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  • HHI CHI CHNG THIEU MAU NG THIEU MAU TRTR EMEM

    11

    PGS.TS. PGS.TS. TrTrnn ThTh MMngng HiHippBoBo MonMon NhiNhi TrTrngng HYK PNTHYK PNT

    Ng.TrngNg.Trng khoakhoa ThnThn--MuMu--NiNi TitTit BV BV NhiNhi ngng 22GiaoGiao ss caccac TrngTrng aiai HocHoc Y Y KhoaKhoa PhapPhap

  • MUC TIEUMUC TIEU

    1. 1. nhnh nghangha c c thiuthiu mumu2. 2. TrnhTrnh byby cccc trtr ss bnhbnh ththngng caca HbHb, MCV , MCV vv

    hnghng cucu lli i trtr emem

    22

    hnghng cucu lli i trtr emem33. . LitLit kk c c cccc TCLS TCLS vv CLS CLS caca thiuthiu mumu4. 4. PhnPhn loiloi thiuthiu mumu dada vovo thth tchtch trungtrung bnhbnh

    hnghng cucu vv dada vaovao sinhsinh lyly benhbenh hochoc

  • I. NH NGHA:I. NH NGHA:

    3 3 trtr soso ccnn lulu yy: : SoSo lnglng HC, HC, TT lele HbHb, DTHC (, DTHC (HctHct)) ThieuThieu maumau: : kkhonghong do do giamgiam soso lnglng HC HC mama lala giamgiam

    33

    ThieuThieu maumau: : kkhonghong do do giamgiam soso lnglng HC HC mama lala giamgiamlnglng oxy do HC oxy do HC chuyenchuyen chch

    nhnh nghangha thieuthieu maumau: : giamgiam lnglng huyethuyet sacsac toto ((HbHb) < ) < --22LC so LC so vvii trungtrung bnhbnh theotheo tutuii..

    CacCac trtr soso bnhbnh ththngng cuacua HbHb, MCV, HC , MCV, HC lili tretre ememnhnh sausau::

  • TuoiTuoiHb TB Hb TB --2 2 LCLC(g/dL)(g/dL)

    MCV MCV (fL)(fL)

    HC lHC lii(10(1033/mm/mm33))

    S sinhS sinh 16,516,513,513,5

    90 90 --120120 200200--400400

    3 3 -- 6 thang6 thang 11,5 11,5 9,59,5

    72 72 -- 8282 4040--8080

    6 thang 6 thang -- 2 tuoi2 tuoi 12,512,510,510,5

    75 75 -- 8585 4040--8080

    44

    10,510,5

    2 2 -- 6 tuoi6 tuoi 12,512,511,511,5

    78 78 -- 8888 4040--8080

    6 6 -- 12 tuoi12 tuoi 13,513,511,511,5

    80 80 -- 9090 4040--8080

    12 12 --18 tu18 tui (trai)i (trai) 14,514,513,513,5

    8888 4040--8080

    12 12 -- 18 tui (gi)18 tui (gi) 14141212

    9090 4040--8080

  • PhanPhan bietbiet::

    ThieuThieu maumau coco apap ngng tuytuy: :

    do do huyethuyet tantan, , chaychay maumau

    ThieuThieu maumau khongkhong apap ngng tuytuy: : giamgiam sansan xuatxuat HCHC

    55

    ThieuThieu maumau khongkhong apap ngng tuytuy: : giamgiam sansan xuatxuat HCHC

    oo lnglng HC HC lili ((btbt: 40.000 : 40.000 80.000/mm80.000/mm33))

  • II. II. LmLm sngsngII.1. II.1. HiHi bnhbnh TuiTui, , giigii ((thiuthiu G6PD: G6PD: trtr traitrai, di , di truyntruyn trntrn NST NST giigii tnhtnh), ), dndn tctc ((BnhBnh HbHb)) TinTin ccn n giagia nhnh: : mm sinhsinh dydy, , sinhsinh i...=> i...=> thiuthiu stst TinTin ccn n bnbn thnthn: : thiuthiu thngthng => => thiuthiu stst ChCh n: n: thiuthiu stst, , bb mm koko didi...... RL RL tiutiu haha: : . . tiutiu chychy koko didi, , kmkm hphp thuthu . . vimvim thcthc qunqun, , trotro ngngcc XutXut huythuyt: : chychy mumu mimi titi phtpht, , rongrong kinhkinh...... DngDng thucthuc: : gygy suysuy tyty, , tntn huythuyt (rifampicine)(rifampicine) 66

