经皮穴位电刺激对老年人腹腔镜术后低氧血症疗效观察:单中心,随机临床试验

注册号:

Registration number:

ITMCTR2025001046

最近更新日期:

Date of Last Refreshed on:

2025-05-26

注册时间:

Date of Registration:

2025-05-26

注册号状态:

Registration Status:

预注册

Prospective registration

注册题目:

经皮穴位电刺激对老年人腹腔镜术后低氧血症疗效观察:单中心,随机临床试验

Public title:

Effect of Transcutaneous Acupoint Electrical Stimulation on Postoperative Hypoxemia in Elderly Patients After Laparoscopic Surgery: A Single-Center Randomized Clinical Trial

注册题目简写:

English Acronym:

研究课题的正式科学名称:

经皮穴位电刺激对老年人腹腔镜术后低氧血症疗效观察:单中心,随机临床试验

Scientific title:

Effect of Transcutaneous Acupoint Electrical Stimulation on Postoperative Hypoxemia in Elderly Patients After Laparoscopic Surgery: A Single-Center Randomized Clinical Trial

研究课题的正式科学名称简写:

Scientific title acronym:

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:

孙龙凯

研究负责人:

孙龙凯

Applicant:

Longkai Sun

Study leader:

Longkai Sun

申请注册联系人电话:

Applicant telephone:

18063110868

研究负责人电话:

Study leader's telephone:

18063110868

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:

slk18063110868@163.com

研究负责人电子邮件:

Study leader's E-mail:

slk18063110868@163.com

申请单位网址(自愿提供):

Study leader's 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:

上海市普陀区兰溪路164号

研究负责人通讯地址:

上海市普陀区兰溪路164号

Applicant address:

164 Lanxi Road Putuo District Shanghai China

Study leader's address:

164 Lanxi Road Putuo District Shanghai 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:

上海中医药大学附属普陀医院

Applicant's institution:

Shanghai University of Traditional Chinese Medicine Affiliated Putuo Hospital

是否获伦理委员会批准:

Approved by ethic committee:

伦理委员会批件文号:

Approved No. of ethic committee:

PTEC-A-2024-48-3

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件

批准本研究的伦理委员会名称:

上海市普陀区中心医院(上海中医药大学附属普陀医院)伦理委员会

Name of the ethic committee:

Ethics Committee of Putuo District Center Hospital Shanghai (Putuo Hospital shanghai University of Traditional Chinese Medicme)

伦理委员会批准日期:

Date of approved by ethic committee:

2025/4/23 0:00:00

伦理委员会联系人:

潘姗姗

Contact Name of the ethic committee:

Shanshan Pan

伦理委员会联系地址:

上海市普陀区兰溪路164号

Contact Address of the ethic committee:

164 Lanxi Road Putuo District Shanghai China

伦理委员会联系人电话:

Contact phone of the ethic committee:

02122234110

伦理委员会联系人邮箱:

Contact email of the ethic committee:

xlt8171@126.com

研究实施负责(组长)单位:

上海中医药大学附属普陀医院

Primary sponsor:

Shanghai University of Traditional Chinese Medicine Affiliated Putuo Hospital

研究实施负责(组长)单位地址:

上海市普陀区兰溪路164号

Primary sponsor's address:

164 Lanxi Road Putuo District Shanghai 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):

上海

市(区县):

Country:

China

Province:

ShangHai

City:

单位(医院):

上海中医药大学附属普陀医院

具体地址:

上海市普陀区兰溪路164号

Institution
hospital:

Shanghai University of Traditional Chinese Medicine Affiliated Putuo Hospital

Address:

164 Lanxi Road Putuo District Shanghai China

经费或物资来源:

自筹

Source(s) of funding:

Self-funded

研究疾病:

低氧血症

研究疾病代码:

Target disease:

hypoxemia

Target disease code:

研究类型:

Study type:

干预性研究

Interventional study

研究设计:

Study design:

随机平行对照

randomized controlled trial(parallel group design)

研究所处阶段:

Study phase:

探索性研究/预试验

Pilot clinical trial

研究目的:

本研究旨在采用单中心随机对照、优效性的临床研究方法,评价经皮穴位电刺激干预对腹腔镜术后低氧血症(POH)的疗效,研究结果将为经皮穴位电刺激的疗效提供高质量临床证据。

