多维度导尿相关膀胱不适量表(CRBD-M)的构建与验证及其与苏醒期躁动的关联:一项前瞻性队列研究

注册号:

Registration number:

ChiCTR2600117315 

最近更新日期:

Date of Last Refreshed on:

2026-01-22 14:24:11 

注册时间:

Date of Registration:

2026-01-22 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

多维度导尿相关膀胱不适量表(CRBD-M)的构建与验证及其与苏醒期躁动的关联:一项前瞻性队列研究

Public title:

Development and Validation of the Multidimensional Catheter-Related Bladder Discomfort Scale (CRBD-M) and Its Association with Emergence Agitation: A Prospective Cohort Study

注册题目简写:

English Acronym:

研究课题的正式科学名称:

多维度导尿相关膀胱不适量表(CRBD-M)的构建与验证及其与苏醒期躁动的关联:一项前瞻性队列研究

Scientific title:

Development and Validation of the Multidimensional Catheter-Related Bladder Discomfort Scale (CRBD-M) and Its Association with Emergence Agitation: A Prospective Cohort 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:

李佳嫒 

研究负责人:

李佳嫒 

Applicant:

Jiayuan Li 

Study leader:

Jiayuan Li 

申请注册联系人电话:

Applicant telephone:

+86 20 8525 3132

研究负责人电话:

Study leader's
telephone:

+86 20 8525 3132

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:

1378189135@qq.com

研究负责人电子邮件:

Study leader's E-mail:

1378189135@qq.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:

广东省广州市天河区天河路600号

研究负责人通讯地址:

天河路600号

Applicant address:

No. 600 Tianhe Road, Tianhe District, Guangzhou City, Guangdong Province

Study leader's address:

600 Tianhe Road Tianhe District Guangzhou Guangdong 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:

中山大学附属第三医院

Applicant's institution:

The Third Affiliated Hospital of Sun Yat-sen University

研究负责人所在单位:

中山大学附属第三医院(中山大学肝脏病医院)

Affiliation of the Leader:

The Third Affiliated Hospital Sun Yat-sen 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:

中大附三医伦II2026-028-01

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:

中山大学附属第三医院医学伦理委员会

Name of the ethic committee:

Medical Ethic Committee of the Third Affiliated Hospital of Sun Yat-sen University

伦理委员会批准日期:

Date of approved by ethic committee:

2026-01-20 00:00:00

伦理委员会联系人:

黄凯琪

Contact Name of the ethic committee:

Huang KaiQi

伦理委员会联系地址:

天河路600号

Contact Address of the ethic committee:

600 Tianhe Road Tianhe District Guangzhou Guangdong China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 20 8525 3302

伦理委员会联系人邮箱:

Contact email of the ethic committee:

420104114@qq.com

研究实施负责(组长)单位:

中山大学附属第三医院(中山大学肝脏病医院)

Primary sponsor:

The Third Affiliated Hospital Sun Yat-sen University

研究实施负责(组长)单位地址:

天河路600号

Primary sponsor's address:

600 Tianhe Road Tianhe District Guangzhou Guangdong 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):

广东省

市(区县):

Country:

China

Province:

Guangdong

City:

单位(医院):

中山大学附属第三医院(中山大学肝脏病医院)

具体地址:

天河路600号

Institution
hospital:

The Third Affiliated Hospital Sun Yat-sen University

Address:

600 Tianhe Road Tianhe District Guangzhou Guangdong China

经费或物资来源:

自选课题(自筹)

Source(s) of funding:

Self-funded

研究疾病:

导尿相关膀胱不适(catheter-related bladder discomfort, CRBD)是全麻术后的常见并发症,典型表现包括膀胱区及尿道烧灼样疼痛、强烈尿意、耻骨上坠胀感以及反复尝试拔尿管等,严重者伴明显躁动和沟通障碍,不仅造成患者的主观痛苦和焦虑,还增加意外拔管、出血、切口撕裂和跌倒等风险,延长麻醉恢复时间和 PACU 停留时间,降低患者满意度及临床工作效率。苏醒期躁动(emerg  

Target disease:

Catheter-related bladder discomfort (CRBD) is a common complication after general anesthesia, with typical manifestations including burning pain in the bladder area and urethra, strong urge to urinate, suprapubic distension, and repeated attempts to remove the ureter Stay time, reduce patient satisfaction and clinical work efficiency. Emergence agitation (EA) is a common acute state of confusion d

研究疾病代码:

Target disease code:

研究类型:

观察性研究

Study type:

Observational study

研究所处阶段:

