What is posthemorrhagic anemia. Posthemorrhagic anemia: treatment of acute and chronic forms Posthemorrhagic anemia: treatment of acute and chronic forms

Often what threatens our lives is not what is in plain sight. Suspecting some kind of serious illness, which is on everyone's lips, we ignore, for example, a stomach ulcer, which only causes us inconvenience from time to time. But such an inconspicuous wound can be much more dangerous than many famous diseases. Losing blood drop by drop, undermining the health of its owner for many months and years, it provokes the appearance of unpredictable post-hemorrhagic anemia.

Danger of excessive blood loss

The total volume of blood in the body of an adult is from 3.5 to 5 liters. Circulating throughout the body, it performs many functions:

• distributes nutrients and oxygen;
• removes decay products from tissues;
• transports hormones from glands to sensitive organs;
• supports constant temperature And chemical composition body;
• participates in wound closure and subsequent tissue regeneration;
• carries out immune responses to external threats.

If the amount of fluid in the vessels drops by more than 10%, the victim clearly feels it. The weakening of the above properties of blood occurs - and the more significant the more serious the blood loss. The transport function is the first to suffer - brain tissue begins to experience oxygen starvation in just a few seconds. The following symptoms are known as common name

"posthemorrhagic anemia".

Types of posthemorrhagic anemia Anemia from blood loss, or posthemorrhagic anemia, is a deficiency of red blood cells in the plasma resulting from excessive blood loss. IN

clinical practice

One of the main reasons for the wide spread of posthemorrhagic anemia in the recent past was the fashion for bloodletting. According to the latest data, it was this procedure that accelerated the death of Mozart. Having fallen ill in 1791, the composer was subjected to a treatment that was innovative at that time, as a result of which he lost about two liters of blood and died in less than a month.

Mechanism of development and symptoms of the disease

The symptoms of posthemorrhagic anemia vary significantly depending on the form of the disease, the severity of blood loss, and the characteristics of the victim’s body.

Clinical picture in acute condition

From the first moments heavy bleeding The human body uses all its resources to compensate for the losses that have occurred.

The production of red blood cell precursor cells called erythroblasts increases sharply. The number of red cells per unit volume of plasma remains constant, although in absolute terms their number decreases. The walls of peripheral vessels quickly spasm, limiting the flow of blood to the skin and skeletal muscles. At the same time, security is maintained for as long as possible nutrients central nervous system

1. , heart and adrenal glands.
2. The victim's pulse quickens.
3. Breathing becomes harsh and shallow.
4. The skin and mucous membranes turn pale.
5. There is a feeling of dizziness, weakness in the limbs, tinnitus, and possibly nausea.

Feces may be dark brown or red in color.

This phase of anemia, which combines the body's immediate reactions to blood loss, is called reflex. It lasts up to 12 hours, after which it becomes compensatory, or hydremic.

At this stage, the body extracts the maximum number of red blood cells from the depot, and interstitial fluid begins to move into the vessels. The filtration properties of the kidneys are adjusted to retain water in the body, resulting in decreased urine production. Red cells are distributed in the plasma, causing the relative concentration of hemoglobin to sharply decrease. The next phase, the bone marrow phase, occurs 4–5 days after the event of blood loss. By this time, the production of erythroblasts and the maturation of red blood cells reaches maximum values

. Prolonged spasm of peripheral vessels can provoke cell gluing in small capillaries, causing them to become clogged. Large blood clots can cause tissue and organ death.

The symptoms of chronic posthemorrhagic anemia show milder manifestations than in the case of an acute course:

• skin manifestations:
  • pallor;
  • slight swelling;
  • dryness;
  • roughness;
• hair defects:
  • fragility;
  • dropping out;
• tachycardia;
• decreased blood pressure;
• general symptoms:
  • dizziness;
  • weakness;
  • decreased appetite;
  • noise in ears.

Features of posthemorrhagic anemia in children

Children are more prone to manifestations of acute posthemorrhagic anemia than to chronic one. The reason for this is obvious - even small blood losses by the standards of an adult become a difficult test for the fragile body of a child.

