— 生理適應 · MEDIUM · SATA —
護理師評估疑似深層靜脈栓塞（DVT）的病人。下列哪些臨床發現符合？（選所有適合的）
A nurse is assessing a client with suspected deep vein thrombosis (DVT). Which findings are consistent with DVT? (Select all that apply.)
- AUnilateral leg swelling✓ 正解單側肢體腫脹
- BCalf pain or tenderness✓ 正解小腿疼痛或壓痛
- CCool, pale skin on the extremity肢體冰冷、蒼白
- DErythema and warmth along the vein✓ 正解沿著靜脈出現發紅與溫熱
- EPositive Homan's signHoman 徵象陽性
— Explanation · 中文詳解 —
DVT 的典型徵象為患肢的單側腫脹、疼痛、發紅及發熱。Homan's sign（背屈足背引起小腿痛）雖曾被廣泛提及，但臨床特異性極低，目前不建議作為診斷標準。冷而蒼白的皮膚通常是動脈阻塞的徵象，而非靜脈栓塞。
Clinical findings consistent with deep vein thrombosis include unilateral leg swelling, calf pain or tenderness, and erythema with warmth along the affected vein. These symptoms result from venous obstruction and the subsequent inflammatory response. Cool, pale skin indicates arterial insufficiency, and Homan's sign is no longer considered a reliable diagnostic indicator.
✦ 台美臨床差異
美國教學醫院已逐漸移除 Homan's sign 的衛教，台灣仍有部分教材保留，但臨床診斷已依賴血管超音波。