[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-115-1-maternal-pediatric-022":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":35,"lastmod":64},"產兒科護理學","maternal-pediatric",{"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-115-1-產兒科護理學-022","nurse-115-1-maternal-pediatric-022",115,1,22,"下列何者是發生產後血栓靜脈炎的主要原因？",{"A":14,"B":15,"C":16,"D":17},"纖維蛋白溶解抑制素增加","多胞胎","妊娠高血壓","產後出血","A",null,[],"本題考點是產後血栓靜脈炎的形成機轉。依 Virchow 三要素(血液高凝狀態、血流滯留、血管內膜受損),妊娠與產後最關鍵的是血液處於高凝狀態:凝血因子與纖維蛋白溶解抑制素同時增加,使已形成的纖維蛋白不易被分解,血栓因而容易生成,故 A 為主要原因。B 多胞胎使子宮明顯增大而壓迫下肢靜脈回流,屬造成血流滯留的危險因子,並非根本機轉。C 妊娠高血壓伴隨血管內皮病變,同樣只是提高風險的條件之一。D 產後出血造成血液濃縮並延長臥床時間,屬間接誘因。三者都是危險因子,但根本原因仍在凝血與纖維蛋白溶解系統之間的失衡。","把產後血栓風險拆回 Virchow 三要素最有條理:高凝狀態來自孕期凝血因子與纖維蛋白原上升、纖維蛋白溶解受抑,產後數週才逐漸回復;血流滯留來自子宮壓迫、久坐久臥與活動減少;血管內膜受損則來自生產或手術操作與感染。三者疊加,使產後成為女性一生中靜脈血栓栓塞風險最高的時期之一,剖腹產風險更高於陰道生產。表淺與深層的表現需區分:表淺型可見沿靜脈走向的紅、腫、熱、觸痛與硬如繩索的血管;深層型則呈單側下肢腫脹、疼痛、皮膚溫熱與周長增加,Homans 徵象敏感度與特異度都不高,不能單憑它排除診斷,診斷仍需影像檢查。最需警覺的併發症是肺栓塞,表現為突發呼吸困難、胸痛、心跳加快與血氧下降。預防的原則性方向是及早下床活動、避免久站久坐與膝下受壓、維持足夠水分。可延伸複習:抗凝血治療期間的出血徵象監測與哺乳相容性。",[24,27,29,31,33],{"term":25,"count":26},"Virchow 三要素",2,{"term":28,"count":26},"產後高凝狀態",{"term":30,"count":26},"肺栓塞",{"term":32,"count":10},"纖維蛋白溶解抑制素",{"term":34,"count":10},"靜脈血流滯留",[36,40,45,49,54,59],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-115-1-maternal-pediatric-023","陰道生產之早期產後出血定義，是以生產後 24 小時內出血量至少超過多少？",23,{"webId":41,"stem":42,"number":43,"year":44,"session":10},"nurse-106-1-maternal-pediatric-019","張女士，產後 2 小時自恢復室返室，惡露呈鮮紅色，1 小時內即浸溼整片產墊，下列敘述何者正確？ ①此為早期出血 ②此為晚期出血 ③可能與子宮收縮不良有關 ④可能與胎盤組織殘留有關",19,106,{"webId":46,"stem":47,"number":48,"year":44,"session":26},"nurse-106-2-maternal-pediatric-033","有關妊娠糖尿病的敘述，下列何者錯誤？",33,{"webId":50,"stem":51,"number":52,"year":53,"session":26},"nurse-107-2-maternal-pediatric-071","持續靜脈灌注前列腺素 E 1 （PGE 1 ）可維持動脈導管開放，增加肺動脈血流。下列何種先天性心臟病，不適合使用 PGE 1 治療？",71,107,{"webId":55,"stem":56,"number":57,"year":58,"session":10},"nurse-109-1-maternal-pediatric-035","有關萎縮性陰道炎之敘述，下列何者錯誤？",35,109,{"webId":60,"stem":61,"number":62,"year":63,"session":10},"nurse-110-1-maternal-pediatric-069","小青，2 歲，罹患先天性甲狀腺功能低下（congenital hypothyroidism），下列敘述何者不適當？",69,110,"2026-08-06",1787299089370]