Penyakit anemia: Perbezaan antara semakan

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Nik aziz (bincang | sumb.)
Nik aziz (bincang | sumb.)
Baris 79:
 
==Rawatan bagi anemia==
Terdapat banyak jenis rawatan bagi anemia dan jenis rawatan bergantung kepada terukketerukan dan punca anemia.
 
Kekurangan zat besi akibat kekurangan makanan amat jarang bagi dewasa tidak haidberhaid (lelaki dan wanita putus haid). Diagnosis kekurangan zat besi menyatakan pencarian bagi potensi punca kehilangan sebegitu seperti pendarahanperdarahan perut (''gastrointestinal'') akibat ulcerulser atau barah kolon. Anemia kekurangan zat besi ringan hingga serdahana dirawat dengan tambahan zat besi menggunakan [[Iron(II) sulfat|ferous sulfat]] atau ferrous gluconate. [[Vitamin C]] mungkin membantu keupayaan tubuh bagi menyerap zat besi.
 
Vitamin tambahan diberikan secara oral ([[asid folik]]) atau suntikan ([[Cyanocobalamin|vitamin B-12]]) akan menggantikan kekurangan khusus.
 
Bagi penyakit anemia kronik, anemia dikaitkan dengan kimoterapikemoterapi (''chemotherapy''), atau anemia dikaitkan dengan penyakit ginjal, sesetengah pakar klinikal prescribe [[recombinant protein|recombinant](protein rekombinan)] [[erythropoietin](eritropoietin)], [[epoetin alfa]], bagi menggalakkan penghasilan sel darah merah.
 
Bagi kes anemia teruk, atau dengan kehilangan darah berterusan, pemindahan darah mungkin diperlukan.
 
===Pemindahan darah kerana anemia===
Secara umum, doktor cuba mengelakkan [[pemindahan darah]] kerana, bukti berlainan menunjukkan peningkatan hasil pesakit bertambah teruk dengan strategi pemindahan yang semakin meningkat. Prinsip physiologifisiologi yang mengurangkan pengaliran oksigen dikaitkan dengan anemia mendorong kepada hasil klinikal teruk diimbangi dengan jumpaantemuan bahawa pemindahan darah tidak semestinya mengurangkan hasil klinikal adversemudarat ini.
 
Bagi pendarahanperdarahan akut, dan teruk, pemindahan darah sering kali menyelamatkan nyawa. Peningkatan dalam daya hidup tercedera di medan perang, sekurang-kurangnya sebahagian darinyadaripadanya, bergantung kepada peningkatan dalam teknik pemindahan darah dan bank darah.
 
TransfusionTransfusi of the stable but anemic hospitalized patient has been the subject of numerous [[clinical trials](ujikaji klinikal)], and transfusion is emerging as a deleterious intervention.
 
Four randomized controlled clinical trials (ujikaji klinikal rambang berkawal)have been conducted to evaluate aggressive versus conservative transfusion strategies (strategi transfusi konservatif)in critically ill patients (pesakit tenat kritikal). All four of these studies failed to find a benefit with more aggressive transfusion strategies. <ref name="pmid9971864">{{cite journal |author=Hébert PC, Wells G, Blajchman MA, ''et al'' |title=A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care (jagaan kritikal). Transfusion Requirements in Critical Care Investigators, Canadian Critical Care Trials Group |journal=N. Engl. J. Med. |volume=340 |issue=6 |pages=409–17 |year=1999 |pmid=9971864 |doi=}}</ref>
<ref name="pmid9293831">{{cite journal |author=Bush RL, Pevec WC, Holcroft JW |title=A prospective, randomized trial limiting perioperative red blood cell transfusions (perioperatif)in vascular patients |journal=Am. J. Surg. |volume=174 |issue=2 |pages=143–8 |year=1997 |pmid=9293831| doi = 10.1016/S0002-9610(97)00073-1}}</ref>
<ref name="pmid10532600">{{cite journal |author=Bracey AW, Radovancevic R, Riggs SA, ''et al'' |title=Lowering the hemoglobin threshold (ambang)for transfusion in coronary artery bypass procedures(prosedur pintas arteri koronari): effect on patient outcome (nasib pesakit)|journal=Transfusion |volume=39 |issue=10 |pages=1070–7 |year=1999 |pmid=10532600| doi = 10.1046/j.1537-2995.1999.39101070.x}}</ref>
<ref name="pmid16960287">{{cite journal |author=McIntyre LA, Fergusson DA, Hutchison JS, ''et al'' |title=Effect of a liberal versus restrictive transfusion strategy on mortality in patients with moderate to severe head injury |journal=Neurocritical care |volume=5 |issue=1 |pages=4–9 |year=2006 |pmid=16960287| doi = 10.1385/NCC:5:1:4}}</ref>
 
