Thursday, March 28, 2024

急性高原病(高原反應)的預防與治療

美國國家醫學圖書館醫療百科全書建議的急性高原病(高原反應)的預防方法是:

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.

預防急性高山病的關鍵包括:

慢慢爬山。循序漸進是預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),就停下來休息一兩天。
儘可能在較低的海拔睡覺。
確保您有能力在需要時快速下降。
了解如何識別高原反應的早期癥狀。
如果您在 9840 英尺(3000 米)以上旅行,您應該攜帶足夠幾天的氧氣。

如果您計劃快速攀登或攀登到高海拔地區,請向您的提供者諮詢可能有幫助的藥物。

如果您有紅細胞計數低(貧血)的風險,請詢問您的提供者您計劃的旅行是否安全。還要詢問鐵補充劑是否適合您。貧血會降低血液中的氧氣含量。這使您更容易患高原反應。

攀登時:

不要喝酒
多喝水
經常吃富含碳水化合物的食物
如果您患有心臟病或肺病,則應避免到高海拔地區。

美國國家醫學圖書館醫療百科全書建議的急性高原病(高原反應)的治療方法是:

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.

治療
早期診斷很重要。急性高原反應在早期階段更容易治療。

所有形式的高山病的主要治療方法是儘可能快速和安全地爬下(下降)到較低的高度。如果您出現癥狀,則不應繼續攀登。

如果可能的話,應該給予額外的氧氣。

患有嚴重高山病的人可能需要住院。

可以給予一種叫做乙酰唑胺 (Diamox) 的藥物來幫助您更好地呼吸。它可以幫助減輕癥狀。這種葯可以使您更頻繁地排尿。服用這種藥物時,請確保多喝水並避免飲酒。在到達高海拔之前服用該藥效果最佳。

如果您的肺部有液體(肺水腫),治療可能包括:


一種叫做硝苯地平的高血壓葯
β激動劑吸入器打開呼吸道
重症呼吸機
增加肺部血流量的藥物稱為磷酸二酯酶抑製劑(如西地那非)
地塞米松 (Decadron) 可能有助於減輕急性高原反應癥狀和大腦腫脹(腦水腫)。

便攜式高壓艙允許徒步旅行者模擬較低海拔的條件,而無需實際離開他們在山上的位置。如果惡劣天氣或其他因素導致無法下山,這些設備將非常有用。

美國國家醫學圖書館醫療百科全書原文鏈接:https://medlineplus.gov/ency/article/000133.htm

旅行醫學雜誌,第 27 卷,第 6 期,2020 年 8 月《使用乙酰唑胺預防高原病》(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.

預防性使用每 12 小時 125 毫克劑量的乙酰唑胺可非常有效地降低高原病 (HAI) 的風險。

旅行醫學雜誌原文鏈接:https://academic.oup.com/jtm/article/27/6/taz106/5693888

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.