General staff adaptability to mountains
The standard atmospheric pressure of people living at sea level is 760mm. The mercury is also an ATA. The air is a mixture of oxygen, nitrogen and other gases. The content of oxygen is 20.95%. With the increase of the topography, the pressure is gradually reduced. The partial pressure of oxygen in the alveoli, arterial blood and tissue also decreases accordingly. When people enter the plateau area from the plains, it usually takes 2-3 months to slowly adapt to the local environment of low oxygen, so that people can survive in this environment, and can perform normal or near normal mental and physical activity , but a degree of pro-border. If people can not adapt to the alpine hypoxic environment will occur alpine diseases, such as high altitude heart disease, high altitude polycythemia, high altitude hypertension, high altitude hypotension.
mountain sickness
The reason for the formation of mountain sickness is that the higher the altitude, the thinner the air, and the lower the air pressure. Therefore, the oxygen pressure needed by the human body is also reduced, but the oxygen content required by the human body remains unchanged, so that the human body maintains the blood Need oxygen content, it is necessary to increase the content of red blood cells, but the human body automatically increase the content of red blood cells takes a few days, so when you just entered the mountains, because of a sudden increase in height, the human body too late to adapt, resulting in insufficient supply of oxygen in the body The higher the height of the situation, the shorter the transition time and the more violent the reaction. This physiological reaction is generally called [Alpine].
The symptoms of mountain sickness are: vomiting, deafness, headache, shortness of breath, loss of appetite, fever, drowsiness, severe symptoms such as dullness, restlessness, mental excitement, thinking, loss of mind, hearing, vision, Odor, taste abnormalities, hallucinations, etc., may also occur edema, shock or paralysis.
The methods of prevention include: The speed of climbing should not be too fast. It is best to calm down smoothly, and cooperate with breathing. At the same time, adjust according to the steepness of the slope, so that the amount of exercise is proportional to the breathing, and in particular, to avoid shortness of breath. The height of ascent should be gradually increased, and the height of daily climbing should be controlled to adapt to the low air pressure and thin air environment. Travel should not be too tight, sleep, diet should be sufficient and normal, regular short-term rest, soft and deep breathing at rest to strengthen the circulation and a high degree of adaptation, usually should be more physical training to increase oxygen function.
First aid for mountain sickness: Oxygen supply and height reduction are the most effective first aid treatments. If there is a shock phenomenon, priority should be given to treatment, and attention should be paid to loss of temperature and other complications. Take a rest immediately and move the patient to a place without wind. If the pain is severe, you can take analgesics to relieve pain. If you still can not adapt, you need to reduce the height until the patient feels comfortable or the symptoms are significantly reduced. In general, people with mountain sickness can be cured when they fall to the ground. Despite this, serious patients still need medical treatment.
The pathogenesis of plateau adaptation insufficiency
For people who have lived in the plateau for a long time, the body can gradually adapt to the special climatic conditions in the plateau region. Under the regulation of the neurohumoral fluid, the functions of the various parts of the body have corresponding changes and changes, mainly the respiratory system and circulatory system are more obvious, and the atmosphere and alveoli in the plateau area. The difference in the partial pressure of oxygen decreases as the altitude of the mountain climbs. Directly affect the alveolar and gas exchange, the oxygen-carrying oxygen in the blood and the release rate of oxygen in the tissue cause the body to supply oxygen and produce hypoxia. The first climber stimulated the respiratory center due to hypoxia, which caused an increase in early ventilation, so the body needs to inhale more oxygen to taste. The higher the altitude, the lower the partial pressure of oxygen in the atmosphere, and the corresponding increase in oxygen deficiency. Speed ​​and labor intensity also affect the degree of altitude sickness. In addition, factors such as mental stress, fatigue, infection, malnutrition, low temperature, cold, and other factors also affect the incidence. The clinical manifestations of high altitude sickness in acute mountain sickness in a short time quickly boarded in the mountains above 3000M above sea level or long-term living in the plateau area, living in the plains for a period of time back to the plateau when there may be headaches, dizziness, palpitations, shortness of breath, chest tightness In severe cases, loss of appetite, nausea, vomiting, insomnia, fatigue, weakness, bloating, mild purple lips, and facial edema. Acute mountain reactions generally occur in mountaineering for 24 hours. Generally, they can adapt to the local alpine climatic conditions within 1-2 weeks after entering the plateau. The above symptoms can disappear on their own, if the symptoms continue to increase can be given symptomatic treatment, the use of industrial dose of 0.25g oral dose of 2-4 times a day, 2 days before the mountain to 3 days after climbing, the drug mainly plays a diuretic effect, can Reduce the incidence and severity of acute mountain sickness, and reduce the lack of oxygen during sleep, prednisone 5-10mg, 2 times per scorpion, use Jintian after the mountain to help reduce symptoms, in addition to moderate sedatives and Various vitamins, and ammonidine.
