altitude sickness
Introduction
Introduction to high altitude disease High altitude disease usually refers to diseases caused by high altitude hypoxia environment that occur when the human body enters the plateau or enters a higher altitude area from the plateau. Can be divided into acute high altitude disease and chronic high altitude disease. Also known as mountain sickness. The hypoxia environment in the plateau causes hypoxia in the body. Upper respiratory tract infection, fatigue, cold, nervousness, hunger, pregnancy, etc. are the cause of the disease. basic knowledge Sickness ratio: 0.05% Susceptible people: no specific population Mode of infection: non-infectious Complications: pulmonary edema
Cause
Cause of high altitude disease
The plateau is characterized by thin air, low atmospheric pressure and low oxygen partial pressure. When the sea level temperature is 0 °C, the atmospheric pressure is 101.2 kPa (760 mmHg), the atmospheric oxygen partial pressure is 21.2 kPa (159 mmHg), the normal human alveolar oxygen partial pressure is 14 kPa (105 mmHg), and the arterial partial pressure of oxygen (PaO2) is 13.3. kPa (100mmHg). When the altitude is increased to 3000m, the atmospheric pressure drops to 77.3kPa (526mmHg), the atmospheric oxygen partial pressure is 14.7kPa (110mmHg), the alveolar oxygen partial pressure is 8.26kPa (62mmHg), PaO2 and arterial oxygen saturation decrease significantly, and the human body lacks. Oxygen phenomenon.
Prevention
Plateau disease prevention
Personnel entering the plateau should understand and adapt to the characteristics of the plateau environment. During the mountaineering, staged adaptive exercise should be carried out according to plan. Pay attention to cold prevention and prevention of upper respiratory tract infection. Those who return to the plateau in the long-term plain should also rebuild their adaptability. It should be obvious heart, lung and blood diseases. Patients should not enter the plateau.
To prevent acute altitude sickness, a diuretic can be used to prevent fluid retention from 1 to 2 days before entering the plateau. Even for one week: (1) acetazolamide 0.25g once every 8 hours. (2) furosemide 20mg, 2-3 times a day, climbing under emergency conditions, available glucocorticoids.
Complication
Plateau disease complications Complications pulmonary edema
Pulmonary edema with left heart failure.
Symptom
Symptoms of high altitude sickness Common symptoms Tired chest tightness, shortness of breath, water and soil dissatisfaction
1, altitude sickness.
2, high altitude pulmonary edema.
3, the plateau coma.
Examine
Examination of altitude sickness
Conditions for diagnosing high altitude sickness:
(1) Entering the plateau, or entering the higher area from a low altitude area.
(2) The symptoms of acute high altitude disease are aggravated with the increase of altitude, and are relieved by entering the lower altitude area, and oxygen therapy is effective.
(3) Most of the treatment of chronic high altitude disease is effective.
(4) Except for other diseases with similar symptoms.
Diagnosis
Diagnosis and differentiation of high altitude disease
Differential diagnosis
1, motion sickness: before entering the plateau, it is also a history of motion sickness, no symptoms of hypoxia. The symptoms of returning to the low-altitude area from the plateau are not alleviated, and the symptoms are improved after stopping the ride.
2, left heart failure pulmonary edema: no prodromal symptoms of altitude sickness. There are rounds of heart disease history, signs and causes of heart failure, oxygen therapy is poor.
3, other coma diseases: physical examination found that hemiplegia should be a high degree of cerebrovascular accident; those with head injuries consider craniocerebral trauma; fever consider infectious diseases. Those who have been exposed to toxic substances before the disease consider poisoning. Those with a history of lung, liver, kidney diabetes, hypertension, and epilepsy consider the disease. Laboratory tests can aid in diagnosis.
4, polycythemia vera: often have splenomegaly and white blood cells, thrombocytosis.
5, other organic heart disease: atherosclerotic heart disease: elderly patients with sudden left heart failure, ECG and serum myocardial enzyme assay have special changes. Rheumatic heart disease: There is a sign of mitral stenosis. Pulmonary heart disease: a history of right heart failure and chronic bronchial obstructive emphysema.
