Aboyans Victor, Guessous Idris, Leclerc Aurélien, Lacroix Philippe
Service de chirurgie thoracique, cardiovasculaire et angiologie, Hôpital Dupuytren, CHU de Limoges, France.
Rev Med Suisse. 2010 Jul 14;6(256):1405-9.
Following the evidence of benefits of ultrasound screening for abdominal aorta aneurysms (AAA), several guidelines support this screening in population. Beyond the prompt diagnosis of AAA prior to its rupture of grim vital prognosis, small AAA can beconsidered as a prognostic marker for cardiovascular diseases (CVD). Yet, its detection is an opportunity for secondary prevention to reduce CVD mortality. Despite, these guidelines are poorly applied: systematic screening campaigns are infrequent, making the screening of family physicians responsibility. While the major benefit from this screening strategy is to reduce AAA-related death (but only trivial effect on long-term total mortality), this explains only partially the lack of guidelines implementation. The reasons of the poor implementation of these guidelines are discussed herein.
基于超声筛查腹主动脉瘤(AAA)有益的证据,多项指南支持对人群进行此项筛查。除了在AAA破裂前做出预后严峻的快速诊断外,小型AAA可被视为心血管疾病(CVD)的预后标志物。然而,其检测是进行二级预防以降低CVD死亡率的契机。尽管如此,这些指南的应用情况不佳:系统性筛查活动并不常见,使得家庭医生承担起筛查责任。虽然这种筛查策略的主要益处是降低与AAA相关的死亡(但对长期总死亡率只有微不足道的影响),但这只是部分解释了指南实施不力的原因。本文讨论了这些指南实施不力的原因。