With the opening of the Qinghai-Tibet Railway, more and more people can easily reach high altitude areas, and more and more people will suffer from altitude sickness. For altitude sickness, we don't have to talk about it, nor can we underestimate the harm it brings. I hope this article can give you a correct understanding of altitude sickness.
Altitude sickness, that is, altitude sickness, refers to that an unaccustomed person quickly enters a plateau area over 3, meters. Due to the decrease of oxygen partial pressure in atmospheric pressure, the body's tolerance to hypoxic environment is reduced, which makes it difficult to adapt to hypoxia, thus causing a series of altitude maladjustments. Of course, in addition to the factors of altitude hypoxia, there are also bad weather such as wind, rain, snow, cold and strong ultraviolet radiation, which can aggravate altitude maladjustment and cause different altitude maladjustment.
after a period of adaptation, the body can undergo a series of adaptive changes, such as increasing ventilation, so that the oxygen utilization of tissues can reach or approach normal levels; Speed up the heart rate and increase the pumping capacity of the heart, so as to increase the amount of bleeding per minute and improve the hypoxia situation; Increase the amount of red blood cells and hemoglobin to increase the oxygen carrying capacity to ensure the oxygen supply of the body. However, some people are sensitive to the low oxygen partial pressure in the air, and their adaptability is poor, and there will be a series of symptoms and changes in functional metabolism, also known as acute altitude sickness. Abroad, it is divided into acute altitude sickness, high altitude pulmonary edema, high altitude cerebral edema, high altitude retinal hemorrhage and chronic altitude sickness, while in China, it is divided into acute and chronic altitude sickness. For individuals, the onset is often mixed and difficult to distinguish, and in the whole onset process, it is more prominent in a certain stage.
Symptoms of altitude sickness and self-judgment
Some people who enter the plateau for the first time have symptoms such as headache, dizziness, dizziness, tinnitus, general fatigue, difficulty in walking and difficulty in falling asleep within 24 hours at an altitude of 3, meters. In severe cases, they have symptoms such as abdominal distension, loss of appetite, nausea, vomiting, palpitation, shortness of breath, chest tightness, purple complexion and lips or facial edema. When these symptoms appear, you should stay at the original height and rest for 3~5 days, or immediately drop the height by hundreds of meters, and generally you can return to normal.
It has been reported that the incidence below 3,5m accounts for 37%~51%, and the incidence between 3,6m and 5,m reaches 5%. This shows that the higher the altitude, the higher the incidence of altitude sickness.
Severe altitude sickness does serious harm to human body. Therefore, after entering the plateau, altitude sickness should be considered if the following symptoms appear:
1. Severe pain in the head, palpitation, shortness of breath, chest tightness, loss of appetite, nausea, vomiting and cyanosis of lips and nails.
2. Consciousness is in a trance, and cognitive ability drops suddenly. The main performance is the difficulty in calculation. Do a simple addition problem before entering the plateau and record the time spent. When symptoms appear, repeat the same calculation problem. If the time spent is longer than before, altitude sickness has occurred.
3. Have hallucinations, feel warm, and often walk behind others aimlessly.
preventive measures and drugs to alleviate symptoms
before entering the plateau, people with severe anemia, hypertension and obvious diseases such as heart, liver, lung and kidney should not enter the plateau. Obese people are generally more likely to have mountain sickness because of their high oxygen consumption.
When you first enter the plateau, you should reduce physical activity to protect your heart, so you should strictly control the climbing speed. Generally, you should not climb more than 1 meters in one day.
from two days before entering the plateau to three days after entering the plateau, preventive oral administration of some drugs can alleviate the symptoms of altitude sickness:
acetazolamide .25g, twice a day. Acetazolamide itself has diuretic effect, which is mainly used for cardiac edema, brain edema and digestive tract ulcer. Preventive use can reduce the symptoms of altitude sickness. The side effects of acetazolamide are renal colic, kidney calculi, sulfanilamide crystallization, nephrotic syndrome and agranulocytosis (sulfanilamide allergy). Long-term use can cause low potassium ions in the blood, and potassium needs to be supplemented (oranges or bananas can be eaten). People with hepatic coma and renal dysfunction should not take it.
