— 藥理與非經腸給藥 · MEDIUM · MCQ —
一位因深部靜脈栓塞接受肝素連續靜脈輸注的病人，護理師應監測哪項檢驗值以評估療效？
A client is receiving a continuous heparin infusion for deep vein thrombosis. Which laboratory value should the nurse monitor to evaluate the therapeutic effectiveness?
- AProthrombin time (PT)凝血酶原時間 (PT)
- BPlatelet count血小板計數
- CActivated partial thromboplastin time (aPTT)✓ 正解活化部分凝血活酶時間 (aPTT)
- DInternational Normalized Ratio (INR)國際標準化比值 (INR)
— Explanation · 中文詳解 —
肝素（Heparin）的作用機轉主要影響內源性凝血路徑，因此臨床監測其療效的核心指標為 aPTT。PT 與 INR 是用來評估口服抗凝劑 Warfarin 的效果。血小板數目雖需監測以預防肝素引起的血小板減少症（HIT），但評估抗凝血療效首選 aPTT。
Heparin acts primarily on the intrinsic coagulation pathway, so the key clinical monitor of efficacy is aPTT. PT and INR are used to monitor warfarin therapy. Platelets must be monitored to detect heparin-induced thrombocytopenia (HIT), but the primary indicator of anticoagulant effectiveness is aPTT.
✦ 台美臨床差異
兩地臨床皆依據 aPTT 調整 Heparin 滴速，遵循共同的抗凝血治療指引。