癲癇兒童的生酮飲食照護經驗

Nursing Care Experience for an Epileptic Child on Ketogenic Diet

生酮飲食可以使人體產生有如在飢餓狀態下的生化變化造成酮症(ketosis)，有助於改善癲癇發作(Berryman, 1997)。本文藉由文獻查證及生酮飲食之照護經驗提出分享。張小弟11歲，因無法以多種抗癲癇藥物控制癲癇，一年前開始接受生酮飲食併用抗癲癇藥物治療。此次適逢張小弟減藥期間，癲癇發作頻率增加而住院。住院期間張小弟的的健康問題為，尿酮值不明原因的低於醫療目標。經由此次護理經驗得到啟示有：(1)廚房工作人員必須接受治療飲食的在職教育，且須在營養師的督視下準備治療飲食。(2)護理個案時，護士需負起評值個案接受治療飲食的情形。

The ketogenic diet induces biochemical changes similar to those that occur in starvation. Such changes results in ketosis and have the potential to improve epilepsy control (Berryman, 1997). The purposes of this case report were to conduct a literature review related to ketogenic diet and to share the nursing care experience with others. An eleven-year-old child whose medications failed to control his seizures was started on a ketogenic diet one year prior to admission. The child was admitted due to the potential for increased frequency of seizures while medications were reduced. During hospitalization, the ketone bodies range value was less than normal with cause unknown. Two important findings of this literature review and care experience were (1) under supervision of dietitians, workers in the kitchen need to receive continued education and training in preparation of therapeutic diets and (2) nurses need to regularly assess the condition of patients' who are on therapeutic ketogenic diets.