血常规与血气分析变化对高原脑水肿早期诊断的意义

目的探讨血常规、动脉血气分析的变化与早期高原脑水肿的关系，希望对高原脑水肿早期诊断提供帮助。方法根据高原反应症状评分以及典型症状，对24200例急进高原人员进行筛查，对其中162例高原脑水肿疑似病例进行观察随访，分析他们急进高原1周内血常规、生化、血气分析等指标的变化。结果在高原脑水肿疑似病例中，有36例最后确诊为高原脑水肿，必须住院治疗。高原脑水肿人群在高原暴露48h后出现更严重的低氧血症、呼吸性碱中毒及白细胞增高表现，与未发生高原脑水肿的观察对象间差异具有统计学意义（P〈0．05）。结论在急进高原早期出现，且不随高原适应时间延长而逐渐改善的低氧血症、呼吸性碱中毒及白细胞增高与早期高原脑水肿的发生密切相关。

Significance of Routine Blood Tests and Blood Gas Analysis in Early Diagnosis of High-altitude Cerebral Edema

Objective To explore the relationship between changes of blood picture and arterial blood gas analysis and early diagnosis of high altitude cerebral edema （HACE） for providing help to the early diagnosis of HACE. Methods In 24 200 people who immediately entered into high-altitude plateau in the recent two years, 162 were highly suspected as having HACE and selected as observation subjects. Their changes of blood picture, biochemical indexes and values of arterial blood gas analysis within the week just after they entered into plateau were analysed. Results Thirty-six subjects were finally diagnosed as HACE patients and needed inhospital treatment. Serious hypoxemia, increase of blood white cells and respiratory alkalosis were found to be more significant in HACE patients in the first 48 hours after high-altitude exposure. Conclusion Severe hypoxemia, respiratory alkalosis and increase of blood white cells in the early stage of acute high-altitude exposure which could not be alleviated may be related closely to occurrence of early HACE.