急进高原武警官兵急性高原反应症状与卫勤措施的调查研究

Acute mountain sickness in armed police officers hurriedly deployed to plateau: A survey of the symptoms and their medical readiness

目的了解急进高原武警部队官兵急性高原反应(acute mountain sickness,AMS)的发生和卫勤措施的落实情况。方法 2016-04,选取武警某部急进高原官兵为研究对象,随机选取其中121名武警官兵,利用自编卫勤调查量表和AMS症状量表,于入高原前7 d和进高原后3 d、7 d和14 d对其进行跟踪调查。结果急进高原前:(1)官兵对低气压和低氧、高寒、强辐射和干燥多风的认知率分别是95.0%、87.6%、81.0%、79.3%;(2)药物预防、健康体检、接受宣教、心理教育与训练、体能锻炼、预缺氧训练预防措施的采取率分别是96.7%、93.4%、78.5%、75.2%、74.4%、72.7%。急进高原后:(1)针对AMS采取的措施主要有服用药物、限制活动、营养膳食、吸氧、心理干预等;(2)进入高原后3 d、7 d、14 d,排在AMS前三位的胸闷气短,头痛、头晕,心率增快、心慌的发生率分别是62.9%、61.1%、45.6%;62.1%、39.8%、23.7%;54.3%、40.7%、38.6%。(3)随着官兵入高原时间推移AMS各症状发生率逐渐降低,不同时间点头痛、头晕(χ~2=34.420,P<0.001),胸闷气短(χ~2=9.100,P=0.010),心率增快、心慌(χ~2=6.480,P=0.040)比较,差异具有统计学意义;其他症状变化差异无统计学意义。(4)进入高原后3 d、7 d、14 d采取卫勤措施的有效率分别是83.0%、85.7%、86.1%,三个时间点措施改善率差异无统计学意义(χ~2=0.401,P=0.818)。结论急进高原武警官兵中AMS发生率依然较高,亟需丰富和完善卫勤保障措施、延长干预时间和提高卫勤质量。

Objective The objective of this study was to investigate the incidence of acute mountain sickness（AMS） in armed police officers hurriedly deployed to plateau and their medical readiness. Methods In April 2016, 121 armed police officers hurriedly deployed to plateau were selected as the study object by means of random sampling. Their symptoms and medical readiness were investigated prior to entering plateau and at the time points of 3 d, 7 d and 14 d after entering plateau by using a self-designed scale. Results Prior to entering plateau：（1） The percentages of being aware of low pressure hypoxia, high altitude cold climate, intense radiation, and dry dusty conditions were respectively 95.0%, 87.6%, 81.0%, and 79.3%;（2） The percentages of having taken preventive measures were 96.7% for drug prevention, 93.4% for health examination, 78.5% for awareness raising, 75.2% for psychological training, 74.4% for physical exercise, and 72.7% for anaerobic training. After entering plateau：（1） The primary measures targeting AMS were taking medication, restricting movement, nutrient diet, inhaling oxygen and psychological intervention;（2） The top three symptoms of AMS were chest distress shortness of breath, headache dizziness, and increased heart rate; the incidence rate of the three symptoms after entering plateau for 3 d, 7 d, 14 d were respectively 62.9%, 61.1%, 45.6%; 62.1%, 39.8%, 23.7%; 54.3%, 40.7%, 38.6%;（3） As time proceeded, the incidence rate of AMS gradually decreased; between different time points, the differences of headache（χ~2=34.420,P0.001）, chest distress shortness of breath（χ~2=9.100, P=0.010） and increased heart rate（χ~2=6.480, P=0.040） were statistically significant, while the differences of other symptoms were not statistically significant;（4） The effective rates of taking medical measures after entering plateau for 3 d, 7 d and 14 d were 83.0%, 85.9%, 86.1%, and the differences were not statistically significant（χ~2=0.401, P=0.818）. Conclusions The incidence of AMS is high. Therefore, the medical readiness should be strengthened by taking more effective measures and extending the intervention time.