The clinical manifestations of high altitude pulmonary edema The incidence rate of high altitude pulmonary edema is 3%. On the basis of acute altitude sickness, when it reaches an altitude of 4000m or above, the disease can also occur when it is quickly boarded at 2500m. Therefore, it takes 3-48 hours after climbing. Rapid onset, can also be late for 3-10 days before the onset of symptoms such as headache, chest tightness, cough, difficulty breathing, can not be supine, individual severe cases may have urinary tract, slightly bloody foam-like sputum, even divinely unclear, cold Hypoxia can be exacerbated by breathing and infection, and coughing or exertion can also be an important cause. Treatment should be given early oxygen, 6-8lc per minute, with pulmonary edema can be used 50% -70% alcohol inhalation of oxygen, absolutely bed rest, pay attention to keep warm, prevent upper respiratory tract infection, is strictly prohibited drinking water, urinary speed 20-40mg, Immediately push or 40-80mg orally, every 2 times orally 2-3 days, pay attention to potassium during diuretic observation dehydration when irritability, a small amount of sedatives can also be used 0.25 alanine soluble in 50% GS40ml, slow static push To reduce pulmonary artery pressure orally prednisone or intravenous infusion of hydrocortisone, reduce capillary permeability and relieve bronchial spasm, patients with respiratory and heart failure should immediately take appropriate treatment measures, and then turn to a lower condition after stable disease Treatment continues at altitude.
High altitude brain edema, also known as high altitude coma or low incidence of high altitude encephalopathy, but more likely to cause death, more common in the rapid entry of more than 4,000 meters, acute onset, and more at night, mainly due to acute hypoxia caused by cerebral vasospasm Increased permeability leads to cerebral edema. In addition to the symptoms of early altitude sickness, the patient was accompanied by increased intracranial pressure, severe headache, and vomiting. There were also symptoms of diversion, depression, or excitement and senility. Individual patients developed convulsions, lethargy, drowsiness, coma, and pulse rate. Increased speed, irregular breathing, pupillary response to light, optic edema of the optic nerve, and bleeding.
The treatment is first to continue to give oxygen 95% oxygen and 5% of carbon dioxide. After waking, oxygen should be discontinued. Use 50% GS mannitol, paroxetine, and cell-emergent E to reduce cerebral edema and reduce brain. Cell metabolism, provide enough energy to promote recovery, please use central N stimulants, such as lobeline, coramine, etc., pay attention to water and salt and electrolyte balance and if necessary, anti-infective treatment, stable condition, turn to low altitude Continued treatment, some climbers will also appear eye syndrome, retinal hemorrhage. Precaution:
All personnel entering the plateau should undergo a comprehensive physical examination. Generally healthy persons are adapted to a hypoxic environment. All patients with hypertension, such as heart, lung, liver and kidney disease, should not enter the plateau region.
In general, physical exercise should be stepped up and the ladder should be opened to gradually adapt. The speed of mountain climbing is extremely important. It is reported in the country that the rate of acute altitude sickness at the altitude of 4200 meters in the plain within 3 miles is 83.5%. However, when the 2261m arrived at 4200m within 7-15 days after step adjustment, the incidence rate was only 52.7% (p<0.001). Drug patients could temporarily reduce the symptoms of incompatibility, but they could not improve, and even delay the body for hypoxia. With regard to adaptability, Chinese medicine personnel in the mountaineering process should be stepped up to ensure early detection and early treatment.
Those who enter the plateau should reduce physical labor and gradually increase the amount of labor depending on the degree of adaptation. The plateau's working environment is mostly below 4,000 meters, and the impact on labor ability is 30%-50% lower than that of the plains. Warmth should be taken to prevent acute upper respiratory tract infections. .
When entering the plateau, you should eat more carbohydrates, multi-vitamins and easily digested foods, high-carbohydrate foods can provide sugar and increase the ability of the lungs to disperse, so as to increase the body's ability to adapt to the plateau. It is absolutely forbidden to drink alcohol, and alpine patients fall asleep When it is best to take a semi-recumbent position, reduce right venous return and pulmonary capillary congestion.
Large temperature difference between day and night in the plateau area should pay attention to insulation, dry climate in the plateau area, strengthen the mucous membrane and skin care, prevent skin chapped.
