超低體重兒與足月適重兒之早期神經行為發展之比較

　　　　　超低體重兒（出生體重低於1001公克）近年來的存活率大幅地提高，因此其早期 評估與治療的工作日顯重要。然而目前為止對其早期的神經行為發展資料非常有限，所以本 研究的目的在比較超低體重兒及足月適重兒早期神經行為發展之狀況。本研究對象為曾住在 臺大新生兒加護病房之18名超低體重兒及18名性別相配的足月適重兒，當其情況穩定且接近 孕後週數40週時接受中文版新生兒神經行為評估，檢查內容包括肌肉張力與動作型態、原始 反射及行為反應三方面。研究結果顯示超低體重兒在中文版新生兒神經行為評估之總分均明顯 較足月適重兒為低（超低體重兒總分為65.8±5.9，足月適重兒總分為73.5±2.8;P＜0.05） 。在單項方面，超低體重兒在腳踝背屈、下滑、俯姿懸空、拉坐、抓握反射及顫抖的單項得 分明顯低於足月適重兒。以上結果顯示超低重兒與足月適重兒之早期神經行為發展在整體上 有明顯的差異，而中文版新生兒神經行為評估可用以有效區辨超低體重兒與足月適重兒早期 之神經行為發展。
　　　　　With the improvement in the survival rate of extremely low-birthweight infants in Taiwan, the medical care of these infants has now gradually focused on early developmental evaluation and management, However, only few studies had been undertaken to examine the early neuromotor performance of extremely low-birthweight infants in Taiwan. Therefore, the purpose of this study was to investigate the neuromotor performance of extremely low-birthweight infants at term post-conceptional age compared with that of normal term infants.Eighteen extremely low-birthweight infants and 18 sex-matched normal term infants who were born at the National Taiwan University Hospital were enrolled. They were examined using the Neonatal Neurobehavioral Examination -Chinese Version（NNE-C）when approaching term post-conceptional age of 40 weeks .The examination consists of three sections:tone and motor pattern, primitive reflexes, and behavioral responses.The results showed that the total scores of the extrmely low-birthweight infants（65.8±5.9）were significantly lower than those of the normal term infants （73.5±2.8）（p＜0.05）.With respect to item scores, the extremely low-birthweight infants showed significantly lower scores than the normal term infants in the ankle dorsiflexion, slip-through,prone sus- pension,grasp and tremor items.Our resultsindicate that the neurobehavioral per- formance of extremely low-birthweight infants in different from that of normal term infants at term post-conceptional age.The NNE-C Scale is valid in discrimi- nating the neurobehavioral performance between extremely low-birthweight infants and normalterm infants.