Objectives of Study:

This study aims to evaluate the efficacy of transcutaneous acupoint electrical stimulation for postoperative hypoxemia (POH) after laparoscopy using a single-center randomized controlled superiority clinical trial design. The results will provide high-quality clinical evidence for the efficacy of transcutaneous acupoint electrical stimulation

药物成份或治疗方案详述:

实验组治疗方案详述: 患者均取仰卧位,对穴位进行常规消毒。选用韩式穴位神经刺激仪(HANS 200A,南京济生医疗科技有限公司生产),自粘贴片贴至双侧足三里(ST36)、列缺(LU7),电刺激强度逐渐从0mA调节至6mA,以肌肉微颤为宜,频率2/100HZ,疏密波,每3秒钟交替一次,波宽2Hz时是0.6ms,100Hz时是0.2ms,完全对称双向脉冲波。TEAS干预方案参照《穴位刺激在围术期应用的专家共识(2021)》,共1次。干预时机为手术结束至拔管前15分钟。

Description for medicine or protocol of treatment in detail:

Detailed Description of the Treatment Protocol for the Experimental Group: The patients were all positioned in the supine position and the acupoints were routinely disinfected. A Korean acupoint nerve stimulator (HANS 200A manufactured by Nanjing Jisheng Medical Technology Co. Ltd.) was used with self-adhesive patches applied to bilateral Zusanli (ST36) and Lieque (LU7). The electrical stimulation intensity was gradually adjusted from 0 mA to 6 mA aiming to induce slight muscle twitching. The frequency was set at 2/100 Hz with a dense-dispersed wave pattern alternating every 3 seconds. The pulse width was 0.6 ms at 2 Hz and 0.2 ms at 100 Hz with a fully symmetric bidirectional pulse wave. The TEAS intervention protocol was based on the "Expert Consensus on Acupoint Stimulation in Perioperative Application (2021)" with a single session. The intervention timing was 15 minutes before extubation after the completion of surgery.

纳入标准:

(1)经临床医师评估,符合SAGES(美国胃肠内镜外科医师学会)腹腔镜手术指南标准,可行腹腔镜术的消化系统非恶性病变患者; (2)年龄大于等于60岁,小于等于90岁,性别不限; (3)美国麻醉医师协会(ASA)术前患者体格情况分级为:I~III级;第一级:体格健康,发育营养良好,各器官功能正常;第二级:除外科疾病外,有轻度并存病,功能代偿健全;第三级:并存病情严重,体力活动受限,但尚能应付日常活动; (4)同意参加临床试验并签署书面知情同意书。 全部符合以上标准者方可纳入。

Inclusion criteria

(1) Patients with non-malignant digestive system diseases assessed by a clinician as meeting the SAGES (Society of American Gastrointestinal and Endoscopic Surgeons) guidelines for laparoscopic surgery; (2) Age ≥60 years and ≤90 years regardless of gender; (3) American Society of Anesthesiologists (ASA) preoperative physical status classification of I–III: Grade I: Physically healthy well-nourished with normal organ function; Grade II: Mild comorbidities in addition to the surgical condition with full functional compensation; Grade III: Severe comorbidities with limited physical activity but still capable of managing daily activities; (4) Willing to participate in the clinical trial and have signed a written informed consent form. Only those meeting all the above criteria are eligible for inclusion.

排除标准:

(1)需要同步联合其他手术或转为开腹手术的患者; (2)年龄<60岁和年龄>90岁患者; (3)近一个月内参加其他临床医学试验研究; (4)患者病史中对计划用药有过敏反应; (5)怀孕或哺乳期妇女; (6)体重指数(BMI)≥35 kg/m²; (7)既往肺部手术、气胸、肺结核、胸腔积液、预期插管困难、呼吸衰竭任何一项或严重肺功能障碍不适合现行麻醉方案; (8)严重心脏传导阻滞(Ⅱ或Ⅲ房室传导阻滞、双束支传导阻滞)、严重窦房结功能障碍、充血性心力衰竭和安装心脏起搏器患者; (9)经皮穴位电刺激部位解剖异常或附近有皮肤疾病的患者 符合以上任意一条即可排除。

