推荐回答(3个)
Clinical Considerations临床注意事项
The major risk factors for abdominal aortic aneurysm (AAA) include age (being 65 or older), male sex, and a history of ever smoking (at least 100 cigarettes in a person's lifetime). 导致腹主动脉瘤的主要因素包括年龄(65岁及以上)、男性,有吸烟史(一生吸过100支)。A first-degree family history of AAA requiring surgical repair also elevates a man's risk for AAA; this may also be true for women but the evidence is less certain.有一级腹主动脉瘤外科手术修复家庭史的人患病率也增加;这对于女性来说也是一样的,只是还未有很多事例。 There is only a modest association between risk factors for atherosclerotic disease and AAA.动脉粥样硬化与腹主动脉瘤的关联不是很大。
Screening for AAA would most benefit those who have a reasonably high probability of having an AAA large enough, or that will become large enough, to benefit from surgery.全身透视筛查对于腹主动脉瘤致病可能较高的人或者更可能做手术的人来说更有用。 In general, adults younger than age 65 and adults of any age who have never smoked are at low risk for AAA and are not likely to benefit from screening. 一般来说,65岁以下或者未吸烟的成年人,以及无法通过透视筛查得知会致病的人致病率也较低。Among men aged 65 to 74, an estimated 500 who have ever smoked—or 1,783 who have never smoked—would need to be screened to prevent 1 AAA-related death in the next 5 years. 65-74岁的男性,吸烟者500人中有一人,未吸烟者1783人中有一人可能会死于腹主动脉瘤,5年内需要透视筛查以预防。As always, clinicians must individualize recommendations depending on a patient's risk and likelihood of benefit. 一如既往的,医生必须根据致病率与治疗效果对不同的病人给于不同的治疗建议。For example, some clinicians may choose to discuss screening with male nonsmokers nearing age 65 who have a strong first-degree family history of AAA that required surgery.比如,某些医生会建议对65岁的非吸烟,且有一级腹主动脉瘤手相术家庭史的男性进行透视筛查。
The potential benefit of screening for AAA among women aged 65 to 75 is low because of the small number of AAA-related deaths in this population. 65-74岁的进行透视筛查的女性查出致病的可能性较小,是因为此年龄段的死亡率较低。The majority of deaths from AAA rupture occur in women aged 80 or older. 死于腹主动脉瘤的女性一般是80岁以上的。Because there are many competing health risks at this age, any benefit of screening for AAA would be minimal. 因为这一年龄段的人危险因素更多,所以透视筛查是最低要求。Individualization of care, however, is still required. 然而不同人要注意不同的方面。For example, a clinician may choose to discuss screening in the unusual circumstance in which a healthy female smoker in her early 70s has a first-degree family history for AAA that required surgery.比如,医生会建议70岁的健康吸烟女性且有一级腹主动脉瘤手相术家庭史在特别的情况下进行透视筛查。
临床考虑
主要的危险因素对腹主动脉瘤(AAA)包括年龄(65以上),男性爱病史,曾经吸烟(至少100支在一个人的一生)。一个一级家族史的AAA要求手术修复也提升了一个男人的AAA的风险;这可能也适用于女性,但证据不太确定。只有一个温和的风险因素之间的关联动脉粥样硬化疾病和AAA。
筛查AAA最适合那些有一个合理的高概率拥有AAA足够大,或者将变得足够大,从手术中获益。一般来说,65岁以下成人,任何年龄的成年人不吸烟的人得为AAA风险小,不太可能受益于筛查。65到74岁之间的男性中,估计有500人曾经吸烟或1783人从未吸烟会需要筛选,以防止1 aaa相关死亡在接下来的5年。一如既往,临床医师必须有个性的建议根据病人的风险和利益的可能性。例如,一些临床医生可以选择讨论筛查与不吸烟的男性年龄接近65人有强烈的一级家族史的AAA,需要手术。
筛查的潜在好处,AAA年龄在65岁至75岁之间的女性很低,因为只有少量AAA相关死亡在这个人口。大多数死亡发生在女性从AAA破裂80岁或以上。
因为有许多相互竞争的健康风险在这个年纪,任何的好处是很小的筛查AAA。个性化的护理,然而,仍然是必需的。例如,医生可能会选择在不同寻常的情况下讨论筛查中,一个健康的女性吸烟者在她早期的70年代有一个一级家族史对AAA,需要手术。
Sun公司一直是串行restructurer这表明愿意以适应市场条件,但我的印象是,他们总是落后一步,汤姆史密斯说,分析师SCP的证券研究
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