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Abstrak :
ABSTRAK
Pendahuluan Acute limb ischemia (ALI) adalah kondisi serius yang ditandai dengan penurunan yang cepat dan mendadak dari perfusi tungkai. 1 Di Amerika Serikat insiden Acute leg ischemia diperkirakan terjadi 14 per 100.000 penduduk per tahun, sedangkan Acute arm ischemia seperlimanya. Penyebab utama dari Acute limb ischemia ini lebih dari 90 % adalah thromboemboli. 2 Acute limb ischemia merupakan salah satu tantangan terberat, penilaian awal dan assestment penting, karena kesalahan diagnosis dapat mengakibatkan amputasi pada pasien atau bahkan kematian.

Metode Jenis penelitian ini adalah deskriptif retrospektif. Dilakukan di Rumah Sakit Cipto Mangunkusumo (RSCM), dengan mengumpulkan data rekam medis pada pasienpasien dengan ALI di divisi Vaskuler dan Endovaskuler periode 1 Januari 2009 – 31 Desember 2011. Kriteria inklusi meliputi semua pasien ALI yang sudah didiagnosis secara pasti dan dilakukan tindakan operasi. Kriteria eksklusi meliputi pasien ALI yang tidak memiliki data rekam medis lengkap.

Hasil Dari 32 kasus ALI yang dirawat di Divisi Vaskuler dan Endovaskuler, didapatkan 22 kasus (69 %) laki-laki dan 10 kasus (31 %) perempuan. Usia terbanyak pada kelompok umur 40 – 60 tahun sebanyak 17 kasus (53 %). Untuk penyebab ALI yang paling sering yaitu thrombus sebanyak 19 pasien (59 %). Faktor resiko yang paling sering adalah pasien dengan atherosklerosis sebanyak 18 pasien. Sebanyak 16 pasien (50 %) datang ke RS sudah masuk dalam klasifikasi III ALI. Sebanyak 26 pasien (81 %) terkena pada ekstremitas bawah dan sebanyak 6 pasien (19 %) terkena pada ekstremitas atas. Dari data didapatkan 3 pasien yang meninggal.

Kesimpulan Manajemen terhadap ALI tetap menjadi tantangan, karena melibatkan salah satu jalur keputusan yang paling kompleks dalam operasi vaskuler. Pasien dengan kondisi Acute limb ischemia, sebaiknya dirujuk ke pusat vaskular tanpa di tunda-tunda.

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ABSTRACT
Background Acute limb ischemia (ALI) is a serious condition characterized by rapid and sudden limb perfusion. In the United States the incidence of acute leg ischemia is thought to be 14 per 100,000 population per year, while one-fifth of acute arm ischemia. The main cause of acute limb ischemia is more than 90% are thromboemboli. Acute limb ischemia is one of the toughest challenges, initial assessment important, because misdiagnosis can lead to amputation or even death in patients.

Method The study was a retrospective descriptive. The study was conducted in Cipto Mangunkusumo Hospital (RSCM), by collecting data from medical records of patients with ALI in Vascular and Endovascular Surgery division from 1st January 2009 through 31st December 2011. Inclusion criteria include all ALI patients already diagnosed with certainty and performed surgery. Exclusion criteria include patients with ALI who did not have complete medical records.

Result Of the 32 cases of ALI, 22 cases were found in men and 10 cases were found in women. Age of majority in the age group 40-60 years 17 cases. For the most frequent cause of ALI is thrombus were 19 patients. The most frequent risk factors were as many as 18 patients with atherosclerotic patients. A total of 16 patients came to the hospital already in the classification III of ALI. A total of 26 patients affected the lower extremities and 6 patients affected the upper extremities. Three patients died.

Conclusion Management of the ALI remains a challenge, as it involves one of the most complex decisions pathways in vascular surgery. Patients with acute limb ischemia conditions, should be referred to a vascular center without delay delay.

Abstrak :
ABSTRAK
Keberhasilan proses haemodialisis ditentukan oleh terpenuhinya dosis HD sesuai dengan kebutuhan pasien. Pemberian dosis HD yang sesuai dengan kebutuhan pasien dapat dinilai dari adekuasi atau kecukupan haemodialisis yang dicapai pasien HD. Dengan nilai Qb yang berbeda memberi pengaruh terhadap bersihan ureum yang dicapai. Penelitian ini diharapkan berguna dalam pengaturan dan pemantauan terhadap Qb sehingga dapat mengoptimalkan kecukupan dialisis pasien dan terciptanya kualitas hidup pasien yang lebih baik.

Tujuan :
Penelitian ini diharapkan dapat memberikan gambaran bagaimana korelasi antara Qb dengan adekuasi haemodialisis pada pasien dengan Arterovenous Fistula (AVF) yang matur. Selain itu mengidentifikasi karakteristik pasien (umur, jenis kelamin dan berat badan interdialisis), Qb pasien dengan AVF yang matur, mengidentifikasi adekuasi haemodialisis yang dicapai oleh pasien dengan AVF yang matur, menganalisa korelasi antara Qb dengan adekuasi haemodialisis pada pasien AVF yang matur dan menganalisa korelasi antara faktor perancu dengan adekuasi haemodialisis pada pasien dengan AVF yang matur.