  • 1. 1. ThieuThieu maumau capcap:: Do Do giamgiam Oxy Oxy vava khoikhoi lnglng tuantuan hoanhoan DaDa niemniem xanhxanh ++++++ MMetet moimoi, , suysuy nhcnhc, , chongchong matmat, , nhcnhc auau, ,

    II. II. LmLm sngsngII.2. II.2. TrieuTrieu chngchng lamlam sangsang

    77

    MMetet moimoi, , suysuy nhcnhc, , chongchong matmat, , nhcnhc auau, , hoahoa matmat

    KchKch thchthch hoachoac ll mm TruyTruy timtim machmach => => keokeo daidai => => khongkhong hoihoi phucphuc

  • 2. 2. ThieuThieu maumau manman::2.1. 2.1. DaDa , , longlong, , toctoc, , mongmong vava niemniem macmac::

    . . DaDa xanhxanh, , niemniem nhtnht

    . . MongMong: : matmat veve ongong aa. . LongLong thatha, , rungrung toctoc

    2.2. 2.2. TuanTuan hoanhoan::. . NhpNhp timtim tangtang nhanhnhanh do oxy do oxy enen momo vava tete baobao giamgiamTuyTuy nhiennhien, , nhunhu caucau oxy oxy cuacua momo vava tete baobao khongkhong giamgiam=> => timtim lamlam viecviec nhieunhieu hnhn

    88

    => => timtim lamlam viecviec nhieunhieu hnhn

    . HA . HA thapthap, , ATTThuATTThu cc nangnang matmat sausau ieuieu trtr

    . . ThieuThieu maumau keokeo daidai, , nangnang: : thatthat (T) to, (T) to, suysuy timtim (T), (T), suysuy timtim toantoan bobo

    2.32.3. . HoHo haphap: : TangTang nhpnhp thth. . ThTh nongnong, , nhanhnhanh..

    2.4. 2.4. ThanThan kinhkinh: : thieuthieu oxy oxy naonao => => chongchong matmat, , nhcnhc auau, , ll , , buonbuon ngungu ... ...

  • LngLng bnbn taytay nhtnht, , mngmng khkh, , mtmt vv ngng

    99

  • NimNim mcmc mtmt nhtnht

    1010

  • TmTm cccc dudu hiuhiu ii kmkm:: StSt XutXut huythuyt ((chch xutxut huythuyt timtim nn)) HiHi chngchng huythuyt tntn: : vngvng dada, , ncnc tiutiu smsm, , gangan lchlch toto GanGan lchlch (( hchhch) to: ) to: bnhbnh mumu cc tnhtnh GanGan lchlch (( hchhch) to: ) to: bnhbnh mumu cc tnhtnhNgheNghe: : cc mm thithi tmtm thuthu cc nngnng do do thiuthiu mumu ??

    1111c bit tr nh nhi: b t, chm tng trng

  • NuNu cc dudu hiuhiu nngnng => => chuynchuyn cpcp cucuDu hiu nngDu hiu nngTng trng suy spTng trng suy sp

    HH hphp: : . . tngtng nhpnhp thth. . thth nhanhnhanh, , nngnng

    Tim mch:Tim mch:. nhp tim nhanh. nhp tim nhanh. h huyt p. h huyt p. sc, try mch. sc, try mch. suy tim. suy tim

    ThnThn kinhkinh::. . riri lonlon tri tri gicgic. . riri lonlon hnhhnh vivi. . gimgim trngtrng lclc cc ((nhnh nhinhi)). . hnhn mm

    1212

  • III. III. TrieuTrieu chngchng sinhsinh hochoc nghngh xtxt nghimnghimHuytHuyt . . HbHb. . TheThe tchtch trungtrung bnhbnh HC HC . . HngHng cucu lili

    TyTy trngtrng hphp: : . . NhmNhm mumu. . BilirubineBilirubine. . UrUr, , creatininecreatinine. . HngHng cucu lili

    HnhHnh dangdang tete baobao trentrenlamlam

    . . UrUr, , creatininecreatinine

    . . NuNu cc stst: CRP, : CRP, cycy mumu, , phtpht mumu tmtm KST SRKST SR

    . . HuytHuyt tntn: : hnhhnh dngdng HC, HC, test de Coombs, test de Coombs, inin didi HbHb, , G6PDG6PD

    . . StSt huythuyt thanhthanh, , FerritineFerritine1313

  • III. III. TrieuTrieu chngchng sinhsinh hochoc

    NuNu huythuyt cc tngtng BC, BC, gimgim hnghng cucu vv tiutiucucu vv cc tt bobo non non mumu ngoingoi vi: vi: chuynchuyn bnhbnh nhnnhn thngthng nn nhngnhng nni i cc khkh nnngngiuiu trtr bnhbnh mumu cc tnhtnh..iuiu trtr bnhbnh mumu cc tnhtnh..

