术中经鼻高流量给氧非插管麻醉改善胸腔镜肺手术患者术后早期肺功能的效果

注册号:

Registration number:

ChiCTR2600123947 

最近更新日期:

Date of Last Refreshed on:

2026-05-04 11:48:43 

注册时间:

Date of Registration:

2026-05-04 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

术中经鼻高流量给氧非插管麻醉改善胸腔镜肺手术患者术后早期肺功能的效果

Public title:

Effect of intraoperative high-flow nasal oxygen therapy with a non-intubated anesthesia approach on early postoperative pulmonary function improvement in patients undergoing thoracoscopic lung surgery

注册题目简写:

English Acronym:

研究课题的正式科学名称:

术中经鼻高流量给氧非插管麻醉改善胸腔镜肺手术患者术后早期肺功能的效果

Scientific title:

Effect of intraoperative high-flow nasal oxygen therapy with a non-intubated anesthesia approach on early postoperative pulmonary function improvement in patients undergoing thoracoscopic lung surgery

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:

李月 

研究负责人:

梁汉生 

Applicant:

Li Yue 

Study leader:

Liang Hansheng 

申请注册联系人电话:

Applicant telephone:

+86 156 0109 3025

研究负责人电话:

Study leader's
telephone:

+86 137 1792 9362

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:

528026016@qq.com

研究负责人电子邮件:

Study leader's E-mail:

doc_lianghansh@sina.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:

中国北京市通州区漷县镇人民大道南57号

研究负责人通讯地址:

中国北京市通州区漷县镇人民大道南57号

Applicant address:

57 Renmin Avenue South, Huoxian Town, Tongzhou District, Beijing, China

Study leader's address:

57 Renmin Avenue South, Huoxian Town, Tongzhou District, Beijing, China

申请注册联系人邮政编码:

Applicant postcode:

101109

研究负责人邮政编码:

Study leader's postcode:

101109

申请人所在单位:

北京大学人民医院

Applicant's institution:

Peking University People’s Hospital

研究负责人所在单位:

北京大学人民医院

Affiliation of the Leader:

Peking University 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:

2026PHB110-001

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:

北京大学人民医院伦理审查委员会

Name of the ethic committee:

Ethics Review Committee of Peking University People's Hospital

伦理委员会批准日期:

Date of approved by ethic committee:

2026-02-11 00:00:00

伦理委员会联系人:

王芳

Contact Name of the ethic committee:

Wang Fang

伦理委员会联系地址:

中国北京市西城区西直门南大街11号

Contact Address of the ethic committee:

11 Xizhimen South Street, Xicheng District, Beijing, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 88324516

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:

北京大学人民医院

Primary sponsor:

Peking University People’s Hospital

研究实施负责(组长)单位地址:

中国北京市西城区西直门南大街11号

Primary sponsor's address:

11 Xizhimen South Street, Xicheng District, Beijing, 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):

北京

市(区县):

Country:

China

Province:

Beijing

City:

单位(医院):

北京大学人民医院

具体地址:

中国北京市西城区西直门南大街11号

Institution
hospital:

Peking University People’s Hospital

Address:

11 Xizhimen South Street, Xicheng District, Beijing, China

经费或物资来源:

北京市通州区科技计划

Source(s) of funding:

The Technology Plan Project of Tongzhou District, Beijing

研究疾病:

术后早期肺功能不全  

Target disease:

Early postoperative pulmonary 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:

II期临床试验 

Study phase:

2

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

利用经鼻高流量给氧替代双腔导管支气管插管、保留自主呼吸替代机械通气以及超声引导下胸椎旁阻滞降低阿片类镇痛药的用量在快速康复外科中改善患者预后的作用,为经鼻高流量给氧非插管麻醉在胸腔镜肺手术的临床推广应用提供科学依据。开发经鼻高流量给氧、保留自主呼吸和超声引导下神经阻滞技术在麻醉领域的临床应用价值,促进临床推广。  

Objectives of Study:

The goal is to determine which anesthetic technique best supports postoperative recovery in thoracoscopic surgery. Specifically, it seeks to verify that using HFNO instead of bronchial intubation with a DLT, maintaining spontaneous breathing instead of mechanical ventilation, and applying ultrasound-guided thoracic paravertebral blocks to reduce opioid use can improve patient outcomes in the context of enhanced recovery after surgery.

