经皮经肝经导管组织胶栓塞与内镜下组织胶注射治疗胃底静脉曲张的随机对照研究

注册号:

Registration number:

ChiCTR-TRC-08000251 

最近更新日期:

Date of Last Refreshed on:

2015-05-12 15:05:06 

注册时间:

Date of Registration:

2008-12-22 00:00:00 

注册号状态:

补注册

Registration Status:

Retrospective registration

注册题目:

经皮经肝经导管组织胶栓塞与内镜下组织胶注射治疗胃底静脉曲张的随机对照研究

Public title:

Percutaneous Transhepatic Variceal Embolization versus Endoscopic Injections with Histoacryl for the treatment of gastric fundus varices: A Randomized Controlled Trial

注册题目简写:

English Acronym:

研究课题的正式科学名称:

经皮经肝经导管组织胶栓塞与内镜下组织胶注射治疗胃底静脉曲张的随机对照研究

Scientific title:

Percutaneous Transhepatic Variceal Embolization versus Endoscopic Injections with Histoacryl for the treatment of gastric fundus varices: A Randomized Controlled Trial

研究课题代号(代码):

Study subject ID:

山东省科技攻关项目2005GG4202024

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:

王启志 

研究负责人:

张春清 

Applicant:

Wang Qizhi 

Study leader:

Zhang Chunqing 

申请注册联系人电话:

Applicant telephone:

+86 0 15969706585

研究负责人电话:

Study leader's
telephone:

+86 0 13583188661

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

+86 0531 87902348

申请注册联系人电子邮件:

Applicant E-mail:

wqzh2@163.com

研究负责人电子邮件:

Study leader's E-mail:

zhchqing@medmail.com.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:

山东省济南市文化西路44号山东大学医学院6-517

研究负责人通讯地址:

山东省济南市经五纬七路324号山东省立医院消化内科

Applicant address:

44 Wenhua Xi Road, Jinan, Shandong, China

Study leader's address:

324 Jinwu Weiqi Road, Jinan, Shandong, China

申请注册联系人邮政编码:

Applicant postcode:

250012

研究负责人邮政编码:

Study leader's postcode:

250021

申请人所在单位:

山东大学附属省立医院

Applicant's institution:

Shandong University School of Medicine

研究负责人所在单位:

Affiliation of the Leader:

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:

NA

伦理委员会批件附件:

Approved file of Ethical Committee:

批准本研究的伦理委员会名称:

山东省立医院伦理委员会

Name of the ethic committee:

Ethics committee of Shandong Provincial Hospital

伦理委员会批准日期:

Date of approved by ethic committee:

2008-11-01 00:00:00

伦理委员会联系人:

Contact Name of the ethic committee:

伦理委员会联系地址:

Contact Address of the ethic committee:

伦理委员会联系人电话:

Contact phone of the ethic committee:

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:

山东省立医院

Primary sponsor:

Shandong Provincial Hospital

研究实施负责(组长)单位地址:

山东省济南市经五纬七路324号

Primary sponsor's address:

324 Jinwu Weiqi Road, Jinan, Shandong, 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):

山东

市(区县):

Country:

China

Province:

Shandong

City:

单位(医院):

山东大学

具体地址:

山东省济南市山大南路27号

Institution
hospital:

Shandong University

Address:

27 Shanda South Road, Jinan, Shandong, China

经费或物资来源:

山东省科技攻关项目(2005GG4202024)

Source(s) of funding:

Shandong Province Key Scientific and Technological Projects

研究疾病:

肝硬化、门静脉高压、胃底静脉曲张、消化道出血  

Target disease:

liver cirrhosis; portal hypertension; gastric fundus varices; alimentary tract hemorrhage

研究疾病代码:

R57

Target disease code:

R57

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

IV期临床试验 

Study phase:

4

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

将永久性栓塞剂α-氰基丙烯酸灌注于胃底曲张静脉,观察经皮经肝胃静脉曲张栓塞技术(PTVE)与内镜下组织胶注射治疗胃底曲张静脉术对患者的即时止血率、再出血率、曲张静脉消失率、复发率及患者生存率的影响,探讨治疗胃底静脉曲张的技术方法。  

Objectives of Study:

To approach the technology in gastric variceal bleeding management, we performed a modified percutaneous transhepatic variceal embolization (PTVE) with histoacryl in gastric varices and the advertitial plexus of the gastric fundus. Meanwhile, we compared this modified PTVE with endoscopic injection of histoacryl in gastric variceal bleeding management for hemostasis, rebleeding, varices eradication, relapse, and survival rate.

