Hasil Pencarian  ::  Simpan CSV :: Kembali

"Penelitian ini merupakan uji klitis paralel, membandingkan kelompok yang mendapat terapi gizi adekuat pascabedah (P) denga:n kelompok yang mendapatkan diet standnr RSUPNCM (K),Sebanyak 17 pasien pascabedah dige.stif yang dirawat di rua:og perawatan bedah kelas III RSUPNCM yang memenuhi kriteria dibagi dalam dua kelompok secara randomisasi blok. Data yang dlambil dari catatan medik pada awal perlal."UM meiiputi usijenis keiamin, lama operasi. jenis opemsi skor ASA, dan jumlah perdaran. Data asupan energi dan protein dengan food recorcL pemeriksaan antropometri (BB. PB dan IMT), dan laboratorium (kadar GDS dau MDA plasma) dilekukan padn awal dan akbir perlakuan. Anal isis data menggunakan uji t tidak berpasangan dan uji Mann Whitney dengan batas kemaknaan 5%.Sebanyak 9 orang kelompok P dan 8 orang kelompok K dengan rata rata usia 38,82±10,89 tahun mengil"Uti penelitian secara lengkap. Jenis opcrasi terbanyak yang dijalani subyek adalah reseksi-anastomosk Lama operasi :subyek perlakuan tergolong lama dan subyek kontrol tergolong singkat. Jumlah perdar.ahan tergolong sedikit. Data awal tidak menunjukkan pcrbedaan bermakna (p> 0,05). Setclah -enam hari perlakuan, didapatkan persentase asupan energi dan protein diba:ndingkan kebutuhan total termasuk kategori adekuat pada kelompok perlakuan dan tidak adekuat pada kelompok kontrol, dan perbedaan ini berm.akna (p<0,05). Pada kedua kelompok didapatkan peningkatan kadar ODS plasma yang lebih tinggi pada kelompok kontrol, namun secara statistik tidak bermakna (p> 0,05). Pada kelompok perlakuan terdapat pcnurunan kadar MDA plasma sedangkan pada kelompok kontrol terdapat peningkatan MDA plasma, meskipun secara statistik tidak berrnakna (p>0,05).Pada kedua kelompok didapatkan peningkatankadar GDS plasma yang lebih tinggi pada kelompok kontrol, namun secara ststistik tidak bermakna serta didapatkan penurunan MDA plasma pada kelompok perlakuan penelitian ini memperlihatkan terapi gizi dapat memperbaikistres metabolik dan oksidatif dibandingkan tanpa terapi gizi.

---

The study was a parallel randomized clinical trial which compared the treatment group received postoperative adequate nutrition therapy (P) and tbe control group received hospital standard diet {K). Seventeen subjects postoperative digestive surgery admitted to Surgery Ward of Dr. Cipto Manguukusumo Hospital woeful filled the study criteria, were divided into two groups using block randomization. Data collection taken from medical record at the beginning of intervention were age, gender, duration of surgery, type of surgery, ASA score, and the amount of blood loss during surgery. Data of energy, and protein intake using food record, anthropometric (body weight, body Jength, and body mass index); and laboratory findings (plasma glucose and malondialdehyde levels) were done before and after intervention. For statistical analysis, unpaired t-test and Mann W1Iitney were used. The level of significance was 5%.Nine subjects in the treatment group and eight subjects in the control group whose mean of age is 38.82±10.89 years old completed the study. The most type of surgery was resection-anatomists. The duration of surgery "'as categorized as longtime in P and shortish inK groups. The amount of blood loss during surgery was little for both groups. The characteristic of the two groups were closely matched at base line (p> 0.05). After six days intervention. the percentage of energy and protein intake in treatment group were adequate in appropriate to the requirement, and these were statistically significant compared to control group (p<0.05). There were increase of plasma glucose levels in both groups which was higher in control group, however the increase wns not statisticaHy significant (p>0"05). Plasma levels of MDA were decrease in treatment group while in control group were increase eventhough the changes between the two groups were not ststitical significant (p>0.05). There were increase of plasma glucose level which was higher in the control group, although has not statistically significant, and there were decrose of plasma MDA levels in treatment group. This study revealed that nutrition therapy can improve metabolic and oxidative stress better than those without nutrition therapy."

