病人正在進行連續靜脈肝素輸注，護理師測得 aPTT 為 120 秒。優先採取何項行動？
A client is receiving a continuous intravenous infusion of heparin. The nurse notes an activated partial thromboplastin time (aPTT) of 120 seconds. Which action is the priority?
- AAdminister subcutaneous vitamin K皮下注射維生素K
- BReduce the heparin drip rate by 10%將肝素滴速減少10%
- CObtain a repeat aPTT in 1 hour1小時後重測活化部分凝血活酶時間
- DStop the heparin infusion immediately✓ 正解立即停止肝素輸注
正常 aPTT 約 25-35 秒，治療範圍通常為對照值的 1.5-2.5 倍（約 60-80 秒）。120 秒顯示抗凝過度，出血風險極高，必須立即停止輸注以防致命性出血。B 項力度不足；A 項為華法林解毒劑；C 項會延誤處置，危及病患安全。
Normal aPTT is approximately 25-35 seconds, and the therapeutic range is generally 1.5-2.5 times the control (about 60-80 seconds). A value of 120 seconds indicates excessive anticoagulation with very high bleeding risk; the infusion must be stopped immediately to prevent life-threatening hemorrhage. Option B is inadequate; option A is the antidote for warfarin; option C delays intervention and endangers patient safety.
台美臨床對於肝素滴定多依循 Nomogram，但若 aPTT 超過警戒值，皆須立即停止輸注並通報醫師。