维生素D缺乏性佝偻病(Vitamin D Deficiency Rickets).ppt

Rachitic vs. normal chick Rickets due to deficiency of vitamin D, Ca, or P Vitamin D Deficiency - Rickets Rickets in wrist - uncalcified lower ends of bones are porous, ragged, and saucer-shaped (A) Rickets in 3 month old infant (B) Healing after 28 days of treatment (C) After 41 days of treatment A B C ????????????????????????????????????? ??????????????????????????????? Approved for: 1 ????????????????????????????????????? Rickets Diagnosis Assessed according to the followings: 1. History 2. Physical examination 3. Laboratory findings 4. Roentgenographic changes Differential diagnosis 1. Hypophosphatemic Vitamin D resistant rickets 2. Rickets of Vitamin D dependency 3. Distal renal tubular acidosis 4. Cretinism 5. Chondrodystrophy Treatment 1. Food and nursing care 2. Prevention of complications 3. Special therapy 1) Vitamin D therapy A. General method Vitamin D 2000-4000IU/day for 2-4 weeks, then change to preventive dosage (400IU). B. A single large dose: For severe case, or Rickets with complication, or those who can’t bear oral therapy. Vitamin D3 200000-300000IU, im, preventive dosage will be used after 2-3 months. Treatment 2) Calcium supplementation: only used for special cases, such as baby fed mainly with cereal, or infants under 3 months of age, and those who have already developed tetany. Dosage:1-3 g/day. 3) Plastic therapy: In children with bone deformities after 4 years old plastic surgery may be useful. Prevention 1. Pay much attention to the health care of pregnant and lactating women, instruct them to take adequate amount of vitamin D. 2. Advocate sunbathing 3.Advocate breast feeding, give supplementary food on time Prevention 4. Vitamin D supplementation: In prematures, twins and weak babies, give Vitamin D 800IU per day, For term babies and infants the demand of Vitamin D is 400IU per day, For those babies who can’t maintain a daily supplementation, inject muscularly Vitamin