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强震期间的手术室:来自2011年东日本大地震的教训

The Operating Room During a Severe Earthquake: Lessons From the 2011 Great East Japan Earthquake.

作者信息

Suzuki Yasuyuki, Fukuda Ikuo, Nakaji Shigeyuki

机构信息

Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate School of Medicine, Aomori, Japan.

Department of Thoracic and Social Medicine, Hirosaki University Graduate School of Medicine, Aomori, Japan.

出版信息

Disaster Med Public Health Prep. 2014 Apr;8(2):123-129. doi: 10.1017/dmp.2014.16.

Abstract

OBJECTIVE

The Great East Japan Earthquake occurred at 14:46 on March 11, 2011, producing serious and widespread damage. To assess damages in hospital operating departments during and after the earthquake, we surveyed hospitals in this region.

METHODS

Questionnaires were sent to 415 acute care hospitals in Tohoku and east Kanto areas. The questionnaires elicited the number of perioperative patients when the earthquake hit, obstacles to continuing surgery, structural and nonstructural damage to the operating department, and the effect on routine surgery after the earthquake.

RESULTS

Of the 213 hospitals (51%) that completed questionnaires, 474 patients were undergoing operations during the earthquake, and 222 operations were canceled afterward. Risk factors for continuing operations, as reported by 102 hospitals, were tremors and electrical blackouts (odds ratio [OR]: 79.3 and 110.5; < .01). In 154 hospitals, difficulties in performing operations after the earthquake were reported. Significant obstacles to the management of operations after the earthquake were characterized by infrastructure disorder scores, seismic intensity, disruption of electrical power and air conditioning, and damage to out-of-hospital telecommunications (OR, 0.46; = .04).

CONCLUSIONS

Tremors and electrical blackouts were important risk factors for performing operations. Nonstructural damage, especially to out-of-hospital telecommunications, affected the management of the operating rooms. Hospital logistics are very important to achieve appropriate disaster management. (. 2014;0:1-7).

摘要

目的

2011年3月11日14:46发生了东日本大地震,造成了严重且广泛的破坏。为评估地震期间及之后医院手术室的受损情况,我们对该地区的医院进行了调查。

方法

向东北地区和关东地区的415家急症医院发放了调查问卷。问卷内容包括地震发生时围手术期患者的数量、继续手术的障碍、手术室的结构和非结构损坏情况以及地震后对常规手术的影响。

结果

在完成问卷的213家医院(51%)中,地震发生时有474例患者正在进行手术,之后有222例手术被取消。102家医院报告的继续手术的风险因素是震颤和停电(优势比[OR]:79.3和110.5;P<0.01)。154家医院报告了地震后手术操作存在困难。地震后手术管理的重大障碍表现为基础设施紊乱评分、地震强度、电力和空调中断以及院外通信损坏(OR,0.46;P = 0.04)。

结论

震颤和停电是进行手术的重要风险因素。非结构损坏,尤其是院外通信损坏,影响了手术室的管理。医院后勤保障对于实现适当的灾害管理非常重要。(.2014;0:1 - 7)

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