Anemia can cause symptoms of the system which

Anemia can cause cardiovascular, nervous, digestive, reproductive and urinary system symptoms, as follows:

(1) cardiovascular system performance:

After physical activity are palpitations, shortness of breath, is the most common symptoms. Severe anemia or heart failure, even when the rest will also appear palpitations, shortness of breath. Have coronary artery disease patients can appear angina. Some patients with angina in peacetime, but because of anemia and increase the level of myocardial ischemia, angina may occur. Physical examination, in the bottom of my heart or apex areas often can hear the soft murmur of the medium-term contraction. Chronic anemia in patients with heart often expanded. To correct anemia, heart murmur and can be expanded disappeared. Anemia can be more serious when a “high output state.” “High-output state,” the clinical features are: jugular vein expansion, the pressure increased, peripheral vascular expansion for the performance of the fall of veins and capillaries pulse, skin warmth, can have Chaohong. Myocardial compensatory function insufficient, there can be congestive heart failure.

Common electrocardiogram ST-segment changes have decreased, T wave flattening or inversion, QRS wave mostly normal. When anemia be corrected, the change could resume normal electrocardiogram.

Patients with severe anemia, even in the absence of heart failure, get up at Yichang in the lower extremities appear mild swelling. Its causes may be related to activities at the veins and capillaries temporarily increased the pressure, penetrating the capillaries and increased sodium retention, and other factors.

(2) nervous system performance:

Severe anemia, nervous system symptoms also Most of the elderly patients in particular. Common symptoms are dizziness, headache, tinnitus, vertigo, now appear black spots or “risk of Venus”, Jingshenbuzhen, burnout sleepiness, attention focused not easy, unresponsive, tingling hands and feet, cold or flu Acupuncture And so on. Anemia can be a serious syncope. If a sharp anemia, patients often irritability.

(3) performance of the digestive system:

Loss of appetite is one of the most common symptoms. There can be abdominal distention, Xinwoweiwan discomfort, nausea, constipation. Sometimes the pain can be a tongue, smooth tongue fur. Severe anemia, enlargement of liver may be mild, particularly in heart failure and often tenderness.

(4) the reproductive system performance:

Female patients often have irregular menstruation and menopause the most common. Anemia often caused by menorrhagia, but occasionally can cause anemia menorrhagia. Patients with more severe anemia have decreased sexual desire.

(5) urinary system performance:

Patients with severe anemia may appear a small amount of protein in urine concentration reduce the function of mild, but in addition there have kidney disease, normally does not cause blood urea nitrogen increased. A large number of acute intravascular hemolysis, urine color or black tea may be a soy sauce-like color (Hemoglobinuria), if at the same time a cycle of failure, can occur oliguria, no urine and acute renal failure.

Anemia patients taking iron attention should be paid what

Taking iron, the first choice should pay attention to preparation. Three iron and organic iron absorption in the intestine is not easy, we must become free of the price of iron, were not absorbed. Existing agents in ferrous sulfate, ferrous carbonate, iron fumarate, ferrous gluconate is the price of. Ammonium citrate iron prices for the three iron to the reduction in the gastrointestinal tract, because it soluble in water, can match 10% solution, for taking the children, it applies to pediatric patients.

This was followed by administration of the dose and time should be sufficient. Patients with iron deficiency anemia, bleeding from the exclusion of factors, if the administration is not adequate, anemia caused by many years, but not completely correct. Reasonable usage is that each adult clothes ferrous sulfate 0.3 - 0.6 grams, three times a day, until the resumption of normal hemoglobin level, and then continue to take a small amount of iron (0.3 per day - 0.6 g) 3 - 6 Months, in order to restore the amount of iron. General iron absorption in the duodenum. When the body is not iron deficiency, iron absorption stop, too much iron from the gut from, the oral iron normally does not cause excessive intoxication. Injection will have to pay attention to when the iron content. Iron on the gastrointestinal tract are stimulating effect, and often cause nausea, vomiting, abdominal pain, should be taken after meals suitable. Serious reaction can be stopped serving a few days later, and then from a small amount, until the required dose. If this can not be tolerated, can switch to injections.

