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催产素鼻喷雾剂预处理对意外创伤性骨折患者术后急性应激障碍的影响:一项单中心前瞻性随机对照临床试验研究方案

Effect of oxytocin nasal spray pretreatment on postoperative acute stress disorder in patients with accidental traumatic fracture: a single-centre prospective randomised controlled clinical trial study protocol.

作者信息

Huang Qingqing, Zhang Hengdi, Ren Ling, Zeng Jingzheng, Wen Yi, Shu Haifeng, Gong Gu

机构信息

Department of Anesthesiology, People's Liberation Army The General Hospital of Western Theater Command, Chengdu, Sichuan, China.

College of Medicine, Southwest Jiaotong University, Chengdu, Sichuan, China.

出版信息

BMJ Open. 2025 Jan 14;15(1):e090167. doi: 10.1136/bmjopen-2024-090167.

Abstract

INTRODUCTION

Patients undergoing surgical procedures are often prone to developing acute stress disorder (ASD) postoperatively. Presently, oxytocin nasal spray has shown significant potential in the treatment of stress-related neuropsychiatric diseases. However, there are few reports on the use of oxytocin nasal spray in postoperative ASD, a condition that can potentially develop into a high-risk factor for post-traumatic stress disorder. This study aims to investigate the effect of pretreatment with oxytocin nasal spray on postoperative ASD in patients with accidental trauma and fracture to provide new clinical insights for the prevention of postoperative ASD.

METHODS AND ANALYSIS

This study is a single-centre, double-blind, randomised controlled clinical trial. The trial aims to recruit 328 patients with accidental traumatic fractures who underwent surgical treatment. Participants will be randomly categorised into two groups: a control group (0.9% normal saline nasal spray, 1 mL) and an oxytocin group (oxytocin nasal spray, 1 mL/40 IU) at a ratio of 1:1 using the random number table method. The primary outcome is the incidence of ASD on postoperative days 1-3. Secondary outcomes include patient resilience, anxiety, depression and pain scores on postoperative days 1-3. The exploratory results include the concentrations of stress response indicators such as malondialdehyde, cortisol and superoxide dismutase in the saliva before the first intervention and on days 1-3 after surgery.

ETHICS AND DISSEMINATION

The trial was approved by the clinical research ethics committee of the General Hospital of the Western Theater Command (identifier: 2024EC3-ky014). The findings of this trial will be disseminated in a peer-reviewed journal and in national or international paediatric research to guide future practice.

TRIAL REGISTRATION NUMBER

ChiCTR2400082612.

摘要

引言

接受外科手术的患者术后常易发生急性应激障碍(ASD)。目前,催产素鼻喷雾剂在治疗应激相关神经精神疾病方面已显示出显著潜力。然而,关于催产素鼻喷雾剂用于术后ASD的报道较少,而术后ASD有可能发展成为创伤后应激障碍的高危因素。本研究旨在探讨催产素鼻喷雾剂预处理对意外创伤骨折患者术后ASD的影响,为预防术后ASD提供新的临床见解。

方法与分析

本研究为单中心、双盲、随机对照临床试验。该试验旨在招募328例接受手术治疗的意外创伤骨折患者。采用随机数字表法,将参与者按1:1的比例随机分为两组:对照组(0.9%生理盐水鼻喷雾剂,1 mL)和催产素组(催产素鼻喷雾剂,1 mL/40 IU)。主要结局是术后1 - 3天ASD的发生率。次要结局包括术后1 - 3天患者的心理复原力、焦虑、抑郁和疼痛评分。探索性结果包括首次干预前及术后1 - 3天唾液中丙二醛、皮质醇和超氧化物歧化酶等应激反应指标的浓度。

伦理与传播

该试验已获得西部战区总医院临床研究伦理委员会批准(标识符:2024EC3 - ky014)。本试验的结果将在同行评审期刊以及国内或国际儿科研究中发表,以指导未来的实践。

试验注册号

ChiCTR2400082612。

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