加速康复外科在单孔胸腔镜肺叶切除术中的临床应用价值,一项随机对照研究

注册号:

Registration number:

ChiCTR2500111029 

最近更新日期:

Date of Last Refreshed on:

2025-10-23 18:05:43 

注册时间:

Date of Registration:

2025-10-23 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

加速康复外科在单孔胸腔镜肺叶切除术中的临床应用价值,一项随机对照研究

Public title:

The clinical application value of accelerated rehabilitation surgery in single port thoracoscopic lobectomy: a randomized controlled study

注册题目简写:

English Acronym:

研究课题的正式科学名称:

加速康复外科在单孔胸腔镜肺叶切除术中的临床应用价值,一项随机对照研究

Scientific title:

The clinical application value of accelerated rehabilitation surgery in single port thoracoscopic lobectomy: a randomized controlled study

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:

曾林 

研究负责人:

袁兵 

Applicant:

Zeng Lin 

Study leader:

Yuan Bing 

申请注册联系人电话:

Applicant telephone:

+86 152 8147 0503

研究负责人电话:

Study leader's
telephone:

+86 134 5849 5697

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:

343329636@qq.com

研究负责人电子邮件:

Study leader's E-mail:

yuanbing0313@163.com

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:

四川省什邡市方亭镇安康路6号

研究负责人通讯地址:

四川省什邡市方亭镇安康路6号

Applicant address:

No. 6, Ankang Road, Fangting Town, Shifang City, Sichuan Province

Study leader's address:

No. 6, Ankang Road, Fangting Town, Shifang City, Sichuan Province

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:

四川省什邡市人民医院

Applicant's institution:

Shifang people's Hospital, Shifang, Sichuan Province, China

研究负责人所在单位:

四川省什邡市人民医院

Affiliation of the Leader:

Shifang people's Hospital, Shifang, Sichuan Province, China

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:

202453

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:

什邡市人民医院伦理委员会

Name of the ethic committee:

Ethics Committee of Shifang People's Hospital

伦理委员会批准日期:

Date of approved by ethic committee:

2024-12-23 00:00:00

伦理委员会联系人:

贺胜强

Contact Name of the ethic committee:

He shengqiang

伦理委员会联系地址:

什邡市方亭镇安康路6号

Contact Address of the ethic committee:

No. 6, Ankang Road, Fangting Town, Shifang City

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 138 9021 0858

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:

什邡市人民医院

Primary sponsor:

Shifang people's Hospital

研究实施负责(组长)单位地址:

四川省什邡市方亭镇安康路6号

Primary sponsor's address:

No. 6, Ankang Road, Fangting Town, Shifang City, Sichuan Province

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

四川

市(区县):

Country:

China

Province:

Sichuan

City:

单位(医院):

什邡市人民医院

具体地址:

四川省什邡市方亭镇安康路6号

Institution
hospital:

Shifang people's Hospital

Address:

No. 6, Ankang Road, Fangting Town, Shifang City, Sichuan Province

经费或物资来源:

德阳市科技计划项目(2024SZY126)

Source(s) of funding:

Deyang Science and Technology Plan Project(2024SZY126)

研究疾病:

肺癌  

Target disease:

Lung cancer

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:

I期临床试验 

Study phase:

1

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

本次研究基于加速康复理念的单孔法胸腔镜肺叶切除术用于治疗早期肺癌患者在临床上的实用效果。  

Objectives of Study:

This study is based on the concept of accelerated rehabilitation and the practical effect of single port thoracoscopic lobectomy for the treatment of early lung cancer patients in clinical practice.

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)临床病理分期>Ⅰ期的患者; 2)伴有意识障碍的患者; 3)存在放疗或者化疗的患者; 4)不符合单孔法胸腔镜亚肺叶切除术手术条件; 5)既往存在恶性肿瘤史者; 6)拒绝参加本次研究者。

Exclusion criteria:

1) Patients with clinical pathological stage>Stage I; 2) Patients with consciousness disorders; 3) Patients undergoing radiotherapy or chemotherapy; 4) Not meeting the conditions for single port thoracoscopic lobectomy surgery; 5) Individuals with a history of malignant tumors; 6) Refusal to participate in this study.