"ABSTRAKLatar belakang: Penggunaan antibiotik profilaksis bedah bertujuan untuk mencegah infeksi daerah operasi pada pasien yang dianggap mempunyai risiko tinggi. Meskipun kebijakan penggunaan antibiotik profilaksis dalam operasi telah ditetapkan, masih terdapat penggunaan yang tidak sesuai yang dapat menyebabkan peningkatan risiko resistensi antibiotik dan peningkatan biaya perawatan di rumah sakit.Tujuan: Mengevaluasi ketepatan penggunaan antibiotik profilaksis serta efisiensi biaya penggunaan antibiotik profilaksis pada pasien bedah digestif di RSUPN-CMMetode: Penelitian ini merupakan studi retrospektif. Data sekunder diambil dari rekam medik pasien rawat inap Departemen Bedah RSUPN-CM selama periode Januari hingga Desember 2015. Pada penelitian ini 102 pasien yang mendapatkan antibiotik profilaksis dievaluasi berdasarkan panduan NHS Lanaskhire untuk ketepatan dosis dan waktu pemberian pada tindakan pembedahan dan panduan antibiotik profilaksis divisi bedah digestif RSUPN-CM untuk pemilihan antibiotik berdasarkan indikasi tindakan.Hasil: Dari 102 pasien penelitian 81,4 pasien mendapatkan antibiotik profilaksis dengan indikasi sesuai tindakan dan 90,8 pasien mendapatkan antibiotik profilaksis tepat dosis. Berdasarkan ketepatan waktu pemberian antibiotik profilaksis, sebanyak 52 pasien mendapatkan antibiotik profilaksis tepat waktu 30 menit . Sementara itu, pasien yang mendapatkan antibiotik profilaksis lebih dari satu dosis yang berarti bukan lagi profilaksis sebanyak 15,7 . Tambahan biaya obat akibat pemberian antibiotik profilaksis yang tidak sesuai pedoman sebesar Rp. 16.016.007,-.Kesimpulan: Hasil penelitian menunjukkan masih adanya penggunaan antibiotik profilaksis yang tidak sesuai pedoman pada pasien bedah digestif RSUPN-CM. Pemberian antibiotik profilaksis yang tidak sesuai pedoman dapat menyebabkan peningkatan biaya perawatan rumah sakit. Diperlukan upaya untuk meningkatkan kepatuhan terhadap pedoman yang digunakan.hr>b>ABSTRACT"Background Prophylactic antibiotic is used to prevent surgical wound infections in surgery patients who are considered to have high risk of contamination. Despite established guideline, some studies reported inappropriate use of prophylactic antibiotic which potentially increase the risk of antibiotic resistance and hospitalization cost.Aim To evaluate the appropriateness and cost of prophylactic antibiotic usage in digestive surgery patients at Cipto Mangunkusumo hospital.Methods This was a retrospective study conducted on digestive surgery patients. Secondary data were collected from medical records of hospitalized patients in Surgery Department of Cipto Mangunkusumo hospital during the periode January to Desember 2015. In this study, 102 patients receiving prophylactic antibiotics were evaluated based on NHS Lanaskhire guideline for dosage and timimg in accordance with surgical types and guideline of digestive surgery division Cipto Mangunkusumo hospital for antibiotic selection.Results In 102 patients 81,3 patients received prophylactic antibiotics with appropriate indications and 91,2 patients received prophylactic antibiotics with appropriate doses. While 52 patient received prophylactic antibiotic with appropriate timing of 30 minutes. Meanwhile, patients that received prophylactic antibiotics more than once, which means not prophylactic anymore, were accounted for 15,7 . The estimated extra cost due to of inappropriate use of prophylactic antibiotics was Rp. 16.016.007, .Conclusion The results showed that inappropriate use of antimicrobial prophylaxis was still found in digestive surgery Cipto Mangunkusumo hospital and it increased drug cost. The most frequent inappropriateness was the timing of administration followed by inappropriate indication and dose. More work is needed in order to increase the adherence to the guidelines. "