其它 

Study phase:

N/A

研究设计:

队列研究 

Study design:

Cohort study 

研究目的:

主要目的是在接受全身麻醉及术中留置导尿管的成年患者中,构建并系统验证一套多维度导尿相关膀胱不适量表(CRBD-M),评价其信度、效度及推荐评分划界值,使其成为临床可用的标准化评估工具。次要目的包括:(1)利用 CRBD-M 描述术后不同时间点导尿相关膀胱不适的严重度分布及时间演变,估计中重度 CRBD 的发生率,并分析其与主要临床危险因素(如性别、手术类型、导尿管直径、球囊体积等)之间的关系。(2)在同一队列中,采用标准化量表评估苏醒期躁动(EA)的发生情况,在调整人口学特征、手术与麻醉方式、术后切口疼痛、导尿相关因素及术后镇静/镇痛策略等潜在混杂因素后,运用多因素 Logistic 回归模型分析 CRBD-M 严重度与 EA 发生之间的独立关联,检验 CRBD 是否为 EA 的独立危险因素。  

Objectives of Study:

The main objective is to construct and systematically validate a set of multidimensional catheterization-related bladder discomfort scale (CRBD-M) in adult patients undergoing general anesthesia and intraoperative indwelling catheterization, and evaluate its reliability, validity and recommended score cut-off value, so as to make it a standardized evaluation tool for clinical use. Secondary objectives include: (1) To describe the severity distribution and temporal evolution of catheterization-related bladder discomfort at different time points after surgery using the CRBD-M, to estimate the incidence of moderate to severe CRBD, and to analyze its relationship with major clinical risk factors (such as gender, type of surgery, catheter diameter, balloon volume, etc.). (2) In the same cohort, a standardized scale was used to assess the emergence agitation (EA), and after adjusting for potential confounding factors such as demographic characteristics, surgical and anesthesia methods, postoperative incision pain, catheterization-related factors, and postoperative sedation/analgesia strategies, multivariate logistic regression models were used to analyze the independent association between CRBD-M severity and the occurrence of EA, and whether CRBD was an independent risk factor for EA.

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.既往明确诊断为重度认知功能障碍、痴呆或严重精神障碍,无法配合量表评估者; 术前存在严重下尿路梗阻、神经源性膀胱等,已留置导尿管者; 术后计划直接转入 ICU 且在苏醒期无法进行常规 CRBD/EA 评估者; 术前已存在明显躁动、谵妄或镇静状态者;研究者认为不适合入组的其他情况。

Exclusion criteria:

1.Those who have been clearly diagnosed with severe cognitive dysfunction, dementia or severe mental disorders in the past and cannot cooperate with the scale assessment;
2.Those who have severe lower urinary tract obstruction, neurogenic bladder, etc. before surgery, and have an indwelling catheter;
3.Those who are planned to be transferred directly to the ICU after surgery and cannot undergo routine CRBD/EA assessment during the recovery period;
4.Those who already have obvious agitation, delirium or sedation before surgery;
5.Other conditions that the investigator deems unsuitable for enrollment.

研究实施时间:

Study execute time:

From 2026-01-24 00:00:00 To 2027-12-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-01-24 00:00:00 To 2027-12-31 00:00:00

干预措施:

Interventions:

组别:

单队列(观察组)

样本量:

1815

Group:

Single cohort (observation group)

Sample size:

干预措施:

干预措施代码:

Intervention:

None

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

广东省 

市(区县):

 

Country:

China

Province:

Guangdong

City:

单位(医院):

中山大学附属第三医院(中山大学肝脏病医院) 

单位级别:

三级甲等 

Institution
hospital:

The Third Affiliated Hospital Sun Yat-sen University

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

中重度 CRBD-M 的发生率

指标类型:

次要指标

Outcome:

Incidence of moderate to severe CRBD-M

Type:

Secondary indicator

测量时间点:

T1:拔管后早期评估窗口,T2:拔管后 0.5 h,T3:拔管后 1 h,T4:拔管后 6 h;T5:拔管后24 h。

测量方法:

①测量工具:使用本研究开发并经专家评估形成的 CRBD-M 量表(中英文版本)。 ②施测者:由经统一培训的麻醉科医师或 PACU 护士进行面对面询问评分。 ③评估方法:根据在本研究中预先设定的截点判定规则(基于传统 CRBD 分级,以 ROC 曲线及 Youden 指数确定阈值),定义中重度 CRBD-M,并计算其发生率。

Measure time point of outcome:

T1,T2,T3,T4,T5

Measure method:

(1) Measurement tools: using the CRBD-M scale (Chinese and English versions) developed in this study and formed by expert evaluation.(2) Examiner: Face-to-face questioning and scoring by a uniformly trained anesthesiologist or PACU nurse.(3) Evaluation method: According to the pre-set interception determination rules in this study (based on traditional CRBD grading, the threshold is determined by ROC curve and Youden index), moderate to severe CRBD-M is defined, and its incidence is calculated.