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. 有胃镜检查禁忌者,如食管狭窄;2. 胃镜发现有严重食管炎者;3. 以前接受过食管胃底静脉曲张的内镜下治疗或手术治疗的患者;4. 严重高血压、冠心病、心肺功能不全;5. 合并有肝癌或其他部位肿瘤;6. 合并有广发门静脉栓塞、严重门静脉海绵样变;7. Ⅱ期以上肝性脑病;明显黄疸,总胆红素在正常3倍以上;8. 合并肝肾综合症或慢性肾功能不全;9. 明显出血倾向,PT>25秒;10. 任何原因所致严重门静脉插管困难者;11. 患者及家属不愿完善术前检查或者不接受术后定期复查者。

Exclusion criteria:

1. Association with the contraindication such as esophageal stenosis for gastroscopy or has grave esophagitis;
2. Had previous endoscopic, surgical treatment or transjugular intrahepatic portal systemic shunt for gastroesophageal variceal bleeding;
3. Grave hypertension, coronary heart disease, or impaired function of cardiorespiratory.
4. Association with hepatocellular carcinoma or other malignancy;
5. Complete obstruction of the portal vein due to thrombosis;
6. Encephalopathy greater than stage II; severe jaundice with serum bilirubin more than 100 mg L-1;
7. Presence of hepatorenal syndrome or chronic renal insufficiency;
8. Obvious hemorrhagic tendency, PT>25s;
9. The portal vein was failure to venous cannula with kinds of cause;
10. Inability or refusal to give the consent to complete preoperative check and postoperative recheck.

研究实施时间:

Study execute time:

From 2003-01-01 00:00:00 To 2006-10-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2003-01-01 00:00:00 To 2006-10-31 00:00:00

干预措施:

Interventions:

组别:

对照组(内镜下组织胶注射治疗)

样本量:

37

Group:

Control group

Sample size:

干预措施:

1. 对入组患者常规行胃镜检查,记录胃底静脉曲张的情况。 2. 进镜前于内镜活检孔道内注射碘油1~2 ml,注射针预冲碘油1ml。 3. 内镜下选择好靶静脉,刺入静脉内快速注入1∶1 的碘油和组织粘合剂的混合液0.5~2 ml/.点,再注入碘油1 ml,将注射针管内的混合液推入。 4. 再注5 %葡萄糖液5 ml冲洗注射针,预防注射针堵塞。 5. 并可依上述步骤进行第二步的注射。每次注射1~2 点,一般每例注射1~2 次。

干预措施代码:

Intervention:

Patients has gastroscopy to investigate the degree of gastric fundus varices; Histoacryl blue injection was performed using an Olympus electronic gastroscope and a disposable injection needle. Each shot contained 0.5ml Histoacryl and 0.5ml Lipiodol. Last the needles were rinsed with 5% Glucose.

Intervention code:

组别:

试验组(PTVE术)

样本量:

35

Group:

Experimental group

Sample size:

干预措施:

1. 对入组患者随机行经皮经肝穿刺门静脉穿刺、插管、造影,X线监视下缓慢注射剂α-氰基丙烯酸,使其沿胃冠状静脉血流漂浮至胃底曲张静脉内至缓慢后退导管栓塞胃冠状静脉主干,将粘合剂经导管注射到胃底粘膜下曲张静脉、壁内穿支静脉及胃底周围,使曲张静脉及其供血静脉彻底永久栓塞。2.若患者合并胃后静脉和胃短静脉供血,用相同方法一并栓塞,直至术后造影曲张静脉栓塞完全。3.拔管前,明胶海绵条或钢圈封闭肝穿刺道,防止穿刺道出血。

干预措施代码:

Intervention:

The included patients was performed PTVE by venipuncture, intubation tube, visualization, histoacryl was then injected continuously until all the gastric fundus varices and opacified. During withdrawal of the sheath, the needle tract was closed with gelatin sponge or stainless-steel coils.

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

山东 

市(区县):

济南 

Country:

China

Province:

Shandong

City:

Ji'nan

单位(医院):

山东省立医院 

单位级别:

三级甲等医院 

Institution
hospital:

Shandong Provincial Hospital

Level of the institution:

Tertiary A hospital

测量指标:

Outcomes:

指标中文名:

再出血率

指标类型:

主要指标

Outcome:

UGI rebleeding

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

CT平扫及门静脉血管三维重建

指标类型:

主要指标

Outcome:

Computerized tomography (CT) scanning and 3D recon

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后生存率

指标类型:

主要指标

Outcome:

survival rate

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

即时止血率

指标类型:

主要指标

Outcome:

Arrest of acute bleeding

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

胃底曲张静脉消失、复发情况

指标类型:

主要指标

Outcome:

Gastric Fundus Varices eradication and relaps

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

临床症状改善状况

指标类型:

次要指标

Outcome:

The improving of clinical symptom

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

肝功能评价

指标类型:

次要指标

Outcome:

Liver functional assessment

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后生活质量评价

指标类型:

次要指标

Outcome:

quality of life

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

并发症

指标类型:

次要指标

Outcome:

Complication

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:

征募研究对象情况:

Recruiting status:

结束

/Completed

年龄范围:

Participant age:

最小 Min age 47 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):

随机数字表

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

Random Number Table

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

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):

山东省立医院

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

Shandong Provincial Hospital

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:

山东大学公共卫生学院

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

School of Public Health Shandong University

数据与安全监察委员会:

Data and Safety Monitoring Committee:

注册人:

Name of Registration:

 2008-12-25 00:00:00