Application Of Cerebration Ultrasound Combined With Serum D Dimer And Lactate Dehydrogenase In The Diagnosis Of Craniocerebral Injury In Premature Infants Of Different Gestational Ages

Objective:To investigate the diagnostic value of craniocerebral ultrasound combined with serum D dimer and lactate dehydrogenase in craniocerebral injury of premature infants of different gestational ages,in order to provide reference for the clinical treatment of craniocerebral injury of premature infants.,so as to improve the prognosis of children with brain injury.Methods:Methods: 100 premature infants and 100 healthy newborns of different gestational ages admitted to neonatal care unit of Affiliated Hospital of Qingdao University from June 2022 to March 2023 were selected as the subjects of this study.Healthy neonates were included in the control group,and preterm infants of different gestational ages were included in the observation group.At the same time,premature infants in the observation group were further divided according to different gestational age segments(<28weeks :21 cases,28 weeks to 29 weeks: 24 cases,30 weeks to 33 weeks: 27 cases,34 weeks to 36 weeks :21 cases).General clinical data of all neonates(including gestational age,sex,birth weight,neonatal asphyxia,fetal distress,placental abruption,etc.)were collected and analyzed statistically.Craniocerebral ultrasound was performed in both groups.Two-dimensional ultrasound was used to observe intracranial structures.At the same time,bilateral middle cerebralartery(Middlecerebralartery,MCA)blood flow,related hemodynamic parameters including Peak systolic,velocity,PSV,End diastolic velocity,EDV and Resistanceindex were recorded.RI),to compare whether the differences of each parameter were statistically significant among the three groups,and to measure the levels of serum D-dimer(D-D)and lactate dehydrogenase(LDH).The diagnostic results of craniocerebral ultrasound,serum D dimer and lactate dehydrogenase(LDH),incidence of craniocerebral injury,detection rate and accuracy of different detection methods were compared between the two groups.The diagnostic value of craniocerebral ultrasound combined with serum D dimer and lactate dehydrogenase for craniocerebral injury of premature infants of different gestational ages was discussed.Results:(1)There was no significant difference in general clinical data between the two groups(P>0.05),which could be used for comparison in this study;(2)The neonates in both groups were examined by craniocerebral ultrasound,and the results showed no obvious abnormal phenomenon in the control group.Craniocerebral injury occurred in 74 patients in the observation group.Among them,the incidence of craniocerebral injury in premature infants <28 weeks of gestational age was significantly higher than that in other gestational age groups,the difference was statistically significant(P <0.05).(3)The EDV and PSV levels in the observation group were lower than those in the control group,and RI levels were higher than those in the control group,with statistical significance(P <0.05).At the same time,the above indexes were also different among preterm infants of different gestational ages in the observation group.The levels of EDV and PSV increased with the increase of gestational age of preterm infants,and RI decreased with the increase of gestational age of preterm infants,with statistical significance(P<0.05).(4)The levels of D-D and LDH in observation group were significantly higher than those in control group.At the same time,in the observation group,with the increase of gestational age,D-D and LDH levels of preterm infants decreased significantly,with statistical significance(P<0.05).(5)Logistic regression analysis showed that decreased GCS,larger hematoma volume and increased serum D-D and LDH levels were independent risk factors for poor prognosis of the children(all P<0.05).(6)According to statistical comparison,the detection rate and accuracy of craniocerebral injury of premature infants at different gestational ages were significantly higher than that of single method,with statistical significance(P<0.05).ROC curve showed that compared with single method detection,craniocerebral ultrasound combined with serum D dimer and lactate dehydrogenase detection had the highest area under curve(AUC)value,the highest diagnostic sensitivity and specificity,which were 95.08% and94.23%,respectively.Conclusion:(1)Craniocerebral ultrasound detection based on color Doppler technology can conduct real-time monitoring of intracranial blood flow in newborns,which has high clinical diagnostic value in craniocerebral injury of premature infants of different gestational ages;(2)craniocerebral ultrasound combined with serum dimer and lactate dehydrogenase can help to improve the detection rate and accuracy of craniocerebral injury in premature infants of different gestational ages,with higher diagnostic value and worthy of clinical promotion.