— 藥理與非經腸給藥 · EASY · MCQ —
一位病人因深部靜脈栓塞接受肝素（heparin）靜脈輸注。護理師應監測哪項檢驗值以評估治療成效？
A client is receiving intravenous heparin for deep vein thrombosis. Which laboratory value should the nurse monitor to assess the effectiveness of the therapy?
- AInternational Normalized Ratio (INR)國際標準化比值（INR）
- BPlatelet count血小板計數
- CProthrombin time (PT)凝血酶原時間（PT）
- DActivated partial thromboplastin time (aPTT)✓ 正解活化部分凝血活酶時間（aPTT）
— Explanation · 中文詳解 —
肝素主要作用於內源性凝血路徑，臨床上以 aPTT 作為監測其抗凝血效果的指標。PT 與 INR 是用來監測 warfarin 的效果。血小板計數雖需監測以排除肝素引起的血小板減少症（HIT），但並非評估治療成效的指標。
Heparin acts primarily on the intrinsic coagulation pathway, and aPTT is used clinically to monitor its anticoagulant effect. PT and INR are used to monitor the effect of warfarin. The platelet count must also be monitored to rule out heparin-induced thrombocytopenia (HIT) but is not an indicator of therapeutic efficacy.
✦ 台美臨床差異
台美臨床皆使用 aPTT 監測，但美國醫院常有護理師根據協議自行調整給藥速率的權限。