PENGARUH PEMBERIAN CAIRAN ISOTONIK PER ORAL SEBELUM PEMERIKSAAN INTRAVENOUS PYELOGRAPHY TERHADAP DENSITAS PELVIS RENIS

Eny Musarifah, dr. Henry Kusumo Husodo, Sp.Rad (K).

2013 | Tesis | S2 Ked.Klinik/MS-PPDS

Intravenous Pyelography (IVP) merupakan pemeriksaan tractus urinaria yang menggunakan sinar-x dengan melakukan suntikan bahan kontras melalui vena. Penggunaan bahan kontras intravaskuler menyebabkan Contrast Induce Nephropaty (CIN). Kondisi yang mempengaruhi terjadinya CIN diantaranya adalah dehidrasi, salah satu strategi mengurangi CIN adalah pemberian hidrasi sebelum pemeriksaan IVP. World Health Organitation (WHO) merekomendasikan cairan isotonic untuk rehidrasi oral. Penilaian systema pelviscalixes ren memerlukan densitas yang optimal. Prosedur persiapan pemeriksaan Intravenous Pyelography yang dilakukan di Instalasi Radiologi RSUP DR. Sardjito salah satunya adalah puasa mulai jam 24.00 wib. Pada penelitian ini diberikan cairan isotonic untuk menghilangkan dehidrasi dengan harapan tidak mempengaruhi densitas foto . Penelitian ini bertujuan menilai pengaruh pemberian cairan isotonik per oral, 500 cc, 30-45 menit sebelum pemeriksaan IVP terhadap densitas pelvis renis. Metode penelitian menggunakan jenis eksperimental, rancangan Randomized Controlled Trial pararel design. Sampel penelitian sebanyak 66 pasien yang di Instalasi Radiologi RSUP Dr. Sardjito pada bulan April – Mei 2012 yang memenuhi kriteria inklusi dan eksklusi. Foto yang terkumpul di ukur densitasnya di Politehnik kementerian kesehatan di Semarang. Data yang terkumpul diolah dengan analisis uji chi_square, nilai kemaknaan p<0,05 Hasil perhitungan statistik dengan chi_square, didapatkan densitas pelvis renis tidak berbeda signifikan pada kelompok subyek yang puasa minimal 8 jam kemudian diberi cairan isotonik per oral, 500 cc, 30-45 menit sebelum pemeriksaan IVP dibandingkan kelompok puasa minimal 8 jam dengan nilai p > 0,05 oleh karena p > 0.05 maka hipotesis diterima Kesimpulan pemberian cairan isotonik per oral 500 cc, 30-45 menit sebelum pemeriksaan IVP menghasilkan densitas yang baik.

Intravenous Pyelography (IVP) is examination of the urinary tract using an X–ray by injection of contrast mediua through a vein. The use of intravascular contrast medium causes Contrast Induced Nephropathy (CIN). Among this conditions that contribute to the incidence of Contrast Induced Nephropathy is dehydration. Therefore, one strategy to reduce CIN is hydration prior to an Intravenous Pyelography examination.The WHO recommends an isotonic solution for oral rehydration. Assessment of the renal pelvis requires an optimal density. The preparatory procedure in an Intravenous Pyelography examination carried out in the Radiology Departement Dr. Sardjito Central General Hospital includes fasting from 24.00 p.m.. In this research an isotonic soluition was given to eliminate dehydration in the hope that it would not affect the density. This study wanted to examine the effect of an isotonic solution taken orally prior 500 cc, 30-40 minutes before intravenous pyelography examination on the density of renal pelvis. The method used in the study was an experimental one, i.e. Randomized Controlled Trial parallel design. The study sample consisted of 66 patients who underwent an Intravenous Pylography examination in the Radiology Department Dr. Sardjito Central General Hospital during April-May 2012 and who had fulfilled the criteria of inclusion and exclusion. The collected photography were measured for their density at Poltekes Kemenkes in Semarang. These data were then processed using chi_square analysis with a signifance value of p<0.05. Statistc calculation using chi_square found there is no significant difference betwen subject who where fasting 8 hours than administrated per oral isotonic solution, 500 cc, 30-45 minutes before IVP examination and subject who where fasting 8 hours before IVP examination with p > 0,05, there for hypothesis was accepted. Therefore, administrated per oral isotonic solution, 500 cc, 30-45 minutes before IVP examinatio resulted in good density.

Kata Kunci : Cairan isotonic, Intravenous Pyelography, Densitas, Pelvis Renis