文档介绍：血液和造血系统
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汇报人：视觉设计
blood volume losses in the adult
percent lost(%)
Volume lost(ml)
symptoms
signs
<20
<1000
+/- anxiety
+/-vasovagal reaction
20~30
1000~1500
anxiety,exercise intolerance,may faint on standing
orthostatic hypotension,exertional tachycardia
30~40
1500~2000
syncope when sits or stands
orthostatic,anxious,tachycardic at rest
>40
>2000
anxious,reatless,often confused,may be short of breath
hypovolemic shock,fall in supine bloodpressure,tachycardic with cool,clammy skin
Erythroid marrow response
The capacity of marrow to respond depends on:
the level of erythropoietin stimulation
the presence of a normal complement of erythroid precursors in a normal marrow structure
an aduquate supply of iron
Erythropoietic response to acute hemorrhage
1-2
days after bleed
3-6
days after bleed
7-10
days after bleed
marrow reticulocyte shift(polychromasia)
+
+ +
+ + +
reticulocyte production index(times normal)
1
1-2
>2-3
E/G ratio
1:3
1:1
>1:1
Red blood cell oxygen delivery
Bohr effect 波尔效应
PH value or H + CO2 concentration and the changes in the differential pressure hemoglobin combined with oxygen ability, the influence of blood pH value reduced or pCO2 rise, make the affinity to reduce Hb O2, in any pO2 next Hb oxygen saturation all lowers oxygen from curve right shift, conversely, pH value rise or pCO2 decrease to increase the affinity of Hb O2, in any pO2 next Hb oxygen saturation increased, oxygen from curve moves left. PH against Hb oxygen acceptor this effect is called Bohr effect.
hemoglobin-oxygen dissoiation curve
Clinical features
Severity of the bleed
Rate and site of the bleed
Capacity of the patient to respond
TCM syndrome differentiation of anemia
Traditional Chinese medicine without anemia name, but the present from the clinical syndrome, such as pallor, body tired weakness, palp