高原环境中的低压低氧、寒冷干燥及紫外线强等均是对机体不利的因素,平原人群进入高原难免发生一系列生理改变。平原人群在高原地区负(战、创)伤时,不仅表现为失血耐受能力降低、易发生休克,而且对液体耐受能力更小,使得脑水肿、肺水肿、右心功能不全以及多器官衰竭早等较易发生。失血是导致伤者的这些病状,乃至死亡的关键原因,而输血治疗也成为高原战创伤救治中更重要的手段。本文首先对本期“高原输血专题”中涉及的平原人群进入高原后血常规变化、高原适应基因表达改变、红细胞形态及携氧功能差异等方面研究作了评述,并分析总结了其中的变化规律及意义,以提高平原人群高原习服适应能力;其次针对高原低氧环境下藏、汉族人群发生高原战创伤时异于平原地区人群的特征,概述了有关高原失血性休克患者的输血策略、特点及其救治的研究进展,分析了高原适应机制与之的相关性;最后针对高原输血目前存在的困窘与亟待解决的问题,提出并探讨了自己的高原的输血策略。 Low-pressure hypoxia in the plateau environment, cold and dry and ultraviolet light are all unfavorable factors on the body, the plain population into the plateau will inevitably occur a series of physiological changes. Plain people in the plateau area negative (war, trauma) injury, not only showed reduced blood loss tolerance, prone to shock, but also less tolerance to liquids, making cerebral edema, pulmonary edema, right ventricular dysfunction and multiple organs Early failure occurs more easily. Blood loss is the key cause of these symptoms and even death of the wounded, and blood transfusions have also become more important means of treating traumatic injuries in the plateau. This article first reviews the research on the changes of blood routine, plateau adaptation gene expression, erythrocyte morphology and oxygen-carrying function after entering the plateau in the current issue of “Plateau Transfusion Topics” and then analyzes and summarizes the In order to improve the adaptability of plateau habitat to plateau habitat.Secondly, according to the characteristics of the different plains in Tibetan Plateau and Han nationality under high altitude hypoxia environment, the blood transfusion strategies in patients with plateau hemorrhagic shock were summarized , Characteristics and its treatment, and analyzed the correlation between plateau adaptation mechanism.Finally, in view of the current embarrassment of plateau transfusion and the problems to be solved urgently, this paper proposed and discussed the transfusion strategy of plateau.