Matsukawa Mai, Miyamoto Tomoya, Yoshioka Yuki, Uekihara Kenta, Sakaguchi Takeshi, Hirayama Ryo, Nakajima Masamichi, Suzuki Ryusuke
Department of Cardiovascular Surgery, Japan Red Cross Kumamoto Hospital, Kumamoto, Japan.
Ann Vasc Dis. 2018 Dec 25;11(4):503-510. doi: 10.3400/avd.oa.18-00107.
Kumamoto was hit by a series of strong earthquakes beginning on April 14, 2016. We treated many deep vein thrombosis (DVT) patients and pulmonary thrombosis (PTE) patients. We came up with a strategy for diagnosis and therapy of venous thromboembolism (VTE). For VTE patients, we prescribed anticoagulant drugs, mainly direct oral anticoagulant (DOAC). To evaluate the validity and safety of the medical strategy for VTE in disasters, we investigated the prognosis of VTE patients at 4 months after the initial quake. In the two months following the initial quake we attended to 43 VTE patients, 11 PTE patients (including 9 patients with both DVT and PTE) and 32 DVT patients. We prescribed DOAC to 34 patients and Warfarin to 4 patients. Based on the survey at 4 months after the first tremblor, the period of anticoagulation therapy was 95.0±17.2 days for PTE and 57.1±36.5 days for DVT and 12 patients were continuing to take anticoagulant drugs. There were no recurrent VTE or bleeding events. DOAC therapy of VTE is therefore considered effective and safe in the event of a natural disaster. (This is a translation of J Jpn Coll Angiol 2017; 57: 33-40.).
2016年4月14日起,熊本遭受了一系列强烈地震。我们治疗了许多深静脉血栓形成(DVT)患者和肺血栓形成(PTE)患者。我们提出了静脉血栓栓塞症(VTE)的诊断和治疗策略。对于VTE患者,我们主要开具直接口服抗凝剂(DOAC)等抗凝药物。为评估灾害中VTE医疗策略的有效性和安全性,我们调查了初次地震后4个月时VTE患者的预后情况。在初次地震后的两个月里,我们诊治了43例VTE患者,其中11例PTE患者(包括9例同时患有DVT和PTE的患者)以及32例DVT患者。我们给34例患者开具了DOAC,给4例患者开具了华法林。根据首次地震后4个月的调查,PTE患者的抗凝治疗时间为95.0±17.2天,DVT患者为57.1±36.5天,且有12例患者仍在继续服用抗凝药物。未出现VTE复发或出血事件。因此,在自然灾害情况下,DOAC治疗VTE被认为是有效且安全的。(本文翻译自《日本血管外科学会杂志》2017年;57:33 - 40.)