Wednesday, April 24, 2024

急性高原病(高原反应)的预防与治疗

美国国家医学图书馆医疗百科全书建议的急性高原病(高原反应)的预防方法是:

Prevention
Keys to preventing acute mountain sickness include:

Climb the mountain gradually. Gradual ascent is the most important factor in preventing acute mountain sickness.
Stop for a day or two of rest for every 2000 feet (600 meters) of climb above 8000 feet (2400 meters).
Sleep at a lower altitude when possible.
Make sure that you have the ability to rapidly descend if needed.
Learn how to recognize early symptoms of mountain sickness.
If you are traveling above 9840 feet (3000 meters), you should carry enough oxygen for several days.

If you plan on climbing quickly, or climbing to a high altitude, ask your provider about medicines that may help.

If you are at risk for a low red blood cell count (anemia), ask your provider if your planned trip is safe. Also ask if an iron supplement is right for you. Anemia lowers the amount of oxygen in your blood. This makes you more likely to have mountain sickness.

While climbing:

Do not drink alcohol
Drink plenty of fluids
Eat regular meals that are high in carbohydrates
You should avoid high altitudes if you have heart or lung disease.

预防急性高山病的关键包括:

慢慢爬山。循序渐进是预防急性高山病最重要的因素。
在 8000 英尺(2400 米)以上每爬升 2000 英尺(600 米),就停下来休息一两天。
尽可能在较低的海拔睡觉。
确保您有能力在需要时快速下降。
了解如何识别高原反应的早期症状。
如果您在 9840 英尺(3000 米)以上旅行,您应该携带足够几天的氧气。

如果您计划快速攀登或攀登到高海拔地区,请向您的提供者咨询可能有帮助的药物。

如果您有红细胞计数低(贫血)的风险,请询问您的提供者您计划的旅行是否安全。还要询问铁补充剂是否适合您。贫血会降低血液中的氧气含量。这使您更容易患高原反应。

攀登时:

不要喝酒
多喝水
经常吃富含碳水化合物的食物
如果您患有心脏病或肺病,则应避免到高海拔地区。

美国国家医学图书馆医疗百科全书建议的急性高原病(高原反应)的治疗方法是:

Treatment
Early diagnosis is important. Acute mountain sickness is easier to treat in the early stages.

The main treatment for all forms of mountain sickness is to climb down (descend) to a lower altitude as rapidly and safely as possible. You should not continue climbing if you develop symptoms.

Extra oxygen should be given, if available.

People with severe mountain sickness may need to be admitted to a hospital.

A medicine called acetazolamide (Diamox) may be given to help you breathe better. It can help reduce symptoms. This medicine can make you urinate more often. Make sure you drink plenty of fluids and avoid alcohol when taking this drug. This medicine works best when taken before reaching a high altitude.

If you have fluid in your lungs (pulmonary edema), treatment may include:

Oxygen
A high blood pressure medicine called nifedipine
Beta agonist inhalers to open the airways
Breathing machine in severe cases
Medicine to increase blood flow to the lungs called phosphodiesterase inhibitor (such as sildenafil)
Dexamethasone (Decadron) may help reduce acute mountain sickness symptoms and swelling in the brain (cerebral edema).

Portable hyperbaric chambers allow hikers to simulate conditions at lower altitudes without actually moving from their location on the mountain. These devices are very helpful if bad weather or other factors make climbing down the mountain impossible.

治疗
早期诊断很重要。急性高原反应在早期阶段更容易治疗。

所有形式的高山病的主要治疗方法是尽可能快速和安全地爬下(下降)到较低的高度。如果您出现症状,则不应继续攀登。

如果可能的话,应该给予额外的氧气。

患有严重高山病的人可能需要住院。

可以给予一种叫做乙酰唑胺 (Diamox) 的药物来帮助您更好地呼吸。它可以帮助减轻症状。这种药可以使您更频繁地排尿。服用这种药物时,请确保多喝水并避免饮酒。在到达高海拔之前服用该药效果最佳。

如果您的肺部有液体(肺水肿),治疗可能包括:


一种叫做硝苯地平的高血压药
β激动剂吸入器打开呼吸道
重症呼吸机
增加肺部血流量的药物称为磷酸二酯酶抑制剂(如西地那非)
地塞米松 (Decadron) 可能有助于减轻急性高原反应症状和大脑肿胀(脑水肿)。

便携式高压舱允许徒步旅行者模拟较低海拔的条件,而无需实际离开他们在山上的位置。如果恶劣天气或其他因素导致无法下山,这些设备将非常有用。

美国国家医学图书馆医疗百科全书原文链接:https://medlineplus.gov/ency/article/000133.htm

旅行医学杂志,第 27 卷,第 6 期,2020 年 8 月《使用乙酰唑胺预防高原病》(The use of acetazolamide for the prevention of high-altitude illness)

The use of prophylactic acetazolamide in a dosage of 125 mg every 12 h is highly effective at diminishing the risk of HAI.

预防性使用每 12 小时 125 毫克剂量的乙酰唑胺可非常有效地降低高原病 (HAI) 的风险。

旅行医学杂志原文链接:https://academic.oup.com/jtm/article/27/6/taz106/5693888

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