    CanCan lulu yy khikhi ococ ketket quaqua huyethuyet oo: : chch chnhchnh xacxac khikhi maumau maumau cc laylay-- trctrc truyentruyen maumau, , -- hoachoac 3 3 thangthang sausau khikhi truyentruyen maumau(do (do coco thethe lala ketket quaqua cuacua maumau cuacua ngingi chocho))

    1414

  • IV. IV. XepXep loailoai thieuthieu maumau1. 1. DaDa vaovao thethe tchtch trungtrung bnhbnh honghong caucau::

    1.1. 1.1. ThieuThieu maumau honghong caucau nhonho::

    -- ThieuThieu satsat, SDD, SDD

    1515

    -- ThieuThieu satsat, SDD, SDD-- NgoNgo ococ chch, INH, Ethanol ... , INH, Ethanol ... -- ThalassemiaThalassemia-- TnhTnh trangtrang viemviem

    -- MotMot soso dangdang thieuthieu maumau huyethuyet tantan bambam sinhsinh..

  • 11..22. . ThieuThieu maumau honghong caucau to to hohocc bibinhnh ththngng::-- ThieuThieu Vitamin BVitamin B1212

    IV. Xep loai thieu mau1. Da vao the tch trung bnh hong cau:

    1616

    -- ThieuThieu acid folicacid folic-- HoiHoi chngchng BlackfanBlackfan DiamondDiamond-- SuySuy giapgiap-- BenhBenh veve gangan-- XamXam lanlan tuytuy

  • 1.3. 1.3. ThieuThieu maumau honghong caucau thethe tchtch bnhbnh thngthng::-- ThieuThieu maumau huyethuyet tantan: :

    BatBat thngthng men men honghong caucau

    IV. Xep loai thieu mau1. Da vao the tch trung bnh hong cau:

    1717

    BatBat thngthng men men honghong caucau BatBat thngthng mangmang honghong caucau ThieuThieu maumau huyethuyet tantan macmac phaiphai

    -- ThieuThieu maumau do do matmat maumau-- ThieuThieu maumau do do suysuy thanthan-- ThieuThieu maumau do do benhbenh maumau acac tnhtnh..

  • 2.1. 2.1. RoiRoi loanloan trongtrong ss tangtang sinhsinh vava phanphan hoahoa tete baobao maumau gocgoc::-- SuySuy tuytuy bambam sinhsinh hay hay macmac phaiphai-- SuySuy giamgiam motmot dongdong honghong caucau

    BamBam sinhsinh: : BlackfanBlackfan DiamondDiamond

    IV. Xep loai thieu mau2. Da vao sinh ly benh hoc:

    1818

    BamBam sinhsinh: : BlackfanBlackfan DiamondDiamond MacMac phaiphai: : thoangthoang qua qua sausau nhiemnhiem sieusieu vivi

    -- XamXam lanlan tuytuy: : benhbenh maumau acac tnhtnh-- GiamGiam sansan xuatxuat Erythropoietin:Erythropoietin:

    suysuy thanthan SDD SDD viemviem mmnn noinoi tiettiet

  • 2.2. 2.2. RoiRoi loanloan trongtrong ss hoanhoan chnhchnh chcchc nangnang taotao HC:HC: ThieuThieu satsat ThieuThieu VitVit. B12, acid folic, thiamine. B12, acid folic, thiamine NgoNgo ococ chch

    IV. Xep loai thieu mau2. Da vao sinh ly benh hoc:

    1919

    NgoNgo ococ chch ThalassemiaThalassemia ((HbHb F F tangtang))2.3. 2.3. ThieuThieu maumau huyethuyet tantan:: NguyenNguyen nhannhan bambam sinhsinh: :

    BatBat thngthng HbHb, , mangmang HC, menHC, men NguyenNguyen nhannhan macmac phaiphai::

    TT mienmien, , nhiemnhiem trungtrung

  • 2020MCV tng, HCL tng: stomatocytose (bnh di truyn, rt him)