— 藥理與非經腸給藥 · MEDIUM · SATA —
病人正接受靜脈肝素輸注。護理師應監測哪些實驗室數值以評估治療效果？（選所有適合的）
A client is prescribed intravenous heparin infusion. Which laboratory value should the nurse monitor to evaluate the effectiveness of the therapy? (Select all that apply.)
- AActivated Partial Thromboplastin Time (aPTT)✓ 正解活化部分凝血活酶時間 (aPTT)
- BProthrombin Time (PT)凝血酶原時間 (PT)
- CInternational Normalized Ratio (INR)國際標準化比率 (INR)
- DAnti-Xa assay✓ 正解Anti-Xa 檢測
- EPlatelet count✓ 正解血小板計數
— Explanation · 中文詳解 —
肝素治療的效果評估主要依賴 aPTT 或 Anti-Xa 測定，兩者皆能反映肝素的抗凝血效果。此外，使用肝素必須定期監測血小板計數，以防範肝素誘發的血小板低下症 (HIT)。PT 與 INR 是用來評估華法林 (Warfarin) 效果的指標，而非肝素。
The effectiveness of heparin therapy is evaluated primarily by aPTT or the anti-Xa assay, both of which reflect the anticoagulant effect of heparin. In addition, platelet count must be monitored periodically during heparin use to detect heparin-induced thrombocytopenia (HIT). PT and INR are indicators used to monitor warfarin, not heparin.
✦ 台美臨床差異
美國部分醫學中心已逐漸轉向以 Anti-Xa 取代 aPTT；台灣大多數基層醫院仍以 aPTT 為主。