With the opening of the Qinghai-Tibet Railway, more and more people can easily reach high altitude areas, and more and more people will suffer from altitude sickness. For altitude sickness, we don't have to talk about it, and we can't underestimate the harm it brings. I hope this article can give you a correct understanding of altitude sickness.
Altitude sickness, that is, altitude sickness, means that people who are not used to it quickly enter the plateau area above 3000 meters. Due to the decrease of oxygen partial pressure at atmospheric pressure, the body's tolerance to anoxic environment is reduced, and it is difficult to adapt to it, resulting in hypoxia, which leads to a series of altitude disorders. Of course, in addition to the factors of altitude hypoxia, there are also bad weather such as wind, rain, snow, cold and strong ultraviolet radiation, which will aggravate the altitude imbalance and cause different degrees of altitude imbalance.
After a period of adaptation, the body can undergo a series of adaptive changes, such as increasing ventilation to make the oxygen utilization rate of tissues reach or approach normal levels; Accelerate the heart rate and increase the pumping capacity of the heart, thereby increasing the amount of bleeding per minute and improving the hypoxia; Increase the amount of red blood cells and hemoglobin to increase the oxygen carrying capacity, so as to ensure the body's oxygen supply. However, some people are sensitive to the partial pressure of hypoxia in the air and have poor adaptability, and a series of symptoms and changes in functional metabolism will occur, which is also called acute altitude sickness. It is divided into acute altitude sickness, high altitude pulmonary edema, high altitude cerebral edema, high altitude retinal hemorrhage and chronic altitude sickness abroad, and it is divided into acute altitude sickness and chronic altitude sickness at home. For individuals, the onset is often mixed and difficult to distinguish, and it is more prominent at a certain stage in the whole onset process.
Symptoms and self-judgment of altitude sickness
Some people who enter the plateau for the first time will have symptoms such as headache, dizziness, dizziness, tinnitus, general fatigue, difficulty walking and difficulty falling asleep within 24 hours at an altitude of 3000 meters. In severe cases, symptoms such as abdominal distension, loss of appetite, nausea, vomiting, palpitation, shortness of breath, chest tightness, purple complexion, swelling of lips or face appear. When these symptoms appear, you should stay at the original height and rest for 3~5 days, or immediately lower the height by hundreds of meters, which can generally return to normal.
It is reported that the incidence below 3500m accounts for 37%~5 1%, and the incidence between 3600m and 5000m reaches 50%. This shows that the higher the altitude, the higher the incidence of altitude sickness.
Severe altitude sickness is very harmful to human body. Therefore, after entering the plateau, altitude sickness should be considered if the following symptoms appear:
1. Severe headache, palpitation, shortness of breath, chest tightness, loss of appetite, nausea, vomiting, cyanosis of lips and nails.
2. Consciousness trance, cognitive ability plummeted. Mainly in the calculation difficulty. Do a simple addition problem before entering the platform period and record the time spent. When symptoms appear, repeat the same calculation problem. If it takes longer than before, it means that altitude sickness has occurred.
3. hallucinating, feeling warm, and often walking behind others aimlessly.
Preventive measures and drugs to relieve symptoms
Strict physical examination before entering the plateau, severe anemia, hypertension, obvious heart, liver, lung, kidney and other diseases, should not enter the plateau. Obese people are generally more prone to mountain sickness because of their high oxygen consumption.
When you first enter the plateau, you should reduce physical activity to protect your heart, so you should strictly control the climbing speed. Generally, it is not advisable to climb more than 1000 meters in one day.
Two days before entering the plateau and three days after entering the plateau, preventive oral administration of some drugs can alleviate the symptoms of altitude sickness:
Acetazolamide 0.25g, twice a day. Acetazolamide itself has diuretic effect, which is mainly used for cardiogenic edema, brain edema and digestive tract ulcer. Preventive use can alleviate the symptoms of altitude sickness. The side effects of acetazolamide are renal colic, kidney calculi, sulfanilamide crystals, nephrotic syndrome and agranulocytosis (sulfanilamide allergy). Long-term use will cause low potassium ions in the blood, so it is necessary to supplement potassium (you can eat oranges or bananas). People with hepatic coma and renal insufficiency should not take it.
