改良阶段性补铁方案治疗婴幼儿营养性缺铁性贫血的疗效观察  

Clinical application of modifying iron phase-supplement treatment for nutritional iron-deficiency anemia in infants

作　　者：陆美华[1] 顾梅青[1] 钱建青 凌万里 周剑峰[1] LU Meihua;GU Meiqing;QIAN Jianqing;LING Wanli;ZHOU Jianfeng(Department of Pediatrics,Changshu Traditional Chinese Medicine Hospital,Changshu 215500,China)

机构地区：[1]常熟市中医院儿科,江苏常熟215500

出　　处：《中国中西医结合儿科学》2017年第6期501-504,共4页Chinese Pediatrics of Integrated Traditional and Western Medicine

摘　　要：目的探讨改良阶段性补铁方案治疗婴幼儿营养性缺铁性贫血的临床疗效。方法 2000年2月至2001年10月常熟市中医院儿科收治中重度缺铁性贫血患儿34例,为对照组。2005年6月至2013年6月常熟市中医院儿科收治中重度缺铁性贫血患儿169例为观察组。两组均口服速力菲薄膜衣片。观察组:第一阶段:血红蛋白<90g/L,以3～4mg/(kg·d),分两次口服;第二阶段:血红蛋白90～110g/L,以3～4mg/(kg·周),每周一次口服,至红细胞分布宽度<14.6%。对照组:第一阶段:血红蛋白<90g/L,以5mg/(kg·d),分两次口服;第二阶段:血红蛋白90～110g/L,以3～4mg/(kg·d),分两次口服;第三阶段:血红蛋白≥110g/L,以3mg/次,2d1次,服至红细胞分布宽度<14.6%。观察组:治疗第1周查血常规和网织红细胞;以后血红蛋白<90g/L每周查一次血常规;血红蛋白90～110g/L每2周查一次血常规;血红蛋白≥110g/L每4周查一次血常规至红细胞分布宽度<14.6%。对照组:治疗第1周查血常规和网织红细胞,以后每2周查一次血常规。观察第二阶段两组治疗红细胞相关参数达指标时间及不良反应。结果两组患儿治疗后血红蛋白、红细胞平均体积、红细胞分布宽度值达标时间比较差异均无统计学意义(P>0.05)。观察组与对照组治疗第1周食欲均明显改善,服药后3～5d大便出现黑色。观察组第一阶段17例有恶心现象,第二阶段时无恶心腹痛和食欲下降情况出现。对照组8例出现腹痛、恶心呕吐反应。结论改良方案可达到了原方案的临床治疗效果,不良反应少,提高家长依从性,且医师对改良方案更易掌握和使用,便于临床推广。Objective To study the clinical effect of modifying iron phase supplement treatment for infants with nutritional iron deficiency anemia.Methods A total of34children with moderate severe iron deficiency anemia were chosen as the control group,who were treated in Changshu TCM Hospital from Feb.2000to Oct.2001.A total of169children with moderate severe iron deficiency anemia were included as the observation group,who were treated from June2005to June2013.In the observation group,ferrous succinate tablet at34mg/(kg·d)(divided into two times)for those children with hemoglobin under90g/L.at the first phase,and at the second phase,ferrous succinate tablet was given at34mg/(kg·week)for those with hemoglobin between90g/L and110g/L,once a week,until the RDW was less than14.6%.In the control group,ferrous succinate tablet was taken at5mg/(kg·d)(divided into two times)for those with hemoglobin under90g/L at the first phase,and at second phase,ferrous succinate tablet was given at34mg/(kg·d)(divided into two times)for those with hemoglobin between90g/L and110g/L;at the third phase,ferrous succinate tablet was taken at3mg/a time,two time a day,for those with hemoglobin over110g/L,until the RDW was under14.6%.In the observation group,blood routine and reticulocytes were examined in the first week of treatment;after that,blood routine examination was performed once a week for those with hemoglobin under90g/L,once in two weeks for those between90g/L and110g/L,and once in four weeks for those over110g/L until the RDW was under14.6%.In the control group,blood routine and reticulocytes were examined in the first week of treatment,and after that blood routine examination was performed once in two weeks.The time of RBC related parameters reaching the standard and the adverse reactions in both groups at the second phase were observed.Results There was no statistical difference in hemoglobin or the time of MCV and RDW reaching standard between the two groups after treatment(P>0.05).The appetite was obviously improved in the first we

关 键 词：缺铁性贫血 元素铁 阶段性 婴幼儿 

分 类 号：R725.5[医药卫生—儿科]