比较左右侧星状神经阻滞对围术期老年患者术后认知功能障碍(POCD)的影响

注册号:

Registration number:

ChiCTR2600117680 

最近更新日期:

Date of Last Refreshed on:

2026-01-27 17:17:11 

注册时间:

Date of Registration:

2026-01-27 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

比较左右侧星状神经阻滞对围术期老年患者术后认知功能障碍(POCD)的影响

Public title:

The influence of left and right stellate ganglion block on postoperative cognitive dysfunction (POCD) in elderly patients during the perioperative period was compared.

注册题目简写:

English Acronym:

研究课题的正式科学名称:

比较左右侧星状神经阻滞对围术期老年患者术后认知功能障碍(POCD)的影响

Scientific title:

The influence of left and right stellate ganglion block on postoperative cognitive dysfunction (POCD) in elderly patients during the perioperative period was compared.

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:

邱小梅 

研究负责人:

邱小梅 

Applicant:

Xiaomei Qiu 

Study leader:

Xiaomei Qiu 

申请注册联系人电话:

Applicant telephone:

+86 181 1161 6698

研究负责人电话:

Study leader's
telephone:

+86 181 1161 6698

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:

q_xm1234@126.com

研究负责人电子邮件:

Study leader's E-mail:

q_xm1234@126.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:

四川省成都市武侯区万象北路18号

研究负责人通讯地址:

四川省成都市武侯区万象北路18号

Applicant address:

No. 18, Wanxiang North Road, Wuhou District, Chengdu City, Sichuan Province

Study leader's address:

No. 18, Wanxiang North Road, Wuhou District, Chengdu 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:

成都市中西医结合医院(成都市第一人民医院)

Applicant's institution:

Chengdu Hospital of Integrated Traditional Chinese and Western Medicine (Chengdu First People's Hospital)

研究负责人所在单位:

成都市中西医结合医院(成都市第一人民医院)

Affiliation of the Leader:

Chengdu Hospital of Integrated Traditional Chinese and Western Medicine (Chengdu First 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年KT第038号

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:

成都市中西医结合医院(成都市第一人民医院)医学伦理审查委员会

Name of the ethic committee:

Medical Ethics Review Committee of Chengdu Hospital of Integrated Traditional Chinese and Western Medicine (Chengdu First People's Hospital)

伦理委员会批准日期:

Date of approved by ethic committee:

2025-09-28 00:00:00

伦理委员会联系人:

余萍

Contact Name of the ethic committee:

Ping Yu

伦理委员会联系地址:

四川省成都市武侯区万象北路18号

Contact Address of the ethic committee:

No. 18, Wanxiang North Road, Wuhou District, Chengdu City, Sichuan Province

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 28 8531 1468

伦理委员会联系人邮箱:

Contact email of the ethic committee:

cdsyyyllb@163.com

研究实施负责(组长)单位:

成都市中西医结合医院(成都市第一人民医院)

Primary sponsor:

Chengdu Hospital of Integrated Traditional Chinese and Western Medicine (Chengdu First People's Hospital)

研究实施负责(组长)单位地址:

四川省成都市武侯区万象北路18号

Primary sponsor's address:

No. 18, Wanxiang North Road, Wuhou District, Chengdu 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):

四川省

市(区县):

成都市

Country:

China

Province:

Sichuan Province

City:

Chengdu City

单位(医院):

成都市中西医结合医院(成都市第一人民医院)

具体地址:

四川省成都市武侯区万象北路18号

Institution
hospital:

anesthesiology department

Address:

No. 18, Wanxiang North Road, Wuhou District, Chengdu City, Sichuan Province

经费或物资来源:

四川省健康促进基金会

Source(s) of funding:

Sichuan Province Health Promotion Foundation

研究疾病:

术后认知功能障碍  

Target disease:

Postoperative cognitive dysfunction

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:

