FAKTOR RISIKO MATERNAL KEJADIAN HIRSCHSPRUNG-ASSOCIATED ENTEROCOLITIS PRA OPERASI DEFINITIF DI RSUP DR SARDJITO YOGYAKARTA

ANDY INDRA SATI, dr. Gunadi, Ph.D; Dr. dr. Akhmad Makhmudi, Sp.B, Sp.BA

2017 | Skripsi | S1 PENDIDIKAN DOKTER

Latar Belakang: Penyakit Hirschsprung (HSCR) adalah kelainan mega kolon kogenital dimana terjadi pembesaran abnormal kolon karena tidak adanya sel-sel ganglion myenterik pada usus besar segmen distal. Hirschsprung-associated enterocolitis (HAEC) merupakan kondisi inflamasi intestinal yang secara klinis dikarakteristikkan dengan adanya demam, distensi abdominal, diarrhea dan sepsis. Salah satu faktor yang mempengaruhi insidensi HAEC adalah usia ibu saat melahirkan, umur kehamilan dan tingkat pendidikan ibu Tujuan Penelitian: Tujuan penelitian ini adalah untuk Mengetahui insidensi HAEC pra operasi dan hubungan masing-masing faktor dengan kejaidan HAEC di RSUP Dr. Sardjito Yogyakarta. Metode: Penelitian ini merupakan penelitian observasi dengan rancangan studi cross-sectional. Penelitian menggunakan data rekam medis pasien HSCR di RSUP Dr. Sardjito sebelum dilakukan operasi definitif dan sudah dilakukan pemeriksaan histopatologi dalam kurun waktu Januari 2010 sampai Desember 2015. Hasil: Didapatkan 61 subyek penelitian yang memenuhi kriteria inklusi. Didapatkan 45 pasien dengan usia ibu lebih dari 35 tahun, dan 16 pasien dengan usia ibu kurang dari 35 tahun dengan nilai P sebesar 0,358. Didapatkan pula, 56 pasien dengan umur kehamilan cukup bulan, dan 5 pasien dengan umur kehamilan kurang bulan dengan nilai p 1,000. Serta didapatkan 2 pasien tidak sekolah, 10 ibu sekolah dasar, 18 pasien ibu SLTP, 22 pasien ibu SLTA, 4 pasien ibu D-3, 4 pasien ibu S-1, 1 pasien ibu s-3 dengan p value 0,210. Kesimpulan: Tidak terdapat hubungan yang bermakna antara umur ibu saat melahirkan, umur kehamilan dan tingkat pendidikan ibu dengan kejadian HAEC pra operasi.

Background : Hirschsprung Disease (HSCR) is an abnormal congenital colon enlargement, because the absence of Ganglion myenterik cells at most of distal segment. Hirschsprung-associated enterocolitis (HAEC) is an inflammation condition Which clinically described by fever, distended abdomen, diarrhea dan sepsis. One of the risk factor that play role on HAEC incidence is maternal age, which can be seen by the strong association of down syndrome and HSCR, Beside a premature inhibition of migrating process of neural crest. The migrating of neural crest process does have an important role, in addition lack of awareness of the mother due to the educational background also involve in this process also be another factor. Aim : To know the maternal risk of Hirschsprung-Associated Enterocolitis (HAEC) pra operasi definitif and its association with the incidence of HAEC in RSUP Dr. Sardjito Yogyakarta. Method : this research is an observational study with a cross-sectional design. This research use medical record of HSCR patients in RSUP Dr. Sardjito that have been done by the histopathology examination and have not receive any operation in range January 2010 until December 2015. Result: There were 61 subject that comply the inclusion criteria. There were 45 patients with maternal age more than 35, and 16 patients with maternal age below 35 with P value 0,358. And also there were, 56 patients with aterm birth and 5 patients with preterm birth with p value 1,000. And there were 2 patients with uneducated mother background, 10 patients with elementary mother background, 18 patient with junior high school mother background, 22 patients with high school mother background, 4 patient with D-3 mother background, 4 patients with S-1 mother background, 1 patients with s-3 mother background with p value 0,210. Conclusion: There were no significant difference among maternal age with HAEC incidence. There were no significant difference between aterm and preterm birth with HAEC Incidence. And also there were no significant difference between mother educational background with HAEC insidence.

Kata Kunci : Hirschsprung, HAEC, pre-operasi, Materna, usia ibu, umur kehamilan, tingkat penidikan ibu,pre-operative, Maternal, maternal age, gestational age, educational background