Thapa Simant Singh, Basnyat Buddha
Department of Medicine, Saint Vincent Hospital, Worcester, Massachusetts, USA.
Mountain Medicine Society of Nepal (MMSN), Kathmandu, Nepal.
BMJ Case Rep. 2018 Dec 3;11(1):bcr2017222888. doi: 10.1136/bcr-2017-222888.
A 55-year-old female Nepali pilgrim presented to the Himalayan Rescue Association Temporary Health Camp near the sacred Gosainkund Lake (4380 m) north of Kathmandu, Nepal, with a complaint of severe headache, vomiting and light-headedness. She was diagnosed with severe acute mountain sickness. Intramuscular dexamethasone was administered. Paracetamol (acetaminophen in the USA and Canada) and ondansetron were given as supportive management for headache and nausea. Arrangements were made to have her carried down by a porter immediately. After the descent, all her symptoms resolved. High-altitude pilgrims are a more vulnerable group than trekkers and mountaineers. Pilgrims generally have a rapid ascent profile, have low awareness of altitude illness and are strongly motivated to gain religious merit by completing the pilgrimage. As a result, there is a high incidence of altitude illness among pilgrims travelling to high-altitude pilgrimage sites.
一名55岁的尼泊尔女性朝圣者前往尼泊尔加德满都以北神圣的戈萨因孔德湖（4380米）附近的喜马拉雅救援协会临时医疗营地，主诉严重头痛、呕吐和头晕。她被诊断为重度急性高原病。给予了肌肉注射地塞米松。对乙酰氨基酚（在美国和加拿大称为醋氨酚）和昂丹司琼用于头痛和恶心的支持性治疗。已安排立即由搬运工将她抬下山。下山后，她所有的症状都消失了。高海拔朝圣者比徒步旅行者和登山者更容易受到伤害。朝圣者通常上升速度很快，对高原病的认识较低，并且强烈希望通过完成朝圣获得宗教功德。因此，前往高海拔朝圣地点的朝圣者中高原病的发病率很高。
