Aiming at the puncture and drainage of clinical intracranial hematoma, we proposed an adaptive bifurcation algorithm based on the hematoma point cloud and optimized the design of the drainage tube. Firstly, based on the CT data of intracranial hematoma patients, a three-dimensional hematoma model was established, the point cloud on the surface of the hematoma was extracted and simplified, and the location of the main drainage tube was located by using the long-axis extraction algorithm. Secondly, the Eight Diagrams algorithm was used to identify the internal point cloud of hematoma, and the positions of multiple absorption points were determined by the K-means clustering algorithm. The locations of the bifurcation points of the main drainage tubes were calculated by the numerical method, and the telescopic lengths and directions of multiple subdrainage tubes were obtained. Finally, connect the main tube and the subtube, design an adaptive bifurcation drainage tube model, and apply it to intracranial hematoma puncture and drainage surgery. The algorithm can accurately determine the puncture point, puncture path, number, and location of subdrainage tubes according to the geometric characteristics of hematoma, achieve a uniform and accurate dose adjustment and drainage of intracranial hematoma, and accelerate the dissolution and drainage speed. The application of an adaptive bifurcation drainage tube can significantly reduce the risk of intracerebral hemorrhage, intracranial infection, and other complications, which has certain guiding significance and application value in clinical practice.