In addition, at least two retrospective studies (kajian retrospektif)have shown increases in adverse clinical outcomes (nasib mudarat klinikal)with more aggressive transfusion strategies.
<ref name="pmid14707558">{{cite journal |author=Corwin HL, Gettinger A, Pearl RG, ''et al'' |title=The CRIT Study: Anemia and blood transfusion in the critically ill--current clinical practice in the United States |journal=Crit. Care Med. |volume=32 |issue=1 |pages=39–52 |year=2004 |pmid=14707558 |doi=10.1097/01.CCM.0000104112.34142.79}}</ref>
<ref name="pmid12243637">{{cite journal |author=Vincent JL, Baron JF, Reinhart K, ''et al'' |title=Anemia and blood transfusion in critically ill patients |journal=JAMA |volume=288 |issue=12 |pages=1499–507 |year=2002 |pmid=12243637| doi = 10.1001/jama.288.12.1499}}</ref>
 
===Hyperbaric Oxygenation (HBO)===
Treatment of exceptional blood loss (anemia)(kehilangan darah luarbiasa) is recognized as an indication for [[hyperbaric oxygen](oksigen hiperbarik)] (HBO) by the [[Undersea and Hyperbaric Medical Society]].<ref name=uhms>{{cite web |url=http://www.uhms.org/ResourceLibrary/Indications/ExceptionalBloodLossAnemia/tabid/277/Default.aspx |title=Exceptional Blood Loss - Anemia |author=Undersea and Hyperbaric Medical Society |accessdate=2008-05-19 }}</ref><ref>{{cite journal |author=Hart GB, Lennon PA, Strauss MB. |title=Hyperbaric oxygen in exceptional acute blood-loss anemia |journal=J. Hyperbaric Med |volume=2 |issue=4 |pages=205–210 |year=1987 |url=http://archive.rubicon-foundation.org/4352 |accessdate=2008-05-19 }}</ref> The use of HBO is indicated when [[oxygen]] delivery to tissue is not sufficient in patients who cannot be [[Blood transfusion|transfused]] for [[medical]] or [[religious]] reasons. HBO may be used for medical reasons when threat of [[blood product]] incompatibility (ketakserasian)or concern for [[Transmission (medicine)|transmissible disease]] are factors.<ref name=uhms/> The beliefs of some religions (ex: [[Jehovah's Witnesses and blood transfusions|Jehovah's Witnesses]]) may prohibit the receipt of transfused blood products.<ref name=uhms/>
 
In 2002, Van Meter reviewed the [[Medical journal|publications]] surrounding the use of HBO in severe anemia and found that all publications report a positive result.<ref>{{cite journal |author=Van Meter KW |title=A systematic review of the application of hyperbaric oxygen in the treatment of severe anemia: an evidence-based approach |journal=Undersea Hyperb Med |volume=32 |issue=1 |pages=61–83 |year=2005 |pmid=15796315 |url=http://archive.rubicon-foundation.org/4038 |accessdate=2008-05-19}}</ref>