— 藥理與非經腸給藥 · MEDIUM · MCQ —
一位深層靜脈栓塞病人獲處方靜脈肝素治療。護理師應監測哪項檢驗值以評估療效？
A client is prescribed intravenous heparin for deep vein thrombosis. Which laboratory value should the nurse monitor to evaluate the effectiveness of this therapy?
- AInternational Normalized Ratio (INR)國際標準化比值 (INR)
- BPlatelet count血小板計數
- CProthrombin time (PT)凝血酶原時間 (PT)
- 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）透過抑制凝血因子來發揮作用，臨床上透過 aPTT 來監測其抗凝血強度的療效。PT/INR 用於監測口服抗凝劑 Warfarin。血小板計數雖需監測但目的是偵測 HIT（肝素誘發血小板減少症），非療效評估標準。
Activated partial thromboplastin time (aPTT) is the standard laboratory test used to monitor the therapeutic effectiveness of intravenous heparin therapy. While platelet counts are monitored to detect heparin-induced thrombocytopenia, they do not measure anticoagulant efficacy. Prothrombin time (PT) and INR are used to monitor oral anticoagulants like warfarin, not heparin.
✦ 台美臨床差異
美國醫院多使用自動化輸液幫浦並配合電腦化 aPTT 調整程式，台灣臨床則多由醫師根據報告單手動調整劑量。