Acid and vitamin C can promote three for the price of iron reducing iron and is conducive to the absorption of iron, iron the clothes, often served with vitamin C, diluted hydrochloric acid. And Antacids, Nongcha decoction of Chinese medicine and can not be the same clothes and iron, can result in Antacids and acid; Nongcha and decoction of Chinese medicine contains tannic acid, iron and iron with a tannic acid precipitation, the impact of iron Absorption. In addition, iron and hydrogen sulfide enteral the combined iron sulfide, a decrease of hydrogen sulfide to stimulate the intestinal wall, so that peristalsis weakened. At the same time, iron sulfide on a convergence of the wall, cause constipation. Precipitation is a black iron sulfide, a black stool samples from patients, patients should be told in advance to avoid misunderstanding patients, causing unnecessary tension.

Digestive complications of chronic renal failure What?

Early symptoms of digestive system CRF is the clinical manifestations, and with the progress of the disease are becoming increasingly prominent. CRF, each of the parts have changed digestive tract. Oral: CRF patients with endocrine of the urease role in the saliva of urea, ammonia stimulate the oral mucosa, thus leading stomatitis, including non-ulcerative stomatitis and ulcerative stomatitis. Esophageal: CRF had systemic bleeding tendency, esophageal mucosa often diffuse bleeding esophageal mucosa can be formed esophageal ulcer-like pseudo diverticulum change can occur even in patients with uremia reflux esophagitis. Stomach and duodenum: stomach symptoms often very prominent, but also one of the earliest symptoms. Common gastritis and duodenitis, multiple ulcers, bleeding gastritis not uncommon. Intestinal: Most patients intestinal mucosa and submucosal edema and hemorrhage, and sometimes with ulcers and necrosis. Advanced disease often appear intractable diarrhea. Uremic patients with colonic disease can cause serious complications. Antacids treatment of the aluminum hydroxide can cause constipation fecal lead guitar, which occurred colonic obstruction, or even obstruction in the sigmoid colon, and other vulnerable sites have necrosis and ulceration and perforation. CRF with colon diverticulum perforation are not uncommon, and colon wall hemorrhage due to a bacterial infection and ulcers, mostly concentrated in the cecum and ascending colon and sigmoid colon, rectum, can cause bleeding. 

Cancer can be self-control

For patients with advanced cancer, the pain is the most common symptom. For advanced cancer, the World Health Organization (WHO) in 1986 formulated the “three analgesic ladder” of the principle of the Ministry of Health in the People’s Republic of China in 1993 was also officially promulgated the “cancer pain treatment ladder three guiding principles” Experts from the medical profession over the years also has been exploring the most effective way to eliminate pain. However, with the exception of mild to moderate pain can still effect, severe pain still lacks effective solutions.

In recent years, both at home and abroad in the treatment of pain using a new type of analgesic, that is, with patient-controlled analgesia (patientcontrolledanalgesia, or PCA). Initially mainly used for post-operative pain, has been widely used in advanced cancer and other intractable pain treatment in the past. Because many people do not understand or do not know of such treatment, making this new technology has not been able to serve the good of advanced cancer patients.

What is the PCA? PCA is the reservoir will be a special drug pump through a small pipe placed in the patients and pain relief drug to a specific PCA pump speed will continue to play a drug pumped into the body antinociceptive effect, in accordance with different degrees of pain can choose different pump speed . Above there is a pump-controlled button, and when the patient may feel pain when their push to inject doses.

What place? PCA pump two points: One is the microcomputer control pump (also known as electronic pumps), a high degree of automation, speed can be arbitrary regulation, easy-to-use, but the price is more expensive, more suitable for use in the hospital; the other is a one-time PCA Pump, a relatively fixed rate of drug injection, and lower prices for home use.

According to the site of pain, scope and extent of different drugs injected into the human body can be divided into three channels: epidural, intravenous and subcutaneous. Generally speaking, the following chest pain location and scope of patients relatively fixed for the epidural space (PCEA) injection; pain wide range of difficulties or epidural puncture, for the intravenous (PCIA) or subcutaneous (PCSA ) injection.

Pump similar to the size of a teacup, a peg above deduction can be linked to the waist, can be installed in the soliciting, on Chenbian can sleep at night. Not hospitalized patients can be placed in the hospital after home with regularly added to the drug pump can be unable to hospitals with serious illness can also be requested by a doctor to pain patients home placement.

