Prognostic Analysis of Different Treatment Options for Cerebral Hemorrhage
Analysis of Related Factors of Hematoma Morphology in Patients With Cerebral Hemorrhage and Prognosis Analysis of Different Regimens for Cerebral Hemorrhage
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Contacts and Locations
Study Contact
Study Contact
- Name: Wu guofeng, Doctor
- Phone Number: 13809431723
Study Contact Backup
- Name: Zhao xu, Master
- Phone Number: 18785775120
- Email: 1684283389@qq.com
Study Locations
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Guizhou
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Guiyang, Guizhou, China
- Recruiting
- Guizhou Medical University Affiliated Hospital
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Contact:
- Wu guofeng, Doctor
- Phone Number: 13809431723
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Age 18-80 years old;
- Intracerebral hemorrhage was diagnosed by head CT examination;
Exclusion Criteria:
- Multiple intracranial hemorrhage;
- Intracranial hemorrhage caused by intracranial tumor, aneurysm, trauma, infarction or other lesions;
- Coagulation disorders or a history of taking anticoagulants;
- Infectious meningitis, systemic infection;
- History of severe stroke, heart, kidney, liver and lung dysfunction in the past;
- Severe brain herniation (mydriasis, respiratory and circulatory failure);
- Incomplete or missing basic data or follow-up information in the hospital.
Study Plan
How is the study designed?
Design Details
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Stereotactic intracranial hematoma puncture treatment group
Check the CT slice of the patient's brain, find out the patient's largest hematoma level, measure the coordinates of the puncture center, locate and mark the skull surface according to the measured coordinates, select the puncture point under the stereotaxic instrument, Mainly avoid important blood vessels, nerves and functional areas.
Use an electric drill to drill the puncture needle into the center of the hematoma, and slowly aspirate the hematoma from the side hole until the suction stops when there is resistance.
The residual hematoma in CT and the location of the drainage tube were determined, and the position of the puncture needle was adjusted for the situation of brain CT.
After the operation, according to the re-examination of cranial CT, urokinase was injected into the hematoma cavity through the drainage tube to dissolve the residual hematoma, and the operation process strictly followed aseptic operation.
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Check the CT scan of the patient's brain, find out the largest hematoma level of the patient, measure the coordinates of the puncture center, locate and mark the skull surface according to the coordinates obtained from the measurement, select the puncture point under the stereotaxic instrument, and mainly avoid important blood vessels , nerves and functional areas.
Use an electric drill to drill the puncture needle into the center of the hematoma, and slowly aspirate the hematoma from the side hole until the suction stops when there is resistance.
The residual hematoma in CT and the location of the drainage tube were determined, and the position of the puncture needle was adjusted for the situation of brain CT.
After the operation, according to the re-examination of cranial CT, urokinase was injected into the hematoma cavity through the drainage tube to dissolve the residual hematoma, and the operation process strictly followed aseptic operation.
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|
drug treatment group
General treatment: Based on high-level nursing care and close and continuous attention to the patient's vital signs, the patient is instructed to stay in bed continuously, give oxygen, and instruct the patient to avoid emotional agitation, etc. ②Special treatment: use hemostatic drugs, control blood pressure to prevent rebleeding, control blood sugar, control body temperature, anti-epilepsy, prevent infection, dehydration and lower intracranial pressure, etc. Multisystem complications such as tract hemorrhage should be actively managed.
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|
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decompressive craniectomy treatment group
Prior to the procedure, all patients obtained endotracheal intubation under general anesthesia following the informed consent provided by their family members.
Upon identifying the hematoma's location through CT imaging, the surgeon made a linear or horseshoe-shaped incision on the scalp and subsequently opened the dura mater after creating a bone flap.
The hematoma was punctured using a brain needle, allowing for effective decompression.
The cerebral cortex was incised along the cerebral gyri, facilitating the separation of brain tissue to eliminate residual hematoma.
Once hemostasis was ensured within the operative area, a silicone drainage tube was inserted, and the cranial bone flap was restored to its original position.
In cases of severe brain edema or cerebral herniation, bone flap decompression was performed.
|
Prior to the procedure, all patients obtained endotracheal intubation under general anesthesia following the informed consent provided by their family members.
Upon identifying the hematoma's location through CT imaging, the surgeon made a linear or horseshoe-shaped incision on the scalp and subsequently opened the dura mater after creating a bone flap.
The hematoma was punctured using a brain needle, allowing for effective decompression.
The cerebral cortex was incised along the cerebral gyri, facilitating the separation of brain tissue to eliminate residual hematoma.
Once hemostasis was ensured within the operative area, a silicone drainage tube was inserted, and the cranial bone flap was restored to its original position.
In cases of severe brain edema or cerebral herniation, bone flap decompression was performed.
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|
Neuroendoscopic treatment group
The patient's preoperative CT and MR imaging data were fused with a neuronavigation system to avoid important functional areas and select the closest point of the hematoma to the cortex as the location point.
Routine craniotomy was performed with a 2*3 cm bone window, the puncture direction was repositioned by neuronavigation, the sheath was placed at the center of the hematoma, the core was removed, the endoscope was gradually aspirated, and the bleeding was stopped with electrocoagulation if there was considerable active bleeding.
A drainage tube was placed, the bone flap was reset after surgery, and the scalp was sutured.
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The patient's preoperative CT and MR imaging data were fused with a neuronavigation system to avoid important functional areas and select the closest point of the hematoma to the cortex as the location point.
Routine craniotomy was performed with a 2*3 cm bone window, the puncture direction was repositioned by neuronavigation, the sheath was placed at the center of the hematoma, the core was removed, the endoscope was gradually aspirated, and the bleeding was stopped with electrocoagulation if there was considerable active bleeding.
A drainage tube was placed, the bone flap was reset after surgery, and the scalp was sutured.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Hematoma expansion rate 24 hours after onset
Time Frame: 24 hours of onset
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The number of cases with enlarged hematoma after re-examination of head CT after 24 hours
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24 hours of onset
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90-day Modified Rankin Rating Scale score;
Time Frame: 90-day
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Modified Rankin Rating Scale score at 90 days after discharge,0-3 indicates good prognosis, 4-6 indicates poor prognosis, and 6 indicates death.
|
90-day
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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90-day mortality
Time Frame: 90-day
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Proportion of patients who died 90 days after discharge
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90-day
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Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Cerebrovascular Disorders
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Vascular Diseases
- Cardiovascular Diseases
- Pathologic Processes
- Hemorrhage
- Pathological Conditions, Signs and Symptoms
- Intracranial Hemorrhages
- Surgical Procedures, Operative
- Neurosurgical Procedures
- Decompression, Surgical
- Craniotomy
- Decompressive Craniectomy
Other Study ID Numbers
Other Study ID Numbers
- JZSJK0828
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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