朝圣者快速上升至 4380 米后出现的高原病。

High altitude illness in pilgrims after rapid ascent to 4380 M.

机构信息

Department of Emergency Medicine, Stanford University Medical Center, Palo Alto, CA, USA; Himalayan Rescue Association, Kathmandu, Nepal.

Mountain Medicine Society of Nepal, Kathmandu, Nepal.

出版信息

Travel Med Infect Dis. 2017 Mar-Apr;16:31-34. doi: 10.1016/j.tmaid.2017.03.002. Epub 2017 Mar 9.

DOI:10.1016/j.tmaid.2017.03.002

PMID:28285976

Abstract

BACKGROUND

The goal of the study was to characterize high altitude illness in Nepali pilgrims.

METHODS

We kept standardized records at the Himalayan Rescue Association (HRA) Temporary Health Camp at Gosainkund Lake (4380 m) in the Nepal Himalaya during the annual Janai Purnima Festival in 2014. Records included rate of ascent and Lake Louise Score (LLS). We defined High Altitude Headache (HAH) as headache alone or LLS = 2. Acute Mountain Sickness (AMS) was LLS≥3. High Altitude Cerebral Edema (HACE) was AMS with ataxia or altered mental status.

RESULTS

An estimated 10,000 pilgrims ascended rapidly, most in 1-2 days, from Dhunche (1960 m) to Gosainkund Lake (4380 m). We saw 769 patients, of whom 86 had HAH. There were 226 patients with AMS, including 11 patients with HACE. We treated patients with HACE using dexamethasone and supplemental oxygen prior to rapid descent. Each patient with HACE descended carried by a porter. There were no fatalities due to HACE. There were no cases of High Altitude Pulmonary Edema (HAPE).

CONCLUSIONS

HAH and AMS were common in pilgrims ascending rapidly to 4380 m. There were 11 cases of HACE, treated with dexamethasone, supplemental oxygen and descent. There were no fatalities.

摘要

背景

本研究旨在描述尼泊尔朝圣者的高原病特征。

方法

在 2014 年尼泊尔喜马拉雅山的 Janai Purnima 节期间，我们在喜马拉雅救援协会（HRA）高海拔湖临时医疗营（海拔 4380 米）记录了标准数据。记录内容包括上升速度和路易斯湖评分（LLS）。我们将高原性头痛（HAH）定义为单纯头痛或 LLS=2。急性高原病（AMS）的 LLS≥3。高原性脑水肿（HACE）为有共济失调或意识改变的 AMS。

结果

据估计，有 10000 名朝圣者迅速从 Dhunche（1960 米）上升到 Gosainkund 湖（4380 米），大多数人在 1-2 天内完成。我们共诊治了 769 名患者，其中 86 人患有 HAH。有 226 名患者患有 AMS，其中包括 11 名 HACE 患者。我们使用地塞米松和补充氧气治疗 HACE 患者，然后快速下降。每位 HACE 患者均由一名搬运工携带下山。无 HACE 相关死亡病例。也无高原性肺水肿（HAPE）病例。