经颅交流电刺激对老年患者髋或膝关节置换术后谵妄发生率的影响:一项随机对照试验

注册号:

Registration number:

ChiCTR2500099808 

最近更新日期:

Date of Last Refreshed on:

2025-12-26 17:50:04 

注册时间:

Date of Registration:

2025-03-28 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

经颅交流电刺激对老年患者髋或膝关节置换术后谵妄发生率的影响:一项随机对照试验

Public title:

Transcranial Alternative Current Stimulation for postoperative delirium in elderly patients undergoing hip and knee replacement surgery:a randomized controlled trial

注册题目简写:

English Acronym:

研究课题的正式科学名称:

经颅交流电刺激对老年患者髋或膝关节置换术后谵妄发生率的影响:一项随机对照试验

Scientific title:

Efficacy of Transcranial Alternating Current Stimulation on Post-surgery Delirium in Elderly Patients Undergoing Hip and Knee Replacement Surgery: A Randomized Controlled Trial

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:

赵晶 

研究负责人:

赵晶 

Applicant:

Zhaojing 

Study leader:

Zhaojing 

申请注册联系人电话:

Applicant telephone:

+86 189 3017 3656

研究负责人电话:

Study leader's
telephone:

+86 189 3017 3656

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:

zhaojing@shsmu.edu.cn

研究负责人电子邮件:

Study leader's E-mail:

zhaojing@shsmu.edu.cn

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

上海市徐汇区宜山路600号

研究负责人通讯地址:

上海市徐汇区宜山路600号

Applicant address:

600#, Yi-Shan Road, Shanghai, China

Study leader's address:

600#, Yi-Shan Road, Shanghai, China

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:

上海交通大学附属第六人民医院

Applicant's institution:

Shanghai Jiaotong University Affiliated Sixth People ’s Hospital

研究负责人所在单位:

上海交通大学附属第六人民医院

Affiliation of the Leader:

Shanghai Jiaotong University Affiliated Sixth People ’s Hospital

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:

2025-035

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:

上海市第六人民医院伦理委员会

Name of the ethic committee:

Ethics Committee of Shanghai Sixth People's Hospital

伦理委员会批准日期:

Date of approved by ethic committee:

2025-03-07 00:00:00

伦理委员会联系人:

孙秀秀

Contact Name of the ethic committee:

Sunxiu xiu

伦理委员会联系地址:

上海市宜山路600号

Contact Address of the ethic committee:

600#, Yi-Shan Road, Shanghai, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 21 6436 9181

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:

上海交通大学附属第六人民医院

Primary sponsor:

Shanghai Jiaotong University Affiliated Sixth People ’s Hospital

研究实施负责(组长)单位地址:

上海市宜山路600号

Primary sponsor's address:

600#, Yi-Shan Road, Shanghai, China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

上海

市(区县):

Country:

China

Province:

Shanghai

City:

单位(医院):

上海交通大学附属第六人民医院

具体地址:

上海市徐汇区宜山路600号

Institution
hospital:

Shanghai Jiaotong University Affiliated Sixth People ’s Hospital

Address:

600#, Yi-Shan Road, Shanghai, China

经费或物资来源:

Source(s) of funding:

None

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:

其它 

Study phase:

N/A

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

通过经颅交流电刺激预防性干预术后谵妄相关脑区,达到降低老年患者髋或膝关节置换手术后谵妄发生率的目的,为术后谵妄的预防及干预探索新的方向,改善患者术后生存质量。  

Objectives of Study:

Through transcranial AC stimulation preventive intervention of postoperative related brain area, the purpose can reduce the incidence of delusion after hip or knee replacement surgery in elderly patients, explore a new direction for postoperative prevention and intervention, and improve the postoperative quality of life of patients.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

Inclusion criteria

排除标准:

①拒绝签署同意书 ②简易认知评估(Mini-Cog)量表≦1分 ③神经系统疾病:如阿尔茨海默病、帕金森病 ④精神疾病史:既往有严重精神疾病史的患者(如重度抑郁症、精神分裂症) ⑤严重听觉障碍 ⑥服用中枢神经系统药物:正在使用镇静剂、抗抑郁药、抗精神病药物或其他中枢神经系统药物的患者 ⑦经颅电刺激禁忌症:如植入性医疗设备、癫痫病史、严重的头皮病变或皮肤感染、颅内肿瘤或其他严重脑部病变等 ⑧急性感染或全身性炎症:急性感染或炎症状态会增加术后并发症的发生,可能影响谵妄的独立评估 ⑨其他研究参与:在最近3个月内参与其他临床试验的患者,以免多重干预对研究结果产生混淆

