Post-hemorrhagic anemia is a dangerous condition for human health and life. Insufficient blood volume leads to the development of a serious pathology - a lack of hemoglobin. If the process of the formation of post-hemorrhagic anemia is not stopped in a timely manner, then there will be a serious threat to life.

The principle of development of anemia

There are many different cells in the blood that perform separate functions. Among them are red blood cells - erythrocytes containing hemoglobin. They play an important role: they deliver oxygen from the lungs to different parts of the human body.

Anemia is a pathological condition when the content of hemoglobin or red blood cells in the blood drops sharply. The most common red blood cell deficiency associated with prolonged bleeding. This phenomenon is called posthemorrhagic anemia.

The condition itself is rarely diagnosed as a separate disease. Usually, the fact of anemia is interpreted as a symptom of another pathology. According to the WHO, more than 30% of the world's inhabitants suffer from anemia.

The danger of this condition is that a long-term lack of erythrocytes against the background of a reduced amount of blood can cause not only oxygen starvation and vascular insufficiency, but also the development of malignant tumors, dystrophy of tissues and organs, and also provoke hematopoietic diseases. The most dangerous is this process during pregnancy, when not only the health of the mother is harmed, but also her unborn child.

Reasons for the appearance of post-hemorrhagic anemia

Various situations can provoke the development of the disease, sometimes arising against the background of existing ailments or due to unexpected force majeure circumstances:

In women, these may be the following reasons for development:

• ectopic pregnancy;
• profuse menstruation;
• uterine bleeding;
• birth trauma.

Disease classification

There are 2 types of post-hemorrhagic anemia:

• sharp;
• chronic.

Acute red cell failure suggests a sharp decrease in hemoglobin. This form of post-hemorrhagic anemia occurs as a result of blood loss due to trauma or surgery, when a person loses 1/8 or more of the total volume.

When is a blood transfusion indicated for low hemoglobin:

Stages of development of the acute form

Doctors distinguish several stages in the development of acute post-hemorrhagic anemia:

Features of chronic post-hemorrhagic anemia

In chronic anemia, there is a small but intermittent constant blood loss over a long period of time. This form is observed in a number of diseases:

• oncology and neoplasms of the gastrointestinal tract;
• peptic ulcer;
• bleeding from varicose veins of the rectum;
• erosive processes in the mucous membrane of the esophagus;
• increased bleeding of the gums (periodontitis and gingivitis).

The chronic form of anemia is most often observed in women due to bleeding against the background of inflammatory processes of the reproductive organs:

Degrees of anemia: mild, moderate, severe

Anemia has 4 degrees of severity. A classification of this kind is based on indicators of the level of hemoglobin in the patient's blood:

• mild degree - hemoglobin is below the permissible norm, but not less than 90 g / l;
• medium degree - hemoglobin index from 70 to 90 g / l;
• severe degree - the level of blood cells up to 70 g / l;
• extremely severe degree - the amount of hemoglobin is below 50 g / l.

In addition to the above forms, there are 2 types of posthemorrhagic anemia:

• relative: characterized by an increase in blood plasma with significant blood loss, often manifesting itself during pregnancy in women;
• absolute: a decrease in hemoglobin due to a decrease in the number of erythrocytes.

According to the International Classification of Diseases, individual conditions associated with the established cause of blood loss are identified:

• congenital anemia of the fetus against the background of blood loss;
• chronic post-hemorrhagic anemia associated with iron deficiency.

Symptoms of the disease

There is a general complex of symptoms that occurs with the development of anemia (anemic syndrome):

• fast fatiguability;
• drowsiness;
• noise in the ears and head;
• dyspnea;
• pallor of integuments.

If acute anemia progresses, then the following symptoms are additionally observed:

• dizziness;
• headache;
• fainting;
• thirst;
• nausea;
• brittle nails;
• profuse sweating;
• dry mouth;
• shallow breathing;
• cardiopalmus;
• lowering body temperature;
• lowering blood pressure.

