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本文作者对疟原虫感染导致的严重贫血(严重疟疾性贫血)的治疗方案从生理学的角度进行了讨论。严重疟疾性贫血者指一血片中查到疟原虫,二是血红蛋白(Hb)等于或小于5g/dl。临床表现为由贫血所引起的心力衰竭的体征和症状。目前治疗一般用利尿剂、地高辛以及用缓慢输血来纠正贫血。但在临床实践中,有的病人因输血导致充血性肺水肿,在孕妇患者中输血出现高死亡率。为此,作者认为,对严重疟疾性贫血的病理生理及其临床急救处理应进行重新评估,以寻找更好的治疗方案。
The authors discussed the treatment of severe anemia (severe malaria anemia) caused by Plasmodium infection from a physiological point of view. Severe malaria anemia refers to a blood film found in malaria parasites, the second hemoglobin (Hb) is equal to or less than 5g / dl. Clinical manifestations of anemia caused by signs and symptoms of heart failure. Current treatments generally use diuretics, digoxin and slow blood transfusion to correct anemia. However, in clinical practice, some patients due to blood transfusion caused congestive pulmonary edema, high blood transfusion mortality in pregnant women. To this end, the author believes that the pathophysiology of severe malarial anemia and its clinical emergency treatment should be re-evaluated in order to find a better treatment.