High-altitude medicine.
High-altitude medicine.
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DOI：
10.4103/0019-5278.64608
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发表时间：
2010-01
影响因子：
0.9
通讯作者：
Paralikar JH
中科院分区：
文献类型：
--
作者：
Paralikar SJ;Paralikar JH
为了娱乐和探险目的，到高海拔地区逗留已变得很普遍。在大多数人中，逐渐上升到高海拔会导致身体发生一系列适应性变化，称为适应。这些变化包括呼吸、心血管、血液系统和细胞适应性的变化，这些变化增强了向组织的氧气输送并增加了氧气摄取。因此，由于肾脏促红细胞生成素分泌的增加，肺通气增加，肺中弥散能力增加，心输出量增加和红细胞计数增加，所有这些都增强了向细胞的氧气输送。细胞的变化，如线粒体数量的增加和细胞色素氧化酶系统的增强，需要数月或数年的发展。上升太快或无法适应会导致高海拔疾病。这些包括急性高山病（AMS）、高原脑水肿（HACE）和高原肺水肿（HAPE）。急性高山病如果早期发现是自限性的。HACE和HAPE都是危及生命的，需要积极治疗。治疗这些疾病的关键是早期识别;补充氧气的管理;以及必要时下降。乙酰唑胺、地塞米松、硝苯地平等药物可按建议给药。
Sojourns to high altitude have become common for recreation and adventure purposes. In most individuals, gradual ascent to a high altitude leads to a series of adaptive changes in the body, termed as acclimatization. These include changes in the respiratory, cardiovascular, hematologic systems and cellular adaptations that enhance oxygen delivery to the tissues and augment oxygen uptake. Thus there is an increase in pulmonary ventilation, increase in diffusing capacity in the lung, an increase in the cardiac output and increase in the red blood cell count due to an increase in erythropoietin secretion by the kidney, all of which enhance oxygen delivery to the cells. Cellular changes like increase in the number of mitochondria and augmentation of cytochrome oxidase systems take months or years to develop. Too rapid an ascent or inability to acclimatize leads to high-altitude illnesses. These include acute mountain sickness (AMS), high-altitude cerebral edema (HACE) and high-altitude pulmonary edema (HAPE). Acute mountain sickness is self limiting if recognized early. Both HACE and HAPE are life threatening and need to be treated aggressively. The key to treatment of these illnesses is early recognition; administration of supplemental oxygen; and descent if required. Drugs like acetazolamide, dexamethasone, nifedipine may be administered as recommended.