00317549

open access

Version of Record

ハンシン アワジ ダイシンサイ ニオケル ザメツ ショウコウグン ノ ハッショウ ニ カンヨスル インシ ノ ケントウ

Prediction of Crush Syndrome in the Great Hanshin-Awaji Earthquake

Japanese (日本語)

神戸大学都市安全研究センター研究報告

3

323-330

神戸大学都市安全研究センター

1999-03

2007-04-10

Many of the patients who were buried under fallen mosonary in the Hanshin-Awaji earthquake of January 17, 1995, developed acute renal dysfunction. These patients were considered victims of "Crush syndrome". Although, it has been reported that crush syndrome has been observed in seismic catastrophes and wars, the mechanism of this disease has not been fully understood. In order to investigate the predictive factors ofcrush syndrome, a retrospective study of the charts of patients injured in the Hanshin-Awaji earthquake was performed. Fifty-nine patients in whorn scrum creatine kinase level was higher than 1000 IU/L were studied. The emergency laboratory data and clinical background of those patients with renal dysfunction were compared with patients without renal dysfunction. Renal dysfunction was defined as levels of serum creatinine greater than 1.5 mg/dl. When clinical variables were compared between the renal dysfunction and the non-renal dysfunction groups, average age, potassium level and white blood cells were significantly higher in the renal dysfunction group, while calcium, total protein and HCO3- in blood gas were significantly lower. When clinical variables were compared between those who died and those who survived, calcium was significantly lower in those who died. As it was only possible to use emergency units, the serum enzyme level from muscles, such as LDH, GOT and GPT exceeded the measurable limit in many cases in the renal dysfunction group. In conclusion, when patients suffer from crush injury, blood chemistry and gas analysis should be performed immediately. If an extrenly high level of musclogenic enzyme and a low level of serum calcium are observed, extensive care will be needed to prevent the risk of renal dysfuntion developing.

紀要論文