ChiCTR2600117221 版本V1.0 版本创建时间2026/01/21 10:52:57 中国临床试验注册中心

审核状态:

Project audit state:

通过审核

Successful

注册号:

Registration number:

ChiCTR2600117221 

最近更新日期:

Date of Last Refreshed on:

2026-01-21 10:52:40 

注册时间:

Date of Registration:

2026-01-21 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

术中脑氧饱和度监测对老年脊柱手术患者术后谵妄的影响

Public title:

Impact of Intraoperative Cerebral Oximetry Monitoring on Postoperative Delirium in Elderly Patients Undergoing Spinal Surgery

注册题目简写:

English Acronym:

研究课题的正式科学名称:

术中脑氧饱和度监测对老年脊柱手术患者术后谵妄的影响

Scientific title:

Impact of Intraoperative Cerebral Oximetry Monitoring on Postoperative Delirium in Elderly Patients Undergoing Spinal Surgery

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

罗涛 

研究负责人:

王彬 

Applicant:

Tao Luo 

Study leader:

Bin Wang 

申请注册联系人电话:

Applicant telephone:

+86 152 8331 4319

研究负责人电话:

Study leader's
telephone:

+86 136 3781 5096

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

ltdoct@163.com

研究负责人电子邮件:

Study leader's E-mail:

774935778@QQ.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

重庆医科大学附属第一医院

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

重庆医科大学附属第一医院

申请注册联系人通讯地址:

重庆市渝中区友谊路1号

研究负责人通讯地址:

重庆市渝中区友谊路1号

Applicant address:

1 Youyi Road, Yuzhong District, Chongqing

Study leader's address:

1 Youyi Road, Yuzhong District, Chongqing

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

重庆医科大学附属第一医院

Applicant's institution:

The First Affiliated Hospital of Chongqing Medical University

研究负责人所在单位:

重庆医科大学附属第一医院

Affiliation of the Leader:

The First Affiliated Hospital of Chongqing Medical University

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

2025年科研伦理(2025-819-01)

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

重庆医科大学附属第一医院伦理委员会

Name of the ethic committee:

Ethics Committee of the First Affiliated Hospital of Chongqing Medical University

伦理委员会批准日期:

Date of approved by ethic committee:

2025-12-03 00:00:00

伦理委员会联系人:

严青

Contact Name of the ethic committee:

Qing Yan

伦理委员会联系地址:

重庆市渝中区友谊路1号

Contact Address of the ethic committee:

1 Youyi Road, Yuzhong District, Chongqing

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 23 8901 1876

伦理委员会联系人邮箱:

Contact email of the ethic committee:

研究实施负责(组长)单位:

重庆医科大学附属第一医院

Primary sponsor:

The First Affiliated Hospital of Chongqing Medical University

研究实施负责(组长)单位地址:

重庆市渝中区友谊路1号

Primary sponsor's address:

1 Youyi Road, Yuzhong District, Chongqing

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

重庆

市(区县):

重庆

Country:

China

Province:

Chongqing

City:

Chongqing

单位(医院):

重庆医科大学附属第一医院麻醉科

具体地址:

重庆市渝中区友谊路1号

Institution
hospital:

The First Affiliated Hospital of Chongqing Medical University

Address:

1 Youyi Road, Yuzhong District, Chongqing

经费或物资来源:

重庆医科大学附属第一医院研究生基金

Source(s) of funding:

Postgraduate fund of the First Affiliated Hospital of Chongqing Medical University

研究疾病:

术后谵妄  

Target disease:

Postoperative delirium

研究疾病代码:

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

探索性研究/预试验 

Study phase:

0

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

本研究聚焦于老年脊柱手术患者,基于NIRS技术,实时监测术中rSO2变化,并在检测到rSO2下降达到干预阈值(较基线下降10%以上或绝对值低于60%)时,实施一系列标准化干预措施(包括血压管理、氧合优化、通气参数调整、血红蛋白水平评估等)。研究将通过随机对照设计,比较干预组与标准组在POD发生率、rSO2变化趋势及其他围术期结局方面的差异,评估基于NIRS的脑氧优化策略在减少POD中的有效性与安全性。  

Objectives of Study:

This study focuses on elderly patients undergoing spinal surgery. Based on NIRS technology, it monitors the changes of rSO2 during the operation in real time. When the rSO2 decline reaches the intervention threshold (a decrease of more than 10% from the baseline or an absolute value of less than 60%), a series of standardized intervention measures (including blood pressure management, oxygenation optimization, ventilation parameter adjustment, hemoglobin level assessment, etc.) are implemented. The study will compare the differences between the intervention group and the standard group in terms of the incidence of POD, the trend of rSO2 changes, and other perioperative outcomes through a randomized controlled design, and evaluate the effectiveness and safety of the brain oxygen optimization strategy based on NIRS in reducing POD.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

1. ASA状态I-III; 2. 年龄≥60岁; 3. 有意识并能够独立思考; 4. 择期行脊柱手术(俯卧位)患者; 5. 同意参加试验。

Inclusion criteria

1. ASA status I-III; 2. Age >=60 years old; 3. Be conscious and capable of independent thinking; 4. Patients scheduled for spinal surgery (prone position); 5. Agree to participate in the trial.

