Penatalaksanaan Asites Ec Sirosis Hati

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  • 7/26/2019 Penatalaksanaan Asites Ec Sirosis Hati

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    Kezia Joselyn

    F10

    102013310

    PENATALAKSANAAN

    ASITES EC SIROSISHATI

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    Laki-laki ! "a#$n %a"an& ke '() RS') %en&an kel$#an*e+$" ,e,esa+ %ise+"ai sesak se.ak 1 ,in&&$ S/RS A%ake,$n& %an ,$al A AK iasa Riaya" saki" k$nin& 3"a#$n yan& lal$ ee+a*a kali ka,$# %ok"e+,en&a"akan saki" #e*a"i"is

    SKENARIO 4

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    Pasien ,en%e+i"a asi"es e5 si+osis #a"i

    HIPOTESIS

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    K'

    Ana,nesis

    PF

    PP

    6)

    E"iolo&i

    E*i%e,iolo&i

    Pa"o7siolo&i

    (e.ala Klinis

    ))

    Pena"alaksanaan

    Ko,*likasi

    P+o&nosis

    Pen5e&a#an

    /IN) /AP

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    I%en"i"as

    K' 8 *e+$" ,e,esa+ sesak

    RPS 8 na9s$ ,akan ,$al ,$n"a# e+a" a%an *en$+$nankesa%a+an

    RP) 8 #e*a"i"is k+onis

    RKK

    RP:RSos

    ANA/NESIS

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    SIROSIS

    *i&,en"asi ,$kas*i%e+ ne;i ;enakola"e+al e+i"e,a*al,a+is &ineko,as"ia"+o7 "es"is .a+i "a$#*e,esa+an kelen.a+*a+o"is si+osis e%e,a

    "$n&kai skle+a ik"e+ikkon.$n&"i;a ane,is

    f apping tremorkesa%a+an ,en$+$n

    ASITES

    *e+$" ,e,$n5i"$,ilik$s seakan-akane+&e+ak ke a+a#ka$%al #e+nia$,ilikalis

    Nye+i "ekan

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    Pe,e+iksaan 5ai+an asi"es8 a+na *+o"ein #i"$n& selak"e+i %an ke&anasan

    'S( a%o,en 8 $k$+an #a"i s*leno,e&ali lea+nya ;ena*o+"a %an ;ena #e*a"ika kelainan 9okal $n"$k %ia&nosis"$,o+ in"+aa%o,en

    PE/ERIKSAAN PEN'NJAN(

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    Le$kosi" >>

    T+o,osi"o*enia

    PPT %an INR ,e,an.an& *a%a kas$s lan.$" " i%ak ,e,aik%en&an s$n"ikan ;i" K

    ili+$in %a*a" ,enin&ka"

    Al$,in >> &a,,a &lo$lin ??

    Alkali 9os9a"ase "i%ak ?2@ a"as no+,al

    ALT %an AST %a*a" ,enin&ka" "a*i se+in&kali no+,al

    PE/ERIKSAAN PEN'NJAN(

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    PE/ERIKSAAN PEN'NJAN(

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    Asi"es e5 si+osis #e*a"is

    Si+osis*e+ke,an&an *enyaki" #a"i k+onis %i,ana selyan& +$sak %i&an"i ole# .a+in&an ika" ke+$sakan

    a+si"ek"$+ %an 9$n&si Ko,*ensa"a

    )eko,*ensa"a

    Asi"es

    Eks$%a"i9T+ans$%a"i9

    6ORKIN( )IA(NOSIS

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    )i a+a" si +osis "e+,as$k 10 esa+ *enyea ke,a"ian"e+se+in& akia" alko#olik %i In%onesia akia" in9eksi ;i+$s#e*a"i"is ,a$*$n C

    H ,enyeakan si+osis seesa+ B0-0 %an HC 30-B0 se%an&kan 10-20 *enyeanya "i%ak %ike"a#$i %an"e+,as$k kelo,*ok ;i+$s $kan %an C

    ETIOLO(I D EPI)E/IOLO(I

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    PATO(ENESIS

    Hi*e+"ensi *o+"a

    Ak"i;i"as #o+,on an"i-%i$+e"ik

    aso%ila"asi as*lan&nik$s

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    Asi"es e5 si+osis#e*a"is

    Asi"es e5 T*e+i"oneal

    Asi"es e5#e*a"o,a

    Cai+an asi"es Kek$nin&an

    SAA( ?11 &:%L

    Ke+$# ,$n&kin

    .$&a e+5a,*$+%a+a#SAA( >11 &:%LP+o"ein?3&:%LTA

    Ke,e+a#an

    SAA( >11 &:%L

    )a+a# Tes ioki,ia %an

    9$n&si #a"i

    al9a-9e"o*+o"ein

    'S( Asi"es $k$+an#a"i ,en&e5il

    Asi"es*enealan,esen"e+i$,*e+len&ke"anl$,en $s$s

    Asi"es#e*a"o,e&ali

    )IFFERENTIAL )IA(NOSIS

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    Si+osis

    )e7ni"i9"+ans*lan"asi

    La,i;$%in 100 ,& o+al

    se"ia* #a+i sela,a 1 "a#$nD In"e+9e+on s$k$"an 3/I' 3@:,in&&$ sela,a B-$lan

    (izi

    P+o"ein 11 - 12 &+:k&

    Ene+&i 2-3kkal:k&:#a+i

    Ti%ak *e+l$ ,en&in%a+ile,ak

    Pan"an& alko#ol

    Asi"es

    Ti+a# a+in& )ie" +en%a# &a+a,

    2&:#a+i

    )i$+e"ik s*i+onolak"in100-200,&:#+ 9$+ose,i%20-B0 ,&:#+

    Pa+asen"esis

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    Si+osis #a"i #i*e+"ensi *o+"al asi"es ;a+ises&as"+oeso*#a&eal s*leno,e&ali ense9alo*a"i #a"i*e+i"oni"is ak"e+ial s*on"an sin%+o, #e*a"o+enal%an ka+sino,a #e*a"osel$le+

    KO/PLIKASI

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    Hanya 20 *asien si+osis #a"i yan& ,a,*$ e+"a#ansa,*ai "a#$n

    PRO(NOSIS

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    aksinasi #e*a"i"is

    )ie" sei,an&

    /en&$+an&i kons$,si alko#ol ,akanan e+le,akase"a,ino9en %osis "in&&i

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    Pasien ,en%e+i"a asi"es e5 si+osis #e*a"is e5 #e*a"i"is

    KESI/P'LAN

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    THANKO'

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