Rhodiola is a drug that many people hope to prevent altitude sickness. Its functions are clearing away heat and toxic materials and eliminating dampness, and it can be used for treating lung heat, pulse heat, pestilence and swelling of limbs. In recent years, salidroside has been isolated from Rhodiola in China, and it has been proved by experiments that it has the effects of strengthening the heart, calming, raising blood pressure and resisting fatigue. Rhodiola extract is used to resist fatigue, increase physical strength and endurance, and be weak after illness. Whether it can prevent and treat altitude sickness, the author has not found a scientific basis.
dexamethasone .75~6 mg can be added according to the hypoxia condition, and taken 2~4 times a day. The main function of this medicine in alleviating altitude sickness hypoxia is to increase the content of red blood cells and hemoglobin, so as to improve the ability to carry oxygen. Dexamethasone is a glucocorticoid drug, and the indications must be strictly controlled. Abuse of this drug will reduce its due role when it is really necessary to be rescued. Large doses can cause obesity, increased intraocular pressure, hypertension, digestive tract ulcers, bleeding and even perforation. Especially those infected with the virus, taking glucocorticoids can spread and aggravate the virus infection.
You Luo Fen can relieve headaches caused by high altitude, and take 5 mg orally, 3-4 times a day. Nifedipine (Xintongding) dilates arterioles, which can reduce pulmonary edema. Moderate sedatives, multivitamins and aminophylline can alleviate symptoms.
When you enter the plateau, you should also pay attention to a reasonable diet, eat more carbohydrates and eat less indigestible food. Special reminder against drinking. Drinking alcohol can speed up the heartbeat and increase the load on the unaccustomed heart; Drinking can dilate the blood vessels of the whole body, increase the heat dissipation of the skin, and then speed up the heartbeat again, and the chances of vicious circle, heart failure and brain edema at high altitude are greatly increased.
Plateau environment and long-term hypoxia can cause an obvious increase in the number of red blood cells and an increase in blood viscosity. Excessive sweating when climbing mountains, coupled with breathing too fast and too deep, increases water consumption in the body and aggravates blood viscosity. Viscous blood leads to poor blood circulation, insufficient blood supply and oxygen supply, so many people have severe headaches, chest tightness, shortness of breath, fatigue and other symptoms, and even lead to heart failure in severe cases. Therefore, drink at least 3~4 liters of water every day to ensure that the body is adequately hydrated. After blood dilution, it can reduce the load on the heart and reduce the symptoms of altitude sickness. Whether water supplement is reasonable or not depends on sufficient urine volume and clear urine, and pay attention to electrolyte balance.
high altitude pulmonary edema and brain edema
altitude sickness is a serious threat to people's lives and health. How can we find out and help each other on the spot in time?
High altitude pulmonary edema is a common severe altitude sickness, with an incidence rate of about 3%. Generally, it occurs above 4 meters, and it often occurs rapidly in 3-48 hours after climbing, and later in 3-1 days. The important inducement is respiratory infection caused by cold, fatigue and decreased resistance. When you have a headache, chest tightness, cough in varying degrees (dry cough at first, phlegm later), and difficulty breathing, you can't lie on your back. In severe cases, you will cough up pink foam-like sputum. The rescuer will put his ear close to the chest wall of the patient and hear the bubbling breathing sound in the lungs (called wet rales in medicine). At this time, the patient is frightened, flustered, cyanosis in the mouth, lips and face, and in severe cases, hematuria or gradual unconsciousness. Severe pulmonary edema can deteriorate rapidly, and the patient will be unconscious and die within a few hours.