指标中文名:

苏醒期救援镇静/镇痛药物使用情况

指标类型:

次要指标

Outcome:

Use of rescue sedation/analgesic medication during the awakening period

Type:

Secondary indicator

测量时间点:

自拔除气管导管(不论在手术间或 PACU)起 30 分钟内。

测量方法:

在自拔除气管导管(不论在手术间或 PACU)起 30 分钟内,记录因躁动、不适或疼痛而追加使用静脉镇静药或镇痛药的情况,包括是否使用、药物种类及大致剂量。

Measure time point of outcome:

Within 30 minutes of the removal of the tracheal tube, whether in the operating room or the PACU.

Measure method:

Record additional use of intravenous sedation or analgesics due to agitation, discomfort, or pain, including whether used, type of medication, and approximate dose, within 30 minutes of removal of the endotracheal tube (either in the operating room or PACU).

指标中文名:

传统 CRBD 分级(0–3 级)

指标类型:

次要指标

Outcome:

Traditional CRBD grading (0–3)

Type:

Secondary indicator

测量时间点:

T1:拔管后早期评估窗口,T2:拔管后 0.5 h,T3:拔管后 1 h,T4:拔管后 6 h;T5:拔管后24 h。

测量方法:

在CRBD-M评估的时间点同时评估传统 CRBD 分级,获取分布情况及其与 CRBD-M 总分的相关性,用来做 CRBD-M 的收敛效度。传统CRBD的分级标准:0 分无不适,1 分轻度(询问时才主诉),2 分中度(主动诉说但无明显行为反应),3 分重度(伴明显躁动、尝试拔管等)。

Measure time point of outcome:

T1,T2,T3,T4,T5

Measure method:

At the time point of CRBD-M evaluation, the traditional CRBD grading was also evaluated, and the distribution and its correlation with the total CRBD-M score were obtained to obtain the convergent validity of the CRBD-M. The grading criteria for traditional CRBD are: 0 points for no discomfort, 1 point for mild (complaints only when asked), 2 points for moderate (active complaint but no obvious behavioral response), 3 points for severe (with obvious agitation, attempted extubation, etc.).

指标中文名:

PACU停留时间

指标类型:

次要指标

Outcome:

PACU stay time

Type:

Secondary indicator

测量时间点:

离开 PACU时。

测量方法:

记录患者到达麻醉恢复室至实际离开 PACU 的时间差。

Measure time point of outcome:

At the time point of living PACU.

Measure method:

The time difference between the patient's arrival in the anesthesia recovery room and the actual departure from the PACU was recorded.

指标中文名:

苏醒期躁动发生率

指标类型:

次要指标

Outcome:

Incidence of Emergence Agitation

Type:

Secondary indicator

测量时间点:

自拔除气管导管(不论在手术间或 PACU)起 30 分钟内。

测量方法:

①测量工具:采用 Riker Sedation–Agitation Scale(RSAS)进行量化评估。 ②施测者:由经统一培训的麻醉科医师或 PACU 护士进行面对面询问评分。 ③评估方法:在预定观察时间窗内,任一时间点评估 RSAS ≥ 5 即判定为发生 EA(是/否)。

Measure time point of outcome:

Within 30 minutes of the removal of the tracheal tube, whether in the operating room or the PACU.

Measure method:

(1) Measurement tools: Riker Sedation–Agitation Scale (RSAS) was used for quantitative evaluation. (2) Examiner: Face-to-face questioning and scoring by a uniformly trained anesthesiologist or PACU nurse. (3) Evaluation method: Evaluate RSAS ≥ 5 at any time point within the predetermined observation time window to determine the occurrence of EA (yes/no).