研究实施时间:

Study execute time:

From 2025-01-01 00:00:00 To 2026-12-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2025-11-01 00:00:00 To 2026-12-31 00:00:00

干预措施:

Interventions:

组别:

研究组

样本量:

30

Group:

research group

Sample size:

干预措施:

采用ERAS理念在单孔胸腔镜肺叶切除术的围手术期处理①术前宣教及心理干预,人院前、人院后开始向患者宣教ERAS处理措施,包括术前戒烟、呼吸功能锻炼、营养饮食、术后早期下床活动及进食的益处。积极与患者沟通,减轻患者心理负担;特别是对手术及预后存在较多顾虑的患者,介绍手术的相关事宜消除顾虑;术前告知患者手术方法、切口大小、术后留置胸管目的等,强调单孔胸腔镜手术的优点。②术前准备,呼吸功能训练及身体锻炼,使用呼吸功能锻炼器或吹气球。存在营养不良者给予适当的营养支持;术前6 h禁食,术前2h可饮水300~500 ml;术前30 min静脉滴注抗生素。③术中处理,常规消毒时注意患者保暖,全身麻醉使用半衰期较短的麻药;术中采用切口保护套保护切口,轻柔操作,避免过度牵拉、挤压肺组织;术中限制性补液,使用血管活性药物升血压,术中补液量少于1000 ml。放置胸腔引流管1根自切口引出。④术后处理,术后当日指导患者在床上坐起2~3次;鼓励患者主动活动下肢或其家属按摩患者下肢肌群及气压泵治疗辅助预防深静脉血栓;术后6h 进水、进流食、拔除尿管,术后1d清晨正常饮食,鼓励下床活动4—6次,每次10min左右,术后2d增加下床活动时间。应用自控镇痛泵镇痛,鼓励咳嗽咳痰。⑤拔管指征,胸管30min挤捏1次,避免管口被堵塞,保证胸腔内渗液顺利引流,加速肺功能的恢复;胸腔闭式引流瓶中无漏气,胸腔积液非血性、乳糜、脓性,x线胸片提示肺复张良好,24h胸腔引流液量<200 ml。术后每日控制静脉补液量<800 ml。

干预措施代码:

Intervention:

Perioperative management of single port thoracoscopic lobectomy using ERAS concept 1 Preoperative education and psychological intervention, ERAS management measures including preoperative smoking cessation, respiratory function exercise, nutritious diet, early postoperative mobilization, and the benefits of eating will be communicated to patients before and after the hospital. Actively communicate with patients to alleviate their psychological burden; Especially for patients who have many concerns about surgery and prognosis, introduce the relevant matters of surgery to eliminate concerns; Prior to surgery, inform the patient of the surgical method, incision size, and the purpose of postoperative chest tube placement, emphasizing the advantages of single port thoracoscopy surgery. 2 Preoperative preparation, respiratory function training and physical exercise, using respiratory function exercisers or blowing balloons. Provide appropriate nutritional support to individuals with malnutrition; Fasting 6 hours before surgery, drinking 300-500 ml of water 2 hours before surgery; intravenous infusion of antibiotics 30 minutes before surgery. 3 During the operation, pay attention to keeping the patient warm during routine disinfection, and use anesthetics with a short half-life for general anesthesia; During the operation, a protective sheath is used to protect the incision, and gentle operation is performed to avoid excessive pulling or squeezing of lung tissue; Intraoperative restricted fluid replacement, using vasoactive drugs to raise blood pressure, with a fluid replacement volume of less than 1000 ml. Place a thoracic drainage tube and lead it out from the incision. 4 Postoperative management, instruct the patient to sit up in bed 2-3 times on the day of surgery; Encourage patients to actively move their lower limbs or their family members to massage their lower limb muscles and use pneumatic pumps to assist in preventing deep vein thrombosis; After 6 hours of surgery, water and liquid intake were introduced, and the urinary catheter was removed. On the first day of surgery, a normal diet was maintained in the morning, and it was encouraged to get out of bed and move around 4-6 times for about 10 minutes each time. On the second day after surgery, the time for getting out of bed and moving around was increased. Apply patient-controlled analgesia pump to relieve pain and encourage coughing and sputum production. 5 Indication for extubation: Squeeze and pinch the chest tube once every 30 minutes to avoid blockage of the tube opening, ensure smooth drainage of pleural effusion, and accelerate the recovery of lung function; There is no air leakage in the closed chest drainage bottle, and the pleural effusion is non bloody, chylous, and purulent. The chest X-ray shows good lung recruitment, and the 24-hour chest drainage volume is less than 200 ml. After surgery, the daily intravenous fluid replacement volume is controlled to be less than 800 ml.