Exclusion criteria:

(1) Patients requiring concurrent other surgeries or conversion to open surgery; (2) Patients aged <60 years or >90 years; (3) Patients who have participated in other clinical trials within the past month; (4) Patients with a history of allergic reactions to the planned medications; (5) Pregnant or breastfeeding women; (6) Patients with a body mass index (BMI) ≥35 kg/m²; (7) Patients with a history of lung surgery, pneumothorax, pulmonary tuberculosis, pleural effusion, anticipated difficult intubation, respiratory failure, or severe pulmonary dysfunction unsuitable for the current anesthesia protocol; (8) Patients with severe cardiac conduction block (second- or third-degree atrioventricular block, bifascicular block), severe sinus node dysfunction, congestive heart failure, or implanted cardiac pacemakers; (9) Patients with anatomical abnormalities or skin diseases near the site of transcutaneous acupoint electrical stimulation. Meeting any one of the above criteria warrants exclusion.

研究实施时间:

Study execute time:

From 2025-03-07

To      2026-05-31

征募观察对象时间:

Recruiting time:

From 2025-06-01

To      2026-05-15

干预措施:

Interventions:

组别:

实验组

样本量:

35

Group:

Experimental group

Sample size:

干预措施:

患者取仰卧位,常规消毒穴位,使用韩式穴位神经刺激仪(HANS 200A),自粘贴片贴于双侧足三里(ST36)和列缺(LU7)。电刺激强度从0mA调至6mA,频率2/100HZ,疏密波,每3秒交替,波宽为2Hz时0.6ms,100Hz时0.2ms,完全对称双向脉冲波。干预时间为手术结束至拔管前15分钟,共1次。

干预措施代码:

Intervention:

The patient is in the supine position, and the acupoints are disinfected. A Korean acupoint stimulator (HANS 200A) is used with self-adhesive patches applied to bilateral Zusanli (ST36) and Lieque (LU7). The electrical intensity is adjusted from 0mA to 6mA, with a frequency of 2/100HZ, sparse-dense wave, alternating every 3 seconds, pulse width 0.6ms at 2Hz and 0.2ms at 100Hz. Intervention is performed 15 minutes before extubation.

Intervention code:

组别:

对照组

样本量:

35

Group:

Control group

Sample size:

干预措施:

患者均取仰卧位,对穴位进行常规消毒,自粘贴片贴至双侧足三里(ST36)、列缺(LU7),不予电刺激处理。

干预措施代码:

Intervention:

All patients are positioned in the supine position, and the acupoints are routinely disinfected. Self-adhesive patches are applied to bilateral Zusanli (ST36) and Lieque (LU7) without electrical stimulation.

Intervention code:

样本总量 Total sample size : 70

研究实施地点:

Countries of recruitment
and research settings:

国家:

中国

省(直辖市):

上海市

市(区县):

Country:

China

Province:

Shanghai

City:

单位(医院):

上海中医药大学附属普陀医院

单位级别:

三级乙等

Institution/hospital:

The Shanghai University of Traditional Chinese Medicine Putuo Hospital

Level of the institution:

Class III Grade B

测量指标:

Outcomes:

指标中文名:

住院时间:从手术结束到出院的时间

指标类型:

次要指标

Outcome:

Hospital stay: the duration from the end of the surgery to discharge

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后血氧水平和术后不适感VAS评分

指标类型:

主要指标

Outcome:

Postoperative Blood Oxygen and Postoperative Discomfort VAS Score

Type:

Primary indicator

测量时间点:

疑拔管至离开复苏室期间和回到病房后3小时

测量方法:

使用乐普牌脉搏血氧仪,医疗器械执行类别:II类07;患者自评表

Measure time point of outcome:

From extubation to leaving the recovery room and 3 hours after returning to the ward

Measure method:

Use the Lepu brand pulse oximeter medical device classification: Class II Category 07; patient self-assessment form.

