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各位朋友大家好，现在是“每天健康三分钟”时间，我是道简心血管康复医生集团的护士张翠。今天我来给大家讲一讲缺铁性贫血补铁治疗的原则和方法。
一、常用口服铁剂：硫酸亚铁、富马酸亚铁、琥珀酸亚铁。口服铁剂后5～10天网织红细胞开始上升，1～2周后血红蛋白开始上升。待血红蛋白正常后，需继续服药3-6个月，补足体内铁贮备。
二、常用注射用铁剂为右旋糖酐铁，其指征为：①因严重消化道反应而无法耐受口服铁剂治疗；②消化道吸收障碍；③严重消化道疾病，服用铁剂后加重病情。
三、病因治疗：纠正饮食习惯，治疗慢性失血，治疗胃肠道疾患等。
四、注意补充含铁食物，食物中的铁有两种来源，即肉类中的血红蛋白铁和蔬菜中的离子铁，即非血红蛋白铁。肉类、鱼类、家禽中的铁40%能被吸收；蛋类、谷类、硬果类、豆类和其他蔬菜中的铁能被人体吸收的不到10%，而菠菜中的铁只能吸收2%左右。因此，补铁应以富含血红蛋白铁的肉类、鸡肉、鱼类等动物性食品；并应注意如何提高铁的吸收率，如注意荤素食品的搭配可提高铁的吸收率；经过发酵的粮食也能提高铁的吸收率，如馒头、发糕等。
五、增加维生素C摄入，维生素C能促进蔬菜中非血红蛋白铁的吸收。若同时摄入富含维生素C的柠檬汁、橘子汁和富含铁的蔬菜，就能使人体对蔬菜中铁的吸收率增加2～3倍。如果同时补充铁制剂，也应和维生素C同时服用。
六、供给高蛋白饮食高蛋白饮食一方面可促进铁的吸收，另一方面也是人体合成血红蛋白所必需的物质。
七、纠正不良的饮食习惯对长期偏食和素食的人，要进行纠正，使其改变饮食习惯，以保证铁和各种营养的供给。
八、不宜饮茶和咖啡限制含鞣酸高的食物，如咖啡中的咖啡因，均能减少食物中铁的吸收。茶叶中的磷酸盐和鞣酸也能与铁结合成不易溶解的复合物，使铁的吸收明显减少。因此，在饮食中，特别是在食用补铁饮食时，不宜饮茶和咖啡，更不能饮浓茶。
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【英文版】
Principles and methods of iron supplement therapy for iron deficiency anemia
Dear friends, nice to meet you!Now it is time for “health talk for three minutes every day”,my name is Zhang Cui, a nurse of Daojian Doctor Group of Cardiovascular Rehabilitation.Today, I'd like to talk about the principles and methods of iron supplement therapy for iron deficiency anemia.
First, commonly used oral iron: ferrous sulfate, ferrous fumarate, ferrous succinate.Reticulocyte began to rise 5-10 days after oral administration of iron, and hemoglobin began to rise after 1-2 weeks.After hemoglobin is normal, the patient should continue to take medicine for 3-6 months to replenish the iron reserve in the body.
Second, iron dextran is commonly used for injection, and its indications are as follows.
Patients can not tolerate oral iron treatment due to severe gastrointestinal reactions. Patients with digestive tract absorption disorders.Patients with severe digestive tract diseases who are aggravated after taking iron.
Third, etiological treatment. Correct eating habits, primary disease such as chronic blood loss, gastrointestinal diseases or other diseases should be treated.
Forth, attention should be paid to supplement iron containing food. There are two sources of iron in food, namely hemoglobin iron in meat, and ionic iron in vegetables, namely non hemoglobin iron.Forty percent of iron in meat, fish and poultry can be absorbed, less than 10% of iron in eggs, cereals, hard fruits, beans and other vegetables can be absorbed by human body,while iron in spinach can only absorb about 2%. Therefore, iron supplement should be based on meat, chicken, fish and other animal foods rich in hemoglobin iron, and attention should be paid to how to improve the absorption rate of iron, such as paying attention to the combination of meat and vegetable food can improve the iron absorption rate. Fermented grain can also improve the iron absorption rate, such as steamed bread, cake, etc.
