Department of Thoracic Surgery, Japanese Red Cross Ishinomaki Hospital, Miyagi, Japan.
Tohoku J Exp Med. 2012 Jul;227(3):199-202. doi: 10.1620/tjem.227.199.
High prevalence of deep vein thrombosis (DVT) in disaster shelters has been reported in the aftermath of earthquakes in Japan. Calf DVT was examined using sonography in the shelters after the Great East Japan earthquake on March 11, 2011. By the end of July 2011, 701 out of 8,630 evacuees suspected with calf DVT, judged by inspections or medical interviews, were examined in 32 shelters, and 190 evacuees were confirmed to have calf DVT. The prevalence of DVT was 2.20%, which was 200 times higher than the usual incidence in Japan. The DVT prevalence seemed to decrease with time. By the end of May, a significantly higher prevalence of DVT was found in tsunami-flooded shelters (109 of 3,871 evacuees; 2.82%) than in non-flooded shelters (53 of 3,155 evacuees; 1.68%). After June, its prevalence was still higher (18/541; 3.33%) in tsunami-flooded shelters than in non-flooded shelters (10/1063; 0.94%). The cause of the high prevalence of DVT was supposed to be dehydration due to the delay in supplying drinking water, vomiting, and diarrhea experienced by the evacuees because of a shortage of clean water to wash their hands. Dehydration was especially noticed in women because they restricted themselves of water intake to avoid using unsanitary toilet facilities. Moreover, crowded shelters restricted the mobility of elderly people, which would exacerbate the prevalence of DVT. Those deteriorated and crowded shelters were observed in tsunami-flooded areas. Therefore, long-term shelters should not be set up in flooded areas after tsunami.
日本发生地震后，避难所中深静脉血栓（DVT）的高发率已有报道。2011 年 3 月 11 日东日本大地震后，在避难所中使用超声检查小腿 DVT。截至 2011 年 7 月底，通过检查或医疗访谈判断有 8630 名避难者中有 701 名疑似小腿 DVT，在 32 个避难所中对 190 名避难者进行了检查，确诊小腿 DVT。DVT 的患病率为 2.20%，是日本通常发病率的 200 倍。DVT 的患病率似乎随时间而降低。5 月底，在海啸淹没的避难所中发现 DVT 的患病率明显更高（3871 名避难者中有 109 名；2.82%），而非淹没的避难所中为 3155 名避难者中有 53 名（1.68%）。6 月后，海啸淹没的避难所中仍高于非淹没的避难所（541 名中有 18 名；3.33%，1063 名中有 10 名；0.94%）。DVT 高发率的原因可能是由于饮用水供应延迟导致的脱水，以及避难者因缺乏清洁水洗手而出现呕吐和腹泻。由于限制摄入以避免使用不卫生的厕所设施，女性尤其注意脱水。此外，拥挤的避难所限制了老年人的活动能力，这会加剧 DVT 的流行。在海啸淹没的地区观察到这些恶化和拥挤的避难所。因此，海啸后不应在洪水淹没地区设置长期避难所。
