統一名詞翻譯
AMS 急性高山病
HACE 高海拔腦水腫
acute altitude illness 急性高海拔疾病
Staged ascent and preacclimatization 分段上升及高度適應
在爬到最高海拔前, 第六天至第七天, 停留於海拔 2200~3000 公尺, 可減少AMS 風險, 增加通氣量及氧和, 也可弱化肺動脈對於接下來高海拔 (4300 公尺) 的反應.
Two studies showed that spending 6 to 7 d at moderate altitude (~2200 to 3000 m) before proceeding to higher altitude (referred to as “staged ascent”) decreases the risk of AMS, improves ventilation and oxygenation, and blunts the pulmonary artery pressure response after subsequent ascent to 4300 m.16,48
有些遊客在前往高海拔前, 會先至海拔 2500-3000 公尺的高山旅館短時間停留. 海拔上升 1500 公尺的短暫停留以預防接下來更高海拔的AMS機率, 從生理角度看起來似乎還蠻合理的.
Many travelers to high altitude visit mountain resorts at more moderate elevations between 2500 and 3000 m. The value of short stays at intermediate elevations of ~1500 m for decreasing the risk of AMS during such ascents makes sense from a physiologic standpoint.
這種高度適應的策略並沒有人做過隨機研究, 雖然之前有研究顯示, 在海拔 1600 公尺處住一晚, 接下來前往海拔 1920-2950 公尺的地區, 可降低AMS機率.
However, this approach has not been studied in a randomized fashion, aside from 1 cross-sectional study finding a decreased risk of AMS in travelers who spent 1 night at 1600 m before ascent to resort communities between 1920 and 2950 m.5
很多研究評估, 在數天至數周內, 反覆暴露於低壓或常壓低氧環境, 這種方式稱為高度適應, 其結果並不一致, 有些研究說可以降低AMS發生率 或是嚴重度, 其他的研究卻顯示無效.
A larger number of studies examining the effects of repeated exposures to hypobaric or normobaric hypoxia in the days and week preceding high altitude travel (referred to as “preacclimatization”) showed mixed results, with some studies finding benefit in terms of decreased AMS incidence or severity49e51 and others showing no effect.52e55
在解讀這些高度適應研究時, 最大的困難是各自的低氧協議不同. 也不是每個研究都有證據顯示, 在這樣的低氧對於生理帶來哪些與高度適應符合的變化,.
A significant challenge in interpreting the literature on preacclimatization is the variability among the hypoxic exposure protocols used, as well as the fact that not all studies include evidence that their protocols induced physiologic responses consistent with acclimatization.
不管是分段上升或是高度適應, 對於多數高海拔的旅客都是很難做到的,
一般說來, 短時間 15-60 分鐘暴露於低氧, 或是在爬升前, 花幾次幾小時的時間暴露於低氧, 對於高度適應可能無用. 長時間(每天8小時, 連續七天) 暴露於低氧, 對於高度適應比較可能有幫助.
Implementation of either staged ascent or preacclimatization may be logistically difficult for many high altitude travelers. In general, short-term exposures (eg, 15 to 60 min of exposure to hypoxia, or a few hours of hypoxia a few times before ascent) are unlikely to aid acclimatization, whereas longer exposures (eg, >8 h daily for >7 d) are more likely to yield benefit.
低壓低氧相較於常壓低氧, 更能有效加速高度適應, 預防AMS. 但目前對於高度適應和分段上升最好的操作方式, 並沒有被徹底檢驗過, 因此專家會議建議, 可考慮這些方式, 但不贊同哪一種協議
Hypobaric hypoxia is more effective than normobaric hypoxia in facilitating preacclimatization and preventing AMS.56 Because the optimal methods for preacclimatization and staged ascent have not been fully determined, the panel recommends consideration of these approaches but does not endorse a particular protocol.
建議: 如果情況許可, 可考慮使用分段上升及高度適應, 來預防 AMS
Recommendation. When feasible, staged ascent and preacclimatization can be considered as a means for AMS prevention.
Recommendation Grade: 1C
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