What drugs? There are three categories of drugs: First, anesthetics, such as morphine, meperidine, fentanyl; Second, local anesthesia drugs, the main bupivacaine third is stable sedative drugs, commonly used midazolam droperidol or more.

Benefits: 1. Automatic delivery, without hospitalization, to participate in the general day-to-day activities. 2. Analgesic effect precise, patients can change their degree of pain additional medication. 3. Fewer complications and difficult addiction to sleep, diet and spiritual impact on the patients. 4. Lasted for a long time, the repeated injection to reduce the inconvenience caused. 5. Less medication, the whole low-cost. Common side effects are: ① nausea and vomiting, common at the beginning with, and gradually reduce. ② pruritus, facial and chest back to the heavy use of sedatives or antihistamines. ③ urinary retention, give abdominal massage or heat, if necessary, temporary catheterization. Four respiratory depression generally not obvious, serious give oxygen. ⑤ other, occasionally constipation, dizziness, lethargy, etc.. According to the quality and performance of pumps vary, generally speaking, including pumps and technology costs, about 600 to 800 yuan. 3 to 7 days plus a drug pump can be used on a 1 to 3 months. Larger than normal municipal hospitals can do such treatment should be to find doctors or narcotic pain by physicians.

Anesthetics used the following methods to curb undesirable Cancer Pain

Clinical Practice has proved that timely, timely use of analgesic drugs, it can not only received good analgesic effect, and the choice of low intensity analgesic drugs, the use of minimal dose. If severe pain when used analgesic drugs, the patient will suffer the pain of torture. If no long-term analgesic treatment, cancer patients prone to pain caused by neuropathic pain associated with the sympathetic nerve dysfunction, expressed as hyperalgesia and abnormal pain, and other intractable pain. Therefore, severe pain should not wait until the analgesic drug use.

Can be partially alleviated pain

Clinically, the patients with cancer pain for analgesic treatment is designed to eliminate pain and improve the quality of life of cancer patients. Let cancer patients in a state of pain does not sleep, analgesic therapy for cancer patients with the minimum standards. Ideal analgesic therapeutic purposes for cancer patients is not in a state of rest pain, activities, work. Must not be satisfied with the pain of cancer patients with partial remission, and the pursuit of pain must be completely eliminated.

Pethidine analgesic use the most effective and safe

Now do not advocate will pethidine analgesic for cancer treatment, WHO will also not pethidine as a treatment for cancer pain analgesic drugs. The reasons are: ① pethidine strength of the analgesic effect of morphine is only 1 / 10 to 1 / 8. ② pethidine morphine analgesia duration of only 1 / 2 to 2 / 3. ③ pethidine metabolites to a pethidine for the central nervous system and kidney toxic role of the long half-life of 3 to 18 hours. 4 pethidine oral bioavailability poor, in order to achieve the analgesic effect of oral dose should be increased at this time, the amount of pethidine to a doubling up. ⑤ pethidine as poor oral bioavailability, the use of intramuscular administration, and intramuscular injection itself will lead to pain. In short, it is not appropriate for long-term pain pethidine patients.

Opioids only to the use of advanced cancer patients with the greatest tolerance

Clinical Practice has proved that opioid analgesic drug dosage greater individual difference, a small number of cancer patients need high-dose analgesic treatment. Pharmacological experiments Tip: opioid analgesic effect without caps. As long as pain, we can increase the amount of opioids increase the analgesic effect of the treatment. For any severe pain patients, regardless of clinical stage cancer sooner or later, is expected duration of survival, as long as analgesic treatment needs should be the timely use of maximum tolerance of opioid analgesics, and not only about the death of advanced cancer patients with the greatest tolerance.

Opioids adverse reactions to disable

Clinical Practice has proved that the adverse reaction opioids, in addition to constipation, mostly temporary, but also can be tolerance. Therefore, an adverse reaction appeared to see the immediate cessation of the use of opioids undesirable practices.

