— 降低風險 · EASY · MCQ —
患有深部靜脈栓塞 (DVT) 的病人正在接受持續性肝素 (Heparin) 輸注。護理師應監測哪項數值以調整劑量？
A client with deep vein thrombosis (DVT) is receiving a continuous heparin infusion. Which laboratory value should the nurse monitor to adjust the dosage?
- 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)
- CPlatelet count血小板計數
- DInternational Normalized Ratio (INR)國際標準化比值 (INR)
— Explanation · 中文詳解 —
肝素 (Heparin) 的治療效果主要透過 aPTT 監測，目標通常為正常對照值的 1.5 到 2.5 倍。PT 和 INR (B, D) 是監測 Warfarin 效果的指標。D（血小板）雖需監測以預防肝素誘發之血小板低下症 (HIT)，但非用於調整輸注劑量的主要依據。
The therapeutic effect of heparin is monitored primarily by aPTT, with a target usually 1.5 to 2.5 times the normal control. PT and INR (B, D) monitor the effect of warfarin. Although platelets (C) need to be monitored to detect heparin-induced thrombocytopenia (HIT), they are not the primary basis for adjusting the infusion dose.
✦ 台美臨床差異
美國臨床多使用 Heparin Protocol（由護理師依 aPTT 或 Anti-Xa 直接調整劑量）；台灣多由醫師下醫囑調整。