Anemia will occur when the red blood cell count, hemoglobin content and hematocrit in a certain volume of circulating blood are lower than the normal standard. Among them, hemoglobin is the most important, which is lower than 120g/L( 12.0g/dl) for adult males and10g/L (11.0/DL) for adult females, which can generally be considered as. Anemia is one of the most common clinical manifestations. However, it is not an independent disease, but it may be an important clinical manifestation of a basic disease or sometimes a complex disease. Once anemia is found, we must find out the cause. Etiological anemia is one of the most common clinical manifestations. However, it is not an independent disease, but it may be an important clinical manifestation of a basic disease or sometimes a complex disease. Once anemia is found, we must find out the cause. The presence or severity of anemia symptoms depends on the degree of anemia, the speed of anemia, the change of circulating blood volume, the age of patients and the compensatory ability of cardiovascular system. Anemia occurs slowly, and the body can adapt gradually. Even if anemia is serious, it can still maintain its physiological function. On the other hand, if anemia occurs in a short time, even if the degree of anemia is not serious, obvious symptoms can appear. Symptoms are more obvious in the elderly, the weak or those with decreased cardiopulmonary function. The general symptoms and signs of anemia are as follows: 1. Weakness: Fatigue and drowsiness are caused by muscle hypoxia. This is the most common and earliest symptom. Second, the skin mucosa is pale: the distribution and contraction of skin, mucosa, conjunctiva and skin capillaries. It is generally believed that the color of eyelid adhesion, thenar of palm and nail bed is reliable. Third, the cardiovascular system: palpitation is one of the most prominent symptoms, accompanied by tachycardia. Soft systolic murmurs can be heard at the apex or pulmonary valve area, which is called anemic murmur. Diastolic murmurs can be heard in severe anemia. Severe anemia or original coronary heart disease can cause angina pectoris, heart enlargement and heart failure. Respiratory system: shortness of breath or dyspnea are mostly caused by hypoxia or hypercapnia in the respiratory center. 5. Central nervous system: dizziness, headache, tinnitus, dizziness, inattention and drowsiness are all common symptoms. Patients with severe anemia or sudden onset, especially elderly patients, may have syncope or even confusion. Digestive system: loss of appetite, flatulence, nausea and constipation are the most common symptoms. Seven, reproductive system: female patients often have menstrual disorders, such as amenorrhea or menorrhagia. Decreased libido is common in both men and women. Eight, urinary system: severe anemia can have mild proteinuria, urine concentration decreased. In addition to red blood cells, hemoglobin and hematocrit, the most basic hematological examination should include: (1) reticulocyte count, corrected reticulocyte count = patient's hematocrit /0.45/L× reticulocyte (%). (2) Determination of 2)MCV and maternal and child health food. (3) Peripheral blood smear, to observe whether there are abnormal red blood cells, such as spherical red blood cells, target red blood cells, mitotic cells, red blood cells with uneven size, low pigment and polychromatic red blood cells, basophilic stippling, cabot's ball, Howe's corpuscles, etc. Changes in the number and morphology of white blood cells and platelets, and the presence or absence of abnormal cells. (4) Bone marrow biopsy is indispensable for diagnosis, and bone marrow biopsy should be done if necessary. Bone marrow examination must include staining to diagnose or exclude iron deficiency anemia and sideroblastic anemia. Urine routine, fecal occult blood and parasite eggs, blood urea nitrogen, blood creatinine and lung X-ray examination can not be ignored. Treatment 1. Etiological treatment: The principle of treating anemia is to take corresponding measures to eliminate the etiology. Many times, the primary disease is much more harmful than anemia itself (such as gastrointestinal cancer), and its treatment is more important than anemia. In the case of unclear etiology diagnosis, don't throw drugs indiscriminately, which complicates the situation and increases the difficulty of diagnosis. Second, drug treatment: avoid abusing blood-enriching drugs and strictly control the indications of various drugs. For example, vitamin B 12 and folic acid are suitable for the treatment of megaloblastic anemia; Iron is only used for iron deficiency anemia, not for non-iron deficiency anemia, because it will cause iron overload and affect the functions of important organs (such as heart, liver, pancreas, etc.). ); Vitamin B6 is used for sideroblastic anemia; Corticosteroids are used to treat autoimmune hemolytic anemia; Testosterone is used for aplastic anemia, etc. Third, blood transfusion: the main advantage of blood transfusion is that it can quickly reduce or correct anemia. Therefore, we must correctly grasp the indications of blood transfusion. If a large amount of blood transfusion is needed, concentrated red blood cells can be infused to reduce the overload of cardiovascular system and reduce blood transfusion reaction. Splenectomy: Spleen is an important organ that destroys blood cells and is also related to the production of antibodies. 5. Bone marrow transplantation: Bone marrow transplantation is a new medical technology in recent years, and it is still in the experimental stage. It is mainly used for patients with acute aplastic anemia who did not receive blood transfusion or rarely received blood transfusion in the early stage. If the transplant is successful, it may be cured.