Efficacy and Safety of Color-Doppler Ultrasound Versus Two-dimensional Ultrasound in Reducing Bleeding During Single-tract (18 Fr) Percutaneous Nephrolithotomy: A Prospective–Retrospective Controlled Study

注册号:

Registration number:

ChiCTR2500114024 

最近更新日期:

Date of Last Refreshed on:

2025-12-05 15:48:43 

注册时间:

Date of Registration:

2025-12-05 00:00:00 

注册号状态:

补注册

Registration Status:

Retrospective registration

注册题目:

评价彩色多普勒超声对比二维超声在经皮肾镜单通道(18 Fr)穿刺建道中减少出血的有效性与安全性的前瞻性-回顾性对照研究

Public title:

Efficacy and Safety of Color-Doppler Ultrasound Versus Two-dimensional Ultrasound in Reducing Bleeding During Single-tract (18 Fr) Percutaneous Nephrolithotomy: A Prospective–Retrospective Controlled Study

注册题目简写:

English Acronym:

研究课题的正式科学名称:

彩色多普勒血流显像在减少经皮肾镜手术出血的临床研究

Scientific title:

Clinical study on color Doppler flow imaging in reducing bleeding during percutaneous nephrolithotomy surgery

研究课题代号(代码):

Study subject ID:

HK24AB231018

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:

颜贤勇 

研究负责人:

颜贤勇 

Applicant:

Xianyong Yan 

Study leader:

Xianyong Yan 

申请注册联系人电话:

Applicant telephone:

+86 150 7838 1195

研究负责人电话:

Study leader's telephone:

+86 150 7838 1195

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:

wy1930yxy@163.com

研究负责人电子邮件:

Study leader's E-mail:

wy1930yxy@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:

广西壮族自治区河池市金城江区中山路445号

研究负责人通讯地址:

广西壮族自治区河池市金城江区中山路445号

Applicant address:

No. 445 Zhongshan Road, Jinchengjiang District, Hechi, Guangxi Zhuang Autonomous Region, China

Study leader's address:

No. 445 Zhongshan Road, Jinchengjiang District, Hechi, Guangxi Zhuang Autonomous Region, 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:

广西医科大学第一附属医院-河池市人民医院

Applicant's institution:

Hechi People’s Hospital ( affiliated to The First Affiliated Hospital of Guangxi Medical University )

研究负责人所在单位:

广西医科大学第一附属医院-河池市人民医院

Affiliation of the Leader:

Hechi People’s Hospital ( affiliated to The First Affiliated Hospital of Guangxi Medical University ),

是否获伦理委员会批准:

是/Yes

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

河医伦审KY(2023-037-02)

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:

河池市人民医院科研伦理委员会

Name of the ethic committee:

Ethics Committee of Scientific Research, Hechi People’s Hospital

伦理委员会批准日期:

Date of approved by ethic committee:

2023-06-19 00:00:00

伦理委员会联系人:

韦彩素

Contact Name of the ethic committee:

Caisu Wei

伦理委员会联系地址:

广西壮族自治区河池市金城江区中山路445号

Contact Address of the ethic committee:

No. 445 Zhongshan Road, Jinchengjiang District, Hechi, Guangxi Zhuang Autonomous Region, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 139 0788 9210

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:

广西医科大学第一附属医院-河池市人民医院

Primary sponsor:

The First Affiliated Hospital of Guangxi Medical University – Hechi People’s Hospital

研究实施负责(组长)单位地址:

广西壮族自治区河池市金城江区中山路445号

Primary sponsor's address:

No. 445 Zhongshan Road, Jinchengjiang District, Hechi, Guangxi Zhuang Autonomous Region, 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):

广西壮族自治区

市(区县):

河池市

Country:

China

Province:

Guangxi Zhuang Autonomous Region

City:

Hechi

单位(医院):

广西医科大学第一附属医院-河池市人民医院

具体地址:

广西壮族自治区河池市金城江区中山路445号

Institution
hospital:

The First Affiliated Hospital of Guangxi Medical University – Hechi People’s Hospital

Address:

No. 445 Zhongshan Road, Jinchengjiang District, Hechi, Guangxi Zhuang Autonomous Region, China

经费或物资来源:

本项目为市级重点科研课题,总投资5.00万元。其中: 河池市科学技术局财政科技经费 0.50 万元(合同号:河科计字〔2023〕10 号,一次性拨付); 河池市人民医院自筹经费 4.50 万元,用于配套设备、耗材及人员劳务等非财政支出; 无其他企业或商业赞助。

Source(s) of funding:

This project is a municipal key research program with a total budget of CNY 50,000. CNY 5,000 is provided by the Hechi Municipal Bureau of Science and Technology (Grant letter No. 〔2023〕10) as a lump-sum government grant; the remaining CNY 45,000 is contributed by Hechi People’s Hospital through institutional self-raised funds. No commercial sponsorship is involved.

