Abdominal aortic aneurysm (AAA)/腹主動脈瘤


Abdominal aortic aneurysm (AAA),[1] also known as a triple-a, is a localized enlargement of the abdominal aorta such that the diameter is greater than 3 cm or more than 50% larger than normal.[2] They usually cause no symptoms except when ruptured.[2]Occasionally there may be abdominal, back or leg pain.[3] Large aneurysms can sometimes be felt by pushing on the abdomen.[3]Rupture may result in pain in the abdomen or back, low blood pressure or a brief loss of consciousness.[2][4]

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’’’腹主動脈瘤’’’({{lang-en|abdominal aortic aneurysm, AAA}}[1]),又稱3A,為{{Link-en|腹主動脈|Abdominal aorta}}局部[[血管舒張|擴大]],其橫徑大於3公分或超過正常橫徑之50%[2]。除非腹主動脈瘤破裂,否則通常無症狀[2]。偶爾造成腹部、背部、腿部等處[[疼痛]][3],較大的腹主動脈瘤,有時甚至可藉由腹部觸診感覺到搏動。破裂時可能造成腹部或背部[[疼痛]]、[[低血壓]]、或[[昏厥|短暫失去意識]][2][4]。

AAAs occur most commonly in those over 50 years old, in men, and among those with a family history.[2] Additional risk factors include smoking, high blood pressure, and other heart or blood vessel diseases.[5] Genetic conditions with an increased risk include Marfan syndrome and Ehlers-Danlos syndrome. AAAs are the most common form of aortic aneurysm.[6] Approximately 85 percent occur below the kidneys with the rest either at the level of or above the kidneys.[2] In the United States screening males with ultrasound who are between 65 and 75 year old and have a history of smoking is recommended.[7] In the United Kingdom screening all men over 65 is recommended.[2] Australia has no guideline on screening.[8] Once an aneurysm is found, further ultrasounds are typically done on a regular basis.[3]

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腹主動脈瘤大部份發生在50歲以上,尤其男性以及具有家族史的病患[2]。其他危險因子包括[[吸菸|抽煙]]、[[高血壓]]、以及[[心血管疾病]][5]。基因方面如[[馬凡氏症候群|馬凡氏(Marfan)症候群}及[[埃勒斯-當洛二氏症候群|橡皮人症候群(Ehlers-Danlos syndrome)]],可能增加罹病風險。腹{{Link-en|主動脈瘤|Aortic aneurysm}}為最常見的動脈瘤[6],大約85%位在腎臟以下的主動脈,其餘則在[[腎|腎臟]]同高或以上的位置[2]。在美國,建議65歲至75歲且抽煙的男性,接受[[超音波]]{{Link-en|篩檢|Screening (medicine)}}[7]。在英國,則建議所有65歲以上男性應接受篩檢[2]。澳洲則沒有篩檢準則。一旦發現腹主動脈瘤後,需要定期作超音波檢查[8]。

Not smoking is the single best way to prevent the disease. Other methods of prevention include treating high blood pressure, treating high blood cholesterol and not being overweight. Surgery is usually recommended when an AAA’s diameter grows to >5.5 cm in males and >5.0 cm in females.[2] Other reasons for repair include the presence of symptoms and a rapid increase in size.[3] Repair may be either by open surgery or endovascular aneurysm repair (EVAR).[2] As compared to open surgery, EVAR has a lower risk of death in the short term and a shorter hospital stay but may not always be an option.[9][2][10] There does not appear to be a difference in longer term outcomes between the two.[11] With EVAR there is a higher need for repeat procedures.[12]

戒菸或不吸菸為預防此疾病的最佳方法。其他則包含治療[[高血壓]]、減少{{Link-en|高膽固醇|Hypercholesterolemia}}的現象、避免[[超重|體重過重]]。當腹主動脈瘤橫徑,在男性超過5.5公分,在女性超過5公分,則建議接受手術[2]。其他修補手術的適應症包括有症狀及大小快速增加[3]。修補可藉由{{Link-en|開腹手術|Open aortic surgery}}或{{Link-en|血管內動脈瘤修補(endovascular aneurysm repair/EVAR)|Endovascular aneurysm repair}}[2]。比起開腹手術,血管內動脈瘤修補雖然有以下好處:短期內死亡風險較低、住院時間較短;但必要時仍需要接受開腹手術[2][9][10]。長期來看兩者並沒有差別[11],但EVAR有較高的機率,需要重複接受EVAR[12]。

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AAAs affect between 2% and 8% of males over the age of 65. Rates among women are four times lower. In those with an aneurysm less than 5.5 cm the risk of rupture in the next year is less than 1%. Among those with an aneurysm between 5.5 and 7 cm the risk is about 10% while for those with an aneurysm greater than 7 m the risk is about 33%. Mortality if ruptured is 85% to 90%.[2] During 2013, aortic aneurysms resulted in 152,000 deaths up from 100,000 in 1990.[13] In the United States AAAs resulted in between 10,000 and 18,000 deaths in 2009.[6]

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2015-04-06 中文維基百科尚未創建條目「腹主動脈瘤」