— 藥理與非經腸給藥 · MEDIUM · MCQ —
病人正在進行靜脈肝素輸注，護理師應監測哪項檢驗值以評估治療成效？
A client is receiving an IV infusion of heparin. Which laboratory value should the nurse monitor to evaluate the effectiveness of the therapy?
- AInternational Normalized Ratio (INR)國際標準化比值 (INR)
- BProthrombin time (PT)凝血酶原時間 (PT)
- CPlatelet count血小板計數
- 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）透過抑制凝血因子發揮作用，主要影響內源性凝血路徑，故臨床監測目標為 aPTT。PT/INR 用於監測 Warfarin 的效果。血小板數則用於監測是否發生肝素誘發之血小板低下症（HIT）。
Heparin acts by inhibiting clotting factors and primarily affects the intrinsic clotting pathway, so the clinical monitoring target is the aPTT. PT/INR is used to monitor the effect of warfarin. Platelet count is monitored to detect heparin-induced thrombocytopenia (HIT).
✦ 台美臨床差異
台美皆依據 aPTT 調整輸注速率，但台灣部分醫院已改用 Anti-Xa 作為更精確的監測指標。