anemii i politsitemiya novorojdennix

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pēdējā laikā gūtās atziņas... anemii i politsitemiya novorojdennix irena zaxare arterialnaya i kletochnaya oksigenatsiya svyazanniy s gemoglobinom- 97-98% kisloroda svyazan s gemoglobinom vozvratnoy svyazyu rastvoryonniy v plazme- 2-3% kisloroda naxoditsya v plazme v rastvoryonnom vide. etot kislorod opredelyaet velichinu partsialnogo davleniya i obespechivaet dvijushuyu silu nasishayushuyu gemoglobin kislorodom transportirovka kisloroda: neobxodimie usloviya dlya dostatochnogo obmena gazov normalnie pokazateli gb i otsk donoshennie novorojdennie gb-16,9(1,6)g/dl otsk-85 ml/kg nedonoshennie novorojdennie - gb-15,9(2,4)g/dl otsk-100ml/kg osobennost novorojdennix fgb - 60%-80% anemii gemorragicheskie- ostraya poterya krovi gemoliticheskie- prejdevremennoe razrushenie eritrotsitov gipoplasticheskie- uxudshenie eritropoeza fiziologicheskie- svyazannie s osobennostyu organizma novorojdennogo anemiya – ponijennaya kontsentratsiya gb ili er v krovi anemii dopustimie kolebaniya pokazateley gemoglobina gb 10 g/dl, donoshennim novorojdennim gb 8 g/dl, v vozraste 4 – 6 ned.s vesom 1000-1500 gb 7 g/dl, s vesom chem 10% ob'yoma tsirkuliruyushey krovi >chem 5% ob'yoma tsirkuliruyushey krovi - detyam s dixatelnimi rasstroystvami, ivl gb chem 25%-50% ob'yoma tsirkuliruyushey …

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massi neobxodimiy ob'em zavisit ot velichini poter 5 – 10 ml/ kg dostatochno dlya podderjaniya normalnogo urovnya gb i obespecheniya dostavki kisloroda tkanyam prevosxodstvo er massi nad tselnoy krovyu v tom, chto neobxodim menshe ob'em umenshaetsya risk gipervolemii preparat otchishen ot plazmennix belkov i leykotsitov perelivanie doljno provoditsya medlenno, ne bolee chem 5 ml /kg /ch monitoring vo vremya transfuzii sostoyanie serdechnoy deyatelnosti dixatelnie rasstroystva temperatura diurez priznaki krovotecheniya, gemoliza otsenka klinicheskogo sostoyaniya i pokazateley kolichestva gb i er posttransfuzionnie reaktsii poyavlyayutsya pri kakoy libo nesovmestimosti mejdu krovyu donora i retsipienta ostrie immunnie - gemoliticheskie, febrilnie na antileykotsitarnie at, anafilakticheskie i allergicheskie reaktsii na plazmenniy belok neimmunnie – bakterialniy shok, gipervolemii,tsitratnaya intoksikatsiya, sindrom massivnogo perelivaniya pozdnie immunnie – gemoliticheskie, proyavlyayutsya tolko v tex sluchayax, kogda pered transfuziey uje bila sensibilizatsiya organizma neimmunnie – nekardiogenniy ottyok lyogkix v sluchae reaktsii na leykotsiti donora immunnoe sostoyanie posle tk er massa  izmeneniya …

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s tyajelimi problemami vsasivaniya jirov, biliarnimi atreziyami, tsisticheskim fibrozom i dr. - nedonoshennim novorojdennim na 2 mesyatse jizni lechenie - vite 25ed. kajdiy den defitsit jeleza jelezo yavlyaetsya vajnoy sostavnoy chastyu fermentov, kotorie uchastvuyut v kletochnom metabolizme i obespechivaet transport kisloroda i katalizatorov znachitelnix protsessov prichini defitsita - bistriy temp rosta i skudniy priyom s pishey - poterya krovi vo vremya rodov ili vnutriutrobno klinicheskie proyavleniya - ponijennaya kontsentratsiya gb iz za nedostatka jeleza - xarakternie izmeneniya formi i okraski er - gb 65% gt >22g/dl:

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pēdējā laikā gūtās atziņas... anemii i politsitemiya novorojdennix irena zaxare arterialnaya i kletochnaya oksigenatsiya svyazanniy s gemoglobinom- 97-98% kisloroda svyazan s gemoglobinom vozvratnoy svyazyu rastvoryonniy v plazme- 2-3% kisloroda naxoditsya v plazme v rastvoryonnom vide. etot kislorod opredelyaet velichinu partsialnogo davleniya i obespechivaet dvijushuyu silu nasishayushuyu gemoglobin kislorodom transportirovka kisloroda: neobxodimie usloviya dlya dostatochnogo obmena gazov normalnie pokazateli gb i otsk donoshennie novorojdennie gb-16,9(1,6)g/dl otsk-85 ml/kg nedonoshennie novorojdennie - gb-15,9(2,4)g/dl otsk-100ml/kg osobennost novorojdennix fgb - 60%-80% anemii gemorragicheskie- ostraya poterya krovi gemoliticheskie- prejdevremennoe razrushenie eritrotsitov gipoplastic...

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