组合式可视肺隔离导管与可视双腔支气管导管在胸外科手术患者插管损伤的比较:多中心、前瞻性、随机对照试验

注册号:

Registration number:

ChiCTR2600125149 

最近更新日期:

Date of Last Refreshed on:

2026-05-21 16:44:32 

注册时间:

Date of Registration:

2026-05-21 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

组合式可视肺隔离导管与可视双腔支气管导管在胸外科手术患者插管损伤的比较:多中心、前瞻性、随机对照试验

Public title:

Comparison of Intubation-Related Airway Mucosal Injury Between a Combined Visual Lung Isolation Tube and a Visualized Double-Lumen Tube in Thoracic Surgery: A Multicenter, Prospective, Randomized Controlled Trial

注册题目简写:

English Acronym:

研究课题的正式科学名称:

组合式可视肺隔离导管与可视双腔支气管导管在胸外科手术患者插管损伤的比较:多中心、前瞻性、随机对照试验

Scientific title:

Comparison of Intubation-Related Airway Mucosal Injury Between a Combined Visual Lung Isolation Tube and a Visualized Double-Lumen Tube in Thoracic Surgery: A Multicenter, Prospective, Randomized Controlled Trial

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:

李想 

研究负责人:

吕欣 

Applicant:

Xiang Li 

Study leader:

Xin Lv 

申请注册联系人电话:

Applicant telephone:

+86 156 0520 1053

研究负责人电话:

Study leader's
telephone:

+86 136 6186 9972

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:

lixiang19950926@163.com

研究负责人电子邮件:

Study leader's E-mail:

xinlvg@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:

上海市杨浦区政民路507号

研究负责人通讯地址:

上海市杨浦区政民路507号

Applicant address:

507 Zhengmin Road, Yangpu District, Shanghai

Study leader's address:

507 Zhengmin Road, Yangpu District, Shanghai

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:

上海市肺科医院

Applicant's institution:

Shanghai Pulmonary Hospital

研究负责人所在单位:

上海市肺科医院

Affiliation of the Leader:

Shanghai Pulmonary 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:

K26-009

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:

上海市肺科医院医学伦理委员会

Name of the ethic committee:

Shanghai Pulmonary Hospital Medical Ethics Committee

伦理委员会批准日期:

Date of approved by ethic committee:

2026-01-22 00:00:00

伦理委员会联系人:

桂涛

Contact Name of the ethic committee:

Gui Tao

伦理委员会联系地址:

上海市杨浦区政民路507号

Contact Address of the ethic committee:

507 Zhengmin Road, Yangpu District, Shanghai

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 21 6511 5006

伦理委员会联系人邮箱:

Contact email of the ethic committee:

fkyygcp@163.com

研究实施负责(组长)单位:

上海市肺科医院

Primary sponsor:

Shanghai Pulmonary Hospital

研究实施负责(组长)单位地址:

上海市杨浦区政民路507号

Primary sponsor's address:

507 Zhengmin Road, Yangpu District, Shanghai

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

上海

市(区县):

Country:

China

Province:

Shanghai

City:

单位(医院):

上海市肺科医院

具体地址:

上海市杨浦区政民路507号

Institution
hospital:

Shanghai Pulmonary Hospital

Address:

507 Zhengmin Road, Yangpu District, Shanghai

经费或物资来源:

上海申康医院发展中心诊疗技术推广及优化管理项目(SHDC12026122)

Source(s) of funding:

Shanghai Shenkang Hospital Development Center Clinical Technology Promotion and Optimization Management Program (Grant No. SHDC12026122)

研究疾病:

无  

Target disease:

None

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:

1.主要目的 比较以组合式可视肺隔离导管为代表的分步式插管策略与以可视双腔支气管导管为代表的一步式插管策略在插管相关气道损伤方面的差异,重点评估中–重度气道黏膜损伤的发生率。 2.次要目的 比较两种插管策略在声带损伤、术后咽痛及声音嘶哑等方面的差异。 3.探索性目的 评估组合式可视肺隔离导管组中发生非预设附加旋转操作的患者,其气道损伤风险是否高于按标准分步式路径完成插管的患者,以探索过声门后附加旋转操作对气道损伤的潜在影响。  