指标中文名:

其他患者质性指标

指标类型:

次要指标

Outcome:

Other qualitative patient indicators

Type:

Secondary indicator

测量时间点:

术后24小时

测量方法:

自我报告表

Measure time point of outcome:

24 hours post-surgery

Measure method:

Self Report Form

指标中文名:

气道抢救次数(定义为需要面罩无创正压通气,或重新插管)

指标类型:

次要指标

Outcome:

Number of airway rescue interventions (defined as the need for non-invasive positive pressure ventilation with a mask or re-intubation)

Type:

Secondary indicator

测量时间点:

术后24小时

测量方法:

Measure time point of outcome:

24 hours post-surgery

Measure method:

指标中文名:

六个时间节点生命体征:血压,心率(T0:手术开始时,T1:手术结束拔管,T2:TEAS操作结束后1h,T3-T5:回到病房后3*q8h);

指标类型:

次要指标

Outcome:

Vital signs at six time points: blood pressure heart rate (T0: start of surgery T1: extubation at the end of surgery T2: 1 hour after TEAS procedure T3-T5: every 8 hours for 3 measurements after returning to the ward)

Type:

Secondary indicator

测量时间点:

术后24小时

测量方法:

血压计/心电监护仪

Measure time point of outcome:

24 hours post-surgery

Measure method:

Blood pressure monitor / ECG (electrocardiogram) monitor

指标中文名:

术后并发症:其他术后并发症将记录在CRF表中

指标类型:

次要指标

Outcome:

Postoperative complications: other postoperative complications will be recorded in the CRF (Case Report Form)

Type:

Secondary indicator

测量时间点:

术后24小时

测量方法:

自我报告表

Measure time point of outcome:

24 hours post-surgery

Measure method:

Self Report Form

指标中文名:

术中阿片类药物使用剂量;

指标类型:

次要指标

Outcome:

Intraoperative opioid dosage

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

在PACU的停留时间

指标类型:

次要指标

Outcome:

Length of stay in the PACU (Post Anesthesia Care Unit)

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后血气分析结果

指标类型:

次要指标

Outcome:

Postoperative blood gas analysis results

Type:

Secondary indicator

测量时间点:

术后次日6:00

测量方法:

Measure time point of outcome:

6:00 AM on the day after surgery

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:

尚未开始

Not yet recruiting

年龄范围:

最小 60
Min age years
最大 90
Max age years

Recruiting status:

Participant age:

性别:

Gender:

男女均可

Both

随机方法(请说明由何人用什么方法产生随机序列):

本试验采用随机、单盲、平行对照设计。随机化与盲态设计人员使用SPSS 26.0软件生成随机数字表,具体方法为:以患者入组顺序为编号,通过SPSS生成0和1的随机序列,其中“0”代表“TEAS经络穴位组”,“1”代表“假TEAS经络穴位组”。随机分配由独立的研究人员完成,并将分组结果密封于不透明信封中,以确保保密性。针灸医师和干预人员在治疗时从密封信封中获取分组信息,患者和结果评估者对分组情况均不知情(单盲)。整个随机化过程严格保密,任何人都不得私自更改分组。本试验遵循盲法精神的三分离原则,即观测记录、治疗操作和数据分析由不同人员独立完成。

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

This trial adopts a randomized single-blind parallel-controlled design. Randomization and blinding are performed using SPSS 26.0 software to generate a random number table. The specific method is as follows: patients are numbered based on their enrollment sequence and a random sequence of 0s and 1s is generated using SPSS where "0" represents the "TEAS acupoint group" and "1" represents the "sham TEAS acupoint group." Random allocation is conducted by an independent researcher and the group assignments are sealed in opaque envelopes to ensure confidentiality. During treatment acupuncturists and intervention personnel obtain group information from the sealed envelopes while patients and outcome assessors remain unaware of the group assignments (single-blind). The entire randomization process is strictly confidential and no one is permitted to alter the group assignments arbitrarily. This trial adheres to the three-separation principle of blinding whereby observation and recording treatment administration and data analysis are independently performed by different personnel.

盲法:

Blinding:

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):

https://www.onetopdata.com/index.html

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

https://www.onetopdata.com/index.html

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:

病例记录表(Case Record Form, CRF)白塔数据管理系统(White Tower Data Management System)

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

(Case Record Form CRF)&(White Tower Data Management System)

数据管理委员会:

Data Managemen Committee:

Yes

研究计划书或研究结果报告发表信息
(杂志名称、期、卷、页,时间;或网址):

Publication information of the protocol/research results report
(name of the journal, volume, issue, pages, time; or website):

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