Target disease:

Kidney stone (nephrolithiasis) requiring percutaneous nephrolithotomy

Target disease code:

ICD-10 N20.0

研究类型:

观察性研究

Study type:

Observational study

研究所处阶段:

诊断试验新技术临床试验 

Study phase:

Diagnostic New Technique Clincal Study

研究设计:

历史对照研究 

Study design:

Historical control 

研究目的:

比较彩色多普勒超声与传统二维超声在经皮肾镜单通道(18 Fr)穿刺建道过程中的出血控制效果,验证彩色多普勒超声能否在不增加手术时间、不降低结石清除率的前提下减少术中出血及术后血红蛋白下降幅度,为临床选择更安全的穿刺引导方式提供循证依据。  

Objectives of Study:

To compare the efficacy and safety of color-Doppler ultrasound-guided versus conventional two-dimensional ultrasound-guided tract creation in single-tract (18 Fr) percutaneous nephrolithotomy (PCNL). The primary objective is to determine whether color-Doppler ultrasound significantly reduces intra-operative blood loss and post-operative haemoglobin drop without prolonging lithotripsy time or compromising stone-free 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:

1.年龄 18–70 岁,性别不限; 2.经 CT 或 KUB 确诊肾盂和/或肾盏结石,最大结石长径 ≥ 2 cm 或鹿角形结石; 3.计划首次接受单通道(18 Fr)经皮肾镜取石术(PCNL); 4.无严重心血管、肝、肾或凝血功能障碍,ASA 分级 ≤ III 级; 5.自愿参加并签署知情同意书(前瞻性队列)或同意使用病历数据(回顾性队列)。

Inclusion criteria

1. Age 18–70 years, either sex. 2. Renal pelvic and/or calyceal stones ≥ 2 cm or staghorn stones confirmed by CT or KUB. 3. Scheduled to undergo first-time, single-tract (18 Fr) percutaneous nephrolithotomy (PCNL). 4. ASA class ≤ III with no severe cardiac, hepatic, renal or coagulation disorder. 5. Willing to participate: signed informed consent (prospective cohort) or agreed to medical-record use (retrospective cohort).

排除标准:

1. 既往同侧肾脏开放或经皮肾镜手术史; 2. 严重凝血功能障碍(INR>1.5 或血小板<50×10⁹/L)或术前7天内接受抗凝/抗血小板治疗且无法停药; 3. 未控制的严重高血压(收缩压>180 mmHg或舒张压>110 mmHg)或ASA≥Ⅳ级; 4. 肾发育异常、肾旋转不良、肾盂输尿管连接部梗阻等解剖畸形; 5. 妊娠期或哺乳期女性; 6. 合并同侧肾肿瘤、活动性泌尿系感染或脓肾; 7. 拒绝签署知情同意或无法配合术后随访。

Exclusion criteria:

1. Previous open or percutaneous renal surgery on the same side. 2. Coagulopathy (INR > 1.5 or platelets < 50 × 10⁹/L) or anticoagulant/antiplatelet therapy that cannot be stopped within 7 days before surgery. 3. Uncontrolled severe hypertension (SBP > 180 mmHg or DBP > 110 mmHg) or ASA ≥ IV. 4. Renal malformation (ectopic, horseshoe, PUJ obstruction, etc.). 5. Pregnancy or lactation. 6. Co-existing ipsilateral renal tumor, active urinary tract infection, or pyonephrosis. 7. Refusal to provide informed consent or inability to comply with post-operative follow-up.

