Zhang Qing, Yu Yun, Lu Yu, Yue Hongli
Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, No.119, Nansihuanxi Road, Fengtai District, Beijing, 100070, China.
BMC Neurol. 2019 Apr 6;19(1):55. doi: 10.1186/s12883-019-1281-y.
Several studies have compared the efficacy and safety of propofol and barbiturates in the treatment of refractory status epilepticus (RSE). This study aims to quantitatively assess the advantages and disadvantages of propofol and barbiturates in controlling RSE.
We searched for studies with relevant data from the PubMed, Embase, Ovid, Cochrane Library, Springer Link, Web of Science, and China National Knowledge Infrastructure databases. By calculating odds ratios and standardized mean differences with 95% confidence intervals, we assessed the disease control rate (DCR), case fatality rate (CFR), average control time (ACT), average tracheal intubation placement time (ATIPT), and incidence of hypotension between propofol and barbiturates in treating RSE.
Seven studies with 261 patients were included in this analysis. Meta-analysis revealed that the DCR of propofol was higher than that of barbiturates (p < 0.001) and that the CFR (p = 0.382) between the two treatment did not significantly differ in controlling RSE. Propofol shortened the ACT (p < 0.001) of RSE and reduced the ATIPT (p < 0.001) of patients with RSE more extensively than did barbiturates and did not increase the incidence of hypotension (p = 0.737).
In comparison with barbiturates, propofol can control RSE and shorten ATIPT in a more efficient and timely manner. Moreover, the drug does not increase the incidence of hypotension and CFR.
多项研究比较了丙泊酚和巴比妥类药物治疗难治性癫痫持续状态（RSE）的疗效和安全性。本研究旨在定量评估丙泊酚和巴比妥类药物在控制RSE方面的优缺点。
我们在PubMed、Embase、Ovid、Cochrane图书馆、Springer Link、Web of Science和中国知网数据库中搜索了有相关数据的研究。通过计算比值比和95%置信区间的标准化平均差，我们评估了丙泊酚和巴比妥类药物治疗RSE时的疾病控制率（DCR）、病死率（CFR）、平均控制时间（ACT）、平均气管插管放置时间（ATIPT）和低血压发生率。
本分析纳入了7项研究中的261例患者。荟萃分析显示，丙泊酚的DCR高于巴比妥类药物（p < 0.001），且两种治疗方法在控制RSE方面的CFR（p = 0.382）无显著差异。与巴比妥类药物相比，丙泊酚更能缩短RSE的ACT（p < 0.001），更广泛地缩短RSE患者的ATIPT（p < 0.001），且不会增加低血压发生率（p = 0.737）。
与巴比妥类药物相比，丙泊酚能更有效、及时地控制RSE并缩短ATIPT。此外，该药物不会增加低血压发生率和CFR。
