Trendelenburg 体位腹部大手术术中动态脑自动调节与术后谵妄的关联:一项前瞻性队列研究

注册号:

Registration number:

ChiCTR2600122957 

最近更新日期:

Date of Last Refreshed on:

2026-04-20 15:54:45 

注册时间:

Date of Registration:

2026-04-20 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

Trendelenburg 体位腹部大手术术中动态脑自动调节与术后谵妄的关联:一项前瞻性队列研究

Public title:

The association between dynamic cerebral autoregulation during abdominal major surgery in Trendelenburg position and postoperative delirium: a prospective cohort study

注册题目简写:

English Acronym:

研究课题的正式科学名称:

Trendelenburg 体位腹部大手术术中动态脑自动调节与术后谵妄的关联:一项前瞻性队列研究

Scientific title:

The association between dynamic cerebral autoregulation during abdominal major surgery in Trendelenburg position and postoperative delirium: 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:

杨博康 

研究负责人:

刘亚涛 

Applicant:

Yang Bokang 

Study leader:

Liu Yatao 

申请注册联系人电话:

Applicant telephone:

+86 131 1447 2787

研究负责人电话:

Study leader's
telephone:

+86 181 5210 7860

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:

y995978713@163.com

研究负责人电子邮件:

Study leader's E-mail:

liuyt@lzu.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:

中国甘肃省兰州市城关区东岗西路199号

研究负责人通讯地址:

中国甘肃省兰州市城关区东岗西路1号

Applicant address:

199 Donggang West Road, Chengguan District, Lanzhou, Gansu, China

Study leader's address:

1 Donggang West Road, Chengguan District, Lanzhou, Gansu, 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:

兰州大学

Applicant's institution:

Lanzhou University

研究负责人所在单位:

兰州大学第一医院

Affiliation of the Leader:

The First Hospital of Lanzhou 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:

LDYYLL2026-16

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:

兰州大学第一医院伦理委员会

Name of the ethic committee:

Ethics Committee of the First Hospital of Lanzhou University

伦理委员会批准日期:

Date of approved by ethic committee:

2026-01-15 00:00:00

伦理委员会联系人:

郭顺林

Contact Name of the ethic committee:

Guo Shunlin

伦理委员会联系地址:

中国甘肃省兰州市城关区东岗西路1号

Contact Address of the ethic committee:

1 Donggang West Road, Chengguan District, Lanzhou, Gansu, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 931 894 8648

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:

兰州大学第一医院

Primary sponsor:

The First Hospital of Lanzhou University

研究实施负责(组长)单位地址:

中国甘肃省兰州市城关区东岗西路1号

Primary sponsor's address:

1 Donggang West Road, Chengguan District, Lanzhou, Gansu, 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):

甘肃

市(区县):

兰州

Country:

China

Province:

Gansu

City:

Lanzhou

单位(医院):

兰州大学第一医院

具体地址:

中国甘肃省兰州市城关区东岗西路1号

Institution
hospital:

The First Hospital of Lanzhou University

Address:

1 Donggang West Road, Chengguan District, Lanzhou, Gansu, China

经费或物资来源:

本研究由指导教师刘亚涛教授的科研项目经费资助

Source(s) of funding:

This study was funded by the research project of Professor Yatao Liu.

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:

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:

在接受Trendelenburg 体位的腹部大手术患者中,量化术中动态脑自动调节受损的累积负荷(DCA%),并验证其是否为术后谵妄(POD)的独立预测因子;解析 DCA%与POD风险之间的剂量-反应关系特征,识别导致风险显著跃升的临床报警阈值(Cut-off value);评估DCA%对术后住院时间、拔管时间等整体转归的影响。  

Objectives of Study:

In patients undergoing major abdominal surgeries in the Trendelenburg position, quantify the cumulative load of impaired dynamic cerebral autoregulation during the operation (DCA%), and verify whether it is an independent predictor of postoperative delirium (POD); Analyze the dose-response characteristics of the relationship between DCA% and the risk of POD, identify the clinical alarm threshold (Cut-off value) that leads to a significant increase in risk; Evaluate the impact of DCA% on overall outcomes such as postoperative hospital stay and extubation time.

