— 藥理與非經腸給藥 · EASY · MCQ —
一位診斷為深層靜脈栓塞的病人開始接受肝素治療。護理師應監測哪項實驗室數值？
A client is diagnosed with deep vein thrombosis (DVT) and is started on heparin therapy. Which laboratory value should the nurse monitor?
- AActivated partial thromboplastin time (aPTT)✓ 正解活化部分凝血活酶時間 (aPTT)
- BBleeding time出血時間
- CInternational Normalized Ratio (INR)國際標準化比值 (INR)
- DProthrombin time (PT)凝血酶原時間 (PT)
— Explanation · 中文詳解 —
肝素（Heparin）的作用機轉主要影響內源性凝血路徑，故臨床上需追蹤 aPTT 以調整劑量。PT 及 INR 主要用於監測口服抗凝血劑（如 Warfarin）。Bleeding time 較少用於抗凝血劑的常規劑量調整。
Heparin's mechanism of action primarily affects the intrinsic coagulation pathway, so aPTT is followed clinically to titrate the dose. PT and INR are mainly used to monitor oral anticoagulants (such as warfarin). Bleeding time is rarely used for routine dose adjustment of anticoagulants.
✦ 台美臨床差異
台美均採用 aPTT 監測，但在台灣醫療機構，肝素給藥常採固定單位劑量，而非僅依 aPTT 調整。