The first-aid measures for pulmonary edema are to rest in an absolute semi-recumbent position, with legs drooping, and immediately take sufficient oxygen, preferably oxygen containing 5%~7% alcohol at a flow rate of 6 ~ 8 liters/minute; Take furosemide (furosemide) 4 mg/day immediately. Using furosemide may cause slight nausea, diarrhea, drug eruption, blurred vision, upright vertigo, muscle spasm, thirst, etc. Be careful not to use it too much at first, and it can be increased to 8 mg twice a day according to the situation. Nifedipine reduces pulmonary edema. Antibiotics and dexamethasone 4 mg can be used to prevent and treat upper respiratory tract infection (only once orally). When you are agitated, you can use a small amount of sedatives. Pay attention to keep warm, and do not drink a lot of water. After the initial first aid, the condition was stable and quickly moved to a lower altitude. Once breathing or cardiac arrest occurs, perform cardiopulmonary resuscitation immediately.
It should be noted that colds should be avoided as much as possible in plateau areas. There is an illusion about the temperature of fever when you have a cold at altitude. The temperature of body temperature is often 1 degree lower than the actual temperature, so it is easy to be ignored. Even a slight respiratory infection can increase the risk of high altitude pulmonary edema. Therefore, it is necessary to strengthen warm prevention. After entering the plateau, reduce the number of baths or not. Take anti-cold medicine immediately when you find the first symptoms of a cold. If you take anti-cold medicine after two days, it is generally ineffective.
people who have recurrent high altitude pulmonary edema are susceptible, and the incidence of male pulmonary edema is five times more than that of female. If pulmonary edema has occurred before, we suggest not to climb mountains above 3 meters.
High altitude brain edema is another severe altitude sickness, which is acute and often occurs at night. The incidence rate is low, but the mortality rate is high. Its symptoms: in addition to early altitude sickness, there are severe headaches, vomiting and even jet vomiting; Gradually trance, poor orientation, personal convulsions, incontinence, and finally lethargy to coma. A few people may have retinal hemorrhage.
In the past, Shanyou used to judge whether there was brain edema according to experience, and the usual method was to let people with suspected brain edema walk in a straight line to judge whether their orientation was poor. From a scientific point of view, this method is not desirable! In patients with brain edema, the brain tissue has been seriously deprived of oxygen. At this time, people who are in a trance are likely to fall to the ground immediately and fall into a coma. This inspection method that aggravates the damage is risky. The correct way to judge is to let the patient lie in a semi-recumbent position, and instruct him to point to his nose, ears, eyes, etc. according to the instructions to see if his movements can be accurate. Once not, it means that brain edema may have occurred.
If brain edema and coma are found, oxygen containing 5% carbon dioxide should be given quickly and continuously until waking up, and oxygen should be given intermittently after waking up. Conditional use of hypertonic glucose, mannitol, adrenocortical hormone, cytochrome C and other treatments to reduce brain edema and promote recovery. Central nervous system stimulants such as lobeline hydrochloride (lobeline) and nikethamide (colamin) can be used as appropriate. Pay attention to the balance of water, salt and electrolyte and the necessary anti-infection measures. After the condition is stable, immediately go down the mountain and rush to the hospital.
In the anoxic environment, people will improve the anoxic condition by accelerating and deepening breathing, which will increase the exhaled carbon dioxide and lead to respiratory alkalosis. Respiratory alkalosis not only constricts the cerebral vessels, but also causes loss of consciousness and brain edema at high altitude. The most effective way to prevent respiratory alkalosis is to roll a newspaper into a cone shape, tear a small hole with a diameter of 1-2 cm at the tip of the cone, and stick the conical newspaper close to the face, so that the exhaled gas can be sucked back again, that is, the exhaled carbon dioxide can be sucked back again, so as to improve the pH in the body and correct respiratory alkalosis.