Alarming symptoms in this case are considered:

• pale skin;
• smoothness of the tongue;
• growth retardation;
• change in behavior (apathy or tearfulness);
• hair fragility;
• violation of taste preferences - a tendency to eat clay and chalk;
• general weakness;
• weight loss.

Weakened by injury children's body becomes sensitive to infectious diseases, so anemia can lead to the development of sore throat, laryngitis, otitis media,.

Stages (degrees) of the disease: mild, moderate, severe

Depending on the intensity of blood loss, there are several stages, or degrees of severity, of posthemorrhagic anemia.

Determining the severity of the disease plays a critical role in planning further treatment. For example, mild anemia may not require drug therapy, while heavy is absolute indication for immediate hospitalization of the victim.

Stages of posthemorrhagic anemia - table

Diagnostics

Compulsory primary stage diagnostics is visual inspection patient, allowing:

• determine the location of damage in case of superficial injury to the body;
• estimate general state the victim in relation to the severity of blood loss;
• find out about the patient's predisposition to bleeding certain type(gastric, intestinal, pulmonary, etc.).

Proctological or gynecological examination carried out if injuries are suspected lower sections digestive system and women's reproductive organs. Analysis of stool and urine can detect damage gastrointestinal tract And genitourinary system. The most commonly used tests are benzidine (Gregersen) and guaiac (Weber) tests. The reagents used in them change color upon contact with free hemoglobin.

The use of the iron isotope 59 Fe in radioimmunoassay makes it possible to describe the distribution of red blood cells, their integrity and activity.

A blood test for acute posthemorrhagic anemia shows very characteristic results:

1. During the first hour after the onset of the condition, the number of platelets increases sharply, and after three hours - leukocytes.
2. Following this, the level of red blood cells drops.
3. Restoring initial indicators takes at least several weeks.

For internal bleeding, radiography, magnetic resonance (MRI) and computed tomography (CT) are widely used. ultrasound diagnostics. With their help, it is possible to accurately localize damage to hollow organs.

These techniques make it possible to differentiate posthemorrhagic anemia from similar conditions.

Differential diagnosis - table

Treatment

The main task in the treatment of posthemorrhagic anemia is to stop the bleeding that provoked it. Subsequent measures are aimed at replenishing the loss of red blood cells, fluid, and nutrients.

Acute therapy

Significant blood loss (more than 1 liter) should be compensated by transfusion of red blood cells with plasma substitutes, but not more than 60% of the lost volume. Exceeding this indicator can provoke intravascular coagulation. It is better to make up the difference with blood substitutes - solutions of albumin, dextran, sodium chloride, gelatinol, rheopolyglucin, Ringer-Locke composition. Lactasol can be used to restore pH values.

After removal acute condition measures are being taken to improve hemoglobin synthesis. Therapy at this stage coincides with treatment chronic form.

Therapy for chronic form

To replenish the amount of lost iron (in iron deficiency conditions), preparations containing the metal in a divalent form are used. Such means include:

• Maltofer;
• Sorbifer;
• Feramide;
• Ferrocal;
• Ferroplex;
• Ferrocene.

Multivitamin complexes that include vitamins B, C, and E help increase metabolism.

Treatment of anemia - video

Diet for posthemorrhagic anemia

• apricots;
• grenades;
• mushrooms;
• strawberries;
• lean meat;
• peaches;
• liver;
• fish;
• cottage cheese;
• blueberry;
• apples;
• eggs.

Develops as a result of repeated minor blood loss (uterine bleeding, etc.) as a result of a decrease in iron reserves in the body and depletion of the regenerative capacity of the bone marrow.

Characteristic fast fatiguability, flashing “flies” in front, pallor of the skin and mucous membranes, puffiness of the face, anemic noises (when listening to the heart and jugular). Blood examination: hypochromic anemia with a sharp drop color index(0.5-0.6) l with the appearance of anisocytosis, poikilocytosis and microcytosis.

Treatment consists of identifying and eliminating the cause of blood loss as early as possible (for example, excision hemorrhoids) and eliminate iron deficiency in the body. Periodic (every 4-5 days) transfusions of 200 ml are recommended whole blood or 100-125 ml of red blood cells (under control), iron supplements (reconstituted 1 g 3-4 times a day), hemostimulin 0.6 g 3 times a day with meals (drink with a diluted solution - 10-15 drops per % glass of water), etc.