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. 术前存在精神分裂症、帕金森病、癫痫、痴呆等神经精神疾病,长期服用精神类药物(如抗抑郁药、抗精神病药)或近期(1个月内)有酒精滥用史; 2. 术前经简易精神状态检查表( Minimum Mental State Examination,MMSE ) 评估存在认知功能障碍(文盲<=17分,小学学历<=20分,中学及以上学历<=24分); 3. BMI >=30 kg/m^2 ; 4. 重度颈动脉狭窄(狭窄率>=70%)或已行颈动脉内膜剥脱/支架植入术; 5. 3个月内发生过急性脑血管事件(脑梗死、脑出血、TIA); 6. 严重肝肾功能不全,严重心肺功能异常; 7. 因严重的视听障碍或语言不通导致无法完成认知评估。

Exclusion criteria:

1. Pre-existing neuropsychiatric disorders such as schizophrenia, Parkinson's disease, epilepsy, or dementia, long-term use of psychiatric medications (e.g., antidepressants, antipsychotics), or a history of alcohol abuse within the recent past (1 month); 2. Preoperative cognitive impairment assessed by the Minimum Mental State Examination (MMSE) (score <=17 for illiterate individuals, <=20 for primary school education, <=24 for middle school education or above); 3. BMI >=30 kg/m^2; 4. Severe carotid artery stenosis (stenosis rate >=70%) or a history of carotid endarterectomy/stenting; 5. Acute cerebrovascular events (cerebral infarction, intracerebral hemorrhage, transient ischemic attack [TIA]) within the past 3 months; 6. Severe hepatic or renal insufficiency, severe cardiopulmonary dysfunction; 7. Inability to complete cognitive assessment due to severe visual or hearing impairment or language barriers.

研究实施时间:

Study execute time:

From 2026-04-01 00:00:00 To 2027-05-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-05-01 00:00:00 To 2027-05-31 00:00:00

干预措施:

Interventions:

组别:

术后谵妄组与非术后谵妄组(每组样本量依照术后随访结果而定)

样本量:

280

Group:

Postoperative delirium group and non-operative delirium group (Sample size per group depends on postoperative follow-up)

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):

甘肃 

市(区县):

兰州 

Country:

China

Province:

Gansu

City:

Lanzhou

单位(医院):

兰州大学第一医院 

单位级别:

三甲 

Institution
hospital:

The First Hospital of Lanzhou University

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

术后 7 天内任一时间点 3D-CAM 评估阳性所定义的术后谵妄(POD)

指标类型:

主要指标

Outcome:

Postoperative delirium (POD) defined by positive 3D-CAM assessment at any time point within 7 days postoperatively

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

拔管时间

指标类型:

次要指标

Outcome:

Time to extubation

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

PACU 停留时间

指标类型:

次要指标

Outcome:

Length of stay in PACU

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

非计划转入 ICU

指标类型:

次要指标

Outcome:

Unplanned admission to ICU

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后住院时间

指标类型:

次要指标

Outcome:

Postoperative hospital 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:

术后并发症(如脑卒中、心力衰竭、肺部感染等)

指标类型:

次要指标

Outcome:

Postoperative complications (e.g., stroke, heart failure, pulmonary infection)

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

VAS 疼痛评分

指标类型:

次要指标

Outcome:

Visual Analog Scale (VAS) 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:

RASS 评分

指标类型:

次要指标

Outcome:

Richmond Agitation-Sedation Scale (RASS) 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:

c反应蛋白(CRP)

指标类型:

次要指标

Outcome:

C-reactive protein (CRP)

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

白蛋白

指标类型:

次要指标

Outcome:

Albumin

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

血红蛋白(Hb)

指标类型:

次要指标

Outcome:

Hemoglobin (Hb)

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

血糖

指标类型:

次要指标

Outcome:

Blood glucose

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

电解质

指标类型:

次要指标

Outcome:

Electrolytes

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

肝肾功能

指标类型:

次要指标

Outcome:

Liver and renal function

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 18 years
最大 Max age NA 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:

公开/Public

盲法:

POD 评估对 DCA% 结果设盲

Blinding:

The POD assessment is blinded to the DCA% 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:

数据由病例记录表采集,由电子采集和管理系统管理

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

One is Case Record Form ( CRF ), the other is Electronic Data Capture ( EDC ). For example, ResMan is an Internet-based EDC.

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:

 2026-04-20 15:54:39