Different types of internal bleeding can manifest themselves in different ways.

The patient can detect the following manifestations of the disease:

• liquefied bloody stools, which may be evidence of a stomach ulcer;
• cough accompanied by bright red sputum, which is characteristic of bleeding in the lungs;
• increasing swelling at the site of a bruise or fracture, confirming intramuscular or subcutaneous bleeding;
• spotting from the vagina.

With the manifestation of a combination of several symptoms characteristic of anemia, you need to urgently consult a doctor to make the correct diagnosis and prescribe the necessary treatment.

What is the reason for the appearance of spotting in the intervals between periods:

Diagnosis of anemia, including blood tests

Diagnosis of anemia is carried out only after stopping bleeding. At the same time, in parallel, in any possible way, the volume of lost blood is replenished (if necessary).

Initially, for maximum effect, in order to bring the patient out of shock and increase blood pressure to normal, doctors carry out a transfusion of at least 500 ml of plasma substitute. The primary introduction of Polyglyukin is performed in a stream, and when the systolic pressure reaches 100, the injection is replaced with a drip. Sometimes the dose of the injected solution can reach two liters.

Only after all the necessary manipulations do doctors begin to diagnose the patient's anemic condition.

Of course, an obligatory stage of diagnosis is the collection of anamnesis and the identification of possible causes underlying the disease. The diagnosis itself is made on the basis of a set of studies carried out: clinical and laboratory.

Basic methods

The diagnosis of post-hemorrhagic anemia is based on basic studies:

• general and biochemical blood test;
• Analysis of urine.

When detecting the presence of post-hemorrhagic anemia, laboratory blood tests will show:

• low hemoglobin content with a slight decrease in erythrocytes;
• a decrease in the level of saturation of erythrocytes with hemoglobin;
• decreased serum iron levels;
• increasing the value of the erythrocyte sedimentation rate;
• decreased platelet count.

Additional examination

To find the place of hidden bleeding, additional diagnostic methods are used:

• analysis of feces for the presence of blood and helminths;
• fibrogastroscopy - to exclude or confirm the outflow of blood in the digestive tract;
• colonoscopy (medical examination under video control of the lower intestine);
• checking the integrity of internal hemorrhoids - sigmoidoscopy;
• Ultrasound and / or x-rays to specify the cause;
• gynecological examination (for women).

In some cases, a cytological and histological examination of the bone marrow is required to make an accurate diagnosis.

Depending on the type of bleeding, the patient needs to consult one or more specialists, such as:

• hematologist;
• surgeon;
• traumatologist;
• gynecologist;
• proctologist;
• gastroenterologist.

Treatment of acute anemia

Very often, in cases of post-hemorrhagic anemia, "delay is like death." If medical assistance is not provided in a timely manner for acute blood loss, then the result will be disastrous. When a person quickly loses more than a quarter of their blood volume, it can be fatal.

Surgical intervention is immediately performed on the site of the damaged organ or body part in order to stop bleeding.

Initially, the lost blood volume is replenished. This is done only if the blood loss is more than 10%. If the blood flow rate was no more than 20%, then a small correction with the use of blood substitutes is required:

• Ringer's solution;
• Dextran;
• Gelatinol;
• Longosterol;
• Volenama.

Preparations for reimbursing blood loss - photo gallery

Albumin is a colloidal preparation
Polyglucin is used in the treatment of post-hemorrhagic anemia
Ringer's solution belongs to crystalloid plasma substitutes
Reopolyglucin is used to treat massive blood loss Gelatinol is similar in structure to blood plasma

The use of a glucose solution is highly undesirable. If the blood loss is more than 20%, then the patient is transfused with a mixture of erythrocyte mass with a plasma substitute in various combinations. Pure donated blood is rarely used. It is impossible to immediately replenish all the blood loss, as this can cause "massive transfusion syndrome", that is, the development of intravascular coagulation or immunoconflict is possible. To correct the water-salt balance in the body, intravenous administration of a sodium chloride solution is prescribed. Be sure to use iron-containing drugs for acute anemia:

