双胎妊娠剖宫产产后出血的预防策略

注册号:

Registration number:

ChiCTR2600127079 

最近更新日期:

Date of Last Refreshed on:

2026-06-24 11:16:57 

注册时间:

Date of Registration:

2026-06-24 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

双胎妊娠剖宫产产后出血的预防策略

Public title:

Prevention Strategy of Postpartum Hemorrhage in Twin Cesarean Deliveries

注册题目简写:

English Acronym:

研究课题的正式科学名称:

缩宫素联合麦角新碱预防双胎妊娠剖宫产产后出血的随机对照试验

Scientific title:

Prevention of Postpartum Hemorrhage with Oxytocin and Ergometrine in Twin Cesarean Deliveries: A Multicenter, Double-blind, Placebo-controlled Randomized Clinical 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:

丁裕斌 

研究负责人:

漆洪波 

Applicant:

Ding Yubin 

Study leader:

Hongbo Qi 

申请注册联系人电话:

Applicant telephone:

+86 15023169558

研究负责人电话:

Study leader's
telephone:

+86 23 63809721

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:

dingyb@cqmu.edu.cn

研究负责人电子邮件:

Study leader's E-mail:

qihongbo728@163.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:

重庆市渝中区医学院路1号

研究负责人通讯地址:

重庆市渝中区袁家岗友谊路1号

Applicant address:

1 Yixueyuan Road, Yuzhong District, Chonqging

Study leader's address:

1 Youyi Road, Yuzhong District, Chongqing, 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:

400016

申请人所在单位:

重庆医科大学附属第一医院

Applicant's institution:

The First Affiliated Hospital of Chongqing Medical University

研究负责人所在单位:

重庆医科大学附属第一医院

Affiliation of the Leader:

The First Affiliated Hospital of Chongqing Medical 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:

2026年科研伦审(ZZ2026-0308-01)

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:

重庆医科大学附属第一医院医学研究伦理审查委员会

Name of the ethic committee:

Medical Research Ethics Review Committee of the First Affiliated Hospital of Chongqing Medical University

伦理委员会批准日期:

Date of approved by ethic committee:

2026-05-25 00:00:00

伦理委员会联系人:

严青

Contact Name of the ethic committee:

Yan Qing

伦理委员会联系地址:

重庆市袁家岗友谊路1号

Contact Address of the ethic committee:

1 Youyi Road, Yuzhong District, Chongqing, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 23 8901 1876

伦理委员会联系人邮箱:

Contact email of the ethic committee:

444158752@qq.com

研究实施负责(组长)单位:

重庆医科大学附属第一医院

Primary sponsor:

The First Affiliated Hospital of Chongqing Medical University

研究实施负责(组长)单位地址:

重庆市袁家岗友谊路1号

Primary sponsor's address:

1 Youyi Road, Yuzhong District, Chongqing, 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):

重庆市

市(区县):

Country:

China

Province:

Chongqing

City:

单位(医院):

重庆医科大学附属第一医院

具体地址:

重庆市袁家岗友谊路1号

Institution
hospital:

The First Affiliated Hospital of Chongqing Medical University

Address:

1 Youyi Road, Yuzhong District, Chongqing, China

经费或物资来源:

自选课题(自筹)

Source(s) of funding:

Self-financed funds

研究疾病:

产后出血  

Target disease:

Postpartum Hemorrhage

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:

上市后药物 

Study phase:

4

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

主要目的: 评估缩宫素联合麦角新碱与单独使用缩宫素相比,在降低双胎妊娠择期剖宫产产后24小时内产后出血及相关并发症复合结局发生率方面的有效性。 次要目的: 1.比较两组间严重产后出血(≥1000ml)的发生率; 2.评估两组的平均产后出血量; 3.比较两组需要额外使用宫缩剂的比例; 4.评估两组输血率和输血量; 5.比较两组需要其他干预措施的比例(如子宫按摩、宫腔填塞、手术介入等); 6.评估两组术后24小时和48小时的血红蛋白下降幅度; 7.比较两组的住院时间; 8.评估干预措施的安全性,包括不良反应发生率; 9.评估两组的患者报告结局; 10.评估干预措施的卫生经济学效。  

Objectives of Study:

Main purpose: Objective to evaluate the efficacy of oxytocin combined with ergometrine compared with oxytocin alone in reducing the incidence of postpartum hemorrhage and related complications within 24 hours after elective cesarean section in twin pregnancy. Secondary purpose: 1. Compare the incidence of severe postpartum hemorrhage (>= 1000ml) between the two groups; 2. Evaluate the average amount of postpartum hemorrhage in the two groups; 3. Compare the proportion of the two groups that need additional uterine contraction agents4. evaluate the blood transfusion rate and blood transfusion volume of the two groups; 5. Compare the proportion of the two groups requiring other interventions (such as uterine massage, uterine tamponade, surgical intervention, etc.); 6. Evaluate the hemoglobin decrease at 24 hours and 48 hours after operation in the two groups; 7. Compare the hospitalization time of the two groups; 8. Evaluate the safety of intervention measures, including the incidence of adverse reactions9. evaluate the patient reported outcomes of the two groups10. evaluate the health economics benefits of interventions.