Chronic posthemorrhagic anemia develops as a result of repeated regular blood loss, even minor (a daily loss of 15-20 ml of blood is enough to deprive the body of the entire amount of iron received per day from food). Often the source of bleeding is so insignificant that it may go unrecognized. Even occult blood loss during ulcerative and neoplastic processes in the gastrointestinal tract, strangulated diaphragmatic hernia stomach or insignificant hemorrhoidal blood loss, repeated day after day, can lead to severe anemia. Identifying the source of such hidden bleeding has great importance For differential diagnosis, prognosis and choice of treatment.

Blood picture characterized hypochromic anemia with a sharp drop in the color index (0.5-0.6) and the appearance of degenerative forms of erythrocytes - microcytes, poikilocytes, schizocytes (color table, Fig. 4). The number of reticulocytes depends on the regenerative capacity of the bone marrow, which is greatly reduced by depletion of stored iron. Chronic posthemorrhagic anemia is usually accompanied by a moderate decrease in the number of leukocytes and platelets with relative lymphocytosis.

Treatment of chronic posthemorrhagic anemia is aimed at eliminating the causes of blood loss and eliminating iron deficiency in the body by prescribing various iron preparations. As replacement therapy and red blood cell transfusions are recommended to stimulate erythropoiesis.

Rice. 4. Blood in chronic posthemorrhagic anemia: 1 and 2 - schizocytes; 3 - segmented neutrophils; 4 - lymphocyte; 5 - platelets.

Anemia due to increased blood destruction - see Hemolytic anemia.

Posthemorrhagic anemia is a disease that is accompanied by a decrease in the number of red blood cells and hemoglobin concentration due to massive acute bleeding or as a result of even minor but chronic blood loss.

Hemoglobin is a protein complex of an erythrocyte that contains iron. Its main function is to transport oxygen through the bloodstream to all organs and tissues without exception. When this process is disrupted, quite serious changes begin in the body, which are determined by the etiology and severity of anemia.

Depending on the root cause and course of posthemorrhagic anemia, acute and chronic forms are distinguished. According to the system international classification The disease is divided as follows:

• Secondary iron deficiency anemia after blood loss. ICD 10 code D.50
• Acute posthemorrhagic anemia. ICD 10 code D.62.
• Congenital anemia after fetal bleeding – P61.3.

In clinical practice, secondary iron deficiency anemia also called posthemorrhagic chronic anemia.

Causes of the acute form of the disease

The main reason for the development of acute posthemorrhagic anemia is the loss of a large volume of blood within a short period of time, which occurred as a result of:

• Trauma that caused damage to the main arteries.
• Damage to large blood vessels during surgery.
• Gap fallopian tube with the development of an ectopic pregnancy.
• Diseases of the internal organs (most often the lungs, kidneys, heart, gastrointestinal tract), which can lead to acute massive internal bleeding.

In young children, the causes of acute posthemorrhagic anemia are most often umbilical cord injuries, congenital pathologies of the blood system, damage to the placenta during caesarean section, early placental abruption, placental previa, birth trauma.

Causes of chronic posthemorrhagic anemia

Chronic posthemorrhagic anemia develops as a result of small but regular bleeding. They may appear as a result of:

• Hemorrhoids, which are accompanied by cracks in the rectum and the appearance of blood in the stool.
• Peptic ulcer of the stomach and duodenum.
• Heavy menstruation uterine bleeding while taking hormonal drugs.
• Damage to blood vessels by tumor cells.
• Chronic nosebleeds.
• Minor chronic blood loss for oncological diseases.
• Frequent blood draws, catheter installations and other similar manipulations.
• Severe kidney disease with bleeding in the urine.
• Helminth infestation.
• Liver cirrhosis, chronic liver failure.

Reason chronic anemia similar etiology may also be hemorrhagic diathesis. This is a group of diseases in which a person has a tendency to bleed due to disruption of homeostasis.

