本文選題：高原輸血策略 + 高原低氧適應　； 參考：《中國輸血雜志》2017年08期

【摘要】：高原環(huán)境中的低壓低氧、寒冷干燥及紫外線強等均是對機體不利的因素,平原人群進入高原難免發(fā)生一系列生理改變。平原人群在高原地區(qū)負(戰(zhàn)、創(chuàng))傷時,不僅表現(xiàn)為失血耐受能力降低、易發(fā)生休克,而且對液體耐受能力更小,使得腦水腫、肺水腫、右心功能不全以及多器官衰竭早等較易發(fā)生。失血是導致傷者的這些病狀,乃至死亡的關鍵原因,而輸血治療也成為高原戰(zhàn)創(chuàng)傷救治中更重要的手段。本文首先對本期"高原輸血專題"中涉及的平原人群進入高原后血常規(guī)變化、高原適應基因表達改變、紅細胞形態(tài)及攜氧功能差異等方面研究作了評述,并分析總結了其中的變化規(guī)律及意義,以提高平原人群高原習服適應能力;其次針對高原低氧環(huán)境下藏、漢族人群發(fā)生高原戰(zhàn)創(chuàng)傷時異于平原地區(qū)人群的特征,概述了有關高原失血性休克患者的輸血策略、特點及其救治的研究進展,分析了高原適應機制與之的相關性;最后針對高原輸血目前存在的困窘與亟待解決的問題,提出并探討了自己的高原的輸血策略。
[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.
【作者單位】： 空軍總醫(yī)院輸血科;
【基金】：全軍后勤科研重大專項子項(AWS13J004),
【分類號】：R457.1

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