— 藥理與非經腸給藥 · EASY · MCQ —
病人因深層靜脈栓塞接受連續肝素滴注治療。護理師應監測何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 determine the therapeutic effectiveness?
- APlatelet count血小板計數
- BActivated partial thromboplastin time (aPTT)✓ 正解活化部分凝血活酶時間 (aPTT)
- CInternational Normalized Ratio (INR)國際標準化比值 (INR)
- DProthrombin time (PT)凝血酶原時間 (PT)
— Explanation · 中文詳解 —
肝素（Heparin）主要透過抑制凝血因子來延長 aPTT，是監測其抗凝血療效的標準指標。PT 與 INR 主要用於監測口服抗凝劑 Warfarin 的效果。血小板計數雖需監測以防肝素誘發之血小板低下症（HIT），但並非評估藥物抗凝療效的工具。
Activated partial thromboplastin time (aPTT) is the standard laboratory test used to monitor the therapeutic effectiveness of continuous heparin infusions. While platelet counts are monitored to detect heparin-induced thrombocytopenia, and PT/INR are used for warfarin therapy, aPTT directly reflects the anticoagulant status required for treating deep vein thrombosis.
✦ 台美臨床差異
台美兩地對於肝素監測均一致，主要差異在於基層單位對 protocol 的執行權限與給藥監測頻率。