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.已知对缩宫素或麦角新碱过敏; 2.有使用麦角新碱禁忌证(如高血压、心血管疾病等); 3.前置胎盘、胎盘植入或可疑胎盘粘连; 4.已知凝血功能障碍或血小板计数<80×10⁹/L; 5.严重内科合并症者(心脏病、肝病、肾病等);肝、肾功能异常;或丙氨酸转氨酶(ALT)和/或天冬氨酸转氨酶(AST)值超出正常值上限2倍者;或肌酐(Cr)大于正常值上限者; 6.子宫肌瘤单个肌瘤≥5cm;或多发肌瘤个数>3个,单个肌瘤≥2cm者; 7.羊水过多(羊水指数>24cm); 8.巨大儿(任一胎儿估重>4000g); 9.术中发现需要其他手术(如卵巢囊肿剔除、子宫肌瘤剔除等); 10.正在参加其他临床研究; 11.研究者认为不适合参加本试验者。

Exclusion criteria:

1. Known allergy to oxytocin or ergometrine; 2. Contraindications for ergometrine use (such as hypertension, cardiovascular disease, etc.); 3. Placenta previa; Placenta accreta; Suspected placenta accreta; 4. Known coagulation dysfunction or platelet count < 80×10⁹/L; 5. Severe medical complications (heart disease, liver disease, kidney disease, etc.); Abnormal liver and kidney function; Or alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) values exceed 2 times the upper limit of normal values; Or creatinine (Cr) is greater than the upper limit of normal value; 6. Uterine fibroids with a single fibroid >= 5cm; or multiple fibroids with more than 3 and a single fibroid >= 2cm; 7. Polyhydramnios (amniotic fluid index > 24cm); 8. Macrosomia (estimated weight of any fetus > 4000g); 9. Other operations (such as ovarian cyst removal, uterine fibroids removal, etc.) are required during the operation; 10. Participating in other clinical studies; 11. The researcher believes that it is not suitable to participate in this experiment.

研究实施时间:

Study execute time:

From 2026-07-01 00:00:00 To 2029-06-30 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-07-01 00:00:00 To 2029-06-30 00:00:00

干预措施:

Interventions:

组别:

对照组

样本量:

1503

Group:

control group

Sample size:

干预措施:

缩宫素 + 安慰剂 第二个胎儿娩出后,缩宫素 10IU 加入 500ml 生理盐水中静脉滴注, 同时给予安慰剂肌内注射(IM),部位为子宫宫体前壁,注射液剂量与麦角新碱相同。

干预措施代码:

Intervention:

Oxytocin + Placebo After delivery of the second fetus, oxytocin 10 IU was administered intravenously in 500 mL of normal saline, concurrently with a placebo injection given intramuscularly (IM) into the anterior wall of the uterine body, using the same injection volume as that of Ergometrine.

Intervention code:

组别:

干预组

样本量:

1504

Group:

Intervention group

Sample size:

干预措施:

缩宫素 + 麦角新碱 第二个胎儿娩出后,缩宫素 10IU 加入 500ml 生理盐水中静脉滴注,同时给予麦角新碱 0.2mg 肌内注射(IM),部位为子宫宫体前壁。

干预措施代码:

Intervention:

Oxytocin + Ergometrine After delivery of the second fetus, oxytocin 10 IU was administered intravenously in 500 mL of normal saline, and Ergometrine 0.2 mg was given intramuscularly (IM) into the anterior wall of the uterine body.

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

重庆市 

市(区县):

 

Country:

China

Province:

Chongqing

City:

单位(医院):

重庆医科大学附属第一医院 

单位级别:

三级甲等 

Institution
hospital:

The First Affiliated Hospital of Chongqing Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

山东省 

市(区县):

 

Country:

China

Province:

Shandong

City:

单位(医院):

济南市妇幼保健院 

单位级别:

三级甲等 

Institution
hospital:

Jinan Maternal and Child Health Care Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

重庆市 

市(区县):

 

Country:

China

Province:

Chongqing

City:

单位(医院):

重庆医科大学附属妇女儿童医院 

单位级别:

三级甲等 

Institution
hospital:

Women and Children’s Hospital of Chongqing Medical University

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

产后 24 小时内产后出血及相关并发症复合结局的发生率。

指标类型:

主要指标

Outcome:

Incidence of the composite outcome of postpartum hemorrhage and related complications within 24 hours postpartum.