Metode :
Penelitian ini merupakan penelitian kuantitatif dengan pendekatan studi cross-sectional. Hasil tersebut ditulis dalam lembar pengumpulan data. Selanjutnya dilakukan pengolahan data hasil observasi dengan menggunakan penghitungan secara statistik melalui SPSS 20.0. Pengambilan sampel dengan tehnik total sampling yang memenuhi kriteria inklusi. Penelitian dilakukan di Divisi Vaskular & Endovaskular FKUI-RSCM Jakarta dan ruang haemodialisa RSCM dan dilakukan pada bulan September sampai November 2015.

Hasil :
Hasil analisis hubungan antara Qb dengan adekuasi haemodialisis (nilai Kt/V) menunjukkan hasil yang tidak signifikan, dimana p value sebesar 0,227 (p > 0,05). Hasil penelitian ini menyimpulkan bahwa tidak ada hubungan yang bermakna antara Qb dengan adekuasi haemodialisis (p = 0,227).

Kesimpulan :
Tidak ada hubungan yang bermakna antara Qb dengan adekuasi haemodialis (nilai Kt/V). Pada penelitian ini terdapat banyak kekurangan diantaranya penilaian adekuasi haemodialisis hanya dengan melihat hasil Kt/V tanpa dilakukan pengukuran URR. Keterbatan lain yaitu ruang HD RSCM menggunakan membran dialyzer jenis low flux, hal ini tentunya mempengaruhi pencapaian bersihan ureum yang pada akhirnya berpengaruh terhadap pencapaian adekuasi haemodialisis.ABSTRACT
Background: The success of the process is determined by the fulfillment hemodialysis HD dose according to the patient's needs. HD dosing according to patient needs can be assessed from the adequacy or adequacy of hemodialysis patients who achieved HD. Qb different with giving effect to the urea clearance is achieved. This study is expected to be useful in setting up and monitoring of the Qb so as to optimize the adequacy of dialysis patients and the creation of quality of life of patients better. Aim: This study is expected to provide an overview of how the correlation between Qb and adequacy of hemodialysis in patients with Arterovenous Fistula (AVF) that mature. Besides identifying patient characteristics (age, sex and weight interdialisis), Qb patients with AVF were mature, identify the adequacy of hemodialysis achieved by patients with AVF were mature, analyzing the correlation between Qb and adequacy of hemodialysis in patients with AVF were mature and analyzing the correlation Among the factors confounding the adequacy of hemodialysis in patients with AVF were mature. Method: This research is a quantitative approach cross-sectional study. The result is written in the data collection sheets. Furthermore, the data processing of observation results using statistical calculation by SPSS 20.0. Sampling with total sampling technique that met the inclusion criteria. The study was conducted at the Division of Vascular & Endovascular Faculty of medicine-RSCM Jakarta and space Haemodialisa RSCM and conducted from September to November 2015. Results: The results of the analysis of the relationship between Qb and adequacy of hemodialysis (value Kt / V) showed significant results, where the p value of 0.227 (p> 0.05). Results of this study concluded that there was no significant relationship between Qb and adequacy of hemodialysis(p=0.227). Conclusion: There is no significant relationship between Qb and adequacy haemodialis (value Kt / V). In this study, there are many shortcomings including hemodialysis adequacy assessment just by looking at the Kt / V without a measurement of URR. Another Keterbatan namely HD space RSCM use dialyzer membrane type of a low flux, it is certainly affect the achievement of urea clearance which ultimately affect the achievement of the adequacy of hemodialysis.;Background: The success of the process is determined by the fulfillment hemodialysis HD dose according to the patient's needs. HD dosing according to patient needs can be assessed from the adequacy or adequacy of hemodialysis patients who achieved HD. Qb different with giving effect to the urea clearance is achieved. This study is expected to be useful in setting up and monitoring of the Qb so as to optimize the adequacy of dialysis patients and the creation of quality of life of patients better. Aim: This study is expected to provide an overview of how the correlation between Qb and adequacy of hemodialysis in patients with Arterovenous Fistula (AVF) that mature. Besides identifying patient characteristics (age, sex and weight interdialisis), Qb patients with AVF were mature, identify the adequacy of hemodialysis achieved by patients with AVF were mature, analyzing the correlation between Qb and adequacy of hemodialysis in patients with AVF were mature and analyzing the correlation Among the factors confounding the adequacy of hemodialysis in patients with AVF were mature. Method: This research is a quantitative approach cross-sectional study. The result is written in the data collection sheets. Furthermore, the data processing of observation results using statistical calculation by SPSS 20.0. Sampling with total sampling technique that met the inclusion criteria. The study was conducted at the Division of Vascular & Endovascular Faculty of medicine-RSCM Jakarta and space Haemodialisa RSCM and conducted from September to November 2015. Results: The results of the analysis of the relationship between Qb and adequacy of hemodialysis (value Kt / V) showed significant results, where the p value of 0.227 (p> 0.05). Results of this study concluded that there was no significant relationship between Qb and adequacy of hemodialysis(p=0.227). Conclusion: There is no significant relationship between Qb and adequacy haemodialis (value Kt / V). In this study, there are many shortcomings including hemodialysis adequacy assessment just by looking at the Kt / V without a measurement of URR. Another Keterbatan namely HD space RSCM use dialyzer membrane type of a low flux, it is certainly affect the achievement of urea clearance which ultimately affect the achievement of the adequacy of hemodialysis.