腹腔动脉瘤查:美国预防服务工作组建议声明
, Douglas K Owens1,2, Karina W Davidson3
1Veterans Affairs Palo Alto Health Care System, Palo Alto, California.
JAMA
|December 11, 2019
概括
对于曾经吸烟的65 - 75岁男性,建议对腹部大动脉动脉瘤 (AAA) 进行查. 没有家族史或吸烟史的妇女不建议进行常规查.
科学领域:
- 血管外科
- 预防医学
- 诊断成像
背景情况:
- 腹腔大动脉瘤 (AAA) 被定义为大动脉扩大≥3.0厘米.
- 在接受查的欧洲男性中,AAA的患病率有所下降,但由于查吸收率低,美国的情况尚不清楚.
- 破裂的AAA携带81%的死亡风险,大多数AAA在破裂之前没有症状.
研究的目的:
- 更新2014年关于AAA查的建议.
- 审查小AAA的查有效性,危害和治疗益处的证据.
主要方法:
- 证据审查由美国公务员部队委托.
- 专注于一次性和重复的AAA查.
- 治疗小AAA (3.0- 5.4厘米) 的考虑好处和危害.
主要成果:
- 在曾经吸烟的65-75岁男性中对AAA查的中等净益.
- 在从未吸烟的65-75岁男性中进行查的净益很小.
- 在65至75岁的吸烟或有家族病史的妇女中进行查的证据不足.
结论:
- 对曾经吸烟过的65-75岁男性进行一次性AAA查 (B建议).
- 选择性地为从未吸烟的65-75岁男性提供查 (C建议).
- 对从未吸烟且没有家族病史的65岁至75岁妇女不建议进行常规查 (D建议).
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