高原野战增压帐篷对急进高原健康人脉搏血氧饱和度及睡眠的影响

Effects of highland field battle pressure-increasing tabernacle on pulse oxygen saturation and sleep in healthy persons entering urgently in highland

目的观察高原野战增压帐篷（增压帐篷）对急进高原健康人脉搏血氧饱和度（SpO2）及睡眠的影响。方法30名20～52岁[平均（34．57±11．76）岁）的健康男性，由低海拔平原（北京，31．2m）乘飞机于3h内急进高原（拉萨，3680m）。并随机均分为3组：于室内使用增压帐篷组（睡在设于室内氧分压为127mmHg的帐篷内），低流量吸氧组（通过鼻导管吸氧，流量2L／min）和对照组（睡在普通的室内），连续两晚进行7h（23：00～6：00）的夜间睡眠监测，通过鼻气流传感仪感应气流压力的变化来记录鼻气流；通过脉氧仪检测指端SpO2。用Lake Louise急性高原病（AMS）问卷了解症状。结果增压帐篷组和低流量吸氧组的平均SpO2、最低SpO2均显著高于对照组（均P〈0．05）；而睡眠呼吸性事件总指数及自发微觉醒总指数均显著低于对照组（均P〈0．05）。增压帐篷组的呼吸性事件总指数及自发微觉醒总指数均显著低于低流量吸氧组（均P〈0．05），而两组间平均SpO2与最低SpO2差异无统计学意义。平均SpO2与呼吸性事件指数及自发微觉醒指数之间呈负相关（均P〈0．05）。AMS评分与呼吸时间总指数和自发微觉醒次数均呈正相关（1=0．412，γ=0．523），与最低SpO2和平均SpO2均呈负相关（γ=0．278，γ=0．380）。结论高原野战增压帐篷能有效纠正高原低压性缺氧，改善睡眠质量、提高血氧浓度，从而减少AMS的发生。

Objective To observe the effects of highland field battle increasing-pressure tabernacle on pulse oxygen saturation （SpO2） and sleep in healthy persons who enter urgently in the highland. Methods Thirty healthy volunteers, all males, aged （34.57±6.26） （20-52） went from Beijing （at 31.2 m above sea level） to Lhasa （at 3 980 m above sea level） by airplane in 3 hours and were divided randomly into 3 equal groups to stay overnight for 2 nights in a tent set in a room with the partial pressure of oxygen at 127 mmHg （highland field battle pressure-increasing tent group）, in a normal room and supplied with oxygen by nasal catheter at the flow rate of 2 L/min （low flow oxygen uptake group）, and in a normal room without oxygen supply （control group）. Sleep was monitored from 11 pm to 6 am by nasal gas flow sensor. Pulse oximetry was used to measure the SpO2. Lake Louise acute mountain sickness （AMS） Questionnaire was used to investigate the symptoms of AMS. Results The mean SpO2 and the lowest SpO2 of the highland field battle pressure-increasing tent group and low flow oxygen uptake group were all significantly higher than those of the control group （all P〈0.05）; and the sleep respiratory event index and spontaneous microarousal index of the highland field battle pressure-increasing tent group and low flow oxygen uptake group were all significantly lower than those of the control group （all P〈0.05）. The sleep respiratory event index and spontaneous microarousal index of the highland field battle pressure-increasing tent group were both significantly lower than those of the low flow oxygen uptake group（both P〈0.05） and there were not significant differences in the mean SpO2 and the lowest SpO2 between these 2 groups. The mean SpO2 was significantly negatively correlated with the sleep respiratory event index andspontaneous microarnusal index （both P〈0.05）.The AMS score was significantly positively correlated with the sleep respiratory event index and spontaneous microarousal index（γ=0.412, γ=0.523）, and significantly negatively correlated with tile lowest and mean SpO2 （γ=-0.278, γ=-0.380）. Conclusion Through elevating the oxygen concentration in blood and improving the state of sleep, the field battle pressure-increasing tabernacle is effective in prevention of AMS.