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. 术前明确严重气道高反应性的患者; 2. 术前存在肺部感染的患者; 3. 术前存在短期胸部外伤或陈旧外伤导致胸部变形严重的患者; 4. 局麻药过敏的患者; 5. 合并心、肺、肝、肾等重要器官严重功能障碍或血液系统疾病; 6. 既往罹患神经或精神疾病史; 7. 中途退出或不能积极配合者; 8. 任何被研究者判断为不适于参加本研究的患者; 9. 近 4 周内参加过其他与肺功能相关的临床试验的患者。

Exclusion criteria:

1. Patients with a clear diagnosis of severe airway hyperresponsiveness before surgery; 2. Patients with preoperative pulmonary infection; 3. Patients with severe chest deformity resulting from recent acute chest trauma or prior remote trauma; 4. Patients allergic to local anesthetics; 5. Patients with severe dysfunction of vital organs (e.g., heart, lungs, liver, kidneys) or with hematological diseases; 6. Patients with a prior history of neurological or psychiatric disorders; 7. Patients who withdraw during the study or are unable to cooperate fully; 8. Any patient judged by the investigator to be unsuitable for participation in this study; 9. Patients who have participated in other clinical trials related to pulmonary function within the past 4 weeks.

研究实施时间:

Study execute time:

From 2025-10-01 00:00:00 To 2027-06-30 00:00:00  

征募观察对象时间:

Recruiting time:

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

干预措施:

Interventions:

组别:

双腔管组 (对照组)

样本量:

105

Group:

Double-lumen tube group (Control group)

Sample size:

干预措施:

常规双腔导管支气管插管,连接麻醉机给予机械通气。双肺通气时:潮气量 6~8 mL/kg,呼吸频率 12 次/分,吸入氧浓度 40-60%,吸呼比 1∶2,氧流量 2.0 L/min,维持呼气末二氧化碳分压(PETCO2)35?45 mmHg;单肺通气时:潮气量 4~6mL/kg,呼吸频率 15~18 次/分,吸入氧浓度 100%。术毕拔管后呼吸空气 15min 查血气。麻醉诱导前桡动脉穿刺置管,查血气。患侧胸椎旁阻滞复合前锯肌平面阻滞。术后镇痛方案相同。

干预措施代码:

Intervention:

Conventional double-lumen tube bronchial intubation followed by mechanical ventilation via anesthesia machine. During bilateral lung ventilation: tidal volume 6–8 mL/kg, respiratory rate 12 breaths/min, inspired oxygen concentration 40–60%, inspiratory:expiratory ratio 1:2, oxygen flow 2.0 L/min, maintaining end-tidal carbon dioxide pressure (PETCO2) at 35–45 mmHg; during single-lung ventilation: tidal volume 4–6 mL/kg, respiratory rate 15–18 breaths/min, inspired oxygen concentration 100%. Arterial blood gas analysis performed 15 minutes after extubation while breathing room air. Radial artery cannulation and blood gas analysis before anesthesia induction. Ipsilateral thoracic paravertebral block combined with serratus anterior plane block. Postoperative analgesia regimen was identical.

Intervention code:

组别:

喉罩组 (试验组 1)

样本量:

105

Group:

LMA group (Trial Group 1)

Sample size:

干预措施:

麻醉诱导后置入喉罩,保留自主呼吸。吸入氧浓度 100%,氧流量 2.0~5.0 L/min。术毕拔喉罩后呼吸空气 15min 查血气。麻醉诱导前桡动脉穿刺置管,查血气。患侧胸椎旁阻滞复合前锯肌平面阻滞。术后镇痛方案相同。

干预措施代码:

Intervention:

After anesthesia induction, a laryngeal mask airway (LMA) was inserted and spontaneous breathing was maintained. Inspired oxygen concentration 100%, oxygen flow 2.0–5.0 L/min. Arterial blood gas analysis performed 15 minutes after LMA removal while breathing room air. Radial artery cannulation and blood gas analysis before anesthesia induction. Ipsilateral thoracic paravertebral block combined with serratus anterior plane block. Postoperative analgesia regimen was identical.

Intervention code:

组别:

经鼻高流量组 (试验组 2)

样本量:

105

Group:

Nasal high-flow oxygen group (Trial Group 2)

Sample size:

干预措施:

麻醉诱导后经鼻高流量吸氧。术毕清醒后呼吸空气 15min 查血气。麻醉诱导前桡动脉穿刺置管,查血气。患侧胸椎旁阻滞复合前锯肌平面阻滞。术后镇痛方案相同。

干预措施代码:

Intervention:

After anesthesia induction, high-flow nasal oxygen was administered. Arterial blood gas analysis performed 15 minutes after emergence while breathing room air. Radial artery cannulation and blood gas analysis before anesthesia induction. Ipsilateral thoracic paravertebral block combined with serratus anterior plane block. Postoperative analgesia regimen was identical.