研究实施时间:

Study execute time:

From 2024-01-01 00:00:00 To 2026-12-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2024-01-07 00:00:00 To 2024-12-30 00:00:00  

干预措施:

Interventions:

组别:

CDFI 组(Color-Doppler 引导组)

样本量:

134

Group:

CDFI Group(Color-Doppler-guided cohort)

Sample size:

干预措施:

干预措施代码:

Intervention:

NA

Intervention code:

组别:

2D-US 组(常规二维超声组)

样本量:

134

Group:

2D-US Group(Conventional 2D ultrasound cohort)

Sample size:

干预措施:

干预措施代码:

Intervention:

NA

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

广西壮族自治区 

市(区县):

河池市 

Country:

China 

Province:

Guangxi Zhuang Autonomous Region 

City:

Hechi 

单位(医院):

广西医科大学第一附属医院-河池市人民医院 

单位级别:

三甲 

Institution
hospital:

The First Affiliated Hospital of Guangxi Medical University – Hechi People’s Hospital

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

术中失血量

指标类型:

主要指标

Outcome:

Intra-operative blood loss

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24 h血红蛋白下降值

指标类型:

主要指标

Outcome:

24-hour post-operative haemoglobin drop

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

输血率

指标类型:

次要指标

Outcome:

Blood transfusion rate

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

介入栓塞率

指标类型:

次要指标

Outcome:

Super-selective renal arterial embolisation rate

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

肾周血肿发生率

指标类型:

次要指标

Outcome:

Perirenal haematoma incidence

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:

组织:

Sample Name:

NA

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:

结束

/Completed

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age 70 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):

未采用随机分组

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

NA - non-randomized 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:

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

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):

共享时间:文章正式发表后12个月内。 共享方式:向通信作者提交研究方案及统计分析计划书,经伦理委员会备案后,通过安全加密的云端链接(OneDrive/谷歌云盘)提供CSV格式数据集及数据说明文件。

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

De-identified individual participant data will be available beginning 12 months after the article’s publication. Qualified researchers may obtain the dataset by submitting a research proposal and statistical analysis plan to the corresponding author for ethics-committee filing. Upon approval, an encrypted OneDrive/Google Drive link containing the CSV data file, data dictionary, and analysis code will be provided.

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:

1. 数据采集平台:使用医院泌尿外科专病数据库(基于REDCap 12.0)建立电子病例报告表(eCRF),设置字段范围、逻辑校验与必填项,确保实时质控。 2. 采集流程:由两名经培训的研究护士在术前24h、术后24h、出院日及术后30天电话随访时统一录入;术中数据由手术医师即时记录、麻醉系统自动导入失血量与输液量。 3. 身份管理:采用唯一研究编号,姓名、身份证号等标识单独存放于加密服务器;导出时删除所有直接标识,仅保留编号与分组变量。 4. 数据核查:每周随机抽取10%病例进行源数据核查(SDV),发现异常即刻双人复核并留痕;数据库锁定前由第三方统计师再次运行逻辑脚本。 5. 存储与备份:本地服务器每日自动增量备份,异地云盘AES-256加密镜像;锁定后只读,任何修正需书面申请并留日志。 6. 权限控制:分级账户(录入/查询/导出/管理员),所有操作记录IP与时间;导出文件加水印,禁止截屏与外链分享。

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

1. Platform: A study-specific electronic case-report form (eCRF) built on REDCap 12.0 is hosted on the hospital’s secure server; range and logic checks plus mandatory fields are preset for real-time quality control. 2. Workflow: Two trained research nurses enter baseline data within 24 h before surgery, intra-operative variables are recorded immediately by the operating surgeon, and anaesthesia machine data (blood loss, fluid volume) are auto-imported; post-operative values and 30-day follow-up are entered within 24 h of availability. 3. Participant identity: Only a unique study ID is used in the eCRF; names, ID numbers and other direct identifiers are stored separately on an encrypted, access-restricted drive and are removed before any dataset export. 4. Data verification: Source-data verification (SDV) is performed weekly on a random 10 % sample; discrepancies are resolved by dual review with audit trail. A final logic script is run by an independent statistician before database lock. 5. Storage & back-up: The server performs daily incremental back-ups; an AES-256 encrypted mirror is maintained on an off-site cloud. After lock the database is read-only; any correction requires written approval and is logged. 6. Access control: Role-based accounts (entry / query / export / administrator) are implemented; all actions are logged with IP and timestamp. Export files are water-marked; screen capture and external file-sharing are disabled.

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:

 2025-12-05 15:47:24