Hubungan antara kriteria mayor dengan reseksi usus pada invaginasi

AUTHOR, Husnul, dr. Akhmad Makhmudi, Sp.B.Sp.BA

2010 | Tesis | S2 Ilmu Bedah

Latar Belakang : Kasus invaginasi merupakan kasus kegawatan pada bagian bedah anak yang biasanya datang ke rumah sakit dalam kondisi yang sudah berat atau complicated. Pengenalan diagnosis dan penatalaksanaan dini invaginasi dapat mengurangi angka morbiditas dan mortalitas penderita invaginasi. Metode Penelitian : Metoda yang digunakan adalah penelitian crossectional observasional dengan analisis statistik dengan uji Fisher dengan menggunakan data sekunder dari rekam medis penderita invaginasi bayi dan anak yang dirawat di RS.Dr.Sardjito Yogyakarta pada kurun waktu bulan Juni 2002 sampai November 2009 yang kemudian diolah dan dibuat diskripsi tentang pemeriksaan yang dilakukan. Variabel yang diteliti adalah kriteria mayor yaitu obstruksi intestinal, invaginasi intestinal dan intestinal vasculare compromise atau venous congestion kemudian dinilai variabel mana yang bermakna secara statistik sebagai faktor resiko terhadap reseksi usus. Hasil : Dari bulan Juni 2002 sampai dengan bulan November 2009 telah dirawat sebanyak 60 penderita invaginasi bayi dan anak, 13 pasien terekslusi karena 10 pasien rekam medis tidak lengkap,2 pasien operasi diluar RS Dr. Sardjito dan 1 pasien menolak operasi. Insidensi lebih banyak terjadi pada laki-laki sebanyak 27 kasus (57,4 %) dengan penderita invaginasi laki-laki usia < 1 tahun 17 kasus (36,2 %). Dari kriteria mayor :obstruksi intestinal 11 kasus (23,4%),invaginasi intestinal 36 kasus (76,6%), intestinal vasculare compromise 47 kasus (100%). Dari ke 47 kasus (100%) tersebut dilakukan tindakan operatif berupa laparotomi milking dan 20 kasus (42,6%) dilakukan tindakan reseksi. Dari kriteria mayor: obstruksi intestinal ,invaginasi intestinal , intestinal vasculare compromise secara uji statistik terhadap dilakukannya reseksi usus diperoleh p = > 0,05. Kesimpulan : Telah dilakukan penelitian pasien invaginasi bayi anak mulai bulan Juni 2002-November 2009 yang sudah dirawat di RS Dr Sadjito , secara statistik kriteria mayor : obstruksi intestinal ,invaginasi intestinal , intestinal vasculare compromise secara statistik tidak ada hubungan yang bermakna terhadap dilakukannya reseksi usus

Background: Invagination is the case of the gravity of cases of surgery on children who normally come to the hospital in a condition which is heavy or complicated. Introduction of early diagnosis and treatment of invagination can reduce morbidity and mortality of patients with invagination. Research Methods: The methods used are cross sectional observational study with statistical analysis by Fisher test using secondary data from medical records of patients with invagination infants and children hospitalized in RS.Dr.Sardjito Yogyakarta during the period from June 2002 to November 2009 which was then processed and made descriptions of audit performed. The variables studied were the major criteria of intestinal obstruction, intestinal invagination and vasculare compromise or venous congestion then assessed which variables are statistically significant as a risk factor for bowel resection. Results: From June 2002 until November 2009 has treated as many as 60 patients with invagination infants and children, 13 patients exclusion because 10 patients incomplete medical records, two patients outside the surgery of Dr. Sardjito hospital and one patient refused surgery. The incidence is more common in men as much as 27 cases (57.4%) with male invagination patients age <1 year 17 cases (36.2%). Of the major criteria: 11 cases of intestinal obstruction (23.4%), intestinal invagination 36 cases (76.6%), intestinal compromise vasculare 47 cases (100%). Of the 47 cases (100%) was made operative action in the form of laparotomy milking and 20 cases (42.6%) resection had been done. Of the major criteria: intestinal obstruction, intestinal invagination, intestinal vasculare compromise the statistical test to do bowel resection was obtained p => 0.05. Conclusion: Invagination patients has been studied infant child starting in June 2002-November 2009 which have been treated in Dr Sadjito hospital, statistically major criteria: intestinal obstruction, intestinal invagination, intestinal compromise vasculare no statistically significant relationship to bowel resection done

Kata Kunci : Invaginasi,Kriteria mayor,Reseksi