Rhodiola is a drug that many people hope to prevent altitude sickness. It has the functions of clearing away heat and toxic materials and removing dampness, and can be used to treat lung heat, pulse heat, plague and limb swelling. In recent years, salidroside has been isolated from Rhodiola in China, which has been proved by experiments to have the effects of strengthening the heart, calming, raising blood pressure and resisting fatigue. Rhodiola extract can be used to resist fatigue, increase physical strength and endurance, and be weak after illness. Whether altitude sickness can be prevented or not has not been found by the author.
According to hypoxia, dexamethasone 0.75~6 mg can be added, 2~4 times a day. The main function of this medicine in relieving altitude sickness hypoxia is to increase the content of red blood cells and hemoglobin, thus improving the oxygen carrying capacity. Dexamethasone is a glucocorticoid drug, and the indications must be strictly controlled. Abuse of this drug will reduce its due effect when it is really necessary to be rescued. Large doses can lead to obesity, elevated intraocular pressure, hypertension, digestive tract ulcers, bleeding and even perforation. Especially for virus-infected people, taking glucocorticoids can spread and aggravate virus infection.
Uloprofen can relieve headache caused by altitude, 50 mg orally, 3~4 times a day. Nifedipine (Xintongding) dilates arterioles, which can reduce pulmonary edema. Moderate sedatives, multivitamins and aminophylline can relieve symptoms.
When entering the plateau, we should also pay attention to a reasonable diet, eat more carbohydrates and eat less indigestible food. Special reminder not to drink. Drinking alcohol will make the heart beat faster and increase the load on the unaccustomed heart; Drinking alcohol can dilate the blood vessels of the whole body, increase the heat dissipation of the skin, and then accelerate the heartbeat again, which greatly increases the chances of vicious circle, heart failure and high altitude brain edema.
Plateau environment and long-term hypoxia can obviously increase the number of red blood cells and blood viscosity. Excessive sweating when climbing mountains, coupled with rapid and deep breathing, increases water consumption in the body and aggravates blood viscosity. Viscous blood leads to poor blood circulation and insufficient blood supply and oxygen supply, so many people have severe headaches, chest tightness, shortness of breath, fatigue and other symptoms, and even lead to heart failure in severe cases. Therefore, drink at least 3~4 liters of water every day to ensure that your body gets enough water. After blood dilution, it can reduce the heart load and relieve the symptoms of altitude sickness. Whether the hydration is reasonable depends on whether the urine volume is sufficient, whether the urine is clear, and pay attention to the electrolyte balance.
High altitude pulmonary edema and brain edema
Altitude sickness seriously threatens people's lives and health. How can we find out in time and help each other on the spot?
High altitude pulmonary edema is a common severe altitude sickness with an incidence of about 3%. It usually occurs above 4000 meters, and it often happens quickly 3-48 hours after climbing, and then in 3- 10 days. The important inducement is respiratory infection caused by cold, fatigue and decreased resistance. When you have a headache, chest tightness, varying degrees of cough (dry cough at first, then phlegm), and difficulty breathing, you can't lie on your back. In severe cases, you will cough up pink foam-like sputum. The rescuer will put his ear close to the patient's chest wall and hear the gurgling breathing sound in the lungs (medically called wet rales). At this time, the patient is frightened, flustered, cyanosis in mouth, lips and face, and in severe cases, hematuria or gradual unconsciousness. Severe pulmonary edema will worsen rapidly, and the patient will be in a coma and die within a few hours.
The first-aid measures for on-site pulmonary edema are to rest in an absolute semi-recumbent position, with legs drooping, and immediately take oxygen, preferably oxygen containing 50%~70% alcohol at a flow rate of 6 ~ 8 liters/minute; Take furosemide (furosemide) 40mg/day immediately. The use of furosemide may cause slight nausea, diarrhea, drug eruption, blurred vision, upright vertigo, muscle spasm, thirst and so on. Be careful not to use too much at first, and you can increase it to 80 mg twice a day according to the situation. Nifedipine reduces pulmonary edema. Antibiotics and dexamethasone 4 mg can be used to prevent and treat upper respiratory tract infection (only once orally). You can use a small amount of sedatives when you are upset. Keep warm and don't drink a lot of water. After initial first aid, the condition was stable and quickly moved to a lower altitude. In case of respiratory or cardiac arrest, perform cardiopulmonary resuscitation immediately.
It should be noted that colds should be avoided as much as possible in plateau areas. When you catch a cold at high altitude, you will have the illusion of fever temperature. The temperature of body temperature is often lower than the actual temperature 1 degree, which is easily overlooked. Even a slight respiratory infection can increase the risk of high altitude pulmonary edema. So keep warm. After entering the plateau, reduce the number of baths or not take a bath. When you find the first symptoms of a cold, take anti-cold medicine immediately. If you take anti-cold medicine after two days, it is generally ineffective.