Intervention code:

组别:

对照组

样本量:

30

Group:

control group

Sample size:

干预措施:

采用传统理念在单孔胸腔镜肺叶切除术的围手术期处理①入院时告知患者及其家属,术前戒烟、呼吸功能锻炼。②术前术前1 d常规告知患者及其家属手术方法、手术切口大小、手术风险及围手术期注意事项;术前1 d晚进流食,术前10 h禁食、禁水。③术中常规扩容升压压,术后24 h进食、进水,常规生命体征监测,肌内注射药物镇痛以及康复指导。④拔管指征,胸腔闭式引流瓶中无漏气,胸腔积液非血性、乳糜、脓性,肺完全复张,24 h胸腔引流液量<100ml。

干预措施代码:

Intervention:

Adopting traditional concepts for perioperative management of single port thoracoscopic lobectomy 1 Upon admission, inform the patient and their family members to quit smoking and engage in respiratory function exercises before surgery. 2 1 day before surgery, patients and their families are routinely informed of the surgical method, incision size, surgical risks, and perioperative precautions; One day before surgery, liquid food should be consumed, and 10 hours before surgery, fasting and water should be avoided. 3 Routine expansion of blood pressure during surgery, feeding and water intake 24 hours after surgery, routine monitoring of vital signs, intramuscular injection of drugs for pain relief, and rehabilitation guidance. 4 Indications for extubation, no air leakage in the closed drainage bottle of the chest cavity, non bloody, chylous, purulent pleural effusion, complete lung recruitment, and 24-hour chest drainage volume<100ml.

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

四川 

市(区县):

 

Country:

China

Province:

Sichuan

City:

单位(医院):

什邡市人民医院 

单位级别:

三甲 

Institution
hospital:

Shifang People's Hospital

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

VAS评分

指标类型:

主要指标

Outcome:

VAS scores

Type:

Primary indicator

测量时间点:

术后6h、12h、24h、48h、72h

测量方法:

Measure time point of outcome:

Postoperative 6h, 12h, 24h, 48h, 72h

Measure method:

指标中文名:

超敏C反应蛋白

指标类型:

主要指标

Outcome:

Hypersensitive C-reactive protein

Type:

Primary indicator

测量时间点:

术前、术后第1天、术后第3天

测量方法:

Measure time point of outcome:

Preoperative, postoperative day 1, and postoperative day 3

Measure method:

指标中文名:

白细胞介素-6

指标类型:

主要指标

Outcome:

Interleukin-6

Type:

Primary indicator

测量时间点:

术前、术后第1天、术后第3天

测量方法:

Measure time point of outcome:

Preoperative, postoperative day 1, and postoperative day 3

Measure method:

指标中文名:

白细胞计数

指标类型:

主要指标

Outcome:

white blood cell count

Type:

Primary indicator

测量时间点:

术前、术后第1天、术后第3天

测量方法:

Measure time point of outcome:

Preoperative, postoperative day 1, and postoperative day 3

Measure method:

指标中文名:

中性粒细胞百分比

指标类型:

主要指标

Outcome:

Percentage of neutrophils

Type:

Primary indicator

测量时间点:

术前、术后第1天、术后第3天

测量方法:

Measure time point of outcome:

Preoperative, postoperative day 1, and postoperative day 3

Measure method:

指标中文名:

术后首次下床时间

指标类型:

次要指标

Outcome:

First time getting out of bed 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:

带管时间

指标类型:

次要指标

Outcome:

Tube time

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

住院时间

指标类型:

主要指标

Outcome:

length of hospital stay

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

住院总费用

指标类型:

次要指标

Outcome:

Total hospitalization expenses

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

患者满意度

指标类型:

次要指标

Outcome:

patient satisfaction

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后并发症的发生率

指标类型:

次要指标

Outcome:

The incidence of postoperative complications

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:

血液

组织:

Sample Name:

blood

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

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 20 years
最大 Max age 80 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):

随机数字表法

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

Random number table method

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:

开放标签,对评估者隐藏分组

Blinding:

Open tags, hide 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

是Yes

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):

上传到ResMan临床试验公共管理平台 http://www.medresman.org

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

use the ResMan Clinical Trial Management Public Platform, http://www.medresman.org

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:

数据以病例记录表的格式上传并使用ResMan数据库进行后期分析

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

Upload the data in CRF format,and use ResMan database for subsequent analysis

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:

 2025-10-23 18:05:30