"Pembangunan pesat yang terjadi di daerah perkotaan membawa berbagai dampak, termasuk dampak terhadap kesehatan. Salah satu dampak terhadap kesehatan adalah meningkatnya jumlah pasien bedah yang membutuhkan operasi. Tahun 2016, 11 dari seluruh penyakit di dunia dapat diselesaikan dengan prosedur pembedahan dan 84 diantaranya adalah kasus pembedahan pada anak. Indonesia, khsususnya di RSUPN Dr. Cipto Mangunkusumo selaku salah satu pusat rujukan bedah anak nasional, lebih dari setengah pasien anak yang dirawat sepanjang tahun 2016 merupakan pasien bedah pencernaan. Tindakan pembedahan biasanya akan disertai keluhan nyeri pasca operasi.Penelitian ini dilakukan untuk menganalisis manajemen nyeri non-farmakologis pada anak pasca pembedahan digestif. Metode yang digunakan adalah laporan kasus asuhan keperawatan yang dilakukan pada dua orang anak yang berbeda dengan intervensi utama teknik distraksi audio visual menggunakan kacamata virtual reality VR dan tanpa menggunakan kacamata VR. Hasil evaluasi selama 4 hari dilakukan manajemen nyeri non-farmakologis menunjukkan bahwa teknik distraksi audio visual menggunakan kacamata VR lebih efektif dibandingkan tanpa menggunakan kacamata VR.

---

Urban developmental have so many effects, including the health. One of the effects is increasing number of surgical patients. In 2016, 11 of all diseases in the world can be solved by surgical procedures and 84 of them are surgical cases in children. Indonesia, especially in Dr. Cipto Mangunkusumo as one of the nation 39;s largest childcare referral centers, more than half of the pediatric patients treated during 2016 are gastrointestinal patients. Surgery usually will be accompanied by postoperative pain management.

This study was conducted to analyze the management of non-pharmacological pain in children after digestive surgery. The method used is case report based on nursing care were gived to two different children with a major intervention of audio visual distraction techniques using virtual reality VR glasses and without the use of VR glasses. The evaluation after 4 day intervention with non-pharmacologic pain management showed that audio visual distraction technique using VR glasses was more effective than without using VR glasses."

"ABSTRAKKasus bedah digestif merupakan masalah yang banyak dijumpai terutama pada pasien bedah anak dengan tatalaksana prosedur pembedahan. Salah satu masalah keperawatan yang muncul pada fase pascaoperasi adalah masalah nyeri akut. Nyeri yang tidak tertangani dapat menimbulkan komplikasi pascaoperasi serta memperlama hari perawatan anak. Perawat berperan penting dalam melakukan manajemen nyeri nonfarmakologi. Salah satu contoh intervensi manajemen nyeri adalah stimulasi kutaneus. Teknik ini bertujuan untuk mengalihkan perhatian anak pada rangsangan taktil yang diberikan serta menghambat proses transmisi dan persepsi nyeri sehingga dapat menurunkan skala nyeri anak. Teknik ini bersifat mudah dan tidak memiliki efek samping. Tujuan dari penulisan karya ilmiah ini adalah untuk memberikan gambaran mengenai proses asuhan keperawatan pada anak pascaoperasi bedah digestif serta penerapan tatalaksana nonfarmakologi stimulasi kutaneus aplikasi dingin dalam menurunkan nyeri luka pascaoperasi. Evaluasi intervensi setelah lima hari perawatan disimpulkan bahwa penggunaan kompres dingin dapat memenuhi kriteria hasil yang diinginkan pada masalah keperawatan nyeri akut pascaoperasi.

---

ABSTRACTDigestive surgical case is a common problem, especially in child surgical patients with surgical procedures. One of the nursing problems that arise in postoperative phase is acute pain. Pain that is not handled adequately can cause postoperative complications and prolong the day of child care. Nurses play an important role in the management of non-pharmacological pain. One example of pain management interventions that can be done is cutaneous stimulation. This technique aims to divert the child 39;s attention to the tactile stimuli provided and inhibits the transmission process and pain perception so as to decrease the pain scale of the child. This technique is easy and has no side effects. This scientific paper is aimed to provide an overview of nursing care post operation in children with digestive surgery case as well as to provide an overview of the effect of non-pharmacological application of cutaneous stimulation of cold application in reducing postoperative wound pain. The results of the intervention after five days of treatment concluded that the use of cold application could meet the desired outcome criteria in acute postoperative pain nursing problems."

