13-33 睡在 2450 米以上就有高原病风险。高原脑水肿和肺水肿(脑子和肺里积水),不及时往低处撤会死。美国…
睡在 2450 米以上就有高原病风险。高原脑水肿和肺水肿(脑子和肺里积水),不及时往低处撤会死。美国疾控中心黄皮书给了三条防重症的规矩:知道早期症状并肯承认;有症状时,不管多轻,都不再往更高处去睡;同一高度休息或治疗后症状还在加重,就下撤。急性高原病往下走 300 米以上通常很快好转。高原脑水肿在偏远地区要马上下撤,有地塞米松和氧气就一起用。高原肺水肿多数情况下必须马上下撤,下撤和吸氧都比吃药有效得多
来源:美国疾病控制与预防中心. 黄皮书·高海拔旅行与高原病:「Any unacclimatized traveler proceeding to a sleeping altitude of ≥2,450 m (≥8,000 ft)—and sometimes lower—is at risk for altitude illness」;上升速度「500 m (1,650 ft) per night in sleeping altitude once above 3,000 m (9,800 ft)」,每上升 1000 米加一天适应日;乙酰唑胺预防「125 mg twice a day; 250 mg twice a day if >100 kg body weight」;「If symptoms become worse despite rest or treatment at the same elevation」必须下撤;「Never ascend to sleep at a higher altitude when experiencing symptoms of altitude illness, no matter how minor the symptoms seem」「AMS improves rapidly with a descent of 300 m (1,000 ft) or more」「In remote areas, initiate descent for anyone suspected of having HACE」「Descent and oxygen are much more effective treatments than medication」. https://www.cdc.gov/yellow-book/hcp/environmental-hazards-risks/high-altitude-travel-and-altitude-illness.html;荒野医学会 (2024). 急性高原病预防、诊断与治疗临床实践指南(2024 更新). Wilderness & Environmental Medicine. https://doi.org/10.1016/j.wem.2023.05.013
补充说明:算的是「睡在多高」,不是白天到过多高。有症状就不再往高处睡,休息后还加重就往下走。走路打晃、意识变化,或者不动也喘不上气,可能是脑水肿或肺水肿,在野外要马上往下撤。吃药比不上下撤和吸氧。