
The most typical sign of this disease is the pale coloration of the layers of the membranes of organs such as the nose, genitals, mucous membrane of the pharynx, iris and skin. At the same time, sick people exhibit the following symptoms:
- Pronounced weakening of the body.
- Increased fatigue.
- The occurrence of dizziness.
- The appearance of noise in the ears.
- Unreasonable drowsiness.
Additionally, they may appear following signs anemia:
- The patient often complains of severe headache.
- The patient experiences shortness of breath.
- Women may experience disruption of their menstrual cycle.
Most of the above phenomena occur because the work of the heart muscle during anemia is aimed at eliminating the lack of oxygen in the blood plasma and poor supply of nutritional components to the blood plasma. various organs. The cardiovascular system performs this task by increasing the intensive blood supply, that is, the number of heart beats per unit of time increases. This leads to tachycardia or murmurs in the heart muscle. Doctors can indirectly judge the appearance of anemia in a patient by past bleeding or by chronic sources of blood loss, which can be considered:
- Inflammatory processes on hemorrhoids.
- Development of signs of dysmenorrhea.
- An increase in the duration of a woman's menstruation process.
During acute type of anemia medium degree When large volumes of blood plasma are poured out, the symptoms of the disease manifest themselves as follows:
- The patient feels very dizzy.
- Nausea develops, which can develop into vomiting.
- A person's consciousness begins to become confused.
- Possible deep fainting.
- In severe cases of the disease, collapse may occur or hemorrhagic shock may develop.
Posthemorrhagic anemia in adolescents under 17 years of age and pregnant women
Posthemorrhagic anemia during medical practice takes up during pregnancy special place. The presence of a large decrease in a woman’s hemoglobin level indicates that she may develop the following lesions during pregnancy:
- Chorioangioma.
- Hematoma and placental tissue abruption.
- Umbilical cord ruptures.
- The presence and rupture of vessels in this area that are located abnormally.
Treatment for the development of posthemorrhagic anemia
At acute course The fight against the disease is carried out by special rehabilitation teams of ambulance doctors and similar structures in clinics. Their main task is to stop bleeding. Then the condition of the patient’s body is assessed and ways to further combat the disease are outlined.
If the volume of blood flowing out is small and the heart is working normally and arterial pressure does not change, then further medical intervention may not be required. The body self-regenerates the loss of blood plasma due to the production the necessary enzymes in the spleen, as well as in the red bone marrow and liver.
Speed up this recovery process This can be done by putting the patient on a diet rich in iron.
If a person loses a lot of blood and vascular insufficiency develops, then an urgent course of therapy and replenishment of the blood plasma lost by the patient is required. To do this, doctors assign him venous catheter and an infusion of substances such as glucose, polyglucin, special Ringer's solution or rheopolyglucin is performed. If necessary, correction is possible using a 4% soda solution. In hospital conditions, such patients are given an infusion (intravenous) of red blood cells or full blood.
The chronic type of disease is a little more difficult to cure. First, doctors determine the source of the bleeding. After such an area is found and the release of blood plasma is stopped, the patient’s hemoglobin level is increased with the help of medications containing iron. They are given together with ascorbic acid, and the patient is prescribed special diet.
Iron preparations and products for posthemorrhagic anemia
These medications can be given by injection or in tablet form. In order for the body to accept them, you need to drink a medicine containing iron along with ascorbic acid and multivitamins, which contain trace elements such as copper, cobalt, manganese. They increase the body's ability to biosynthesize the necessary iron. This leads to an increase in the level of hemoglobin in the patient’s body. Today, ferrum-containing drugs are used, such as the drug feramide, iron lactate and glycerophosphate, and the drug ferrum-lek.
The patient is prescribed a special diet, which must include the following products:
- Fresh lean meat and fish.
- Cottage cheese and dairy products.
It is also possible to introduce into the diet any fruits and vegetables that contain a lot of iron, such as apples and bananas. All should be removed from use fatty foods, since fats can inhibit the process of blood restoration. In this case, doctors and the patient must take into account the presence of the underlying disease that caused the hemorrhage.
In any case, when posthemorrhagic anemia appears, you should not self-medicate - this can only complicate the course of the disease.
If signs of illness appear, you should urgently contact medical care to the clinic.
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