• Feramide. Active ingredients: nicotinamide and ferric chloride. The iron content is low. For the greatest effectiveness, an additional intake of ascorbic acid is required.
• Ferroplex. It is a combination of ferrous sulfate and vitamin C. It is easily tolerated and has minimal restrictions on its use.
• Ferrocerone. The active ingredient is the sodium salt of orthocarboxybenzoylferrocene. Highly efficient. When taking it, it is necessary to exclude sour, sour and pickled food from the diet.
• Conferon. The activity of the drug is based on the action of sodium dioctyl sulfosuccinate and ferrous sulfate. Easily absorbed. Does not require additional intake of ascorbic acid.

At the end of the obvious manifestations of anemia, iron preparations are taken in half the dose for another six months.

If the patient is in shock, use large doses of Prednisolone. An increase in the pH in the tissues helps to remove the baking soda solution. Heparin is used to eliminate blood clots at the level of capillary vessels. Sometimes it is required to connect humidified oxygen through a breathing tube.

Therapy for chronic post-hemorrhagic anemia

The chronic form of the disease requires a different approach. Initially, the true cause of constant blood loss, its source, is identified. Sometimes it is so insignificant that it may not be recognized.

In some cases, the doctor prescribes hemostatic drugs (coagulants) that promote blood clotting. Usually, such drugs are used for capillary, parenchymal and uterine bleeding. It can be:

• Vikasol;
• Dicinon;
• Etamsilat;
• hemostatic collagen sponge;
• Amben;
• Tobarpin;
• Thrombin;
• Prothrombin complex.

Blood transfusion and the use of blood substitutes are rare. As in the acute form, iron supplements and vitamins are used to treat chronic anemia. Symptomatic therapy is prescribed, aimed at eliminating dysfunctions in the body.

Aspects of anemia treatment - video

The use of traditional medicine

One should not hope for the possibility of curing anemia with the help of only folk remedies. They can be used only as an addition to the main treatment. But before starting therapy, a doctor's consultation is required. Most often, doctors recommend using:

• burnet;
• strawberry;
• black currant;
• water pepper;
• nettle;
• rose hip.

Nutrition for anemia

A special diet is an adjunct to the treatment of post-hemorrhagic anemia. The patient's diet should be dominated by foods with a high iron content:

• fresh and boiled vegetables;
• lean beef and pork;
• rabbit meat;
• veal;
• liver;
• cottage cheese;
• egg white;
• greenery;
• sea ​​fish.

Replenishment of fluid in the body is required, so doctors recommend drinking at least 2 liters of water daily. In addition, natural juices will be very useful:

• plum;
• cranberry;
• pomegranate;
• currant;
• grapefruit;
• apple.

Disease prevention

During the recovery period of the body after a previous illness, patients need to increase the immune barrier. This is due to the susceptibility to infection by various pathogenic microorganisms. In this situation, immunostimulants based on aloe, ginseng, lemongrass, and echinacea extract are used.

Prevention of the development of post-hemorrhagic anemia involves, first of all, maintaining a healthy lifestyle, observing safety rules in any field of activity and in everyday life, and timely treatment of all current diseases.

Do not forget about good nutrition. Products should be rich in micro- and macronutrients, vitamins.

In cases with any type of injury, it is imperative to contact a medical institution for timely diagnosis.

Prognosis for a successful recovery

Extremely fast medical assistance and appropriate hemostatic measures contribute to a favorable outcome. With a large loss of blood, the patient may die. Slow but volumetric blood loss leads to various complications, but it is less dangerous.

The prognosis of the success of the treatment of acute post-hemorrhagic anemia depends not only on the amount of blood loss itself, but also on the speed of blood flow.

The success of the treatment of subsequent complications depends on the timeliness and correctness of the therapy of anemia itself. In this case, an important role is played by the regenerative abilities of the bone marrow, since the duration of the treatment of anemia depends on this.