Once the use of opioids can not be suspended

In medical practice, as long as the cause of pain in patients with cancer under control, and the pain is eliminated, could be out of opioid analgesics. When the morphine dosage of 30 to 60 mg, suddenly stopping generally not accidents. A large number of long-term treatment of patients will not stop gradually reducing accidents. Gradually reducing the withdrawal specific practices: in the first two days of the reduction 25% -50%, following every two days after the 25 per cent reduction, the amount of up to 30 ~ 60 mg when to stop. Gradual reduction in the process, there should be observed in patients with cancer pain symptoms. If a pain score greater than 4 and should be further reductions slow, too fast to avoid a withdrawal symptoms and pain withdrawal symptoms.

Opioids can not be used in patients with lung cancer

Practice has proved that opioids can be safe and effective for the treatment of pain in patients with lung cancer. That opioids can not be used in the treatment of patients with lung cancer pain is the source of opioids are respiratory depression side effects. In fact, the lung disease caused by breathing difficulties peripheral pulmonary lesions of the disease that is caused by opioids and respiratory depression caused by the respiratory center inhibition caused by the side effects. Opioids do not increase pulmonary disease. At the same time, opioids inhibit the respiratory center of the side effects occurred in only general drug overdoses or renal dysfunction caused when the drug accumulation.

What is pain?

Pain in patients with advanced cancer is a widespread problem. According to World Health Organization statistics, at present, the world of cancer patients in each of the approximately 700 million, of which 30% to 50% with varying degrees of pain. China’s recent survey shows that in general hospitals and specialist hospitals in various cancers in patients with varying degrees of pain, 51.1%. Pain is the most painful cancer patients, the most difficult one of the symptoms of tolerance, regardless of their doctors or patients should have a clear understanding.

Caused pain for cancer patients can be divided into: ① by the cancer itself is the cause of the pain, such as tumors in partial or transfer parts of nerve fibers or oppression caused by the pain, this is the most common cause. ② caused by the treatment of pain, such as post-operative scarring in chronic pain, such as chemotherapy after stomatitis. ③ life from the pain caused by the loss of capacity, such as constipation, bed sores. ④ has nothing to do with cancer pain, such as osteoarthritis, pain, etc. fasciitis.

Because pain is a subjective sensation, thus a matter of subjective factors (such as sensitivity, attention, emotional, physical condition, etc.) larger. If the same pain, high sensitivity, focus, depression and general physical condition of human-induced pain on the strong. You may have had this experience, to concentrate on doing a tense work or activities (such as a competition), hands or body was pierced bleeding, but did not feel that, and someone else told you that before realize injured. Many cancer pain patients often complain that doctors will be at night than during the day heavy pain. This is because the day will engage in various activities, with light, sound stimulation, these patients will be scattered attention on the pain, and that the activities were not stopped at the light and sound stimulation, attention also focused on the location of the pain, the pain would worsen.

It is cancer pain patients should be fully aware of these factors, confidence in conquering pain, perseverance and a strong and courageous attitude towards it, and some distracting activities, such as watching television, listening to the radio, reads the newspaper or recall some interesting things, it will largely reduce the pain of torture.

Pregnant women are susceptible pyelonephritis

Pyelonephritis pregnancy is common urinary tract diseases. This is because:
1, the ureter during pregnancy estrogen and progesterone effects of the expansion, which organized relaxation luminal expansion of the slow movement, the exclusion of urinary retention, urinary retention in the regular ureter and renal pelvis, thus bacteria in the renal pelvis and ureter the creation of conditions for growth and reproduction.
2, female urethra directly adjacent to the gathered easy bacterial vaginal mouth and anus, and the urethra is shorter, only 3 to 4 centimeters, such as neglect of health, seized bacteria easily penetrated uplink pelvis and urethra caused pyelonephritis.
3, couples in sexual intercourse before not cleaning genitalia, sexual intercourse between men and women when in close contact with the genitalia and friction, and the woman’s urethra collisions, often resulting in the opportunity invasive urethral bacteria, the bacteria as a result of the renal pelvis.
4, uterine pregnancy can cause constipation squeeze tube, thereby resulting from colon bacteria in the intestine via the lymphatic invasion ureter, urinary bladder, urethra and pelvis.
5, arrived in the body during pregnancy engage in lower risk of gingivitis, pharyngitis, tonsillitis, otitis media, rhinitis, infected lesions of bacteria, can be spread via blood circulation urinary system, which led to pyelonephritis.
In order to protect the health of pregnant women and fetuses, pregnant women must stress health, and maintain genital hygiene, washing Qin Chen Ku, diligence bath, rub feces should be from the former backward to avoid pollution urethra. Sex can be the best solution after a woman’s urine, in order to the bacteria may enter the urethra-out. Pregnant women to strengthen moderate physical activity, body resistance enhance the ability to prevent the disease in pregnant women should drink boiled water and eat fresh vegetables, fruits, in order to increase urine, flushing urethra to prevent the growth of bacteria. If suffering from pyelonephritis, it is necessary to timely treatment, and to have damage to the kidneys banned drugs, such as gentamicin, kanamycin, iodine contrast agents.