There is no need to be reluctant to face the plateau
Not everyone who climbs the plateau will have altitude sickness. The incidence and recovery speed of altitude sickness are related to the individual's compensatory adaptability, which varies greatly from individual to individual. People who do not have altitude sickness this time may not have no reaction when they climb the plateau next time. Some people have altitude sickness every time. These people are sensitive person or highly prone to altitude sickness. What needs to be reminded here is that altitude sickness can not be overcome by repeated exercise. Therefore, in order to ensure good health, it is suggested that people prone to altitude sickness should not continue to climb such high areas, and fitness mountaineering in low altitude areas can also cultivate sentiment and exercise.
Lhasa area of Tibet tourism strategy:
Potala Palace
It is open every day from 9: to 12: 3, from 15: to 18:
It takes more than 2 hours to visit. However, after more than an hour of opening hours, tickets are basically no longer sold. Every Monday, Wednesday and Friday is the day when Tibetans worship Buddha, and there are many people. You can also drive directly to the top from the back door by car, and get down from the front door after the visit, which is more labor-saving.
Note:
1. The palace is high, so go up and down slowly.
2. It's cold in the temple, so it's better to prepare a coat even in summer.
3. If you want to take photos in the temple, the fee is very high. Gu suggested hanging the camera on your chest instead of flashing blind shot, which is also satisfactory.
4. Toilets in Bugong are few and hard to find, so it is better to solve them at the entrance before the tour. The toilet at the back door of another cloth palace is very distinctive and a sight. Don't miss it.
5. The inspection of the cloth palace is very strict, so it is almost impossible to evade tickets. There is a method that can be tried, that is, Tibetans go when they turn the scriptures on the first, third and fifth days, and don't buy tickets when they enter the front door. After climbing the steps, there is a small room where Tibetans buy tickets for 2 yuan/Zhang. You can ask Tibetans to buy one for you. Before entering the main hall, some people will collect tickets for inspection, so it is best to dress up in advance and hand.
Tickets to 4 yuan, if you go to Jinding to visit 1 yuan, 1 yuan, the cultural relics exhibition room.
Jokhang Temple
7: -12: a.m. 15: -18: 3 a.m.
It takes more than an hour to visit Jokhang Temple. In the morning, most people go to the Buddha, and there are many people. Generally, tour groups go through the side door in the afternoon. If you are a self-help individual, I suggest you go there in the morning, go in with the people who pay the fees from the main entrance, and you don't need to buy a ticket, and many small halls are open in the morning. From Jokhang Temple, Bajiao Street is particularly worth visiting. It is not only a turning road, but also the best place to buy souvenirs and experience Tibetan folk customs. You can visit the houses in the lane by the way. There is a song that says: "There are more windows than doors in the ancient Bajiao Street. The girl in the window has softer bones than meat."
Note:
1. When you come to Jokhang Temple, you must be careful of the beggars here. Either prepare more change of 1 cents, or ignore them and go away quickly, otherwise you will have a lot of painful experiences.
2. It's best not to be impulsive when shopping in Bajiao Street, and be careful to regret it.
Tickets 25 yuan
Sera Temple
is open from 8: a.m. to 18: 3 a.m., and the visit time must be 2 hours. It is worth seeing the Lama's Buddhist scriptures (15: -17: p.m.) from Monday to Friday afternoon. Bus No.5 can go directly to 2 yuan/Ren in front of the temple, and you can wait at Jokhang Temple parking lot, Qingnian Road and Niangniang Road. Sera Temple is not far from the city, and it's called 1 yuan.
Note:
1. It is recommended to visit from Monday to Friday afternoon and arrive before 15: .
2. The inspection of Sera Temple is not strict. The ticket office is outside in a small house on the side of the road. If you don't look like a tourist, you can just walk in. If they see that you are not a Buddhist, tell them that you belong to the General Hospital of the Military Region next door. If you come to find someone, you can get by.