小儿营养性贫血(NUTRITIONAL-ANEMIA).ppt

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1、NUTRITIONALANEMIA1NewwordsNutritional营养的Megaloblastic巨幼细胞Hamorrhage出血Irritability激惹Lethargy嗜睡Fatigue疲乏Anorexia厌食Appetite食欲Microcytic小细胞的Hypochromic低色素的Thalassemia海洋性贫血Ferroussulfate硫酸亚铁Hookworm钩虫Epistaxis鼻出血Reticulocyte网织红细胞2NutritionalanemiaMegaloblasticanemi

2、avitaminB12deficiencyfolicaciddeficiencyIrondeficiencyanemiairondeficiency3IrondefeciencyanemiaIntroductionCauseofIrondeficiencyanemiaClinicalfeaturesLaboratoryfindingsDiagnosisDefferentialdiagnosisTreatment4IronDeficiencyAnemia,IDAIncidenceofIDA:10-70%(WHO)40

3、%(6m-6y，China)5IDAisthemostcommoncauseofanemiainchildhood.Itusuallyresultsfrominadequatedietaryintakeratherthanlossofironthroughhemorrhage.6IroninmilkBothofbreastandcow`smilkarelowinironIronisbetterabsorbedfrombreastmilk(50%)comparedtocow`smilk(10%)Formulamilk

4、sarefortifiedwithiron(4%)7Dietarysourcesofiron8DietarysourcesofironRedmeatFortifiedbreakfastcerealsDarkgreenvegetablesBlackbreadabout10-15%ironofdietaryisabsorbed9IronrequirementsThefetusabsorbsironfromthemotheracrosstheplacenta.Terminfantshaveadequatereservef

5、orthefirst4monthsoflife.Preterminfantshavelimitedironstoresandbecauseoftheirhigherrateofgrowth,theirironreserveswereusedupby8weeksofage.Adolescentsalsoneedmoreironbecauseof1.Growthspurt2.Dietarydeficiency3.Menstrualbloodloss10Referencenutrientintakeofironare:6

6、months:4mg/day12months:8mg/dayAdultmale:9mg/dayAdultfemale:15mg/day11（一）thedecreaseofironstoreslowbirthweightpreterminfantshemorrhageCausesofirondeificiency12Causesofirondeificiency（二）Nutritionaldeficiencyiscommonincertainat-riskgroupspreterminfantsrequireiron

7、supplementsfrom6-8weeks.Terminfantswilldevelopirondeficiencyafter4monthsif1.mixedfeedingisundulydelayed2.unmodifiedcow`smilkisintroducedearly.Itiscommoninthefirsttwoyearsofage13Causesofirondeificiency(三）MalabsorptionmaybecomplicatedbyirondeficiencyThechildrenu

8、suallycompanywithanothermalnutrition.14Causesofirondeificiency(四）Bloodlossisalesscommoncauseinchildren,butmayoccurwith:MenstruationHookworminfectionRepeatedvenesectioninbabiesMecke