Post-hemorrhagic anemia is a disease requiring compulsory medical intervention. Only correct and timely treatment will help save a person from serious complications.

Chronic post-hemorrhagic anemia is a phenomenon caused by frequent and low blood loss. This, in turn, causes a deficiency of iron in the body, as well as a decrease in erythrocytes and a decrease in the concentration of hemoglobin.

This condition is divided into three types:

1. Acute post-hemorrhagic anemia is characterized by a large amount of lost blood.
2. Secondary iron deficiency anemia that occurs after blood loss.
3. In rare cases, congenital anemia occurs, it is observed in unborn children in the womb.

Secondary iron deficiency anemia is most often referred to as chronic post-hemorrhagic anemia.

Reasons for the development of chronic post-hemorrhagic anemia

Small but regular bleeding can accompany a person for many years, allowing anemia to develop. It is caused by such conditions as:

Chronic or iron deficiency anemia leads to an acute shortage of iron and hemoglobin. For normal functioning, the body needs a hemoglobin level in the range of 135-160 g / l, in the male body and in the female, 120-140 g / l. In a child's body, hemoglobin ranges from 150 to 200 g / l, in accordance with its age. So the symptoms:

1. The first symptoms of chronic post-hemorrhagic anemia are dizziness and the appearance of blackheads before the eyes. A person quickly gets tired and against this background his skin becomes pale, becomes thin and dry.
2. The next symptom is a loss of appetite by the patient, he has nausea, while stool is disturbed - diarrhea replaces constipation and vice versa. During this period, extraneous noises may appear in the patient's heart.
3. With the development of the disease, the condition of the skin worsens, it becomes thin and flaky. At the same stage of the disease, the hair becomes sore and brittle, and the nails exfoliate.
4. In a severe stage of anemia, the patient's perception of taste is disturbed, he begins to eat outwardly non-edible things, for example, chalk. He perceives odors inadequately, since the olfactory and taste buds stop working correctly. At this stage, the patient's teeth begin to deteriorate rapidly, and caries develops.
5. Blood pressure becomes painfully low.

Diagnostics of the chronic post-hemorrhagic anemia

Diagnoses this type of anemia using a blood test. At the same time, the blood picture is compiled according to the number and state of erythrocytes, microcytes and schizocytes. The reasons for the patient's condition must be established; for this, the state of his internal organs is determined using ultrasound equipment.

In addition, the patient is examined by narrow specialists, this is a gastroenterologist, a proctologist, a hematologist, a gynecologist for women and an endocrinologist, such an approach to diagnosis allows, with a high degree of probability, to establish the cause of the disease.

Treatment of post-hemorrhagic anemia

However, the most important point in the treatment of this pathology is the restoration of iron in the body. Indeed, even an insignificant loss of blood from 10 to 15 ml, deprives the body of that amount of iron that entered it within 24 with food intake. In this regard, the patient is prescribed a number of preparations containing not only iron, but also a complex of vitamins of group B. It can be Sorbifer, Durules, Ferroplex or Fenyuls. All drugs are prescribed by the attending physician, he also calculates the dosage based on the patient's condition and on the fact that an adult needs about 100 -150 mg per day. gland.

If the patient's condition is serious, then he is prescribed injections of drugs such as "Ferlatum", "Faltofer" or "Likferr". He also undergoes a procedure such as a blood transfusion, while not all plasma is transfused, but only the erythrocyte mass.

In parallel, the patient is assigned a special diet consisting of foods rich in iron and vitamins. Products containing animal and vegetable protein are also prescribed.

The diet is calculated individually for each patient. It necessarily includes lean beef, chicken eggs, kefir, cottage cheese, goat cheese. It is mandatory to use beef liver, sea fish, caviar, as well as beans, peas, buckwheat, oatmeal and walnuts.

The presence of fresh vegetables, fruits and berries in the diet is imperative, they help the iron to be absorbed by the body faster and better. These can be oranges, tangerines, lemons, persimmons, raspberries and black currants.