Symptoms and blood picture of anemia due to acute blood loss

Clinical picture Acute posthemorrhagic anemia develops very quickly. The main symptoms of this disease include manifestations of general shock as a result of acute bleeding. In general, the following are observed:

• Reduced blood pressure.
• Cloudiness or loss of consciousness.
• Severe pallor, bluish tint of the nasolabial fold.
• Thready pulse.
• Vomit.
• Increased sweating, and so-called cold sweat is observed.
• Chills.
• Cramps.

If the bleeding was successfully stopped, then such symptoms are replaced by dizziness, tinnitus, loss of orientation, blurred vision, shortness of breath, and irregular heartbeat. Pallor of the skin and mucous membranes and low blood pressure still persist.

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Changes in blood test results within a few days after bleeding has stopped and the development of anemia are closely related to compensation mechanisms that “turn on” in the body in response to the loss of a large volume of blood. They can be divided into the following stages:

• The reflex phase, which develops on the first day after blood loss. Redistribution and centralization of blood circulation begins, peripheral vascular resistance increases. In this case, there is a decrease in the number of red blood cells with normal values hemoglobin and hematocrit concentrations.
• The hydremic phase occurs from the second to the fourth day. Extracellular fluid enters the vessels, glycogenolysis is activated in the liver, which leads to an increase in glucose content. Gradually, symptoms of anemia appear in the blood picture: the concentration of hemoglobin decreases, the hematocrit decreases. However, the color index value is still normal. Due to the activation of thrombus formation processes, the number of platelets decreases, and due to the loss of leukocytes during bleeding, leukopenia is observed.
• The bone marrow phase begins on the fifth day after bleeding. Insufficient oxygen supply to organs and tissues activates hematopoietic processes. In addition to decreased hemoglobin, hematocrit, thrombocytopenia and leukopenia, at this stage there is a decrease in the total number of red blood cells. When examining a blood smear, the presence of young forms of red blood cells is noted: reticulocytes, sometimes erythroblasts.

Similar changes in the blood picture are described in many situational tasks for future doctors.

Symptoms and diagnosis of anemia in chronic bleeding

Chronic posthemorrhagic anemia is similar in its symptoms to iron deficiency, since regular, mild bleeding leads to a deficiency of this microelement. The course of this blood disease depends on its severity. It is determined depending on the concentration of hemoglobin. Normally, in men it is 135–160 g/l, and in women 120–140 g/l. In children, this value varies depending on age from 200 in infants to 150 in adolescents.

Degree of posthemorrhagic chronic anemia Hemoglobin concentration

• 1 (light) degree 90 – 110 g/l
• 2nd degree ( moderate severity) 70 – 90 g/l
• Grade 3 (severe) below 70 g/l

On initial stage progression of the disease, patients complain of slight dizziness, flashing “flies” before the eyes, increased fatigue. Externally, pallor of the skin and mucous membranes is noticeable.

At the second stage, the listed symptoms are added to a decrease in appetite, sometimes nausea, diarrhea or, conversely, constipation, shortness of breath. When listening to heart sounds, doctors note heart murmurs characteristic of chronic posthemorrhagic anemia. The condition of the skin also changes: the skin becomes dry and peels. Painful and inflamed cracks appear in the corners of the mouth. The condition of hair and nails worsens.

Severe anemia is manifested by numbness and a feeling of tingling in the fingers and toes, specific taste preferences, for example, some patients begin to eat chalk, and the perception of smells changes. Very often this stage of chronic posthemorrhagic anemia is accompanied by rapidly progressing caries and stomatitis.

Diagnosis of posthemorrhagic anemia is based on the results clinical analysis blood. In addition to the decrease in the amount of hemoglobin and red blood cells characteristic of all types of anemia, a decrease in the color index is detected. Its value ranges from 0.5 – 0.6. In addition, with chronic posthemorrhagic anemia, modified red blood cells (microcytes and schizocytes) appear.

Treatment of anemia after massive blood loss

First of all, it is necessary to stop the bleeding. If it is external, then it is necessary to apply a tourniquet and a pressure bandage and take the victim to the hospital. In addition to pallor, cyanosis and confusion, internal bleeding is indicated by severe dry mouth. It is impossible to help a person in this condition at home, so stopping internal bleeding carried out only in a hospital setting.

