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高原脱习服症诊疗与健康管理专家共识(2026版)OA

Expert consensus on the diagnosis,treatment,and health management of high-altitude deacclimatization syndrome(2026 edition)

中文摘要英文摘要

高原脱习服症(HADS),又称高原脱适应症,是指连续暴露于高原环境(海拔≥2500 m)超过3个月的人群返回平原后,因氧分压骤升致使机体为重新适应平原相对高压富氧的环境而引发的一系列多系统功能失调综合征.我国每年超2000万人往返于高原和平原地区,HADS发病率高达30.0%~87.5%,已成为严重影响高原移居人群健康的公共卫生问题.HADS临床表现多样,包括神经、心血管、呼吸、消化等多系统症状,轻者工作效能和生活质量显著降低,重者可出现器官损伤甚至被迫重返高原.鉴于HADS发病率高、危害显著且缺乏规范诊疗方案的现状,陆军军医大学陆军卫勤训练基地组织多学科专家组,基于循证医学原则,制定《高原脱习服症诊疗与健康管理专家共识(2026版)》.本共识采用GRADE系统对证据进行分级,在高原健康管理基本理论和前沿进展的指导下,通过文献研究法、半结构访谈法等形成16条推荐意见,涵盖HADS的病理生理、诊断分型、预防策略、药物治疗及康复措施等方面.此外,本共识还基于高原健康全周期管理原则,构建以"预防为主(P)、早期识别(I)、分级干预(I)、及时康复(R)"为核心的HADS健康管理模式,覆盖高原返回前、返回途中及返回后3个阶段,逐步形成"预防-治疗-康复"三位一体的防控体系,旨在为临床工作者提供科学、规范的诊疗依据,提升HADS的防治水平,改善患者生活质量.

High-altitude deacclimatization syndrome(HADS),also known as high-altitude deadaptation syndrome,refers to a series of multi-system dysfunction syndromes occurring in individuals who have been continuously exposed to a high-altitude environment(altitude≥2500 m)for more than 3 months after returning to plains.It results from a sharp increase in partial pressure of oxygen,as the body readapts to a relatively higher-pressure and oxygen-rich environment at low altitude.In China,more than 20 million people travel between high-altitude and plain areas annually,with the incidence of HADS ranging from 30.0%to 87.5%,which has become a major public health issue seriously affecting the health of migrants to high-altitude regions.HADS presents with diverse clinical manifestations involving multiple systems such as nervous,cardiovascular,respiratory,and digestive systems.Mild cases lead to significant declines in work efficiency and quality of life,while severe cases may develop organ injury or even a forced return to high-altitude.In view of the high incidence,severe harm and lack of standardized diagnosis and treatment protocols for HADS,the Army Health Service Training Base of Army Medical University organized a multidisciplinary expert panel to formulate the"Expert consensus on the diagnosis,treatment,and health management of high-altitude deacclimatization syndrome(2026 edition)",grounded in evidence-based medicine principles.This consensus employs the Grading of Recommendations Assessment,Development,and Evaluation(GRADE)system to appraise the quality of evidence.Guided by basic theories and cutting-edge advances in high-altitude health management,and informed by literature review and semi-structured interviews,the panel formulated 16 recommendations encompassing the pathophysiology,diagnostic classification,prevention strategies,pharmacotherapy,and rehabilitative interventions for HADS.Furthermore,based on the principle of full-cycle high-altitude health management,this consensus established a HADS health management model centered on"Prioritizing Prevention first(P),early Identification(I),graded Intervention(I),and timely Rehabilitation(R)".This model spans three critical phases-prior to descent,during descent,and following descent-and progressively establishes an integrated"prevention-treatment-rehabilitation"tripartite framework,aiming to provide scientific and standardized diagnostic and therapeutic evidence for clinicians,improve the prevention and treatment of HADS,and enhance the quality of life of affected patients.

黄河;黄竹;陈照立;王关嵩;后显华;李茂仕;罗勇军

联勤保障部队第940医院神经内科,甘肃 兰州 730000||陆军军医大学陆军卫勤训练基地军事医学地理学教研室,重庆 400038西部战区总医院高压氧科,四川 成都 610083军事科学院军事医学研究院环境医学与作业医学研究所,天津 300050陆军军医大学新桥医院呼吸与危重症医学科,重庆 400037陆军军医大学西南医院神经内科,重庆 400038西藏军区总医院高山病科,西藏 拉萨 850007陆军军医大学陆军卫勤训练基地军事医学地理学教研室,重庆 400038

医药卫生

高原脱习服症诊断预防治疗康复专家共识

high altitude de-acclimatization syndromediagnosispreventiontreatmentrehabilitationexpert consensus

《解放军医学杂志》 2026 (5)

649-659,11

This work was supported by the National Natural Science Foundation of China(42377466)the Second Tibetan Plateau Scientific Expedition and Research Project of Ministry of Science and Technology(2019QZKK0607),and the Tianshan Yingcai Medical and Health High-Level Talent Training Program(TSYC202301B046)国家自然基金面上项目(42377466)国家科技部第二次青藏高原综合科学考察研究专题(2019QZKK0607)"天山英才"医药卫生高层次人才培养计划(TSYC202301B046)

10.11855/j.issn.0577-7402.0390.2026.0402

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