Patients with recurrent high altitude pulmonary edema are susceptible, and the incidence rate of men is five times that of women. If pulmonary edema has occurred before, we recommend not to climb mountains above 3000 meters.
High altitude brain edema is another serious high altitude disease, which has an acute onset and often occurs at night. The incidence rate is low, but the mortality rate is high. Its symptoms: in addition to early altitude sickness, there are severe headaches, vomiting and even jet vomiting; Gradually trance, poor sense of orientation, personal convulsions, incontinence, and finally lethargy to coma. A few people may have retinal hemorrhage.
In the past, mountain friends always judged whether there was brain edema by experience. The usual method is to let people suspected of brain edema walk in a straight line to judge whether their directional ability is poor. From a scientific point of view, this method is not desirable! The brain tissue of patients with cerebral edema has been seriously deprived of oxygen. At this point, people in a trance state are likely to fall to the ground immediately and fall into a coma. This inspection method that aggravates the damage is risky. The correct judgment method is to let the patient lie in a semi-supine position and guide him to point to the nose, ears, eyes and so on. According to the instructions, see if his movements can be accurate. Once there is no, it means that brain edema may have occurred.
If brain edema and coma are found, oxygen containing 5% carbon dioxide should be given quickly and continuously until waking up, and oxygen should be given intermittently after waking up. Conditional use of hypertonic glucose, mannitol, adrenocortical hormone, cytochrome C and other treatments can reduce brain edema and promote recovery. Central nervous system stimulants such as lobeline hydrochloride and nikethamide can be used as appropriate. Pay attention to the balance of water, salt and electrolyte and the necessary anti-infection measures. After the condition is stable, immediately go down the mountain and rush to the hospital.
In the anoxic environment, people will improve the anoxic state by accelerating and deepening breathing, which will increase the exhaled carbon dioxide and lead to respiratory alkalosis. Respiratory alkalosis not only constricts cerebral vessels, but also leads to loss of consciousness and brain edema at high altitude. The most effective way to prevent respiratory alkalosis is to roll the newspaper into a cone, tear a small hole with a diameter of 1-2 cm at the tip of the cone, and stick the cone-shaped newspaper close to the face, so that the exhaled gas can be sucked back, that is, the exhaled carbon dioxide can be sucked back again, thus improving the pH in the body and correcting respiratory alkalosis.
There is no need to reluctantly face the plateau.
Not everyone who climbs the plateau will have altitude sickness. The incidence and recovery speed of altitude sickness are related to the individual's compensatory adaptability, which varies greatly from individual to individual. People who have no altitude sickness this time may not be unresponsive when they climb the plateau next time. Some people have altitude sickness every time. These people are sensitive or highly prone to altitude sickness. What needs to be reminded here is that altitude sickness cannot be overcome by repeated exercise. Therefore, in order to ensure good health, it is suggested that people who are prone to altitude sickness should not continue to climb such high-altitude areas. Fitness mountaineering in low-altitude areas can also cultivate sentiment and exercise.
Tourism strategy in Lhasa, Tibet;
the Potala Palace
Business hours are 09: 00-12: 3015: 00-18: 00 every day.
Access time must exceed 2 hours. However, after the opening hours of 1 hour, tickets are basically no longer sold. Every Monday, Wednesday and Friday is the day when Tibetans worship Buddha, and there are many people. You can also drive directly to the top from the back door by car, and get down from the front door after the visit, which is more labor-saving.
note:
1. Palace height, up and down slowly.
It's cold in the temple, so it's best to prepare a coat even in summer.
If you want to take photos in the temple, the cost is very high. Gu suggested hanging the camera on his chest instead of flashing it, which was also satisfactory.
There are few toilets in Bugong, so it is better to solve them at the entrance before the tour. The toilet at the back door of another cloth palace is very distinctive and a landscape. Don't miss it.
The inspection of Bugong is very strict, and it is almost impossible to evade tickets. There is a way to try, that is, Tibetans go to the front door on the first, third and fifth days of junior high school, and don't buy tickets first. After climbing the stairs, there is a small room where Tibetans buy tickets, 2 yuan/Zhang. You can ask Tibetans to buy one for you. Before entering the main hall, someone will come to collect and check the tickets, so it is best to dress up in advance and raise your warm hands.