After identifying the source and stopping the bleeding, it is necessary to urgently restore blood supply to blood vessels. For this purpose, rheopolyglucin, hemodez, polyglucin are prescribed. Acute blood loss also compensated by blood transfusion, taking into account the compatibility of the Rh factor and blood group. The volume of blood transfusion is usually 400 – 500 ml. These activities must be carried out very quickly, since quick loss even ¼ of the total blood volume can be fatal.

After stopping the state of shock and carrying out all the necessary manipulations, they proceed to standard treatment, which consists of administering iron supplements and enhanced nutrition to compensate for the deficiency of vitamins and microelements. Ferrum lek, ferlatum, maltofer are usually prescribed.

Usually recovery normal picture blood occurs after 6 - 8 weeks, but the use medicines To normalize hematopoiesis, continue for up to six months.

Treatment of chronic posthemorrhagic anemia

The first and most important stage in the treatment of posthemorrhagic chronic anemia is to determine the source of bleeding and its elimination. Even the loss of 10 - 15 ml of blood per day deprives the body of the entire amount of iron that was received during that day with food.

Held comprehensive examination patient who is mandatory includes consultations with a gastroenterologist, proctologist, hematologist, gynecologist for women, and endocrinologist. After identifying the disease that caused the development of chronic posthemorrhagic anemia, treatment begins immediately.

At the same time, medications that contain iron are prescribed. For adults it daily dose is about 100 – 150 mg. Appointed complex means, which in addition to iron contain ascorbic acid and B vitamins, which promote its better absorption. These are sorbifer durules, ferroplex, fenyuls.

At severe course posthemorrhagic chronic anemia, red blood cell transfusion and injection are indicated to stimulate hematopoietic processes medicines with iron. Ferlatum, maltofer, likferr and similar medications are prescribed.

Recovery after the main course of treatment

The duration of taking iron-containing drugs is determined by the doctor. In addition to the use of various medications to restore normal oxygen supply to organs and replenish iron reserves in the body, proper nutrition is very important.

The diet of a person who has suffered posthemorrhagic anemia must contain proteins and iron. Preference should be given to meat, eggs, fermented milk products. The leaders in iron content are meat by-products, especially beef liver, meat, fish, caviar, legumes, nuts, buckwheat and oatmeal.

When creating a diet, attention should be paid not only to how much iron a particular product contains, but also to the degree of its absorption in the body. It increases with the consumption of vegetables and fruits that contain vitamins B and C. These are citrus fruits, black currants, raspberries, etc.

Course and treatment of posthemorrhagic anemia in children

Posthemorrhagic anemia in children is much more severe, especially its acute form. The clinical picture of this pathology is practically no different from that of an adult, but develops faster. And if in an adult a certain volume of lost blood is compensated by the body’s protective reactions, then in a child this can lead to death.

Treatment of acute and chronic forms of posthemorrhagic anemia in children is the same. After identifying the cause and eliminating the bleeding, a transfusion of red blood cells is prescribed at the rate of 10 - 15 ml per kg of weight, and iron supplements. Their dosage is calculated individually depending on the severity of anemia and the condition of the child.

For children aged about six months, early introduction of complementary foods is recommended, and you should start with foods with increased content gland. Infants are advised to switch to special fortified mixtures. If the disease that led to the development of posthemorrhagic anemia is chronic and cannot be treated, then preventive courses of iron supplements must be repeated regularly.

With timely initiation of treatment and non-critical blood loss, the prognosis is generally favorable. After compensation for iron deficiency, the child quickly recovers.

In the Basics Hemorrhagic anemia There may also be a combination of typical phenomena, for example, blood loss and iron deficiency.

Symptoms of hemorrhagic anemia

The clinical situation contains a set of syndromes. Thus, eunuchoidism of hemolysis is expressed in icteric coloring of the sclera and skin, darkening of urine, enlargement of the spleen and liver.

Anemia: signs and therapy

If erythropoiesis is unsuccessful, bone destruction is likely. “Weak eunuchoidism” is considered universal for anemia of various origins:

Weakness, drowsiness and asthenicity. Another name for anemia, “tired blood” disease, is explained by these manifestations:

Decreased and pathological appetite.

