— 降低風險 · HARD · MCQ —
一位肝硬化病人出現哪項評估發現，代表其出血風險極高？
Which assessment finding in a client with cirrhosis indicates a high risk for bleeding?
- AJaundice黃疸
- BSpider angioma蜘蛛狀血管瘤
- CElevated ALT/ASTALT/AST 升高
- DThrombocytopenia✓ 正解血小板低下
— Explanation · 中文詳解 —
肝硬化病人因脾功能亢進導致血小板破壞增加（血小板減少症），加上肝臟合成凝血因子能力下降，極易導致凝血功能異常。血小板數值過低直接對應出血風險。其他選項雖為肝硬化徵象，但與出血風險的直接關聯性不如血小板數值。
Patients with cirrhosis develop hypersplenism, which increases platelet destruction (thrombocytopenia); coupled with reduced hepatic synthesis of clotting factors, this readily produces abnormal coagulation. A low platelet count directly corresponds to bleeding risk. Although the other options are signs of cirrhosis, their direct relationship to bleeding risk is not as strong as that of the platelet count.
✦ 台美臨床差異
美台臨床皆視肝硬化病人之凝血指數（PT/INR）及血小板計數為監測出血風險的核心指標。