Such nutrition should quickly restore the correct metabolism in the body. But it is important that it be fractional and multiple. Ideally, the patient should eat 7 times a day in small portions. Alcohol and cigarettes are strictly prohibited.

Treatment of posthemorrhagic anemia in children

Considering all this, acute and chronic post-hemorrhagic anemia in children is treated in a hospital under the constant supervision of a doctor. First of all, the very cause of bleeding is eliminated. Then a blood transfusion is done, and as many times as necessary, that is, not once.

Necessarily prescribed preparations containing iron, including injections, for faster absorption. For children under one year old, special nutritional mixtures rich in iron and vitamins are introduced into the diet.

Treatment continues even after the condition has returned to normal. Sometimes therapy lasts up to 6 months, as the metabolism of children is constantly changing and they are in a phase of rapid growth.

As a rule, the restoration of the iron level in the child's body leads to a positive prognosis and in the future it grows without deviations from the norm. The treatment is carried out by a pediatrician, but he relies on the data provided by other narrow specialists.

Prognosis for posthemorrhagic anemia

In general, the prognosis for post-hemorrhagic anemia is positive. But only under the condition of correct and competent therapy, which includes the elimination of chronic bleeding, even if this requires a surgical operation.

Prevention of post-hemorrhagic anemia

In order for post-hemorrhagic anemia not to develop in the body of an adult or a child, it is necessary to timely treat diseases leading to blood loss. But there is a complication - most of these are more beneficial to proceed unnoticed by a person, he can feel good while a colony of parasites grows in his body or kidney stones accumulate. In this regard, it is necessary to undergo a full medical examination regularly, at least once a year. It should include the study of internal organs, analysis for the presence of parasites, as well as monitoring the quality of blood. Namely - the content of iron and erythrocytes in it.

What is Acute Post-Hemorrhagic Anemia

Acute post-hemorrhagic anemia is understood as anemia that develops as a result of the rapid loss of a significant amount of blood.

In the mechanism of development of the main symptoms of acute blood loss, the leading role is played by a rapid decrease in the total volume of blood, especially its plasma. A decrease in the volume of red blood cells leads to acute hypoxia, which is clinically manifested by the appearance of shortness of breath, palpitations.

Collapse (fainting) or hypotension (low blood pressure) are mainly caused by loss of plasma. During and immediately after bleeding, the adrenal glands release catechol amines, which causes peripheral vasospasm. The decrease in the volume of the vascular bed helps to compensate for the decrease in the volume of circulating blood. However, prolonged spasm of peripheral vessels adversely affects microcirculation and can lead to the development of shock. One of the main mechanisms of self-regulation of the body is the restoration of blood volume by mobilizing its own interstitial fluid and its release into the vascular bed. This process is called autohemodilution. If autohemodilution is insufficiently expressed or depleted, then decompensation sets in, and the patient dies without treatment. As a result of hypoxia associated with blood loss, the content of

erythropoietin, resulting in an increased formation of cells sensitive to it and the release of reticulocytes.

Symptoms of Acute Post-Hemorrhagic Anemia

Acute post-hemorrhagic anemia primarily causes collapse symptoms. The patient has severe weakness, dizziness, pallor, dry mouth, cold sweat, vomiting. The arterial and venous pressure decreases, the cardiac output of blood decreases, the pulse sharply increases. The filling of the pulse becomes weak.

The clinical picture is determined by the amount of lost blood, the rate of its outflow, and to some extent also depends on the source of blood loss. There is evidence of unequal compensation depending on the source of bleeding.

P = K + 44lgIIIU,

Where P - blood loss as a percentage;

TO - coefficient equal to 27 with gastrointestinal blood loss, 33 - with cavity bleeding, 24 - with injuries of the extremities and 22 - with lesions of the chest;

SI - shock index, equal to the ratio of pulse rate to systolic pressure.

In the first hours with a large blood loss, there may be a slight decrease in the level of hemoglobin and erythrocytes, respectively, the hematocrit (part of the blood volume accounted for by uniform elements) is not reduced, and only a study of the volume of circulating erythrocytes can reveal its significant decrease.