排除标准:

1. 术前简易精神状态量表(MMES)评分小于24分; 2. 前额有手术、外伤、病变和感染史; 3. 合并严重疾病,包括严重肝肾功能损伤、心脑血管疾病等;糖尿病、高血压控制不佳; 4. 依从性不佳,难以配合治疗合随访。

Exclusion criteria:

1. The preoperative Mini-Mental State Examination (MMES) score was less than 24 points; 2. There is a history of surgery, trauma, lesion and infection on the forehead; 3. Combined with serious diseases, including severe liver and kidney function damage, cardiovascular and cerebrovascular diseases, etc. Poor control of diabetes and hypertension; 4. Poor compliance, making it difficult to cooperate with treatment and follow-up.

研究实施时间:

Study execute time:

From 2026-02-01 00:00:00 To 2026-12-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-02-01 00:00:00 To 2026-12-31 00:00:00

干预措施:

Interventions:

组别:

干预组

样本量:

69

Group:

Intervention group

Sample size:

干预措施:

干预组在常规麻醉管理基础上,额外以rSO2不低于基线值的10%或绝对值不低于60%为干预目标。当rSO2一侧或另一项下降超过基线值的10%或绝对值低于60%时,依照以下流程实施干预:1、确定电极位置是否准确;调整头颈体位,避免颈静脉回流受阻;2、优化氧合:逐步提高FIO2至100%,确保脑氧供应最大化;3、调整呼吸参数,将呼吸频率调整至10-12次/分或将潮气量低到6ml/kg,将二氧化碳分压提高至45-50mmHg,诱导轻度高碳酸血症,促进脑血管扩张;4、优化灌注,加快输液速度,使用血管加压药:静推去氧肾上腺素25-100μg或麻黄碱6mg,使收缩压≥20%,且平均动脉压不超过110mmHg。

干预措施代码:

Intervention:

The intervention group, on the basis of conventional anesthesia management, set an additional intervention target of rSO2 not less than 10% of the baseline value or an absolute value of no less than 60%. When the rSO2 on one side or the other side drops by more than 10% of the baseline value or the absolute value is less than 60%, the intervention shall be carried out in accordance with the following process: 1. Determine whether the electrode position is accurate; Adjust the position of the head and neck to avoid obstruction of jugular venous return. 2. Optimize oxygenation: Gradually increase FIO2 to 100% to ensure maximum brain oxygen supply; 3. Adjust the respiratory parameters, setting the respiratory rate to 10-12 times per minute or reducing the tidal volume to 6ml/kg, and increasing the partial pressure of carbon dioxide to 45-50 MMHG to induce mild hypercapnia and promote cerebral vascular dilation. 4. Optimize perfusion, accelerate the infusion rate, and use vasopressors: administer 25-100μg of norepinephrine or 6mg of ephedrine intravenously to ensure a systolic blood pressure of ≥20% and a mean arterial pressure not exceeding 110mmHg.

Intervention code:

组别:

对照组

样本量:

69

Group:

Control group

Sample size:

干预措施:

对照组在整个手术过程中使用脑/体血氧仪进行监测rSO2,但仅接受常规围术期麻醉管理,管理目标为系统性血流动力学与氧合稳定,不响应脑氧饱和度(rScO2)的变化。

干预措施代码:

Intervention:

The control group was monitored for rSO2 throughout the operation using a brain/body oxygen meter, but only received conventional perioperative anesthesia management. The management goal was to stabilize systemic hemodynamics and oxygenation, without responding to changes in cerebral oxygen saturation (rScO2).

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

重庆 

市(区县):

重庆 

Country:

China

Province:

Chongqing

City:

Chongqing

单位(医院):

重庆医科大学附属第一医院 

单位级别:

三甲  

Institution
hospital:

The First Affiliated Hospital of Chongqing Medical University

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

术后谵妄发生率

指标类型:

主要指标

Outcome:

The incidence of postoperative delirium

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后认知功能障碍发生率

指标类型:

次要指标

Outcome:

The incidence of postoperative cognitive dysfunction

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后疼痛评分

指标类型:

次要指标

Outcome:

Postoperative pain score

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

麻醉药物用量

指标类型:

次要指标

Outcome:

Dosage of anesthetic drugs

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

住院天数

指标类型:

次要指标

Outcome:

Length of hospital stay

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

None

Tissue:

人体标本去向

其它  

说明

Fate of sample:

0thers  

Note:

征募研究对象情况:

Recruiting status:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age 60 years
最大 Max age 100 years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

由一名未参与本研究的助理执行随机化,采用Microsoft Excel生成的随机数字按1:1的比例将参与者随机分至对照组和干预组

Randomization Procedure (please state who generates the random number sequence and by what method):

Randomization was performed by an assistant who was not involved in the study, and random numbers generated by Microsoft Excel were used to randomly divide participants into Control group and intervention group in a ratio of 1:1

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

公开/Public

盲法:

单盲(对受试者隐藏分组),对评估者不隐藏分组

Blinding:

Single blind (hidden grouping for subjects), no hidden grouping for evaluators

试验完成后的统计结果(上传文件):

Calculated Results after
the Study Completed(upload file):

是否共享原始数据:

IPD sharing

否No

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

None

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

Excel表格及SPSS软件

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Excel tables and SPSS software

数据与安全监察委员会:

Data and Safety Monitoring Committee:

暂未确定/Not yet

注册人:

Name of Registration:

 2026-01-21 10:52:40