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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.

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|December 11, 2019
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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.

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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).