Ishiura Yoshihisa, Fujimura Masaki, Yamamoto Hiroki, Shiba Yasutaka, Ohkura Noriyuki, Kasahara Kazuo, Ishida Youichi
The Department of Internal Medicine, Toyama City Hospital, Toyama, Japan.
J Med Invest. 2013;60(1-2):61-5. doi: 10.2152/jmi.60.61.
On March 11, 2011, a 9.0-magnitude earthquake struck east Japan, following tsunami. Many people are forced to live in evacuation shelters without enough life-saving drugs. Asthma control for management of health crisis is required, because asthma exacerbation is a major cause of morbidity, can need acute care and results in death. However, it remains obscure what parameter should be used in primary clinic of evacuation shelters. The objective of this study is to elucidate the practical efficacy of asthma assessment tool in primary clinic for victims of this disaster. Asthma control test (ACT), a brief and patient-based tool to evaluate asthma control, was conducted for 17 patients with asthma in evacuation shelters at Tohoku district. Total sum of ACT scores were significantly decreased after this disaster. Significant decreases were observed for the items; "Asthma keeps you from getting much done at work", "Shortness of breath", "Asthma symptoms wake you up" and "Patient rating of control". ACT, an easy and practicable tool, clearly demonstrated the asthma exacerbation in evacuation shelters without the use of lung function testing. ACT may contribute to the management of health crisis not only for this East Japan disaster but also for the other forthcoming unavoidable disasters.
2011年3月11日,日本东部发生9.0级地震并引发海啸。许多人被迫住在避难所,那里没有足够的救命药物。由于哮喘恶化是发病的主要原因,可能需要紧急护理并导致死亡,因此在健康危机管理中需要对哮喘进行控制。然而,在避难所的基层诊所应使用何种参数仍不明确。本研究的目的是阐明哮喘评估工具在本次灾难受害者基层诊所中的实际效果。对东北地区避难所的17名哮喘患者进行了哮喘控制测试(ACT),这是一种基于患者的简短评估哮喘控制的工具。本次灾难后,ACT总分显著下降。在“哮喘使你无法完成很多工作”“呼吸急促”“哮喘症状会把你惊醒”和“患者对控制的评分”等项目上观察到显著下降。ACT是一种简单可行的工具,无需进行肺功能测试就能清楚地显示避难所中的哮喘恶化情况。ACT不仅可能有助于管理东日本这次灾难的健康危机,也有助于应对其他即将到来的不可避免的灾难。