Exclusion criteria:

1 Refusal to sign the consent form 2 Mini-Cog score <= 1 3 Nervous system diseases: such as Alzheimer's disease, Parkinson's disease 4 History of mental illness: patients with a previous history of serious mental illness (e.g., major depression, schizophrenia) 5 Severe hearing impairment 6 Taking central nervous system drugs: patients who are using sedatives, antidepressants, antipsychotic drugs, or other central nervous system drugs 7 Contraindications to transcranial electrical stimulation: such as implantable medical devices, history of epilepsy, severe scalp lesions or skin infections, intracranial tumors or other serious brain lesions 8 Acute infection or systemic inflammation: Acute infection or inflammatory state will increase the incidence of postoperative complications and may affect the independent assessment of delirium 9 Other study participation: patients who participated in other clinical trials within the last 3 months, so as not to confound the study results with multiple interventions

研究实施时间:

Study execute time:

From 2025-01-12 00:00:00 To 2026-07-12 00:00:00  

征募观察对象时间:

Recruiting time:

From 2025-04-01 00:00:00 To 2025-07-23 00:00:00

干预措施:

Interventions:

组别:

干预组

样本量:

133

Group:

Active tACS Group

Sample size:

干预措施:

1.接受真实经颅交流电刺激。 2.参数:10 Hz 频率,2 mA 强度,每次持续30分钟。 3.刺激电极置于左背外侧前额叶皮层(阳极)和右眶额区(阴极)。 4.围术期共进行6次刺激(术前3次,术后3次)

干预措施代码:

Intervention:

1. Receive real transcranial alternating current stimulation. 2. Parameters: 10 Hz frequency, 2 mA intensity, each lasting 30 minutes. 3. Stimulating electrodes were placed in the left dorsolateral prefrontal cortex (anode) and the right orbitofrontal region (cathode). 4. A total of 6 stimuli were performed during the perioperative period (3 before surgery and 3 after surgery).

Intervention code:

组别:

对照组

样本量:

133

Group:

sham?tACS Group

Sample size:

干预措施:

1.接受伪/假刺激以进行盲法对照。 2.仅在刺激开始和结束时各有 30秒的电流渐强和渐弱过程。 3.不施加持续的2 mA、10 Hz真实刺激。 4.除无持续电流外,电极放置、操作流程和刺激次数与主动组完全相同。

干预措施代码:

Intervention:

1. Receive pseudo-stimulation for blinded control.2. There were only 30 s of current crescendo and decrescendo processes at the beginning and end of the stimulus. 3. No continuous 2 mA, 10 Hz real stimulation was applied. 4. Except for the absence of continuous current, electrode placement, operation procedure and stimulation times were exactly the same as those of the active group.

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

上海 

市(区县):

 

Country:

China

Province:

Shanghai

City:

单位(医院):

上海交通大学附属第六人民医院 

单位级别:

三甲 

Institution
hospital:

Shanghai Jiaotong University Affiliated Sixth People's Hospital

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

谵妄

指标类型:

主要指标

Outcome:

postoperative delirium (POD)

Type:

Primary indicator

测量时间点:

术后第1天上午8点(T1)及下午4点(T2)、术后第2天上午8点(T3) 及下午4点 (T4)、第3天上午8点(T5)及下午4点(T6),共6个时间点。

测量方法:

《3分钟意识模糊评估法》(3D-CAM)用于普通病房患者;《重症监护室意识模糊评估法》(CAM-ICU)用于ICU患者。

Measure time point of outcome:

Measure method:

3 Minute Diagnostic Interview for CAM Defined Delirium (3D CAM/CAM-ICU)

指标中文名:

谵妄持续时间

指标类型:

次要指标

Outcome:

Duration of delirium

Type:

Secondary indicator

测量时间点:

测量方法:

从首次阳性评估到末次阳性评估之间的天数

Measure time point of outcome:

Measure method:

指标中文名:

谵妄严重程度

指标类型:

次要指标

Outcome:

Severity of delirium

Type:

Secondary indicator

测量时间点:

测量方法:

《意识模糊评估法-严重程度》(CAM-S)

