— 照護管理 · MEDIUM · MCQ —
護理師正在收納一位有肺栓塞（PE）症狀的病人，下列哪項診斷性檢查通常是首先用來確診 PE 的？
A nurse is admitting a client with symptoms suggestive of pulmonary embolism (PE). Which diagnostic test is typically performed first to confirm a diagnosis of PE?
- APulmonary angiography肺血管攝影
- BComputed tomography pulmonary angiography (CTPA)電腦斷層肺血管攝影 (CTPA)
- CVentilation-perfusion (V/Q) scan通氣/灌流 (V/Q) 掃描
- DD-dimer assay✓ 正解D-二聚體檢測
— Explanation · 中文詳解 —
D-dimer 是一種纖維蛋白裂解產物，若結果為陰性，其高陰性預測值能讓醫師較有把握排除肺栓塞（PE）。若結果為陽性，則需進一步進行確診檢查（如 CTPA）。雖然 CTPA 是診斷 PE 的黃金標準，但 D-dimer 快速、非侵入性且能快速篩檢，常作為臨床懷疑 PE 時的第一線檢查。V/Q scan 則用於無法進行 CT 檢查的病人。
A D-dimer assay is typically the first diagnostic test performed to rule out pulmonary embolism in low- to intermediate-risk patients due to its high sensitivity. While CT pulmonary angiography is the gold standard for confirmation, D-dimer serves as an initial, non-invasive screening tool.