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241 cases of iron deficiency anemia in the elderly cause analysis
Old names of diseases diagnosis of iron deficiency anemia diseases Over. Clinical manifestations (1) general symptoms of anemia. (2) anemic hypoxia, ischemia caused by the body tissues and organs symptoms. brain tissue hypoxia dizziness, sleepiness, physical weakness and lack of memory loss. the gastrointestinal tract can occur during hypoxia gastrointestinal disorders, loss of appetite, nausea, vomiting, diarrhea and other symptoms. cardiovascular system can occur during hypoxia rapid heartbeat, heart strong, systolic blood pressure, pulse pressure increase, palpitation shortness of breath, severe anemia, myocardial ischemia was, ECG ST-T changes may occur (myocardial damage), Finally, can lead to enlargement of the heart, the apex systolic murmur, heart failure, heart disease called anemia. 2. Laboratory and special examinations: (1) blood test. (2) bone marrow examination. Treatment: 1. Cause of treatment. 2. Iron supplementation. Classification of Diseases, symptoms and signs of clinical features of Geriatrics: (1) older women because of menstruation during pregnancy and lactation has not influence the prevalence of no difference with men. (2) the signs and symptoms of anemia in young and elderly are the difference between pain when swallowing (plummer-vinson syndrome), tongue atrophy, a higher incidence of chapped mouth. (3) common three-line reduction of blood can occur. The main symptoms and


signs: fatigue, drowsiness, tinnitus, loss of appetite, palpitation shortness of breath (activity after the increase), emotional instability, pale skin and hair are dry, swollen ankle and lower extremity edema, heart rate acceleration, the apex systolic murmur . Diagnostic laboratory tests showed hypochromic anemia of small cells: MCV 16%. Bone marrow shows red blood cells vary in size, the center light staining, iron staining hemosiderin granules disappear, sideroblastic most disappeared. Diagnosis: The diagnosis of typical symptoms is not difficult, can, according to the cause, red blood cell morphology, iron metabolism in check, change and the red bone marrow iron stain make the diagnosis. Diagnosis of iron treatment of iron deficiency anemia test is a simple and reliable method. Iron deficiency anemia in patients with daily oral iron, the short term was significantly higher reticulocyte count peaked ,5-10d, and later returned to normal. This reaction is only seen in iron deficiency anemia. Study confirmed iron deficiency anemia, the need to further identify the cause of iron deficiency, must be comprehensive and systematic physical examination, paying particular attention gastrointestinal examination, if no ulcer disease, hemorrhoids, intestinal parasites. Special attention to female patients of menstruation and gynecological examinations. Fecal occult blood test should be used as any unexplained iron deficiency anemia a routine examination. According to the clues found in the further progress made targeted special examinations, such as imaging and biochemistry, immunology, aiming proven iron deficiency and iron deficiency anemia causes. Treatment (1) causes of iron deficiency anemia elderly patients should first identify the cause. Cause of treatment to correct anemia and prevent its recurrence are important. Pure iron treatment has the potential to improve or restore normal blood, but the primary disease without treatment, will not consolidate the results. (2) iron treatment with oral iron: 1, ferrous sulfate, 0.15-0.3g, 3 / d; 2, ferrous succinate (Speed Power Philippines) 0.1-0.2g, 3 / d, decreased stimulation of the gastrointestinal tract; 3, force the Philippines to 150mg, 2 / d ,4-6 weeks to 150mg, 1 / d less stimulation of the gastrointestinal tract. To reduce the stimulation of iron on the stomach, after a meal should be taken orally, should be first a small amount, gradually up to adequate ,2-3 months to 1 course of treatment. Diagnosis of true effect, which may provide a significant improvement in 1-2 weeks ,5-10g reticulocytes increased and reached the peak of hemoglobin began to rise after 2 weeks, an average of 2 months of recovery. To prevent recurrence, to make up the reserve of iron, that is, hemoglobin, and then extend the treatment for 1 month. 6 months can also be re-treated 3-4 weeks. If oral iron of no reticulocyte response, no increase in hemoglobin, consider the following factors: 1, the patient fails to take medications; 2, patients without iron deficiency, should reconsider the diagnosis; 3, hemorrhage still exists, the elderly should pay attention to gastrointestinal cancer; 4, infection, inflammation, cancer and other chronic diseases, interfere with the use of bone marrow iron; 5, iron malabsorption, should consider switching to injection of iron. Available when necessary, iron deficiency anemia iron injection therapy. However, due to injection of iron toxicity are more convenient and more expensive than oral, it must strictly adhere to its indications. The indications are as follows: 1, oral iron is invalid or other adverse reactions due to gastrointestinal tract who can not stand; 2, an urgent need to correct anemia, such as short-term need for surgery; 3, no effort control chronic blood loss, iron loss over the intestinal absorption; 4, gastrointestinal disorders and had had gastric resection line; 5, chronic diarrhea or malabsorption syndrome patients. Commonly used iron injected with iron dextran and iron sorbitol. 5% Fe iron dextran, the first dose is 50mg, deep intramuscular injection. If no adverse reaction, the first 2 days from the day, 100mg, each increase of hemoglobin 10g / L, required iron dextran 300mg, total dose (mg): 300 normal hemoglobin concentration (g / dI) - patients with hemoglobin concentration (g / dI ) +500 mg (additional storage of iron). Available intravenous iron dextran, but the many and serious adverse reactions, should be used with caution. Iron sorbitol can not be administered intravenously every low the hemoglobin 10g / L, to be sorbitol iron 200-250mg. The total dose to be in accordance with the total dose required for D-iron formula. About 5% of patients local pain after injection of iron, lymphadenitis, headache, dizziness, fever, nettle consultation, joint pain, muscle pain, hypotension, anaphylactic shock of individual patients, long-term injection of excess iron poisoning can occur adverse reactions. The edge of sheet iron is ferrous lactate, gelatin and protein effects of zinc are used as ingredients, iron, nutrition and blood plus one three, to better prevention and improved anemia, enhance human immunity. (3) treatment of points: 1, positive for the cause and (or) the primary disease treatment. 2, oral iron therapy in young people with the same, but older people wish to add services or dilute hydrochloric acid vitamin C will help iron absorption. 3, after the formal iron treatment received only a temporary improvement in hematological elderly, should be highly alert to the presence of the tumor. 4, 3-4 weeks of treatment with iron should think about whether iron deficiency is invalid because the diagnosis was wrong or not removed. Part of the combined copper deficiency mixed with iron deficiency anemia, iron poor response to treatment, plus copper agent may be effective. Drug safety 1. Treatment of active treatment of the primary causes of morbidity and causes, such as inadequate iron intake or chronic blood loss and so on. 2. Iron supplements (1) ferrous succinate 0.3g, 3 times a day on the drug than the ferrous sulfate was significantly less gastrointestinal irritation, if any, reduction reaction may be appropriate, but also can be applied to other iron and appropriate Vitamin C. (2) or oral iron were significantly more severe illness that can be used intramuscular injection of iron dextran and iron citrate alcohol 111 pears. Iron content of the two preparations were 50mg/ml, the first 50mg dose of intramuscular injection, without reaction, 100mg daily intramuscular injection. Application of iron in the hemoglobin rose to normal, do not stop, should continue treatment 3-6 months to supplement the storage of iron; shall rethe serum ferritin, serum ferritin to 100ug / L or more.


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