radicalducati Chapter 625
Chapter 625
"Go take a blood routine and see if it's anemia..."
Lin Feng billing,
Ask the patient's mother to take the boy to draw blood.
......
An hour later,
The patient's mother returned with a checklist.
"Doctor Lin, the results of the examination are out."
Lin Feng glanced at the checklist.
Hemoglobin 72g/L (reference value 120-150)
This is moderate anemia!
Why is there anemia?
Blood, is it lost for a short time, or for a long time?
As mentioned earlier,
The causes of anemia are nothing less: less hematopoiesis, more blood loss!
Then, Lin Feng asked: did he vomit blood, black stool is not black, what is the history of disease (hemolytic anemia), whether there are hemorrhoids...
Asked a bunch ...
"None of this..."
Mom shook her head.
Lin Feng breathed a sigh of relief.
Then, it should not be a problem of bleeding.
If bleeding occurs, it is generally more dangerous, acute, and troublesome.
Since it is not bleeding, consider other possibilities.
Combined with the previous complaints:
Dizziness at first...
Then progresses intermittent abdominal pain and symptoms of fatigue and headaches...
But there is no cold, no fever...
The child began to vomit...
"Poisoned?"
"Poisoning and anemia..."
"That is 'toxic hemolytic anemia'..."
The so-called "toxic hemolytic anemia",
It refers to anemia caused by chemical poisons that increase the destruction of red blood cells and exceed the ability of the bone marrow to compensate.
• Oxidizing poisons can oxidize hemoglobin to methemoglobin, producing Hern bodies leading to hemolysis (see Toxic methemoglobinemia).
Among the non-oxidizing hemolytic poisons, methyldopa, high-dose penicillin several quinidine can destroy red blood cells through type II. allergic reaction, hydrogen arsenide can affect red blood cell membrane to cause hemolysis, copper and copper sulfate poisoning caused hemolysis mechanism is unknown.
Lin Feng: "I currently suspect poisoning..."
Mom was stunned: "Poisoning? How can it be poisoned? "
Lin Feng: "Do you recall that you did eat anything?" And it's still this time, and I've been eating. "
Only by eating all the time, will it continue to accumulate, but it is not acute.
My mother pondered hard and thought for two minutes, but she didn't expect anything special.
"The meals at home are no different from usual, if you say that you are poisoned for a long time, it should not be... As for the school, it stands to reason that there are so many other students..."
Finally, Mom shook her head.
Lin Feng: "There are also external applications, have you used any external applications for children?" "
Mom thought for a while and nodded: "Yes, recently my son had a rash, and I gave him ointment..."
Lin Feng: "What ointment?" "
Mom shook her head: "It was opened by a pharmacy, I don't remember ..."
Lin Feng: "Is there anyone in the family?" Take a picture and come over. "
Mom: "Yes, yes, my husband is here, I will let him shoot now..."
A phone call went back, and 20 seconds later, the photo came in.
Lin Feng took a look.
I'll go......
Huangdan powder!
Isn't this 'lead'?
Lin Feng immediately understood——
"Lead poisoning"!!
"Why use this thing?"
"My son has eczema, and the neighbor said that Huangdan powder is useful and can treat eczema, and then he applied it to him..."
Lin Feng shook his head.
"How can you use Huangdan powder casually?"
Huangdan powder, also known as lead pill, can detoxify, build muscle, and has a great effect.
However, it needs to be used strictly and moderately under the advice of a professional physician. Long-term use of the human body is easy to cause lead poisoning, so infants and children should be used with caution or banned.
Why?
Because the skin of such people is relatively thin and tender, it may be absorbed faster through the skin, and because the development is immature, the metabolism is more difficult, lead poisoning metabolism is slow, and will cause multi-organ harm.
The most common is the digestive system, which causes vomiting and diarrhea, the blood system can cause anemia, and the most common is convulsions in the nervous system.
As for this little boy in front of him.
Lack of concentration and then hyperactivity.
Lead, with the toxicity of inhibiting neuronal growth and survival, low concentrations of lead can cause apoptosis of nerve cells, the specific symptoms are: inattention, learning difficulties, movement disorders, impulsivity, intelligence and spatial comprehensive ability decline.
This corresponds exactly.
Diarrhea, vomiting, which is gastrointestinal poisoning, also corresponded.
There is another symptom: anemia.
The main effect of lead on the blood system is to inhibit hemoglobin synthesis and shorten the life of circulating red blood cells, so anemia occurs.
It should also be noted that lead poisoning does not lead to a decrease in iron in plasma, so conventional ischemic iron supplementation and iron treatment are ineffective.
Through the above analysis,
Finally, monism is derived:
"Lead poisoning"!!
Lin Feng opened the bill.
"Go draw a blood, check the blood lead..."
After my mother knew that it was lead poisoning, she panicked. While cursing and cursing at the neighbors, he took his son to draw blood.
......
Another hour passed,
The "blood lead" results came out.
·「 Blood lead" value reached 429!
Lin Feng was taken aback.
According to the standard:
Mild lead poisoning: blood lead level is 200~249ug/L
Moderate lead poisoning: blood lead level is 250~449ug/L
Severe lead poisoning: blood lead level ≥ 450 ug/L
This is already considered moderate lead poisoning.
"This one is a bit high, it's better to need to be hospitalized... In case of severe lead poisoning encephalopathy, it is troublesome. "
"Okay, okay, you can do anything, everything is at your command, Dr. Lin!"
Mom was completely panicked.
As for "lead poisoning", how to treat it?
Generally, it is combined with and excreted by "lead excretion drugs" to prevent the toxic effect of lead on the body.
Lead expulsion therapy is reserved for lead poisoning with moderate or higher blood lead levels.
But!
Lead excretion has side effects.
Drug One: Metal Chelator Editing
The carboxyl group (-COOH) is chelated with free lead to promote the elimination of lead from the blood through the kidneys.
The side effects are: chelating lead also chelates essential trace elements in the body, which is easy to cause imbalance of trace elements in the body, such as zinc and iron, during the treatment process. (So when treating, these trace elements should be supplemented)
In addition, there will be a certain load on the kidneys, and people with kidney failure cannot be used.
Second, the active sulfhydryl group (-SH) is used to seize lead bound to tissues to promote the dissociation of lead from tissues and eliminate them.
Its advantage is that it has strong scavenging power of lead in tissues, and has a better effect on the improvement of biochemical changes caused by lead toxicity.
However, there are many disadvantages: there may be adverse reactions such as rash, gastrointestinal discomfort, nausea and vomiting, diarrhea, decreased appetite, etc., and individual children will have abnormal liver transaminases.
In addition, lead drainage may not be complete.
in a word
Lead poisoning, lead discharge is not easy.
Need to be hospitalized, at least more than half a month of continuous treatment and observation.
(Summary: Huangdan powder, do not use it indiscriminately.) Other medicines, in the absence of a clear composition of the drug, it is better not to give it to the child, it is better to see a doctor. ）
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PS: Traditional Chinese medicine is currently facing a big problem, that is, it only indicates its medicinal effects, but it is difficult to clearly say its side effects. (There are too many folk usages, and they do not know the side effects, so the reputation of traditional Chinese medicine is despised by Western medicine) (Western medicine instructions, about side effects, taboos are marked relatively clear, Chinese medicine has a long way to go).