[ABSTRAK
Ulkus peptikum perforasi merupakan salah satu kasus bedah gawat darurat yang cukup sering di RSCM. Perkembangan medikamentosa dalam tatalaksana ulkus peptikum telah berkembang pesat sehingga menurunkan angka tindakan bedah secara elektif. Studi ini bertujuan untuk melihat karakteristik dan faktor risiko pasien dengan morbiditas dan mortalitas ulkus peptikum perforasi. Seluruh pasien ulkus peptikum perforasi yang dilakukan tindakan pembedahan emergensi di Instalasi Gawat Darurat Rumah Sakit Cipto Mangunkusumo periode Januari 2006 sampai dengan Maret 2012 dievaluasi secara retrospektif. Empat puluh delapan pasien ulkus peptikum perforasi telah dilakukan tindakan pembedahan di IGD RSCM yang terdiri dari 36 pasien laki-laki dan 12 pasien perempuan dengan usia berkisar antara 17 ? 97 tahun. Faktor risiko terbanyak adalah pemakaian obat-obatan ulserogenik (NSAID dan jamu) sebanyak 70.83%. Sebanyak 52.08% pasien dengan ulkus peptikum perforasi datang dengan keluhan yang dirasakan >24 jam dengan rerata durasi 42 jam. Lokasi perforasi tersering adalah prepilorus sebanyak 66.7% dengan median diameter perforasi 10 mm. Tindakan tersering yang dilakukan adalah penjahitan primer dengan omental patch sebanyak 93.75%. Komplikasi tersering adalah acute kidney injury, sepsis dan infeksi luka operasi sebanyak 45.83%, 31.25% dan 14.58%. Angka morbiditas dan mortalitas pasien ulkus peptikum perforasi adalah 68.75% dan 33.3%. Pada studi ini tidak ditemukan hubungan yang bermakna antara karakteristik pasien dengan morbiditas dan mortalitas. Angka morbiditas dan mortalitas pasien ulkus peptikum perforasi masih tinggi. Faktor risiko yang ada dapat digunakan untuk meningkatkan pilihan tindakan dan menurunkan morbiditas dan mortalitas pasien ulkus peptikum perforasi. ABSTRACT Perforated peptic ulcer is one of the most common emergency case in RSCM. Development medicine treatment in peptic ulcer treatment had developed hence had decreased number of elective surgical treatment. This study was aimed to identify patients? characteristic and risk factor in perforated peptic ulcer in morbidity and mortality. All of the patient of perforated peptic ulcer that was done emergency laparotomy in emergency operating room of Cipto Mangunkusumo Hospital since 2006 January until 2012 March was evaluated retrospectively. Fourty eight percent of perforated peptic ulcer patients had been done surgery in Emergency Operating Room of Cipto Mangunkusumo Hospital that consist of 36 male and 12 female with age range 17 ? 97 years old. The most common risk factor is ulcerogenic drug using (70.83%). Patients came to hospital >24 hours (52.08%) after felt complaint with mean duration 42 hours. The most common location of perforation was prepiloric with median of diameter was 10 mm. The most common surgical treatment was primary suturing with omental patch (93.75%). The common complication were acute kidney injury, sepsis and surgical wound infection around 45.83%, 31.25% and 14.58%/. Morbidity rate was 68.75%. Mortality rate was 33.3%. There were no relation between patients? characteristic with morbidity and mortality. Morbidity and mortality rate in perforated peptic ulcer were still high. Risk factor that still be used to increase more choice for surgical treatment and decrease morbidity and mortality rate in perforated peptic ulcer., Perforated peptic ulcer is one of the most common emergency case in RSCM. Development medicine treatment in peptic ulcer treatment had developed hence had decreased number of elective surgical treatment. This study was aimed to identify patients’ characteristic and risk factor in perforated peptic ulcer in morbidity and mortality. All of the patient of perforated peptic ulcer that was done emergency laparotomy in emergency operating room of Cipto Mangunkusumo Hospital since 2006 January until 2012 March was evaluated retrospectively. Fourty eight percent of perforated peptic ulcer patients had been done surgery in Emergency Operating Room of Cipto Mangunkusumo Hospital that consist of 36 male and 12 female with age range 17 – 97 years old. The most common risk factor is ulcerogenic drug using (70.83%). Patients came to hospital >24 hours (52.08%) after felt complaint with mean duration 42 hours. The most common location of perforation was prepiloric with median of diameter was 10 mm. The most common surgical treatment was primary suturing with omental patch (93.75%). The common complication were acute kidney injury, sepsis and surgical wound infection around 45.83%, 31.25% and 14.58%/. Morbidity rate was 68.75%. Mortality rate was 33.3%. There were no relation between patients’ characteristic with morbidity and mortality. Morbidity and mortality rate in perforated peptic ulcer were still high. Risk factor that still be used to increase more choice for surgical treatment and decrease morbidity and mortality rate in perforated peptic ulcer.] |
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