How to prevent the recurrence of pyelonephritis

Pelvis inflammation is a common infection of the urinary tract diseases, occur in women. Pyelonephritis is due to bacterial invasion pelvis, kidney and renal calyceal caused by the substance of suppurative inflammation. Clinical sub-acute, chronic two. Acute onset of acute fever, shivering, frequency, urgency, Niaotong, turbid urine, accompanied by abdominal pain. Chronic renal pelvic inflammation varying severity of symptoms, may be no symptoms early, late renal dysfunction may be due to hypertension, such as performance of uremia. Acute pyelonephritis if timely treatment, infection control, proper rest, most of the treatment can be cured. However, if treatment is timely, thorough, easy to relapse, but deferred a chronic process, and even lead to renal failure.

Therefore, in patients with pyelonephritis again after a recurrence must be prevented, should pay attention to the following aspects.

1. Attention to the genital hygiene and urethra. To Qinhuan underwear, especially in the women’s menstrual period, pregnancy or body resistance decline, such as pay no attention to genital hygiene, bacteria can enter the bladder through the urethra, and the bladder, ureter reflux impetus to the pelvis, and then and real transgression, a urinary tract infection.

2. Diet to high-calorie, high-vitamin, semi-liquid or easily digested ordinary diet. More water, daily income of not less than 3000 ml to increase urine output, to wash urinary tract, promoting bacteria, toxins and inflammatory secretions from.

3. Increase physical activity enhance the physical body’s ability to resist disease. Attention to the rest, avoid exertion and constipation.

4. Female patients cured after the acute phase, less than one year should pay attention to contraception.

5. Female patients prohibit bath, bath water to avoid countercurrent to the bladder, causing infections. Standing drugs: 0.1 g furan Tanding, oral, 3-4 times daily, urinary tract infection effective. Pipemidate 0.5-0.75 grams daily oral 3-4 times. Vitamin C1 grams, oral, three times a day, can enhance the role of furan Tanding. (Vitamin C can urine acidification, furan Tanding in the antibacterial effect of acid in the urine increased).

Treatment drugs - methadone

Methadone is opioid receptor agonist, is a narcotic analgesic drugs, from the Second World War when German chemists synthesized. 1960 study found the drug in the United States would be able to control the withdrawal symptoms of heroin started on treatment. 30 years ago, Western Europe and the United States become the country’s major drug detoxification. 20 in the early 1970s, Hong Kong has implemented the methadone treatment programme and achieved satisfactory results, the World Health Organization (WHO) said that the Asian region is better modalities. 1993 China’s Ministry of Health issued the “opiate addicts commonly used drug therapy
Guiding Principles, “the first choice for methadone treatment (detoxification) in the treatment.

(1) Principle

Methadone is potent opioid drugs. Have with other opioid-dependent and tolerance, could be replaced by any of the opioids. The half-life (drug concentration in the blood of a 50 per cent reduction of the time required) long, their withdrawal symptoms lesser extent, to become the methadone for opioid addiction substitution, in accordance with detoxification treatment. Drug and other drug compared with methadone to control withdrawal symptoms significant effect, the high success rate of detoxification treatment; can be administered orally, the drug can produce a 24-hour clinical effects of medication safety, without serious side effects. Methadone has become the most commonly used drug detoxification treatment. At present, methadone alternative method reduced opioid addiction is the conventional method of treatment. The goal of therapy is to eliminate the illicit opiate drug use, patients resume normal work, study and life, reduce crime and anti-social behaviour.