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

北京 

市(区县):

 

Country:

China

Province:

Beijing

City:

单位(医院):

北京大学人民医院 

单位级别:

三甲 

Institution
hospital:

Peking University People’s Hospital

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

肺功能变化率

指标类型:

主要指标

Outcome:

The rate of change in the oxygenation index (ΔOI)

Type:

Primary indicator

测量时间点:

术前准备期和术后恢复期

测量方法:

通过血气分析结果计算

Measure time point of outcome:

The preoperative preparation period and the postoperative recovery period

Measure method:

Calculate using the results of blood gas analysis.

指标中文名:

疼痛评分

指标类型:

次要指标

Outcome:

Postoperative pain scores

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

麻醉时长

指标类型:

次要指标

Outcome:

Anesthesia duration

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

手术时长

指标类型:

次要指标

Outcome:

Surgical duration

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

苏醒时间

指标类型:

次要指标

Outcome:

Awakening 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:

失血量

指标类型:

次要指标

Outcome:

Blood loss

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

输液量

指标类型:

次要指标

Outcome:

Total fluid infusion volume

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

麻醉药物用量

指标类型:

次要指标

Outcome:

Anesthetic drug consumption

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

血管活性药物用量

指标类型:

次要指标

Outcome:

Vasoactive drug dose

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后喉咙不适

指标类型:

次要指标

Outcome:

Postoperative throat discomfort

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:

外科医生满意度

指标类型:

次要指标

Outcome:

Surgeon 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:

术后住院时长

指标类型:

次要指标

Outcome:

Postoperative length of hospital 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:

住院费用

指标类型:

次要指标

Outcome:

Medical costs

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后并发症发生率

指标类型:

次要指标

Outcome:

Incidence of postoperative pulmonary complications

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

纵隔摆动分级

指标类型:

副作用指标

Outcome:

Degree of mediastinal shift

Type:

Adverse events

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术中体动及呃逆发生率

指标类型:

副作用指标

Outcome:

Incidence of patient movement or hiccup during surgery

Type:

Adverse events

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

低氧血症发生率

指标类型:

副作用指标

Outcome:

Incidence of hypoxemia

Type:

Adverse events

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 64 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):

采用计算机生成的随机数字表(SPSS 26.0)进行随机分组。分组分配信息由一位不参与本研究的研究人员装入密封信封中。

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

Randomization is performed using a computer-generated random number table (SPSS 26.0). Group allocation information is placed in sealed envelopes by an independent person not involved in this study.

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:

Blinding:

None

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):

本研究中所生成与分析的数据集,可向通讯作者合理索取。

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

The datasets generated and analyzed during the current study are available from the corresponding author upon reasonable request.

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:

所有原始数据均使用纸质病例报告表收集,并存放在上锁的柜子中。所有研究人员均遵守专业的保密准则,以保护病历和个人身份信息的隐私。纸质病例报告表将在研究完成后三年销毁。数据录入电子数据库并经核对无误后,患者的个人信息将被隐匿,电子数据经过加密和保护,数据库的访问受到限制。由指定人员组成的数据管理团队负责所有数据的保密管理。主要研究者定期核对数据库和表格内容的准确性、数据录入的及时性、随访及入组进度,并计算脱落率和失访率。研究结束后,研究部门将随机抽取至少20%的病例报告表,审核其完整性与真实性。

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

All raw data are collected using paper case report forms (CRFs) and stored in locked cabinets. All researchers adhere to professional confidentiality guidelines to protect the privacy of medical records and personally identifiable information. The paper CRFs will be destroyed three years after the completion of the study. After the data are entered into the electronic database and verified to be error-free, patients' personal information is concealed, the electronic data are encrypted and protected, and access to the database is restricted. A data management team, composed of designated personnel, is responsible for the confidential management of all data. The principal investigator regularly reviews the accuracy of the database and form content, the timeliness of data entry, follow-up and enrollment progress, and calculates dropout and loss-to-follow-up rates. At the conclusion of the study, the research department will randomly select at least 20% of the CRFs to review for completeness and authenticity.

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:

 2026-05-04 11:48:38