— 降低風險 · MEDIUM · MCQ —
護理師照護一位接受連續靜脈輸注肝素（Heparin）的病人，應監測哪項檢驗結果以評估治療效果？
A nurse is caring for a client receiving continuous IV heparin therapy. Which laboratory finding should the nurse monitor to assess the therapeutic efficacy?
- AActivated partial thromboplastin time (aPTT)✓ 正解活化部分凝血活酶時間 (aPTT)
- BPlatelet count血小板計數
- CInternational Normalized Ratio (INR)國際標準化比率 (INR)
- DProthrombin time (PT)凝血酶原時間 (PT)
— Explanation · 中文詳解 —
肝素（Heparin）透過抑制凝血因子來延長凝血時間，臨床上以 aPTT 作為監測其抗凝效果的指標。PT 與 INR 則是用於評估口服抗凝劑如 Warfarin 的效果。血小板計數雖需監測以防 HIT，但非評估肝素抗凝效果的關鍵。
Activated partial thromboplastin time (aPTT) is the standard laboratory test used to monitor the therapeutic efficacy of intravenous heparin therapy because heparin affects the intrinsic coagulation pathway. While platelet counts are monitored to detect heparin-induced thrombocytopenia, aPTT specifically guides dosage adjustments for anticoagulation.
✦ 台美臨床差異
台美臨床均以 aPTT 作為肝素監測依據，但醫院對於 aPTT 的治療範圍（Therapeutic range） protocol 可能略有不同。