Shortness of breath and arrhythmias.

Visual pathologies (“spots”), which are a consequence of hypotension.

Iron deficiency (sideropenia) is considered the most common factor hemorrhagic anemia. For this reason, general anemic hyperthyroidism is generally expanded by the properties of anemia iron deficiency symptoms sideropenia:

Epithelial syndrome. The skin tone changes: it can be green (pale sickness), the color of yellow wax, blue-violet. There are zones with hyperpigmentation or depigmentation near the mouth, and redness of the edge of the tongue can be seen. The skin is dry, peeling (disease), subject to cracking; hairline pale, fragile, split ends. Spoon-shaped marigolds (koilonychia) indicate neglected anemia. Trophic lesions of the mucous layers are formed: cracks in the corners of the mouth (inflammation), inflammation, dysphagia, disease.

Perversion of taste, instinct. Geophagy and pagophagia often appear.

The blue tone of the sclera, associated with dystrophic transformations of the cornea, can be seen in almost 90% of patients.

Muscle deficiency due to myoglobin deficiency. When this symptom appears, the activity of the sphincters is disrupted and incontinence is formed. Myocardial disease can cause prolonged heart failure.

Typical tooth decay: caries, enamel pathologies.

What it is?

When a person’s blood plasma, after obvious blood loss, is diagnosed with a lack of elements containing iron, then they speak of posthemorrhagic anemia. Another name for it, more precisely general concept, this is anemia - a decrease in the amount of hemoglobin in the blood not related to its loss.

Posthemorrhagic deficiency of iron-containing blood elements can be acute and chronic. If the patient suffers from frequent bleeding, even in a small amount, this is a chronic form of anemia. If the loss of blood occurred suddenly and in considerable volume, we're talking about about acute anemia. Minimum quantity blood loss for adults that poses a threat to life is considered to be 500 ml.

Severity of anemia after blood loss

In total, there are four degrees of blood loss - light, moderate, severe and massive, let's consider the two most significant of them.

Lightweight

Treatment of a timely identified disease is not particularly difficult. It is often enough to resort to taking medications that will replenish the iron deficiency in the body and the patient will recover. As a rule, a course of therapy is required, which will take at least three months. The patient may be temporarily hospitalized.

Heavy

If severe anemia develops, the victim from loss of a large volume of blood is immediately placed in a hospital medical institution. To remove the patient from a dangerous condition, the following measures are taken:

• stopping bleeding;
• replenishment of blood loss by any means;
• transfusion artificial substitute plasma in a volume of at least 500 milliliters;
• measures to raise and stabilize blood pressure.

Kinds

Acute posthemorrhagic anemia

With large blood loss, usually with damage to the main arteries, or during surgery, when the patient loses about 1/8 of the total blood volume, posthemorrhagic anemia develops acute form, which in turn has several stages.

• In the reflex-vascular stage, the arterial pressure of the mucous membranes drops sharply, and skin turn pale, tachycardia occurs. Peripheral vessels spasm due to lack of oxygen supplied to internal organs. The body, independently trying to prevent pressure from decreasing to critical values, involves the mechanisms of plasma removal from the organs and compensatory return of blood to the heart.
• The patient may remain in the hydremic compensatory stage for several days. Approximately five hours after blood loss, the basis will be created for the flow of interstitial fluid into the blood vessels. When irritated, the necessary receptors begin to be involved in maintaining the volume of fluid that circulates through the vessels. Aldosterone is intensively synthesized, preventing sodium from being removed from the body, which in turn retains water. But at the same time, plasma dilution occurs, which leads to a decrease in the level of hemoglobin and red blood cells.
• Acute posthemorrhagic anemia passes into the bone marrow stage approximately five days after the onset of bleeding. Progression of hypoxia is observed. Erythropoietin levels become higher. The formation of red blood cells increases, but hemoglobin levels are reduced. This stage is characterized as hypochromic, due to a sharp deficiency of iron in the blood.

Chronic posthemorrhagic anemia

This type of posthemorrhagic anemia, after emergency assistance the patient to restore the full volume of blood plasma and eliminate iron deficiency requires treatment of the disease that caused the development of chronic blood loss.

