Uji Faal Paru pada Penderita Tuberkulosis Paru pasca pengobatan dengan strategi Dots di BP4 Yogyakarta

SUTANTO, Hani Mustikawati, Prof.dr. Soesanto Tjokrosonto, MSc.,PhD

2004 | Tesis | S2 Ilmu Kedokteran Tropis

Latar belakang: Penyakit tuberkulosis (TB) merupakan masalah kesehatan terpenting didunia yang terus meningkat angka kejadiannya. Pasca pengobatan Tuberkulosis paru, terjadi perubahan struktur paru yang bersifat menetap serta bervariasi yang menyebabkan kelainan faal paru. Pemeriksaan faal paru sederhana dapat membantu menentukan gangguan faal paru yang bersifat restriksi, obstruksi maupun campuran pada penderita Tuberkulosis paru pasca pengobatan. Tujuan: Tujuan penelitian ini adalah untuk mengetahui penurunan faal paru pada penderita TB paru yang telah selesai menjalani pengobatan dengan strategi DOTS. Rancangan penelitian: Rancangan yang digunakan pada penelitian ini adalah Observasional dengan rancang bangun cross sectional. Metode: Lokasi penelitian di BP4 Yogyakarta, selama lima setengah bulan. Selama penelitian didapat 81 penderita TB paru yang dinyatakan selesai pengobatan (sembuh atau pengobatan lengkap), 6 penderita tidak diikutkan penelitian karena tidak memenuhi kriteria inklusi. Ana lisa hasil penelitian dengan uji korelasi, uji kai kwadrat, multivariate serta uji t. Hasil: Pasca pengobatan TB paru hasil pemeriksaan faal paru menunjukkan kelainan campuran restriksi obstruksi, kelainan restriksi merupakan kelainan yang dominan. Status gizi serta hasil pemeriksaan ronsen pasca terapi secara statistik bermakna berpengaruh terhadap hasil pemeriksaan faal paru (p<0,05). Hasil pemeriksaan KV, KVP dan VEP1 pasca pengobatan mengalami penurunan secara bermakna ( p< 0,05) dibanding angka standar faal paru Indonesia (Pneumobile). Berat badan penderita rata rata pasca pengobatan mengalami kenaikan sebesar 4,21 kg yang secara stasistik bermakna dibanding sebelum pengobatan (p<0,05). Kesimpulan: Pasca pengobatan TB paru dengan strategi DOTS pada pemeriksaan faal paru terdapat penurunan KV, KVP dan VEP1. Kelainan faal paru yang dominan adalah restriksi dan campuran restriksi obstruksi. Berat badan penderita pasca pengobatan mengalami peningkatan berat badan yang bermakna dibanding sebelum pengobatan.

Background : Tuberculosis is the most important health problem in the world and the number of the incidence rate is increasing. In post medication of Lung Tuberculosis, there is a change of the lung structure which is permanent and varies. This change causes the disparity of lung function. A simple inspection of lung function can help to determine the problem related to lung function which is either restrictive, obstructive or both for the patients at the post medication of Pulmonary Tuberculosis. Objective : The objective of the research is to find out the reduction of lung function at patients of Pulmonary Tuberculosis who have undergone the medication using DOTS strategy. Study design : The design which was used in this research was observational using cross sectional design. Material and methods : The location of the research was in BP4 Yogyakarta. It was conducted for five and half month. There were 81 patients of Pulmonary Tuberculosis who have finished having medication and recovered. 6 patients were not involved in this research since they did not fulfill inclusion criteria. The analysis of the research result was using correlation test, chi square test, multivariate, and also t-test. Result : In post medication of Pulmonary Tuberculosis, the result of the lung function inspection showed that there was a disparity of both restrictive and obstructive and the restrictive disparity was dominant one. Body mass index and also inspection x-ray post medication showed that, statistically significant, it affected on the result of the inspection of pulmonary function (p<0,05). The result of VC, FVC, and FEV1 inspection (post medication) was decreasing (p<0,05); compared to the standard number of Pneumobile. The body weight of patients who have finished having medication increased up to 4,21 kilogram on average; which was statistically, significant compared to pre medication (p<0,05). Conclusions : There was reduction of VC, FVC and FEV1 on post medication of lung tuberculosis using DOTS strategy at the inspection of lung function. The dominant lung function was restriction and the mixture of restriction and obstruction. The body weight of patients increased significantly if it was compared to pre medication

Kata Kunci : Kedokteran Tropis,Penyakit Tb Paru,Pengobatan DOTS,Uji Faal Paru, Tuberculosis, lung function, and DOTS.