[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-108-2-medical-surgical-051":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":35,"lastmod":64},"內外科護理學","medical-surgical",{"id":7,"webId":8,"year":9,"session":10,"subject":4,"number":11,"stem":12,"options":13,"answer":18,"answerNote":19,"images":20,"explanation":21,"explanationDeep":22,"topics":23,"freq":26},"nurse-108-2-內外科護理學-051","nurse-108-2-medical-surgical-051",108,2,51,"肺栓塞病人於血栓形成後 72 小時內，可給與下列何種藥物以快速溶解血塊？",{"A":14,"B":15,"C":16,"D":17},"aspirin","heparin","streptokinase","warfarin","C",null,[],"本題考點在於區分「溶解已形成血栓」與「預防血栓延伸」兩類藥物。streptokinase 屬於血栓溶解劑(fibrinolytic),能活化 plasminogen 轉為 plasmin，直接分解 fibrin 網、溶解已形成的血塊，且對急性肺栓塞多主張在血栓形成 72 小時內的黃金期給藥，故選 C。aspirin 是抗血小板劑，抑制血小板凝集，只能預防新血栓、無法溶解既有血塊。heparin 為抗凝血劑，作用在阻止凝血瀑布延伸與新血栓形成，不具溶解作用。warfarin 抑制維生素 K 依賴凝血因子合成，屬長期口服抗凝，起效慢更無溶栓效果。故只有血栓溶解劑符合「快速溶解」要求。","記憶三分法：抗血小板(aspirin)防凝集、抗凝血(heparin\u002Fwarfarin)防延伸、溶栓劑(streptokinase、urokinase、t-PA)溶血塊。溶栓劑經 plasmin 分解 fibrin，療效與時間強相關，愈早給溶解愈完整，故有 72 小時或更短的時間窗概念。streptokinase 為鏈球菌來源異體蛋白，可能引發過敏與抗體，重複給藥效果下降。最大風險是出血，用前須評估禁忌(近期手術、出血、腦中風史)。",[24,27,29,31,33],{"term":25,"count":26},"血栓溶解劑",1,{"term":28,"count":26},"plasminogen 活化",{"term":30,"count":26},"抗凝血劑 heparin",{"term":32,"count":26},"抗血小板劑 aspirin",{"term":34,"count":26},"warfarin 維生素K拮抗",[36,40,45,49,54,59],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-108-2-medical-surgical-052","肺栓塞病人使用肝素以阻止新的血塊形成，通常須維持部分凝血活酶時間（aPTT）為正常值的多少倍？",52,{"webId":41,"stem":42,"number":43,"year":44,"session":26},"nurse-109-1-medical-surgical-068","有關糖尿病酮酸中毒（DKA）的敘述，下列何者正確？",68,109,{"webId":46,"stem":47,"number":10,"year":48,"session":26},"nurse-110-1-medical-surgical-002","多發性硬化症（multiple sclerosis; MS）使用 Cyclophosphamide 藥物治療之最主要目的，下列何者正確？",110,{"webId":50,"stem":51,"number":52,"year":53,"session":26},"nurse-111-1-medical-surgical-040","有關放射線治療病人照射處皮膚照護之敘述，下列何者錯誤？",40,111,{"webId":55,"stem":56,"number":57,"year":58,"session":10},"nurse-112-2-medical-surgical-004","若右眼外旋神經受到血腫壓迫導致複視（diplopia），病人在下列那一種指示下，右眼複視最為明顯？",4,112,{"webId":60,"stem":61,"number":62,"year":63,"session":10},"nurse-113-2-medical-surgical-018","有關心房纖維顫動臨床處置之敘述，下列何者正確？",18,113,"2026-09-04",1788510706618]