国际荒野医学协会关于急性高原病预防和治疗循证指南的演变历程及对高原卫勤保障的启示  

Evolution of consensus guidelines for prevention and treatment of acute mountain sickness by the Wilderness Medical Society and their implications for high⁃altitude military medical support

作　　者：李晓方 杜可 滕岱青 罗勇军 LI Xiaofang;DU Ke;TENG Daiqing;LUO Yongjun(Department of Military Medical Geography,Army Health Service Training Base,Army Medical University,Chongqing 400038,China;Cadet Group One,School of Basic Medical Sciences,Army Medical University,Chongqing 400038,China)

机构地区：[1]陆军军医大学陆军卫勤训练基地军事医学地理学教研室,重庆400038 [2]陆军军医大学基础医学院学员一大队,重庆400038

出　　处：《军事医学》2024年第12期918-925,共8页Military Medical Sciences

基　　金：国家自然科学基金面上项目(42377466)。

摘　　要：急性高原病是进入高原地区,人体暴露于低压低氧环境后产生的各种病理性反应。我国高原地区面积辽阔,地形复杂,战略位置十分重要,近年来随着实战实训大练兵活动的开展,越来越多的平原部队进入高原开展高原驻训活动,高原低压低氧的特殊环境,严重影响部队战斗力生成。国际荒野医学协会(WMS)分别在2010、2014、2019和2024年发布了关于急性高原病预防和治疗循证指南,指出急性高原病常用的预防和治疗药物,如乙酰唑胺、地塞米松、对乙酰氨基酚和硝苯地平等;常用的非药物预防和治疗方法,如逐渐升高海拔、预适应、吸氧、降低海拔和便携式高压氧舱等。该文旨在分析4版指南中各预防和治疗方法的演变历程,掌握最新的急性高原病预防和治疗方法,为部队高原驻训、作战等任务卫勤保障提供参考,为维护和提高高原驻训部队战斗力提供理论依据。Acute mountain sickness is a variety of pathological reactions that occur when people enter high altitude areas and are exposed to a hypobaric and hypoxic environment.China has vast high-altitude regions with complex terrains and of strategic importance.With the increase in large-scale combat training activities,more troops have entered high-altitude areas to carry out training.The hypobaric and hypoxic environment at high altitudes impacts the generation of combat effectiveness.The Wilderness Medical Society(WMS)has issued consensus guidelines for the prevention and treatment of acute mountain sickness in 2010,2014,2019 and 2024,respectively.The commonly used drugs for the prevention and treatment of acute mountain sickness include acetazolamide,dexamethasone,acetaminophen and nifedipine while non-pharmaceutical approaches include gradual ascendance,pre-acclimation,oxygen inhalation,descendance to a lower altitude,and portable hyperbaric oxygen chambers.This article was intended to trace the evolution of each means of prevention and treatment specified in the four editions of the guidelines,keep track of the latest approaches to acute mountain sickness,and provide a reference for military medical support for related training.

关 键 词：国际荒野医学协会 急性高原反应 高原脑水肿 高原肺水肿 卫勤保障 

分 类 号：R826.2[医药卫生—临床医学]