The standard atmospheric pressure of people living at sea level is 760mm. The mercury is also an ATA. The air is a mixture of oxygen, nitrogen and other gases. The content of oxygen is 20.95%. With the increase of the topography, the pressure is gradually reduced. The partial pressure of oxygen in the alveoli, arterial blood and tissue also decreases accordingly. When people enter the plateau area from the plains, it usually takes 2-3 months to slowly adapt to the local environment of low oxygen, so that people can survive in this environment, and can perform normal or near normal mental and physical activity , but a degree of pro-border. If people can not adapt to the alpine hypoxic environment will occur alpine diseases, such as high altitude heart disease, high altitude polycythemia, high altitude hypertension, high altitude hypotension.
mountain sickness
The reason for the formation of mountain sickness is that the higher the altitude, the thinner the air, and the lower the air pressure. Therefore, the oxygen pressure needed by the human body is also reduced, but the oxygen content required by the human body remains unchanged, so that the human body maintains the blood Need oxygen content, it is necessary to increase the content of red blood cells, but the human body automatically increase the content of red blood cells takes a few days, so when you just entered the mountains, because of a sudden increase in height, the human body too late to adapt, resulting in insufficient supply of oxygen in the body The higher the height of the situation, the shorter the transition time and the more violent the reaction. This physiological reaction is generally called [Alpine].
The symptoms of mountain sickness are: vomiting, deafness, headache, shortness of breath, loss of appetite, fever, drowsiness, severe symptoms such as dullness, restlessness, mental excitement, thinking, loss of mind, hearing, vision, Odor, taste abnormalities, hallucinations, etc., may also occur edema, shock or paralysis.
The methods of prevention include: The speed of climbing should not be too fast. It is best to calm down smoothly, and cooperate with breathing. At the same time, adjust according to the steepness of the slope, so that the amount of exercise is proportional to the breathing, and in particular, to avoid shortness of breath. The height of ascent should be gradually increased, and the height of daily climbing should be controlled to adapt to the low air pressure and thin air environment. Travel should not be too tight, sleep, diet should be sufficient and normal, regular short-term rest, soft and deep breathing at rest to strengthen the circulation and a high degree of adaptation, usually should be more physical training to increase oxygen function.
First aid for mountain sickness: Oxygen supply and height reduction are the most effective first aid treatments. If there is a shock phenomenon, priority should be given to treatment, and attention should be paid to loss of temperature and other complications. Take a rest immediately and move the patient to a place without wind. If the pain is severe, you can take analgesics to relieve pain. If you still can not adapt, you need to reduce the height until the patient feels comfortable or the symptoms are significantly reduced. In general, people with mountain sickness can be cured when they fall to the ground. Despite this, serious patients still need medical treatment.
The pathogenesis of plateau adaptation insufficiency
For people who have lived in the plateau for a long time, the body can gradually adapt to the special climatic conditions in the plateau region. Under the regulation of the neurohumoral fluid, the functions of the various parts of the body have corresponding changes and changes, mainly the respiratory system and circulatory system are more obvious, and the atmosphere and alveoli in the plateau area. The difference in the partial pressure of oxygen decreases as the altitude of the mountain climbs. Directly affect the alveolar and gas exchange, the oxygen-carrying oxygen in the blood and the release rate of oxygen in the tissue cause the body to supply oxygen and produce hypoxia. The first climber stimulated the respiratory center due to hypoxia, which caused an increase in early ventilation, so the body needs to inhale more oxygen to taste. The higher the altitude, the lower the partial pressure of oxygen in the atmosphere, and the corresponding increase in oxygen deficiency. Speed ​​and labor intensity also affect the degree of altitude sickness. In addition, factors such as mental stress, fatigue, infection, malnutrition, low temperature, cold, and other factors also affect the incidence. The clinical manifestations of high altitude sickness in acute mountain sickness in a short time quickly boarded in the mountains above 3000M above sea level or long-term living in the plateau area, living in the plains for a period of time back to the plateau when there may be headaches, dizziness, palpitations, shortness of breath, chest tightness In severe cases, loss of appetite, nausea, vomiting, insomnia, fatigue, weakness, bloating, mild purple lips, and facial edema. Acute mountain reactions generally occur in mountaineering for 24 hours. Generally, they can adapt to the local alpine climatic conditions within 1-2 weeks after entering the plateau. The above symptoms can disappear on their own, if the symptoms continue to increase can be given symptomatic treatment, the use of industrial dose of 0.25g oral dose of 2-4 times a day, 2 days before the mountain to 3 days after climbing, the drug mainly plays a diuretic effect, can Reduce the incidence and severity of acute mountain sickness, and reduce the lack of oxygen during sleep, prednisone 5-10mg, 2 times per scorpion, use Jintian after the mountain to help reduce symptoms, in addition to moderate sedatives and Various vitamins, and ammonidine.
