[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-108-2-medical-surgical-052":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":35,"lastmod":65},"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-052","nurse-108-2-medical-surgical-052",108,2,52,"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？",{"A":14,"B":15,"C":16,"D":17},"1.0～1.4","1.5～2.5","2.6～3.5","3.6～4.5","B",null,[],"本題考點為 heparin 抗凝治療的實驗室監測指標與治療範圍。heparin 主要延長內在凝血途徑，臨床以部分凝血活酶時間(aPTT)監測，治療劑量的目標是維持 aPTT 為正常對照值的 1.5～2.5 倍，此區間可有效抗凝又不過度增加出血風險，故選 B。選項 A 的 1.0～1.4 倍幾乎等同未達治療濃度，抗凝不足、血栓仍可能延伸。選項 C 的 2.6～3.5 倍與 D 的 3.6～4.5 倍皆超過治療上限，會顯著提高出血併發症風險，屬於過度抗凝。因此以安全與療效兼顧的 1.5～2.5 倍為標準答案。","對比記憶：heparin 看 aPTT(1.5～2.5 倍)、warfarin 看 PT\u002FINR(一般 2～3)。heparin 過量以 protamine sulfate 中和；warfarin 過量以維生素 K 中和。aPTT 反映內在途徑(因子 XII、XI、IX、VIII)，heparin 經 antithrombin III 抑制 thrombin 與因子 Xa，故延長 aPTT。監測頻率在調整期需密集追蹤，並觀察牙齦出血、血尿、瘀斑等出血徵象。",[24,27,29,31,33],{"term":25,"count":26},"heparin 抗凝",1,{"term":28,"count":26},"aPTT 監測",{"term":30,"count":26},"治療範圍 1.5-2.5 倍",{"term":32,"count":26},"antithrombin III",{"term":34,"count":26},"出血風險",[36,40,45,50,55,60],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-108-2-medical-surgical-053","肺葉切除術後，常放置兩支胸管引流，下列敘述何者正確？",53,{"webId":41,"stem":42,"number":43,"year":44,"session":26},"nurse-109-1-medical-surgical-069","有關重症病人常發生高血糖狀態，下列何者為最可能之原因？",69,109,{"webId":46,"stem":47,"number":48,"year":49,"session":26},"nurse-110-1-medical-surgical-003","下列何者為重症肌無力病人最早受到影響的肌肉？",3,110,{"webId":51,"stem":52,"number":53,"year":54,"session":26},"nurse-111-1-medical-surgical-041","有關癌症病人出血問題之敘述，下列何者錯誤？",41,111,{"webId":56,"stem":57,"number":58,"year":59,"session":10},"nurse-112-2-medical-surgical-005","有關病人因腦腫瘤引起顱內壓升高的症狀與徵象，下列敘述何者錯誤？",5,112,{"webId":61,"stem":62,"number":63,"year":64,"session":10},"nurse-113-2-medical-surgical-019","下列何者不是骨質疏鬆症之危險因素？",19,113,"2026-09-04",1788510706622]