"Pendahuluan. Tiroidektomi total merupakan prosedur baku pada penanganan keganasan tiroid maupun kelainan jinak tiroid yang gagal pengobatan. Namun sering terjadi komplikasi hipokalsemia akibat cedera kelenjar paratiroid. Upaya untuk mengurangi komplikasi tersebut telah banyak dilakukan, namun komplikasi hipokalsemia tetap tinggi. Banyak faktor dapat menimbulkan hipokalsemia pasca tiroidektomi total telah diteliti di seluruh dunia. Di RSCM sejauh ini belum ada studi yang terfokus pada faktor-faktor yang memengaruhi kejadian hipokalsemia pasca tiroidektomi total.Metode. Studi potong lintang dilakukan pada subjek yang menjalani tiroidektomi total dan completion pada periode Januari 2013 ? Desember 2015 di Divisi Bedah Onkologi FKUI/RSCM. Faktor yang memengaruhi hipokalsemia diketahui melalui telusur rekam medis.Hasil. Dari 250 subjek (33 laki-laki, 217 perempuan) dilakukan tiroidektomi total (197 subjek) dan completion (53 subjek). Diperoleh prevalensi hipokalsemia 39,6%. Rerata usia subjek 44,2 tahun. Ukuran tumor tiroid lebih besar dari 4 cm pada 161 subjek (64%). Metastasis KGB pada 56 subjek (26,8%). Histopatologik tiroid ganas pada 209 subjek (83,6%). Diseksi leher dilakukan pada 56 subjek (22,4%). Operator junior sebagai operator utama pada 129 subjek (51,6%). Rata-rata Lama rawat 4,85±2,2 hari bila timbul hipokalsemia. Mayoritas (70,7%) penurunan kalsium serum terjadi pada hari pertama pascaoperasi. Gejala hipokalsemia ringan pada 82 subjek (82,8%). Hanya 1% yang mengalami hipokalsemia berat. Analisis statistik menunjukkan diseksi leher dan operator junior merupakan faktor risiko yang bermakna (nilai P. 0,027 dan nilai P. 0,002).Kesimpulan. Prevalensi hipokalsemia pasca tiroidektomi total sebesar 39,6%. Faktor yang berisiko menyebabkan hipokalsemia pascaoperasi tiroidektomi total adalah dilakukan diseksi leher dan operator junior.

---

ABSTRACTIntroduction: Total thyroidectomy is a standard procedure in the treatment of thyroid malignancies and benign thyroid disorder treatment failures. The most frequently complication of total thyroidectomy is hypocalcemia due to injury to the parathyroid glands. Efforts to reduce these complications has been widely applied, but the complication rate is still high. Many factors could cause hypocalcaemia recognizable after total thyroidectomy has been investigated throughout the world. In the Faculty of medicine / RSCM no study has focused on the factors that influence the incidence of hypocalcemia after total thyroidectomy.Methods: A cross-sectional study was conducted by taking medical record data subjects who have undergone total thyroidectomy and completion operations in the period January 2013 - December 2015 in the Division of Surgical Oncology Faculty of Medicine / RSCM. The factors that affect hypocalcemia identified through a search of medical records.Results: Of the 250 subjects (33 male, 217 female) with thyroid tumor action has been taken total thyroidectomy (197 subjects) and completion (53 subjects). Hypocalcemia prevalence of 39.6%. The mean age of subjects was 44.2 years. 64% (161 subjects) to measure thyroid tumors larger than 4 cm. 26.8% (56 subjects) had metastatic lymph nodes. 83.6% (209 subjects) with malignant thyroid tumors. 22.4% of the subjects underwent neck dissection. 51.6% (129 subjects) surgery performed by a junior operator. The average length of stay was 4.85 ± 2.2 days in case of hypocalcaemia. The majority (70.7%) decrease in serum calcium occur on the first day after surgery. 82.8% (82 subjects) experienced mild symptoms of hypocalcemia. Only 1% experiencing severe hypocalcemia. Factors that cause the risk of hypocalcemia is performed neck dissection and junior operator.Conclusion: The prevalence of post-thyroidectomy hypocalcemia total of 39.6%. These risk factors cause postoperative hypocalcemia total thyroidectomy was performed neck dissection and junior operator.Keywords: Total thyroidectomy; completion; hypocalcemia; parathyroid glands."