Measure time point of outcome:

Measure method:

指标中文名:

谵妄亚型

指标类型:

次要指标

Outcome:

Subtypes of Delirium

Type:

Secondary indicator

测量时间点:

测量方法:

《Richmond躁动镇静量表》(RASS)

Measure time point of outcome:

Measure method:

指标中文名:

焦虑

指标类型:

次要指标

Outcome:

Anxiety

Type:

Secondary indicator

测量时间点:

术前一天上午8点(T0)?术后第1天上午8点(T1)?术后第二天上午8点(T3)?术后第三天上午8点(T5)及术后第七天上午8点 (T7)。

测量方法:

《医院焦虑与抑郁量表-焦虑子量表》(HADS-A)

Measure time point of outcome:

Measure method:

指标中文名:

抑郁

指标类型:

次要指标

Outcome:

Depression

Type:

Secondary indicator

测量时间点:

术前一天上午8点(T0)?术后第1天上午8点(T1)?术后第二天上午8点(T3)?术后第三天上午8点(T5)及术后第七天上午8点 (T7)

测量方法:

《医院焦虑与抑郁量表-抑郁子量表》(HADS-D)

Measure time point of outcome:

Measure method:

指标中文名:

疼痛

指标类型:

次要指标

Outcome:

Pain

Type:

Secondary indicator

测量时间点:

术后第1天上午8点(T1)及下午4点(T2)、术后第2天上午8点(T3) 及下午4点 (T4)、第3天上午8点(T5)及下午4点(T6),共6个时间点。

测量方法:

《数字评定量表》(NRS)

Measure time point of outcome:

Measure method:

指标中文名:

睡眠质量

指标类型:

次要指标

Outcome:

Quality of sleep

Type:

Secondary indicator

测量时间点:

第一天上午(T1)、第二天上午(T3)、第三天上午(T5)及术后第7天 (T7)

测量方法:

《理查兹-坎贝尔睡眠问卷(Richards-Campbell Sleep Questionnaire,RCSQ)》

Measure time point of outcome:

Measure method:

指标中文名:

炎症指标

指标类型:

次要指标

Outcome:

Markers of inflammation

Type:

Secondary indicator

测量时间点:

术前(T0)?术后第一天(T1)

测量方法:

CRP + IL-6

Measure time point of outcome:

Measure method:

指标中文名:

认知功能

指标类型:

次要指标

Outcome:

Cognitive function

Type:

Secondary indicator

测量时间点:

测量方法:

《蒙特利尔认知评估--电话版》(T-MoCA)

Measure time point of outcome:

Measure method:

指标中文名:

术后恢复质量

指标类型:

次要指标

Outcome:

Quality of postoperative recovery

Type:

Secondary indicator

测量时间点:

测量方法:

15项恢复质量量表(QoR-15)

Measure time point of outcome:

Measure method:

指标中文名:

住院时间

指标类型:

次要指标

Outcome:

Length of stay

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30天内并发症发生率

指标类型:

次要指标

Outcome:

Incidence of complications within 30 days after surgery

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

不良事件

指标类型:

次要指标

Outcome:

Adverse events

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

全因死亡率

指标类型:

次要指标

Outcome:

All-cause mortality

Type:

Secondary indicator

测量时间点:

术后30天及90天

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:

结束

/Completed

年龄范围:

Participant age:

最小 Min age 65 years
最大 Max age 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):

采用简单随机化法,独立的统计学专业人员使用 SPSS 23.0 软件中的随机数字表法,把符合条件的患者按 1:1 的比例随机分到干预组和对照组。

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

Using the simple randomization method, independent statistical professionals used the random number table method in SPSS 23.0 software to randomize eligible patients to the intervention group and the control group.

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:

双盲。 研究参与者:参与者将被告知他们将会接受经颅交流电刺激干预,但不会被告知具体是哪一种干预方式(交流电刺激干预或安慰剂)。 研究执行者:评估人员(例如,护士、医生)将不知道参与者被分配到哪个组别。

Blinding:

Double blinded. Study Participants: Participants will be informed that they will receive a transcranial AC electrical stimulation intervention, but not exactly which intervention it is given (AC electrical stimulation intervention or placebo). Study performer: The assessors (e. g., nurse, doctor) will not know to which group the participant is assigned.

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:

病例记录表

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

Case Record Form, CRF

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:

 2025-03-28 16:57:38