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胃手术后贫血分两类:一、缺铁性小细胞低色素性贫血:二、缺乏维生素B_(12)和/或叶酸的巨幼细胞性贫血。缺铁性贫血较常见,但两种类型可同时存在。(一)缺铁性贫血:部分胃切除后缺铁性贫血发病率为33—50%,主要由于铁吸收不良,其机理为:1.胃术后胃酸缺乏。胃酸可将食物中铁游离化,只有游离铁才能被吸收。胃酸又能将高铁变为易吸收的低铁;2.肠道吸收铁的能力以十二指肠为最强(约承担50%铁的吸收),肠道下部铁的吸收少。胃切除术后的缺铁性贫血见多于迷走神经切除加引流术,毕氏Ⅱ式吻合(胃空肠吻合)术的病人。
Anemia after gastric surgery divided into two categories: First, iron deficiency microcytic hypochromic anemia: Second, the lack of vitamin B 12 and / or folic acid megaloblastic anemia. Iron deficiency anemia is more common, but both types can coexist. (A) iron deficiency anemia: partial gastrectomy after iron deficiency anemia incidence of 33-50%, mainly due to iron malabsorption, the mechanism is: 1. Gastric acid deficiency. Stomach acid can iron free food, only free iron can be absorbed. Gastric acid and high iron can become easily absorbed low iron; 2 intestine to absorb iron capacity to the duodenum strongest (about 50% absorption of iron), intestinal absorption of iron less. Iron deficiency anemia after gastrectomy see more than vagotomy and drainage surgery, Pittsburgh-style anastomosis (gastrojejunostomy) patients.