If the bleeding was stopped, then after 2-3 days a decrease in the level of hemoglobin and erythrocytes is observed due to the penetration of tissue fluid into the blood, therefore, in the first time after blood loss, anemia is normochromic. The content of platelets during bleeding may be reduced due to their consumption during thrombus formation.

The diagnosis of latent massive bleeding is based on clinical manifestations, supported by some laboratory data (tests by Gregersen, Weber, an increase in the level of residual nitrogen in case of bleeding from the upper digestive tract).

Treatment of Acute post-hemorrhagic anemia

Treatment of acute post-hemorrhagic anemia begins with stopping bleeding and taking anti-shock measures. Indications for blood transfusion in acute blood loss are: prolonged bleeding, a significant drop in systolic blood pressure to 90 mm Hg. Art. and below, an increase in heart rate compared to the norm by 20 beats per minute or more. Blood loss within 10-15% of the initial circulating blood volume (BCC) does not require blood replacement, and the loss of even 25% of the BCC requires only minor correction. Transfusion of blood substitutes is carried out for patients with a loss of more than 25% of blood. For replacement therapy use

polyglucin in a volume of up to 2 l / day. In order to improve microcirculation, intravenous administration of rheopolyglucin, gelatinol or albumin is used. Erythrocyte mass in the amount of 30-40% of blood loss should be used only after the restoration of blood circulation by replenishing the BCC with the above solutions. To improve the rheological properties of blood, the erythrocyte mass is diluted with rheopolyglucin or 5% albumin solution in a 1: 1 ratio.

With massive blood loss, the rate of transfusion is of great importance. Usually venous pressure is sharply reduced, the ulnar veins are collapsed, so one should resort to puncture of the subclavian veins or venous sections followed by jet injection of solutions into 2-3 veins. It should be emphasized the inadmissibility of replenishing all blood loss with blood in order to avoid the "massive transfusion syndrome". It is also necessary to remember about the correction of plasma proteins, for which albumin or protein is used. In order to correct the body's water balance, intravenous infusions of 0.9% sodium chloride solution, 5% glucose solution, Ringer-Locke's solution are performed. Lactasol is used to normalize blood pH.

Whole blood transfusion is generally impractical.

Which doctors should you contact if you have Acute post-hemorrhagic anemia?

Hematologist

Therapist

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Posthemorrhagic anemia is a pathology that in medicine belongs to the category of iron deficiency. The cause of its development can be a severe trauma with significant bleeding or the presence of a focus of chronic blood loss in the body. 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 profuse bleeding, while the chronic form is the result of systematic, but not profuse bleeding.

In the presence of bleeding in the body, there is a rapid decrease in the volume of circulating blood and, first of all, its plasma. Accordingly, a sharp drop in the level of erythrocytes is observed, which leads to the development of acute hypoxia and further anemia, which belongs to the post-hemorrhagic group.

Symptoms

When collecting complaints and anamnesis, the doctor receives the following clinical picture: the patient experiences weakness of the body, severe and frequent dizziness, which can reach fainting. Also, with post-hemorrhagic anemia, nausea is observed, with an acute form of the condition, vomiting may occur. During the course of the pathology, trophic disorders are observed in the body, respectively, structural pathological changes in the skin, hair and nails occur.

With this variant of anemia, shortness of breath, heart pain of the type of angina pectoris, muscle weakness can often be observed. Patients quite often complain of dryness in the oral cavity and difficult to quench thirst, flashing of flies in front of their eyes, tinnitus. Also, the clinic for this type of anemia includes a sharp decrease in body temperature.

With heavy bleeding, symptoms of hemorrhagic shock may develop.

Diagnostics

The presence of post-hemorrhagic anemia can only be established using laboratory blood tests. When diagnosing, it is also worth taking into account the patient's history, complaints and the results of instrumental studies, which determine the location of the source of bleeding. In this case, the instrumental diagnostic methods include fibrogastroduodenoscopy and colonoscopy.