The clinical manifestations of high altitude pulmonary edema The incidence rate of high altitude pulmonary edema is 3%. On the basis of acute altitude sickness, when it reaches an altitude of 4000m or above, the disease can also occur when it is quickly boarded at 2500m. Therefore, it takes 3-48 hours after climbing. Rapid onset, can also be late for 3-10 days before the onset of symptoms such as headache, chest tightness, cough, difficulty breathing, can not be supine, individual severe cases may have urinary tract, slightly bloody foam-like sputum, even divinely unclear, cold Hypoxia can be exacerbated by breathing and infection, and coughing or exertion can also be an important cause. Treatment should be given early oxygen, 6-8lc per minute, with pulmonary edema can be used 50% -70% alcohol inhalation of oxygen, absolutely bed rest, pay attention to keep warm, prevent upper respiratory tract infection, is strictly prohibited drinking water, urinary speed 20-40mg, Immediately push or 40-80mg orally, every 2 times orally 2-3 days, pay attention to potassium during diuretic observation dehydration when irritability, a small amount of sedatives can also be used 0.25 alanine soluble in 50% GS40ml, slow static push To reduce pulmonary artery pressure orally prednisone or intravenous infusion of hydrocortisone, reduce capillary permeability and relieve bronchial spasm, patients with respiratory and heart failure should immediately take appropriate treatment measures, and then turn to a lower condition after stable disease Treatment continues at altitude.
High altitude brain edema, also known as high altitude coma or low incidence of high altitude encephalopathy, but more likely to cause death, more common in the rapid entry of more than 4,000 meters, acute onset, and more at night, mainly due to acute hypoxia caused by cerebral vasospasm Increased permeability leads to cerebral edema. In addition to the symptoms of early altitude sickness, the patient was accompanied by increased intracranial pressure, severe headache, and vomiting. There were also symptoms of diversion, depression, or excitement and senility. Individual patients developed convulsions, lethargy, drowsiness, coma, and pulse rate. Increased speed, irregular breathing, pupillary response to light, optic edema of the optic nerve, and bleeding.
The treatment is first to continue to give oxygen 95% oxygen and 5% of carbon dioxide. After waking, oxygen should be discontinued. Use 50% GS mannitol, paroxetine, and cell-emergent E to reduce cerebral edema and reduce brain. Cell metabolism, provide enough energy to promote recovery, please use central N stimulants, such as lobeline, coramine, etc., pay attention to water and salt and electrolyte balance and if necessary, anti-infective treatment, stable condition, turn to low altitude Continued treatment, some climbers will also appear eye syndrome, retinal hemorrhage. Precaution:
All personnel entering the plateau should undergo a comprehensive physical examination. Generally healthy persons are adapted to a hypoxic environment. All patients with hypertension, such as heart, lung, liver and kidney disease, should not enter the plateau region.
In general, physical exercise should be stepped up and the ladder should be opened to gradually adapt. The speed of mountain climbing is extremely important. It is reported in the country that the rate of acute altitude sickness at the altitude of 4200 meters in the plain within 3 miles is 83.5%. However, when the 2261m arrived at 4200m within 7-15 days after step adjustment, the incidence rate was only 52.7% (p<0.001). Drug patients could temporarily reduce the symptoms of incompatibility, but they could not improve, and even delay the body for hypoxia. With regard to adaptability, Chinese medicine personnel in the mountaineering process should be stepped up to ensure early detection and early treatment.
Those who enter the plateau should reduce physical labor and gradually increase the amount of labor depending on the degree of adaptation. The plateau's working environment is mostly below 4,000 meters, and the impact on labor ability is 30%-50% lower than that of the plains. Warmth should be taken to prevent acute upper respiratory tract infections. .
When entering the plateau, you should eat more carbohydrates, multi-vitamins and easily digested foods, high-carbohydrate foods can provide sugar and increase the ability of the lungs to disperse, so as to increase the body's ability to adapt to the plateau. It is absolutely forbidden to drink alcohol, and alpine patients fall asleep When it is best to take a semi-recumbent position, reduce right venous return and pulmonary capillary congestion.
Large temperature difference between day and night in the plateau area should pay attention to insulation, dry climate in the plateau area, strengthen the mucous membrane and skin care, prevent skin chapped.
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