术后认知功能障碍(postoperative cognitive dysfunction, POCD)是指手术和麻醉后认知功能较基线水平有所下降,主要表现为手术后出现的多种神经系统相关并发症。据报道 ,非心脏手术后患者术后1周内 POCD 发病率 41% ~ 75%,术后3个月的发病率18% ~ 45%。而及时的早期干预可以有效降低 POCD 的发生率,从而在最大程度上减轻脑损伤。因此有效预防 POCD 对于患者术后恢复至关重要。星状神经节阻滞(stellate ganglion block, SGB)是一项将局部麻醉药物直接注入含有星状神经节的疏松结缔组织的医疗手段,目的是对颈交感干、颈交感神经节及其延伸的节前和节后神经进行可逆性阻滞。这种操作有助于治疗多种疼痛(颈部疼痛或神经痛)和非疼痛性疾病(睡眠障碍或认知障碍)。既往研究报道,SGB可通过平衡自主神经系统、调节神经内分泌反应,发挥神经保护作用。SGB还可通过抑制小胶质细胞激活,抑制神经炎症,从而预防POCD 发生 。 目前SGB临床应用中的研究,主要聚焦于其在特定疼痛管理中的效用。少量研究已经证明SGB作为一种神经阻滞技术,可能通过调节交感神经活性改善术后认知功能。然而,目前尚不清楚不同侧(左侧、右侧)星状神经节阻滞对老年患者术后认知功能的影响是否存在差异,围术期病人的临床应用还不够广泛。本研究目的旨在探讨不同侧星状神经节阻滞(左侧、右侧)对老年患者术后认知功能障碍的影响,以及降低老年患者POCD的作用机制,为临床实践提供依据。  

Objectives of Study:

Postoperative cognitive dysfunction (POCD) refers to a decline in cognitive function after surgery and anesthesia, compared to the baseline level. It mainly manifests as various neurological-related complications that occur after the surgery. It has been reported that the incidence of POCD within one week after non-cardiac surgery ranges from 41% to 75%, and the incidence within three months after the surgery is 18% to 45%. Timely early intervention can effectively reduce the incidence of POCD, thereby minimizing brain damage to the greatest extent. Therefore, effective prevention of POCD is crucial for the postoperative recovery of patients. Stellate ganglion block (SGB) is a medical method that directly injects local anesthetic drugs into the loose connective tissue containing the stellate ganglion, with the aim of performing reversible blockage on the cervical sympathetic trunk, cervical sympathetic ganglia, and their pre- and post-ganglionic nerves. This operation helps treat various pains (neck pain or neuralgia) and non-painful diseases (sleep disorders or cognitive disorders). Previous studies have reported that SGB can exert neuroprotective effects by balancing the autonomic nervous system and regulating neuroendocrine responses. SGB can also prevent the occurrence of POCD by inhibiting microglial cell activation and suppressing neuroinflammation. The current research on the clinical application of SGB mainly focuses on its efficacy in specific pain management. A few studies have demonstrated that SGB, as a nerve block technique, may improve postoperative cognitive function by regulating sympathetic nerve activity. However, it is still unclear whether there are differences in the effects of bilateral (left and right) stellate ganglion block on postoperative cognitive function in elderly patients, and the clinical application of perioperative patients is not yet widespread. The purpose of this study is to explore the effects of bilateral stellate ganglion block (left and right) on postoperative cognitive dysfunction in elderly patients, as well as the mechanism of reducing POCD in elderly patients, in order to provide a basis for 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术前已存在认知功能障碍。 ②严重心肺功能不全或其他重大合并症。 ③对阻滞药物过敏或有神经阻滞禁忌症。 ④任何原因不能配合研究(如视力障碍、听力障碍、无法使用汉语进行正常交流等)或研究者认为不宜纳入本研究。

Exclusion criteria:

1. Cognitive dysfunction existed prior to the surgery; 2. Severe cardiac or pulmonary dysfunction or other major comorbidities; 3. Allergic to blocking drugs or having contraindications for nerve block; 4. Unable to cooperate with the study for any reason (such as visual impairment, hearing impairment, inability to communicate normally in Chinese, etc.) or the investigator deems it inappropriate to include in this study. Note.

