Spontaneous cerebral hemorrhage
Conditions
Interventions
Experimental group:Preventive anticoagulation therapy should be initiated within 24-48 hours after the surgery: subcutaneous injection of low molecular weight heparin (4100 IU per dose), once a day (q
Control group:Conventional preventive chemical anticoagulation is not carried out.
Sponsors
Chengdu Medical College Clinical Medical College · First Affiliated Hospital
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Inclusion criteria
Inclusion criteria: 1. Age: 18 - 80 years old; 2. Diagnosed with spontaneous intracerebral hemorrhage through imaging examination; 3. The patient's GCS score was >= 4 at 24 - 48 hours after surgery, and the vital signs were stable during this period; 4. Met the consistent surgical indications as per the ESO/EANS 2025 guidelines and underwent the surgery: A: Supratentorial lobar ICH (GCS 5 - 14 points), onset 15 mL or progressive neurological deterioration, and/or brainstem compression, and/or obstructive hydrocephalus. Completed posterior cranial fossa hematoma evacuation surgery, and could be combined with external ventricular drainage; 5. Complete head CT examination 6 hours after surgery. Recheck head CT at 24 + 6 hours (before medication), and if there is no recurrent hemorrhage or the increase in the bleeding focus is less than 33% or 5 mL of the previous CT volume, it is considered a stable lesion; 6. Complete duplex Doppler ultrasound of the lower extremities veins within 24 - 48 hours after surgery, and no baseline DVT was found; 7. The patient or the family member signed a written informed consent form.
Exclusion criteria
Exclusion criteria: 1. Patients with active intracranial hemorrhage as indicated by a CT scan within 24 hours after surgery; 2. Patients with previous VTE events; 3. Patients with severe coagulation dysfunction: 1). Genetic diseases: hemophilia, von Willebrand disease, hereditary coagulation factor deficiency (such as hereditary factor VIII deficiency); hereditary fibrinogen deficiency; hereditary thrombocytopenia, hereditary giant platelet syndrome; 2). Acquired diseases: severe liver (Child-Pugh grade C) and kidney (serum creatinine > 451 µmol/L) dysfunction; disseminated intravascular coagulation (DIC); hematological malignancies: acute leukemia, lymphoma, multiple myeloma; autoimmune diseases: systemic lupus erythematosus, idiopathic thrombocytopenic purpura, allergic purpura, autoimmune hemolytic anemia; 4. Platelet count lower than 100×10^9/L or coagulation dysfunction; 5. Death or unplanned secondary surgery within 24-48 hours after surgery; 6. Patients who have received long-term therapeutic anticoagulation before admission and are assessed to need to resume therapeutic anticoagulation or undergo therapeutic bridging within 7 days after surgery; 7. Patients with active bleeding from activities such as bronchial dilation, hemorrhoids, esophageal and gastric fundus varices; 8. Patients with contraindications or intolerance to anticoagulant drugs; 9. Patients with poor compliance and unable to complete the study requirements; 10. Patients who cannot be weaned off the ventilator within 6 hours after surgery.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| VTE composite events within 7 days;Any intracranial hemorrhage occurs;Ninety days after discharge;90-day modified Rankin Scale (mRS) score; | — |
Secondary
| Measure | Time frame |
|---|---|
| ISTH (International Society for Thrombosis and Hemostasis) major bleeding and any bleeding events;All-cause deaths within 90 days; | — |
Countries
China
Contacts
Public ContactXun Xia
Chengdu Medical College Clinical Medical College · First Affiliated Hospital
Outcome results
None listed