Tickets for 40 yuan are 65,438+00 yuan for visiting Jinding and 65,438+00 yuan for the cultural relics exhibition room.
Jokhang Temple.
07: 00 am-12: 00 am15: 00 am-18: 30 am
Access time exceeds 65,438+0 hours. Most people go to worship Buddha in the morning, and there are many people. Generally, tour groups take the side door in the afternoon. If you are a self-help traveler, I suggest you go in the morning and go in through the main entrance with the payer. You don't need to buy a ticket. Many small halls open in the morning. From Jokhang Temple, Bajiao Street is particularly worth visiting. It is not only a turning road, but also the best place to buy souvenirs and experience Tibetan folk customs. You can visit the house in the alley. There is a song that says, "There are more windows than doors in the old Bajiao Street. The girl in the window has softer bones than meat. "
note:
1. When you come to Jokhang Temple, you must be careful of the beggars here, either prepare more change of 1 cent, or ignore them and go away quickly, otherwise you will have a lot of painful experiences.
It's best not to be impulsive when shopping in Bajiao Street, and be careful to regret it.
Tickets to 25 yuan
Sera temple
The opening hours are 08:00- 18:30, and the visit time is 2 hours. From Monday to Friday afternoon, there is an interpretation of the Buddhist scriptures of the Lama (15: 00- 17: 00), which is worth seeing. Bus No.5 can go directly to 2 yuan/Ren at the entrance of the temple, and can be found in Jokhang Temple parking lot, Qingnian Road and Niangniang Road. Sera Temple is not far from downtown. Taxi 10 yuan.
note:
1. It is recommended to visit Monday to Friday afternoon and arrive before 15: 00.
2. The inspection of Sera Temple is not strict. The ticket office is outside in a small house by the road. If you don't look like a tourist, you can just drive in. If they see that you are not a Buddhist, tell them that you are from the General Hospital of the Military Region next door. If you come to find someone, you can get along.
Tickets to 30 yuan
drepung monastery
It is open from 08: 00 in the morning to 18: 30 in the evening. The visit time must be two and a half hours, which is far from the urban area. In the morning, there are no.4 buses to Sanyuan Temple, and no.3 buses only to the foot of the mountain. Walk 1 hour, take a taxi 15-20 yuan. Drepung monastery is very big, and it is built on a mountain, so it naturally has the opportunity to evade tickets.
Note: There are sacrificial ceremonies every Wednesday, and many lamas get together to chant Buddhist scriptures. It's even more rewarding to get there at this time.
Tickets to 30 yuan
Norbulingka
09:30- 18:30
The visit time is 1.5 hours. No.2 bus passes by, and No.3 bus has a long way to go. This scenic spot is not very impressive, so you can give it up when time is tight. Go on Sundays or important festivals, and get tickets to 2 yuan. Because of the holidays, locals go to Karin more often.
Tickets to 25 yuan
Wang Yao rock paintings
One scenic spot on the U-turn road is open all day, and there is no CMB passing by, so it is convenient to take a taxi. The cliff paintings here are very distinctive. You can climb to the top of the mountain to see Lhasa. It is also an excellent place to have a panoramic view of Potala Palace.
note:
1. Tickets are generally free, and occasionally lamas will come to collect your money from 5 yuan.
There are many stones carved in Tibetan on the mountain, which are sacred objects offered by Tibetans. Don't take it casually.
DGA '-ldan； Ganden
Gandan Temple, located 40km east of Lhasa, was built at 1409, and is the first monastery of Gelug Sect. It was severely damaged during the Cultural Revolution and only rebuilt in recent years.
Admission: Tibetans are free, tourists ￥15; Opening hours: 09: 00- 16: 00.
Visiting time: The visiting time should be less than 2 hours, but it takes a whole day because of the long distance and many bus trips.
Note: Due to the shortage of personnel, CMB may cancel or change flights to other destinations. The scenery along the way is unique, with mountains, water and grasslands. Round trip 16 dollars, used when the ticket is refunded.
Chubu temple
Located in the upper reaches of Chubu River, 60 kilometers west of Lhasa. There is no accommodation in Chubu Temple, so you'd better not miss the only return bus. However, on the way back, many schools and buildings in the village can stay, and the scenery on the road is beautiful. You can consider walking and hitchhiking back to Lhasa.
Admission: Tibetans are free, 20 yuan per tourist; Opening hours: 09: 00- 14: 00.