Prophylaxis

First of all, you need to try to avoid the disease of post-hemorrhagic anemia, therefore, it is worth avoiding as much as possible any injuries that can cause blood loss and bleeding.

The prevention of the development of post-hemorrhagic anemia also includes a healthy lifestyle and proper nutrition, in which the blood and all body systems receive the required amount of trace elements and vitamins. The diet must contain iron-containing foods, namely, fresh fruits, lean red meat, legumes, fresh green vegetables, whole grain breads and greens.

Treatment

The first stage of therapy for posthemorrhagic anemia is aimed at eliminating the source of bleeding and preventing shock. Next, you need to carry out treatment aimed at replenishing the lost blood, while the body must be replenished with heparin 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 rest of the deficit is replenished with the help of blood substitutes.

At the third stage of therapy, after stopping the bleeding, blood loss is restored, and nothing threatens life, therapeutic therapy is carried out with the help of iron-containing preparations and vitamin complexes.

After the elimination of the symptoms of anemia, treatment with iron-containing drugs continues for another 6 months, but the amount of drugs taken is halved.

Posthemorrhagic anemia is a complex of changes in the blood picture and in the state of the body as a whole, which develops against the background of acute or chronic blood loss.

Posthemorrhagic anemia is a life-threatening condition and is accompanied by symptoms such as: pallor of the skin, severe shortness of breath, sharp darkening in the eyes, significant. In severe cases, loss of consciousness and the development of a shock state are possible.

With post-hemorrhagic anemia, the volume of blood circulating in the body is significantly reduced. In parallel, the level of red blood cells in the blood falls. A wide variety of pathologies can lead to the development of this violation: diseases of any internal organs, complicated by bleeding, injuries and trauma, and not only. The nature of anemia can be acute or chronic.

Long-term disturbance of hemodynamics in post-hemorrhagic anemia leads to pronounced organ tissues with their further dystrophy. In severe cases, posthemorrhagic anemia can be fatal.

Acute hemorrhagic anemia develops as a result of acute blood loss. This happens with internal or external bleeding. It is characterized by massiveness and high speed. Damage to the vascular walls is most often mechanical. Moreover, large blood vessels are affected. Also, acute post-hemorrhagic anemia can lead to bleeding from the cavities of the heart against the background of injuries or after undergoing surgery. Heart attacks accompanied by rupture of the chambers of the heart walls, rupture of the aortic aneurysm, violation of the integrity of the pulmonary artery and its large branches - all this can cause acute blood loss with further development of anemia. Other risk factors include: rupture of the spleen, damage to the integrity of the epididymis, for example, when life begins in it.

In general, any profuse bleeding from the uterine cavity, even with prolonged menstruation, can lead to the development of acute post-hemorrhagic anemia. Dangerous in this regard, diseases of the digestive system, in particular, and.

In children during the neonatal period, post-hemorrhagic anemia can also develop, which most often manifests itself against the background of birth trauma or placental bleeding.

Chronic post-hemorrhagic anemia develops with the following disorders:

Minor, but regular bleeding in diseases of the gastrointestinal tract.

Frequent nosebleeds.

Bleeding hemorrhoids.

Recurrent renal bleeding.

DIC and hemophilia. These conditions are characterized by a violation of the blood clotting process.

Dry mouth.

A drop in body temperature, which is especially noticeable in the area of ​​the upper and lower extremities.

The ingress of clammy and cold sweat.

Increased pulsation with a decrease in its strength.

Drop in blood pressure.

If bleeding develops in a child under one year old, then it will be much more difficult for him to endure than an adult.

If the blood loss is profuse, and blood is poured out of the vascular bed quickly, then the victim may collapse. Hypotension will be extremely pronounced, the pulse is barely palpable, or it may be absent altogether. Breathing becomes shallow, and episodes of vomiting and seizures are common. In most cases, human consciousness is absent.