Objectives of Study:

1. Primary Objective To compare the differences in intubation-related airway injuries between the stepwise intubation strategy represented by the combination visual lung isolation catheter and the one-step intubation strategy represented by the visual double-lumen bronchial tube, with a focus on assessing the incidence of moderate to severe airway mucosal injuries. 2. Secondary Objective To compare the differences between the two intubation strategies in terms of vocal cord injury, postoperative sore throat, and hoarseness. 3. Exploratory Objective To evaluate whether patients in the combination visual lung isolation catheter group who undergo unplanned additional rotational maneuvers have a higher risk of airway injury compared to patients who complete intubation according to the standard stepwise pathway, in order to explore the potential impact of additional rotational maneuvers past the glottis on airway injury.

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.术前已存在气道损伤、咽痛或声音嘶哑; 2.胸部 CT 的胸骨柄平面的气管横断面的最小内径小于13mm; 3.预期困难气道(包括既往困难气道史;最大张口度<3 cm;颈部活动受限(如颈椎活动明显受限、颈椎固定、严重颈椎疾病);甲颏距离<6 cm;BMI >= 35 kg/m^2;Mallampati评分 4等); 4.高风险呼吸道并发症或活动期气道/肺部炎症(如控制不佳哮喘、急性咽炎、COPD 急性加重、近期肺炎等); 5.既往有单肺通气史。

Exclusion criteria:

1.Pre-existing airway injury, sore throat, or hoarseness prior to surgery; 2.Minimal transverse tracheal diameter <13 mm at the level of the manubrium sterni on preoperative chest computed tomography (CT); 3. Anticipated difficult airway (including a history of difficult airway; maximum mouth opening < 3 cm; limited neck mobility (such as significantly restricted cervical spine movement, cervical spine fixation, severe cervical spine disease); thyromental distance < 6 cm; BMI >= 35 kg/m^2; Mallampati score of 4, etc.); 4. High-risk respiratory complications or active airway/lung inflammation (such as poorly controlled asthma, acute pharyngitis, acute exacerbation of COPD, recent pneumonia, etc.); 5. History of single-lung ventilation.

研究实施时间:

Study execute time:

From 2026-05-25 00:00:00 To 2026-12-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-05-25 00:00:00 To 2026-07-20 00:00:00

干预措施:

Interventions:

组别:

组合管组

样本量:

96

Group:

Compounded Tube Group

Sample size:

干预措施:

在视频喉镜引导下采用组合式可视肺隔离导管实施插管与肺隔离。按照分步式置入策略,先将外管置入气管建立气道通路,随后在导管前端摄像头实时可视引导下置入内管并定向进入左主支气管,完成单肺通气;术毕恢复双肺通气时拔除内管,仅保留外管通气。

干预措施代码:

Intervention:

Endotracheal intubation and lung isolation are performed using a combined visualized lung isolation tube under video laryngoscopic guidance. Following a stepwise insertion strategy, the outer tube is first advanced into the trachea to establish a secure airway. Subsequently, the inner tube is inserted under real-time visual guidance from the distal camera and directed into the left main bronchus to achieve one-lung ventilation. At the end of surgery, when two-lung ventilation is resumed, the inner tube is removed while the outer tube is retained to maintain ventilation.

Intervention code:

组别:

可视双腔管组

样本量:

96

Group:

VDLT Group

Sample size:

干预措施:

在视频喉镜引导下采用传统可视双腔气管导管实施插管与肺隔离。按照常规操作流程置入导管,通过旋转定向使支气管端进入左主支气管,在可视化引导下完成定位并建立单肺通气。

干预措施代码:

Intervention:

Endotracheal intubation and lung isolation are performed using a visualized double-lumen tube under video laryngoscopic guidance.Following the conventional single-step insertion approach, the tube is advanced into the trachea and rotated to orient the bronchial lumen into the left main bronchus. Proper positioning is achieved under visual guidance, and one-lung ventilation is subsequently established.