Signs of anemia after bleeding

After blood loss, the development of anemia is manifested by the following symptoms:

• When the blood loss is large, the victim necessarily experiences shortness of breath, the heart rate increases, and a sharp drop in pressure is observed;
• The skin/mucous membranes turn pale;
• The patient complains of dizziness. There is a noise in his ears and darkness in his eyes;
• Vomiting often occurs;
• Sudden feeling of dryness in oral cavity indicates the development of internal bleeding;
• When there is bleeding in the digestive organs, a sharp rise in body temperature and signs of intoxication are observed;
• One of the signs of internal bleeding will be the patient reporting a feeling of compression of the internal organs;
• The stool turns black.

Cause of posthemorrhagic anemia

Posthemorrhagic anemia can develop due to blood loss in the following cases:

• in case of injury with damage to an artery or other blood vessels;
• when suffering from pulmonary ailments, when the patient coughs and produces blood;
• as a result of the operation;
• with the onset heavy bleeding in a woman due to an ectopic pregnancy;
• at peptic ulcer in the digestive tract, when internal bleeding develops;
• when hemostasis is impaired.

Diagnosis based on blood test

First of all, when a bleeding victim is admitted to the hospital, it is necessary to conduct a blood test in the form of a detailed analysis, which will help to correctly diagnose the degree of anemia and assess the patient’s condition. To do this, define:

• platelet count;
• hemoglobin and red blood cell levels;
• the presence of neutrophilic leukocytosis;
• determination of the increase in the number of reticulocytes;
• plasma iron level.

Blood tests are necessary throughout the patient’s recovery period. Depending on the form of anemia, the duration of rehabilitation varies.

Treatment

After rendering urgent help When the bleeding has stopped, the victim needs treatment in the inpatient department of a medical institution.

To replenish the patient's blood volume, in the event of a sharp drop in pressure, it is necessary to transfuse a blood substitute ( jet injection). When the blood pressure can be raised to 100 to 60, the transfusion can be switched to drip mode.

If the patient is in a state of shock, it may be necessary to administer humidified oxygen, an intravenous catheter for infusion of blood substitutes, and a number of medications.

In some cases, when the volume of blood loss is more than one liter, donor blood transfusions are required, however, this measure is contraindicated when the amount of blood lost is smaller - it is fraught with complications in the form of an immune conflict or the development of intravascular coagulation syndrome.

Posthemorrhagic anemia chronic type provides ambulatory treatment in cases where there are no exacerbations of the underlying disease or there is none at all. It is possible to prescribe surgery after the cause of bleeding has been established.

When treating anemia, it is impossible to do without immunostimulants and complex vitamin preparations, in order to support immune system a patient who is particularly vulnerable to infection by pathogens during the recovery period.

Features of the treatment of posthemorrhagic anemia

In children

In order to reduce chronic blood loss in young patients, prevention of nosebleeds is necessary. For girls in adolescence you need to ensure that the menstrual cycle is correctly formed.

If there is anemia in infants, it is necessary to check the health status of their mother. Perhaps treatment will need to start with her.

Iron supplements are available in a pediatric form. As a rule, they are dosed taking into account the baby’s body weight.

Children are usually prescribed oral medications. In the form of injections, children receive treatment in a hospital setting, when there are any contraindications.

The duration of therapy for children is determined according to the severity of anemia:

• light – two months;
• average – up to four months;
• in case of severe disease, treatment lasts at least five months.

In older people

It is very difficult to treat anemia in older patients, due to:

• symptoms of anemia are often disguised as various diseases chronic;
• in many cases, anemia in an elderly patient can be combined with infectious diseases of an acute/chronic nature;
• neoplasms can be identified whose condition is very advanced;
• a combination of reasons for the development of anemia;
• risk of drug overdose.

For the sick old age important:

• organize a balanced diet;
• carry out individual dosing of medications and prescribe optimal minimum doses;
• diagnose and treat inflammatory diseases and tumors.

Prevention

Preventive measures for the occurrence of anemia after blood loss come down to caution and healthy image life. Necessary:

• monitor your health and promptly treat diseases;
• to refuse from bad habits;
• avoid injury;
• eat well.