東日本大震災と生活習慣病:被災された方々の健康管理

摘要

東日本大震災での生活習慣病管理上の問題について報告する．余震や避難生活によるストレス，不眠などにより，高血圧患者100人中で血圧上昇したのは65%であった．非常食などによる炭水化物負荷が多くなり，血糖，中性脂肪の上昇する糖尿病患者があった．一方生活習慣が変わり，血圧，血糖，脂質の値が低下し投薬を中止した者もあった．避難所生活，寒さ，水の不足，栄養および衛生状態の悪化，粉塵の吸入，深部静脈血栓症，生活不活発病等で体調を崩し入院する者もあった．薬物在庫不足を想定し1週間以上の処方制限が行われた．患者一部は薬の内容が不明で内服を中断した．普段から最低2週分の薬の備蓄の実行が大切であった．入院患者の給食は支援物資が来るまでの3日間は備蓄した非常食で対応した．電源，水道，ガスなどライフラインの問題も健康管理に影響した．普段からの個人あるいは社会の災害対策，食物や薬の備蓄などが大切であり減災につながるものと考えられた．%We report on problems of health management after Japan Earthquake and Tsunami occurred in March 11, 2011. Compared with before the earthquake, blood pressure increased in 65% of hypertensive patients due to stress and insomnia. In diabetic patients, some increased blood glucose and lipid levels because of carbohydrate-rich survival foods, others decreased those levels because of getting fewer foods and unusual physical exertion.rnRegulation of drug prescription was conducted, in case drug shortage should happen. Maximal prescription duration was limited to seven days during this period. Some patients had to stop medications, because their prescription records were lost. It turned out important to instruct patients to stock up at least 2 weeks' amount of medications.rnFor 3 days after the earthquake, hospital meals were substituted by survival foods. Shortage of electricity, water and gas supply also affected public health management status. We accepted patients suffering from low body temperature, dust inhalation, deep vein thrombosis or disuse syndrome occurred in evacuation camps.rnIt is suggested that individuals as well as the society should be ready for disasters. Building food and drug stockpiles will be effective to minimize damage from disasters.