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

上海 

市(区县):

 

Country:

China

Province:

Shanghai

City:

单位(医院):

上海市肺科医院 

单位级别:

三甲 

Institution
hospital:

Shanghai Pulmonary Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

上海 

市(区县):

 

Country:

China

Province:

Shanghai

City:

单位(医院):

上海交通大学医学院附属仁济医院 

单位级别:

三甲 

Institution
hospital:

Renji Hospital, School of Medicine, Shanghai Jiao Tong University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

上海 

市(区县):

 

Country:

China

Province:

Shanghai

City:

单位(医院):

上海市第一人民医院 

单位级别:

三甲 

Institution
hospital:

Shanghai General Hospital

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

中–重度气管黏膜损伤发生率

指标类型:

主要指标

Outcome:

Incidence of intubation-related moderate-to-severe tracheal mucosal injury

Type:

Primary indicator

测量时间点:

拔管时

测量方法:

Measure time point of outcome:

During intubation

Measure method:

指标中文名:

气管黏膜各部位损伤评分

指标类型:

次要指标

Outcome:

Site-specific tracheal mucosal injury scores

Type:

Secondary indicator

测量时间点:

拔管时

测量方法:

Measure time point of outcome:

During intubation

Measure method:

指标中文名:

声带损伤发生率

指标类型:

次要指标

Outcome:

Incidence of vocal cord injury

Type:

Secondary indicator

测量时间点:

拔管时

测量方法:

Measure time point of outcome:

During intubation

Measure method:

指标中文名:

术后咽痛发生率及严重程度

指标类型:

次要指标

Outcome:

Incidence and severity of postoperative sore throat

Type:

Secondary indicator

测量时间点:

PACU内,术后第1、2天

测量方法:

Measure time point of outcome:

In PACU, postoperative day 1 and 2

Measure method:

指标中文名:

术后声音嘶哑发生率及严重程度

指标类型:

次要指标

Outcome:

Incidence and severity of postoperative hoarseness

Type:

Secondary indicator

测量时间点:

PACU内,术后第1、2天

测量方法:

Measure time point of outcome:

In PACU, postoperative day 1 and 2

Measure method:

指标中文名:

插管用时

指标类型:

次要指标

Outcome:

Intubation time

Type:

Secondary indicator

测量时间点:

插管完成后

测量方法:

Measure time point of outcome:

after intubation

Measure method:

指标中文名:

插管尝试次数

指标类型:

次要指标

Outcome:

Number of intubation attempts

Type:

Secondary indicator

测量时间点:

插管完成后

测量方法:

Measure time point of outcome:

after intubation

Measure method:

指标中文名:

肺萎陷效果评分

指标类型:

次要指标

Outcome:

Quality of lung collapse

Type:

Secondary indicator

测量时间点:

手术开始后10分钟

测量方法:

Measure time point of outcome:

10 minutes after beginning of surgery

Measure method:

指标中文名:

术中气道峰压及平台压

指标类型:

次要指标

Outcome:

Intraoperative peak airway pressure and plateau pressure

Type:

Secondary indicator

测量时间点:

插管后双肺通气,单肺通气,术毕双飞通气

测量方法:

Measure time point of outcome:

After intubation during two-lung ventilation, During one-lung ventilation, At the end of surgery after resumption of two-lung ventilation

Measure method:

指标中文名:

组合管组内非预设附加旋转操作发生率及其相关结局

指标类型:

附加指标

Outcome:

Incidence of unplanned additional rotational maneuvers in the combined tube group and associated outcomes

Type:

Additional indicator

测量时间点:

拔管时,PACU内,术后第1、2天

测量方法:

Measure time point of outcome:

during intubation, In PACU, postoperative day 1 and 2

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

none

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 75 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):

随机序列由计算机生成,采用分层区组随机化方法,以研究中心为分层因素,区组长度设为 4。

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

The randomization sequence will be generated by a computer using a stratified block randomization method, with study center as the stratification factor and a fixed block size of 4.

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:

对术后随访评估者(负责术后咽痛及声音嘶哑评估),统计分析人员设盲

Blinding:

The postoperative follow-up evaluators (responsible for assessing postoperative sore throat and hoarseness) and the statistical analysts were blinded.

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:

CRF

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

CRF

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2026-05-21 16:44:09