蜘蛛膜下腔出血 (subarachnoid hemorrhage, SAH) 是一種出血點位於蜘蛛膜與軟腦膜之間的疾病。出血原因包括創傷性腦出血以及自發性腦出血。倘若於急性期又出現再出血的併發症，往往伴隨著高致死率。然而過去文獻顯示，tranexamic acid (TXA) 因為具有促進凝血的效果而可以使用於SAH，但角色並不明確。相反的，TXA 的藥品相關資訊卻將SAH 列為禁忌症。在資訊衝突之下，本文利用文獻回顧探討TXA 用於SAH 之有效性及安全性。以現有的文獻回顧，TXA 使用於SAH 的病人，似乎可有效預防初期再出血，但對於臨床結果卻無改善效果。安全性的部分，各個文獻結果仍不一致，仍欠缺更有力的證據證明其安全性。

 

Subarachnoid hemorrhage (SAH) is a disease in which the bleeding point is located between the arachnoid and pia mater. Causes of bleeding include traumatic and spontaneous events. However, according to previous reports, tranexamic acid (TXA) can be used for the treatment of SAH due to its effect on promoting blood clotting, but the exact mechanism is unclear. In contrast, the drug-related information on TXA lists SAH as a contraindication. This article reviews the effectiveness and safety of TXA in patients with SAH. TXA used in patients with SAH is effective in preventing acute rebleeding, but it does not affect the clinical endpoint. In terms of safety, the results of various studies are still mutually interrelated, and exists a lack of solid evidence to prove its safety.

 

Submited for publication: 2021.4.15; Accepted for publication: 2021.8.23