Severe anemia can be fatal, which occurs against the background of acute hypoxia of internal organs. The work of the heart and respiratory center stops.

Separately, the symptoms of chronic blood loss, in which mild anemia develops, should be designated.

This is characterized by the following violations:

The skin becomes dry and cracked.

Any wounds on the skin take a very long time to heal and may fester.

The pallor of the skin and mucous membranes is not too pronounced, but it is difficult not to notice it.

Nails become brittle, exfoliate.

Hair grows dull, begins to fall out.

The heart works in an increased rhythm, which often breaks down.

Sweating increases.

Body temperature can remain at the level of subfebrile marks for a long time.

The patient often has ulcers in the mouth, possibly the formation of carious teeth.

Such symptoms do not have a clear severity and can disturb the patient from time to time. This is due to the fact that the body triggers compensatory mechanisms and works at the peak of its capabilities. However, sooner or later, they will run out.

Diagnosis of post-hemorrhagic anemia begins with questioning the patient's complaints and examining him. The doctor must measure the patient's blood pressure, assess the nature of his mucous membranes and skin. If the doctor suspects such a diagnosis in the patient, he will refer him to a series of examinations.

The laboratory tests will be as follows:

A blood test to determine the level of hemoglobin and erythrocytes, which will be reduced.

Blood chemistry.

Analysis of urine with control of its daily volumes.

Determination of the total volume of circulating blood.

Bone marrow puncture is performed only if the diagnosis remains in doubt. It is imperative to establish the cause of post-hemorrhagic anemia. For this, an ultrasound examination of the internal organs and organs of the small pelvis, FGDS, colonoscopy, sigmoidoscopy, and an electrocardiogram are taken. Wives should visit a gynecologist.

The scheme of the therapeutic effect on the patient depends on what exactly caused the development of post-hemorrhagic anemia. Detected bleeding should be stopped as soon as possible. If the blood loss is due to external bleeding, then a tourniquet or bandage is applied to the wound, it is possible to suture the vessels and damaged tissues and organs. The victim must be urgently hospitalized.

If the blood loss is massive, then the following measures are shown:

Transfusion of erythrocyte mass, plasma and plasma substitutes (Reopolyglyukin, Gemodez, Polyglyukin). This measure must be taken promptly, since large blood loss is associated with a high risk of death.

Prednisolone (a hormonal drug) is administered when the patient develops a shock state.

Solutions of albumin, glucose, saline - all these substances are administered to the patient intravenously to restore the salt balance in the body.

To replenish iron stores, injections of Sorbifer Durules or Ferroplex can be used. However, it must be borne in mind that their use is associated with a high likelihood of an allergic reaction.

Severe anemia requires the administration of large doses of blood. Doctors call this procedure a blood transplant. If, after the restoration of the total blood volume, the patient's blood pressure normalizes, and its qualitative composition improves, then this indicates that the therapy was selected correctly. To improve the patient's well-being, he is prescribed B vitamins.

Symptomatic treatment should be aimed at restoring the functioning of the heart and blood vessels, brain, liver and kidneys, as well as other organs affected by hypoxia.

Delayed therapy involves the patient's adherence to a diet that is aimed at restoring the quality composition of the blood. To do this, you will need to eat low-fat red meat, liver, eggs, fermented milk drinks, vegetables and fruits, cottage cheese, fish. You should drink at least 2 liters of water per day, a rosehip decoction is useful.

The more massive the volume of lost blood, the worse the prognosis for recovery. What if a person loses at once? part of the total blood volume, then the likelihood of developing hypovolemic shock is extremely high. Should blood loss be equated to? parts, then the victim will not be able to survive. Provided that anemia develops with chronic blood loss, then most often it can be neutralized after the source of bleeding has been found and eliminated.

Education: In 2013 he graduated from the Kursk State Medical University and received a diploma "General Medicine". After 2 years, she completed her residency in the specialty "Oncology". In 2016, completed postgraduate studies at the National Medical and Surgical Center named after N.I. Pirogov.