Duncan J L, Wolf B, Nichols D M, Lindsay S M, Cairns J, Godden D J
Department of Surgery, Raigmore Hospital, Inverness, UK.
Br J Surg. 2005 Aug;92(8):984-8. doi: 10.1002/bjs.5120.
Screening for abdominal aortic aneurysm has been shown to reduce aneurysm-related mortality, but the applicability of the results to the whole of the UK has been questioned. This study examined screening in a remote and rural area.
Over 3 years, men aged 65-74 years were offered screening in the community by ultrasonography, usually in general practitioner surgeries. Men with an aneurysm were rescanned at intervals or assessed for surgery. The screening and hospital costs of the programme were calculated.
Some 9323 men were offered screening of whom 8355 (89.6 per cent) attended. Uptake was high in all areas. A total of 430 scans (5.1 per cent) were abnormal; 40 men had an aneurysm greater than 55 mm in diameter. Twenty further men had an aorta that enlarged to greater than 55 mm during follow-up. A total of 54 men had elective repair with one death (mortality rate 2 per cent). The cost of screening alone was 16 pound per invitation and the overall cost of the programme, including surgery, was 58 pound per invitation.
Screening for abdominal aortic aneurysm can be carried out in a remote and rural area with high uptake, acceptable clinical results and at no greater cost than in more densely populated areas.
腹主动脉瘤筛查已被证明可降低与动脉瘤相关的死亡率，但该结果在英国全国的适用性受到质疑。本研究对一个偏远农村地区的筛查情况进行了调查。
在3年多的时间里，为65至74岁的男性提供社区超声筛查，通常在全科医生诊所进行。对患有动脉瘤的男性定期进行复查或评估是否需要手术。计算了该项目的筛查和住院费用。
约9323名男性接受了筛查，其中8355人（89.6%）参加。所有地区的参与率都很高。共有430次扫描（5.1%）异常；40名男性患有直径大于55毫米的动脉瘤。另外20名男性在随访期间主动脉直径扩大至大于55毫米。共有54名男性接受了择期修复手术，1人死亡（死亡率2%）。仅筛查的费用为每次邀请16英镑，该项目的总成本，包括手术费用，为每次邀请58英镑。
腹主动脉瘤筛查可以在偏远农村地区进行，参与率高，临床结果可接受，且成本不高于人口更密集地区。
