初进高原者耐缺氧机制与高原条件下的输血策略

发布时间：2018-06-23 19:29

本文选题：高原输血策略 + 高原低氧适应　；参考：《中国输血杂志》2017年08期

【摘要】：高原环境中的低压低氧、寒冷干燥及紫外线强等均是对机体不利的因素,平原人群进入高原难免发生一系列生理改变。平原人群在高原地区负(战、创)伤时,不仅表现为失血耐受能力降低、易发生休克,而且对液体耐受能力更小,使得脑水肿、肺水肿、右心功能不全以及多器官衰竭早等较易发生。失血是导致伤者的这些病状,乃至死亡的关键原因,而输血治疗也成为高原战创伤救治中更重要的手段。本文首先对本期"高原输血专题"中涉及的平原人群进入高原后血常规变化、高原适应基因表达改变、红细胞形态及携氧功能差异等方面研究作了评述,并分析总结了其中的变化规律及意义,以提高平原人群高原习服适应能力;其次针对高原低氧环境下藏、汉族人群发生高原战创伤时异于平原地区人群的特征,概述了有关高原失血性休克患者的输血策略、特点及其救治的研究进展,分析了高原适应机制与之的相关性;最后针对高原输血目前存在的困窘与亟待解决的问题,提出并探讨了自己的高原的输血策略。
[Abstract]:Low pressure and hypoxia, cold and dry, and strong ultraviolet ray are all unfavorable factors to the body, so a series of physiological changes inevitably occur when the people in the plain enter the plateau. At the time of negative (war, wound) injury in the high altitude area, the plain people not only showed that the ability of blood loss tolerance was decreased, but also the ability of fluid tolerance was lower, which caused brain edema, pulmonary edema, Right ventricular insufficiency and multiple organ failure are more common. Blood loss is the key cause of these symptoms and even death, and blood transfusion has become a more important means in the treatment of high altitude war trauma. In this paper, we first reviewed the changes of blood routine, gene expression, erythrocyte morphology and oxygen carrying function of the people in plateau after entering the plateau in this issue of "Special topic of High altitude Blood Transfusion". The changes were analyzed and summarized in order to improve the adaptability of the people in the plateau. Secondly, the Han nationality was different from the people in the plain when the war trauma occurred in the environment of altitude hypoxia. This paper summarizes the strategy, characteristics and treatment of blood transfusion in patients with high altitude hemorrhagic shock, analyzes the correlation between high altitude adaptation mechanism and high altitude blood transfusion, and finally aims at the problems existing in high altitude blood transfusion and the problems that need to be solved urgently. The strategy of blood transfusion at high altitude was put forward and discussed.
【作者单位】：空军总医院输血科;
【基金】：全军后勤科研重大专项子项(AWS13J004),
【分类号】：R457.1

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