高山醫療研究一以玉山國家公園排雲山莊為例

The Mountain Medicine Study-in Paiyun Village of Yushan National Park

玉山為台灣最高峰。每年約有70萬人攀登玉山主峰，海拔3952 公尺。排雲山莊標高 3402 公尺，是玉山主峰登頂的最後休息據點，一般人選擇在排雲山莊住宿一夜後，翌日凌晨再攻頂玉山主峰。我們在玉山國家公園管理處（簡稱玉管處），開放玉山主峰線登山期間，每雙週六、日（除氣候因素或禁止入山等的因素外）皆派遣醫護人員、前往玉山排雲山莊駐診，提供醫療服務，並研究山友的醫療需求。結果發現：九十三年一月一日至十二月三十一日期間，總共參與18週的醫療服務，有34人尋求醫療協助。其中33人是與高山症相關症狀，1人是足踝扭傷。尋求醫療協助34人中有18人是第一次攀登三千公尺以上高山，佔求診人數52.9% （18/34）。尋求醫療協助34人中有18人達到露易絲湖急性高山病 （Lake Louise acute mountain sickness） 的診斷標準，佔求診人數 52.9% （18/34）。高山症（High altitude syndrome） 以頭痛症狀最多，佔所有人數的 67.6% （23/34）最多，噁心佔 52.9% （18/34），無力佔47.1% （16/34），為高山症症狀前三名。症狀區分為五級，第零級為無此症狀。所有症狀的嚴重度區分為：第一級--輕度：佔 61.8%。第二級--中度：佔 24.5%。第三級--重度：佔 9.1%。第四級--非常嚴重，佔 4.6%。治療分別以休息，給氧及藥物，在高山上大都可以緩解症狀，僅1人需下山求醫，佔求診人數 2.9% （1/34）。

Yushan Mountain is the highest mountain of Taiwan. There are about 700,000 people per year aspiring to reach the main peak, rising 3952 meters above sea level. In general, Paiyun Village, 3402 meters above sea level, is the last place for overnight lodging and before moving further up to the peak the next morning. Our medical service team provides free medical service to Paiyun village on a bi-weekly basis and on weekends except for when inclement weather forbids entry to Yushan National Park.The findings of our study by the medical service team show the following demands for the medicine by mountaineers in Paiyun Village: first, we provided free medical service 18 times in 2004. We examined 34 persons, of whom 33 people showed symptoms of high altitude syndrome and one had a strain of the ankle, and for 18 people, taking up 52.9 % of the total service numbers, it was their first time climbing the 3000-meter mountain. Of the 34 people,18 cases met the criteria of Lake Louise consensus for diagnosis of acute mountain sickness. Among high altitude syndrome people, the first three symptoms are headache (67.6%), nausea (52.9%), and weakness (47.1%). We differentiate high altitude syndrome into five degrees: zero degree with no symptom and the seriousness of the symptom into four degrees: first degree-- mild, holding 61.8%, second degree--moderate, holding 24.5%, third degree--severe, holding 9.1%, and fourth degree—very severe , holding 4.6% of all the symptoms. Almost all symptoms subsided after patients had taken a rest, oxygen therapy, or oral medicine except one who was sent down for further treatment, taking up 2.9%.