夏季高原军事作业中急性高原病的现场观察与防护研究  

Observation and prevention of acute highland disease in highland military works in summer

作　　者：于晟[1] 张世范[1] 薛小东[1] 解好群[1] 吴明延[1] 刘惠萍[1] 张德海[1] 高炜[1] 吕国祯[1] 

机构地区：[1]兰州军区兰州总医院

出　　处：《西北国防医学杂志》2002年第2期104-106,共3页Medical Journal of National Defending Forces in Northwest China

基　　金：全军"十五"指令性课题资助 (O1L0 0 3

摘　　要：目的 :探讨高原军训中的发病特点规律、血气变化及防治。方法 :将由低海拔区进驻高原的青年群体 4 80例随机分为复方红景天 (RhadiodaCompoundRCO)防治组 (RGn =12 0 ) ,参芪花粉合剂 (AstragalusCodonopsisCompoundACO)防治组 (AGn =12 0 ) ,安慰合剂组 (PCO)对照组 (CGn =2 4 0 ) ,均于进驻高原前 2 4h分别服用RCO、ACO和PCO。按预设方案登记呼吸次数 (R)·min-1、脉搏次数 (P)·min-1和进驻高原不同梯度 (2 90 0m、32 0 0m、370 0m、4 4 0 0m)后的R、P ,并按记分标准登记用药前后不同梯度的高原反应。随机抽测三组的中心动脉血气、肺功、指氧饱合度 (SatO2 )。结果 :在 32 0 0m、370 0m、4 4 0 0m不同海拔梯度急性高原病 (AHAD)RG和AG明显低于CG ,至 4 4 0 0mAHAD(含 3例高渗脱水 )累计发生率 16 7/ 4 80例 (34.8% ) ,RG、AG、CG分别为 35 / 12 0 ,30 / 12 0 ,10 2 / 2 4 0 ;有明显呼吸功能不全 (AIR)或脑水肿、肺水肿症征者分别为 1/ 12 0 ,1/ 12 0 ,14 / 2 4 0。在 370 0m ,44 0 0m两个梯度的PaO2 RG比CG分别高出 4 .4mmHg(P <0 .0 1) ,3.4mmHg(P <0 .0 1)。结论 :预服中药RCO、ACO可增强高原致适应性 ,提高PaO2 ,降低AHAD、AIR发生率 。Objective:To investigate the occurring law and prevention and cure of acute highland disease of military group in highland training.Methods:480 young soldiers were randomly divided into three groups:Rhadiola Compound(RCO)group,Astragalus Codonopsis Compound(ACO)group and contrast groups(PCO),in which RCO,ACO and placebo compound PCO were taken orally 24 hours before entering the highland.Respiratory times(R)and pulse times(P) in different altitude(2 900 m,3 200 m,3 700 m,4 400 m)were recorded respectively and indexes of arterial blood gas,pulmonary function,oxygen saturation(SatO 2)were determined randomly in the three groups.Results:The cases of acute highland disease reaction(AHAD)and acute respiratory insufficiency(ARI)occurred in RCO and ACO were obviously fewer than those in PCO in altitude of 3 200 m,3 700 m and 4 400 m.The accumulated incidence rates of AHAR were respectively 35/120(RCO),30/120(ACO),102/240 and the corresponding occurring rates of ARI cerebral edema,HAPE and serious hypertonic dehydration were 1/120,1/120,14/240 respectively.Moreover,the average PaO 2 in RCG was 4.4 mmHg and 3.4 mmHg in altitude 3 700 m and 4 400 m higher than that in PCO( P <0.01).Conclusion:Chinese traditional drugs RCO and ACO may enhance the highland adaptation,increase the arterial PaO 2 value and decrease the occurring rate of AHAD and ARI,they could be applied to highland protection for large quantities of soldiers stationing in.

关 键 词：急性高原病 动脉血气 中药 红景天 参芪花粉 防护 AHAD 夏季 高原军事作业 

分 类 号：R594.3[医药卫生—内科学] R825[医药卫生—临床医学]