指标中文名:

术后切口疼痛评分

指标类型:

次要指标

Outcome:

Postoperative incision pain score

Type:

Secondary indicator

测量时间点:

T1:拔管后早期评估窗口,T2:拔管后 0.5 h,T3:拔管后 1 h,T4:拔管后 6 h;T5:拔管后24 h。

测量方法:

在CRBD-M评估的时间点同时使用数字等级评定量表(numerical rating scale,NRS)评估切口疼痛。数字等级评定量表NRS:用0~10数字的刻度标示出不同程度的疼痛强度等级,由患者指认,“0”为无痛,“10”为最剧烈疼痛,4以下为轻度痛(疼痛不影响睡眠),4~6为中度痛,7以上为重度痛(疼痛导致不能睡眠或从睡眠中痛醒)。

Measure time point of outcome:

T1,T2,T3,T4,T5

Measure method:

Incision pain was assessed using a numerical rating scale (NRS) at the time points of CRBD-M assessment. Numeric rating scale NRS: uses a scale of 0~10 numbers to indicate different degrees of pain intensity levels, identified by the patient, "0" is no pain, "10" is the most severe pain, 4 or less is mild pain (pain does not affect sleep), 4~6 is moderate pain, and 7 or more is severe pain (pain causes inability to sleep or wake up from sleep).

指标中文名:

多维度导尿相关膀胱不适量表总分及量表学特征

指标类型:

主要指标

Outcome:

Total score and psychometric properties of the Multidimensional Catheter-Related Bladder Discomfort Scale (CRBD-M)

Type:

Primary indicator

测量时间点:

T1:拔管后早期评估窗口,T2:拔管后 0.5 h,T3:拔管后 1 h,T4:拔管后 6 h;T5:拔管后24 h。

测量方法:

①测量工具:使用本研究开发并经专家评估形成的 CRBD-M 量表(中英文版本)。 ②施测者:由经统一培训的麻醉科医师或 PACU 护士进行面对面询问评分。 ③评估方法:在每个时间点,评估者按照量表条目向患者提问或解释条目含义,根据患者主诉及行为表现即时评分;感觉条目和情绪条目必须自评,行为条目可观察。

Measure time point of outcome:

T1,T2,T3,T4,T5

Measure method:

(1) Measurement tools: using the CRBD-M scale (Chinese and English versions) developed in this study and formed by expert evaluation. (2) Examiner: Face-to-face questioning and scoring by a uniformly trained anesthesiologist or PACU nurse. (3) Evaluation method: At each time point, the evaluator asks questions or explains the meaning of the items to the patient according to the scale items, and scores them immediately according to the patient's complaints and behavioral performance; Feeling and

指标中文名:

与EA/CRBD可能相关的不良事件发生情况

指标类型:

次要指标

Outcome:

Occurrence of adverse events that may be associated with EA/CRBD

Type:

Secondary indicator

测量时间点:

从拔管后早期(T1)开始,贯穿至拔管后24 h(T5)

测量方法:

所有不良事件将记录其发生时间、持续时间、严重程度、处理措施及结局,并描述其与围术期处理或研究评估流程的时间相关性。重点关注事件包括:明显血尿 / 尿道损伤;严重躁动导致自伤或意外拔管;呼吸抑制、低氧;非计划转入 ICU等。

Measure time point of outcome:

From the early post-extubation period (T1) and through to 24 h after extubation (T5)

Measure method:

All adverse events will be recorded in time, duration, severity, management measures and outcomes, and their temporal correlation with perioperative management or study evaluation processes will be described. Key events of interest include: overt hematuria/urethral injury; Severe agitation leading to self-injury or accidental extubation; respiratory depression, hypoxia; Unplanned transfer to ICU, etc.

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

NA

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 18 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):

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

None

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

不公开/Private

盲法:

Blinding:

None

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):

不建立公开下载。论文发表后,若有合理学术需求,可在伦理批准、数据去标识化及签署数据使用协议后,由通讯作者评估并向合格研究者提供相关去标识化数据与数据字典。

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

No public downloads are established. After the publication of the paper, if there is a reasonable academic need, the corresponding author may evaluate and provide relevant de-identified data and data dictionaries to qualified researchers after ethical approval, data de-identification and data use agreement signed.

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:

CRF 表: 采用结构化、封闭式为主的 CRF 统一采集围术期及量表数据,入组前经预测试和培训验证可行性,研究过程中持续核查入排标准、评估时间点和完整性,规范记录缺评、不良事件及违背方案。 EDC 系统: 数据由 CRF 录入 EDC,实行双人核对、定期源数据核查和修改日志管理,数据清理后锁库并定期备份,按伦理要求安全存档。

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

CRF: A structured and closed-form CRF is used to uniformly collect perioperative and scale data, and the feasibility is verified by pre-testing and training before enrollment. EDC system: Data is entered into EDC by CRF, and two-person verification, regular source data verification and modification log management are implemented.

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2026-01-22 14:24:00