— 生理適應 · MEDIUM · MCQ —
一位深層靜脈栓塞病人正在接受肝素（Heparin）持續點滴輸注，護理師應監測哪項檢驗值？
A patient with a deep vein thrombosis (DVT) is receiving a continuous heparin infusion. Which laboratory value should the nurse monitor?
- APlatelet count血小板計數
- BProthrombin time (PT)凝血酶原時間 (PT)
- CInternational Normalized Ratio (INR)國際標準化比值 (INR)
- 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（Heparin）透過抑制凝血因子來達成抗凝血效果，其療效監測指標為 aPTT。PT/INR 主要用於監測口服抗凝劑 Warfarin。雖然血小板計數需監測以預防肝素誘導之血小板減少症（HIT），但評估抗凝血療效的標準檢驗是 aPTT。
Heparin acts by inhibiting clotting factors; its therapeutic effect is monitored with activated partial thromboplastin time (aPTT). PT/INR primarily monitors warfarin. Although platelet count must be watched for heparin-induced thrombocytopenia (HIT), the standard test to evaluate anticoagulant efficacy is aPTT.
✦ 台美臨床差異
美國醫院多使用 nomogram 根據 aPTT 自動調整肝素劑量；台灣臨床多由醫師根據報告結果手動調整醫囑。