Bansal Deepak, Totadri Sidharth
Pediatric Hematology-Oncology Unit, Department of Pediatrics, Advanced Pediatric Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India,
Indian J Pediatr. 2014 Jan;81(1):42-50. doi: 10.1007/s12098-013-1159-8. Epub 2013 Aug 11.
It is common for primary care physicians to be faced with children with hematological disorders in everyday practice. The article seeks to provide realistic information for the first-contact physician in handling common hematological diseases in children. Practical step-wise approach to understanding and investigating anemia and bleeding disorders is illustrated. Requirement of iron in normal children and management of iron deficiency anemia (IDA) and thalassemia is explained. The gold standard for IDA continues to be ferrous sulphate which has good bioavailability and is inexpensive. There is emerging concept of delayed clamping of umbilical cord at birth, particularly in regions with widespread IDA, to augment iron stores in infancy. Typical case scenarios of children with immune thrombocytopenia (ITP) and hemophilia are provided to facilitate the understanding of management in day to day practice. The vital role of the medical practitioner in shared care of patients with acute lymphoblastic leukemia and febrile neutropenia is emphasized. A risk based treatment algorithm for febrile neutropenia is provided.
在日常医疗实践中,初级保健医生经常会遇到患有血液系统疾病的儿童。本文旨在为一线医生提供处理儿童常见血液疾病的实用信息。文中阐述了理解和调查贫血及出血性疾病的实用分步方法。解释了正常儿童的铁需求以及缺铁性贫血(IDA)和地中海贫血的管理。IDA的金标准仍然是硫酸亚铁,它具有良好的生物利用度且价格低廉。在出生时延迟脐带结扎这一新兴概念正在出现,特别是在IDA普遍存在的地区,以增加婴儿期的铁储备。提供了免疫性血小板减少症(ITP)和血友病患儿的典型病例,以促进对日常实践中管理的理解。强调了医生在急性淋巴细胞白血病和发热性中性粒细胞减少症患者共享护理中的重要作用。还提供了一种基于风险的发热性中性粒细胞减少症治疗算法。