Visiting time: 12: 00, two hours is enough by car. But the whole journey takes one day.
Transportation: within 200 meters of the southbound flower garden on the west side of Jokhang Temple, from 07: 00 to 08: 00, the bus will leave as soon as the passengers are full. Ticket price 15 yuan, the original bus 15: 00 return.
1. self-help two-day tour itinerary recommendation
Day 1 day:
8: 30: Eat at the Postal Hotel and walk for 5 minutes to the Potala Palace.
9: 00- 12: 00: Visit the Potala Palace and get a panoramic view of the Potala Palace Square after coming out.
12: 30- 13: 00: Go to the Snow God Palace Tibetan Restaurant on the west side of Potala Palace and enjoy an authentic flavor meal.
14: 00- 16: 00: Sera Temple. 15: 00 is the time to read the Bible from Monday to Saturday, which is worth seeing.
16: 30- 17: 30: Visit Jokhang Temple and take photos at Jinding Potala Palace on the second floor. The effect is excellent.
17: 30- 19: 30: Go shopping and sightseeing in Bajiao Street, and have a drink at Bajiao Cafe or Maggie Ami while watching people turn to the meridian.
19: 30-20: 30: Try Nepalese food and feel exotic food at Xuefu Restaurant (50m to the right of Jokhang Temple Square).
The next day:
9: 30- 12: 30: Visit drepung monastery (take bus No.3 from the Postal Hotel, but CMB only goes to the foot of the mountain, so you need to transfer to a motorized tricycle or CMB to go up the mountain, which is a long way; You can also call directly)
14: 30- 16: 00: Visit Norbulingka. You can take CMB directly from drepung monastery. )
16: 30- 18: 00: Go to the opposite museum after coming out.
19: 00-2 1: 00: Enjoy all kinds of snacks in Xijiao night market.
Remarks: If time is tight in Lhasa, you can only choose the first day of the trip, which is already representative; If you have more time, Wang Yao Rock Painting, Jokhang Temple, Nun Temple, Chongsaikang and Longwangtan Scenic Resort Scenic Holiday Park are also worth visiting.
Tickets for opening hours of scenic spots in the city
Potala Palace: 9: 00-13: 0015: 00-18: 00 40 yuan.
Jokhang Temple: 9: 00-12: 3015: 00-18: 30 25 yuan.
Norbulingka: 09: 30- 17: 30 25 yuan drepung monastery: 09: 30- 17: 00 30 yuan.
Museum: 10: 00- 18: 00 20 yuan Sera Temple: 9: 30- 17: 00 30 yuan.
Lhasa tourism practical information
Local transportation:
1. Taxi: downtown 10 yuan. If you go far, you need to negotiate. Don't beat your watch.
2. Buses: CMB is the main passenger transport in this city. You can take CMB to several major scenic spots, from far to near 2 yuan.
3. Tricycle: beckon to stop and bargain, generally 3-6 yuan.
Shopping recommendation:
1. Tibetan medicine and Tibetan-specific medicinal materials (if you want to rest assured, you'd better buy them in state-owned pharmacies)
2. Tibetan souvenirs: prayer wheel, thangka, Tibetan boots, handmade carpets, heads of cattle and sheep, beads of Buddha, eye stones, turquoise ornaments, Tibetan knives (must be mailed), etc.
3. Handicrafts from Nepal and India: both economical and unique. There are handicraft shops, and there are several specialty stores in Bajiao Street. (Crafts are mainly concentrated in Yutu East Road, Bajiao Street (opposite to Jokhang Temple Square) and the entrance of Potala Palace and Norbulingka)
Catering and entertainment:
1. Tibetan flavor: The Horri-bull Tibetan food in beijing east road Kili Hotel and the Snow God Palace Tibetan food at the west end of Potala Palace are authentic.
2. Nepalese flavor: Located at No.4 Hospital Road, Tibet, the Snowscape Restaurant in the north of Jokhang Temple Square has an elegant environment and good taste.
3. Chinese food: mainly concentrated in the western suburbs, mainly Sichuan style, but also special snacks, such as jade buns.
4. Cafe: Bajiao Cafe near Jokhang Temple Square, Maggie Ami in Bajiao Street, all kinds of special drinks, western food, very emotional, all have Internet cafes.
5. Entertainment: Nightclubs are concentrated in the western suburbs, and Tibetan Langma Ballroom can be seen everywhere. Batty, the highest peak of Jiangsu Road, is especially worth a visit.