Type:

Primary indicator

测量时间点:

产后24小时

测量方法:

采用容积法结合称重法综合评估术中及术后24h内出血量;采用休克指数作为评估出血量的补充指标。

Measure time point of outcome:

24 hours postpartum

Measure method:

Blood loss was comprehensively assessed using a combination of volumetric and gravimetric methods intraoperatively and within 24 hours postoperatively. The shock index (SI) was used as a supplementary indicator for blood loss assessment.

指标中文名:

产后 24 小时内严重产后出血(≥1000 ml)

指标类型:

次要指标

Outcome:

Severe postpartum hemorrhage (>=1000 mL) within 24 hours postpartum.

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

需要追加二线宫缩剂的比例

指标类型:

次要指标

Outcome:

Proportion of patients requiring additional second?line uterotonics.

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 24 小时和 48 小时血红蛋白下降幅度

指标类型:

次要指标

Outcome:

The magnitude of hemoglobin decrease at 24 and 48 hours postoperatively.

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

心血管相关不良事件

指标类型:

次要指标

Outcome:

Cardiovascular 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:

术后恢复质量

指标类型:

次要指标

Outcome:

Quality of postoperative recovery

Type:

Secondary indicator

测量时间点:

测量方法:

术后 24 小时 QoR-15 评分,患者主观恢复体验及满意度

Measure time point of outcome:

Measure method:

QoR?15 score at 24 hours postoperatively, patient?reported recovery experience, and satisfaction.

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 45 years

性别:

女性

Gender:

Female

随机方法(请说明由何人用什么方法产生随机序列):

由独立统计学家使用计算机生成随机数字表,采用按研究中心分层的区组随机化(区组大小=4),按1:1比例分配至试验组或对照组。 由独立统计学家通过中心分层、区组随机产生随机序列。统计学家将对每个纸箱进行随机编号,每家医院都会分发适当编号的药物。随机化代码只会在研究完成后或在临床必要的情况下才会透露给研究人员。

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

An independent statistician generated a computer‑derived random number table. Patients were allocated in a 1:1 ratio to the experimental group or control group using block randomization (block size = 4), stratified by study center.

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:

由成都倍特药业有限公司提供标签(包括所有纸箱和瓶子),确保研究者和受试者均不知晓试验药品的分配,包括 PI、参与研究的医生、临床试验中心药房的药剂师、项目管理人员和其他参与试验的人员。对以上人员设盲。麦角新碱注射液与安慰剂注射液采用相同规格、相同安瓿材质、相同外观、相同标签版式及相同外包装,因此无法通过外观辨认不同的试验药品。

Blinding:

Labels (including those on all cartons and vials) were provided by Chengdu Beite Pharmaceutical Co., Ltd. to ensure that investigators and participants remained blinded to the allocation of study drugs. This blinding applied to the principal investigator (PI), study physicians, pharmacists at the clinical trial site pharmacy, project management staff, and all other personnel involved in the trial. The Ergometrine injection and placebo injection were identical in specifications, ampoule material, appearance, label format, and outer packaging, rendering them indistinguishable by visual inspection.

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):

本研究拟在主要结果发表后共享去标识化的研究数据(含数据字典/变量说明、CRF字段映射及必要的统计分析说明)。数据共享形式为受控共享:研究者可向通讯作者/数据管理员提交书面申请,经研究团队审核并签署数据使用协议后提供去标识化数据集与相关元数据。共享数据不包含任何可识别受试者身份的信息。

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

De-identified individual participant data (IPD), together with a data dictionary/metadata, CRF-to-dataset mapping, and key analysis documentation, will be shared after publication of the primary results. Data will be available via controlled access upon reasonable request to the corresponding author/data manager, subject to review of a research proposal, ethics compliance where applicable, and execution of a data use agreement. No direct identifiers will be shared.

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:

本研究使用标准化病例报告表(CRF)收集全部研究数据,研究人员接受CRF填写培训,数据录入后由第二人核对。建立专门研究数据库进行数据管理,设置录入逻辑核查与范围检查,采用双录入并一致性比对后入库,定期数据清理;数据库设置访问权限,仅授权人员可访问,并定期备份。临床试验结束后进行统计分析前盲态审核与数据库锁定,锁定后数据妥善保存备查。受试者信息严格保密,使用受试者编号替代姓名,识别码与个人信息对照表单独保存,研究结果发表不包含可识别身份信息;由监查员执行数据监查并进行源数据核查,确保eCRF与原始文件一致。

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

Data will be collected using standardized Case Report Forms (CRFs). Study staff will be trained on CRF completion, and all entries will be second-checked. A dedicated study database will be used with built-in logic and range checks. Data will be double-entered and reconciled before being locked; routine data cleaning will be performed. Role-based access control and regular backups will be implemented. After study completion, a blinded review will be conducted prior to database lock and unblinding for statistical analysis. Participant confidentiality will be protected by using subject IDs instead of names, with the linkage file stored separately; no identifiable information will be included in publications. Independent monitoring and source data verification will be performed to ensure consistency between eCRF and source documents.

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2026-06-24 11:16:49