研究实施时间:

Study execute time:

From 2026-02-01 00:00:00 To 2028-10-01 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-02-01 00:00:00 To 2028-02-01 00:00:00

干预措施:

Interventions:

组别:

对照组(C组)

样本量:

60

Group:

Control group (Group C)

Sample size:

干预措施:

常规麻醉管理

干预措施代码:

Intervention:

Routine anesthesia management

Intervention code:

组别:

左侧星状神经节阻滞组(L-SGB组)

样本量:

60

Group:

Left stellate ganglion block group (L-SGB group)

Sample size:

干预措施:

术前30分钟行超声引导下星状神经节阻滞,使用1%利多卡因5ml,阻滞在左侧进行

干预措施代码:

Intervention:

Ultrasound guided stellate ganglion block was performed 30 minutes before surgery, using 5ml of 1% lidocaine, and the block was performed on the left side

Intervention code:

组别:

右侧星状神经节阻滞组(R-SGB组)

样本量:

60

Group:

Right stellate ganglion block group (r-sgb group)

Sample size:

干预措施:

术前30分钟行超声引导下星状神经节阻滞,使用1%利多卡因5ml,阻滞在右侧进行

干预措施代码:

Intervention:

Ultrasound guided stellate ganglion block was performed 30 minutes before surgery, using 5ml of 1% lidocaine, and the block was performed on the right side

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

四川省 

市(区县):

成都市 

Country:

China

Province:

Sichuan

City:

Chengdu

单位(医院):

成都市中西医结合医院(成都市第一人民医院) 

单位级别:

三级甲等 

Institution
hospital:

Chengdu Hospital of Integrated Traditional Chinese and Western Medicine (Chengdu First People's Hospital)

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

术后7天内POCD的发生率

指标类型:

主要指标

Outcome:

Incidence of POCD within 7 days after surgery

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

检测血清炎症因子水平(如IL-6、IL-10)的变化

指标类型:

次要指标

Outcome:

The levels of serum inflammatory factors (such as IL-6 and IL-10) were detected

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后谵妄发生率

指标类型:

次要指标

Outcome:

Incidence of postoperative delirium

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后不良事件

指标类型:

次要指标

Outcome:

Postoperative 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:

24小时内恶心呕吐发生率

指标类型:

次要指标

Outcome:

Incidence of nausea and vomiting within 24 hours

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3天恢复质量QoR-15评分

指标类型:

次要指标

Outcome:

Postoperative 3-day recovery quality QoR-15 score

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 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):

由一名不参与本研究的研究助理采用SPSS软件产生随机数字表,按照1:1:1比例随机分成左侧星状神经节阻滞组(L-SGB组)、右侧星状神经节阻滞组(R-SGB组)、对照组(C组)。术后随访人员、统计人员及患者对分组不知情。

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

A random number table was generated by a non-participating research assistant using SPSS software. The patients were randomly divided into the left stellate ganglion block group (L-SGB group), the right stellate ganglion block group (R-SGB group), and the control group (C group) in a 1:1:1 ratio. Neither the postoperative follow-up personnel, the statisticians, nor the patients were aware of the grouping.

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:

盲法实施方面,采用单盲设计,术后随访人员、统计人员及受试者均对分组情况不知情,有效规避测量偏倚及主观干扰,保障试验结果客观性。

Blinding:

In terms of the implementation of blinding, a single-blind design was adopted. The postoperative follow-up personnel, statisticians, and participants were all unaware of the group allocation, effectively avoiding measurement bias and subjective interference, and ensuring the objectivity of the test results.

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:

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

None

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:

 2026-01-27 17:16:10