宮城県内の避難所から

DOI 参考文献18件
  • 柴田 宗一
    宮城県立循環器・呼吸器病センター循環器科

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タイトル別名
  • Disaster Response to Prevent Venous Thromboembolism, Report from Miyagi

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Background: A magnitude 9.0 earthquake followed by a tsunami hit the eastern part of Japan on March 11, 2011. High rate incidence of deep vein thrombosis (DVT) among evacuees after giant earthquake has been reported. We took a mobile ultrasound screening as part of disaster response as well as the Iwate-Miyagi Nairiku Earthquake in 2008. Methods: In the collaboration of local headquarters for emergency disaster control, Calf sonography by portable ultrasound machines was performed to 330 subjects in 27 shelters of Miyagi prefecture during five weeks after the earthquake of 2011 and 127 subjects during three years after the earthquake of 2008. Direct ultrasound signs, thrombotic echoes or lack of venous compressibility allows a definite diagnosis of deep vein thrombosis. Multivariate analysis was performed using logistic regression analysis with the presence of DVT as independent variables. Time course of residual DVT probability was estimated by the Kaplan-Meier procedure from the data of 20 evacuees with DVT. Results: In the earth quake of 2011, 74 of 330 evacuees (22%) developed DVT in the calf. 41 of 65 (54%) were symptomless. Trauma in lower extremities [odds ratio (OR): 6.133, 95% confidence interval (CI): 2.326–16.170, P= <0.001], refrain from urination [OR: 3.565, 95% CI: 1.978–6.426, P= <0.001] were independent positive predictors of DVT in this disaster. From the three-year follow-up data of the earthquake of 2008, the ratio of evacuees with residual DVT decreased gradually to a plateau of 55% at one and a half years, then dropped to 16% at three years. Discussion: A DVT incidence of 22% is much higher than annual incidence. Tsunami increased risks of DVT in stricken area, through venous injury associated with leg injury, immobility and hypercoagulable state secondary to suboptimal living space. Prolonged DVT presence indicates that early intervention and continuous follow-up are important as a disaster response to prevent venous thromboembolism.

収録刊行物

  • 静脈学

    静脈学 23 (4), 321-326, 2012

    日本静脈学会

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