(2) the implementation of the methadone treatment programme

① asked drug experience and body of the state organs, and make medical records.

② medical examination, chest X-ray lens, heart, EEG examination.

③ laboratory tests include: blood, urine, feces three routine examination, liver function, HIV test, urine opioid substances.

④ for patients with the appropriate dose of methadone solution, in principle, could be the first of the 30 mg, then served in need periodic adjustments.

⑤ during treatment with psychological counselling and health education and counselling.

⑥ health care workers and patients, families, in close coordination, improve relations, help patients treatment success.

⑦ with methadone should be subject to strict control, strict supervision of liquid methadone patients Yanxia.

⑧ regularly checked the patient’s urine samples, testing the urine of opioids.

(3) pharmacological effects

Pharmacological effects of methadone and morphine in the nature of the same. Its characteristics are strong analgesic effect of oral effective. Opioid addiction to the physical withdrawal symptoms significant therapeutic effect, the lasting effects of repeated application of effective. Apply to opiate addicts in drug treatment.

It sedation and respiratory inhibition, as well as smooth muscle and cardiovascular system and the role of morphine similar, but weaker than morphine.

Methadone is a potent analgesic effect of morphine for their effectiveness 2 ~ 3 times, the analgesic effectual slow, and lasted for a long time, apply to chronic pain, acute pain effect is not good. Single dose arising from the role of hypnosis in the light equivalent dose of morphine, such as the repeated application can cause significant sedation. Methadone caused by narrowing the pupil, antitussive effect on the pituitary hormone and the impact of the same nature and morphine.

Gastrointestinal Motility methadone to slow down, extended gastric emptying, intestinal smooth muscle static increase the tension, significantly reduced the advance of the rectum, can lead to constipation. This is more common in methadone treatment.

Methadone of pregnancy with fetal respiratory inhibition, it does not apply to obstetric analgesia.

(4) the pros and cons of methadone treatment:

① methadone withdrawal symptoms in the control of the precise;

② role in a long time, clinical effect 24 to 36 hours, taking convenience;

③ without serious side effects;

④ repeated use can produce long-term clinical effects;

⑤ long-term use of methadone can be formed physical dependence, psychological dependence and tolerance;

⑥ of methadone addiction and the tendency to abuse should not be overlooked, we must establish a strict management system of methadone to avoid wastage into drugs.

Digestive complications caused by drug abuse

The role of drug appetite suppressants can cause not only physical suffering from weight loss, but also raises some essential vitamin and mineral deficiencies, which led to a series of malnutrition syndrome. Lack of vitamin B group will damage the central nervous system by memory, attention, learning ability decreased significantly even lead to unconsciousness. Lack of vitamin B group will cause various peripheral neuritis and dermatitis. Lack of iron can cause iron-deficiency anemia, therefore drug addicts in iron-deficiency anemia is common.

Drugs often cause stomach caused constipation thereby slowing peristalsis. This very stubborn constipation, a long-term drug addicts to the distressed poor. Sometimes drug addicts every week or more than 10 days a stool, defecation, bleeding very common. Gastrointestinal Motility slowed intestinal obstruction can be caused. To some people sneaking drugs into hospitals, churches, and other treatment, the use of physical hiding drugs, swallowed condoms containing drugs, could cause intestinal obstruction. In addition, drug addicts such acts often cause accidental poisoning deaths.

Opioid drugs addicts in drug will be discontinued suddenly appeared abnormal gastrointestinal peristalsis accelerated performance for serious abdominal pain and diarrhea. Severe diarrhea, dehydration can occur.

Cocaine on systemic vascular have strong contraction of the continuing high degree of intestinal vascular contraction can cause intestinal ischemia and necrosis. Treatment to surgical resection.

Hepatitis widely popular among drug users, and even abroad Somebody suggested: “as long as they are identified drug addicts, we will certainly associated with hepatitis.” A study confirmed that the 69 drug addicts in the closed conditions under six months of observation, found that at least 52 people have one or more abnormal liver function test results. Generally believed that hepatitis B is due to the sharing of contaminated syringes by the infection. Heroin easily cause of chronic liver dysfunction may be related to the direct heroin on liver toxicity effects.