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ABSTRAK

PROFIL PENDERITA SINDROM DISPEPSIA YANG SUDAH

DILAKUKAN TINDAKAN ENDOSKOPI DI RUMAH SAKIT IMANUEL

WAY HALIM BANDAR LAMPUNG PERIODE JANUARI-DESEMBER

2015

Yosua Timotius Haryono, 2017

Pembimbing I : dr. Sijani Prahastuti, M.Kes.

Pembimbing II : dr. Sylvia Soeng, M.Kes, PA(K)

Dispepsia adalah sekumpulan gejala yang berlokasi di epigastrium, terdiri dari

nyeri ulu hati, mual, muntah, kembung, sendawa, rasa cepat kenyang, perut rasa

penuh dan rasa terbakar. Pemeriksaan endoskopi saluran cerna bagian atas atau

Esofagogastroduodenoskopi (EGD) dan histopatologi merupakan pemeriksaan

penunjang yang penting dalam diagnosis penyebab dispepsia. Penelitian ini

bertujuan untuk mengetahui profil pasien sindrom dispepsia yang sudah dilakukan

tindakan endoskopi di Rumah Sakit Imanuel Bandar Lampung periode Januari-

Desember 2015. Metode penelitian ini adalah deskriptif retrospektif cross-

sectional menggunakan data rekam medik di Rumah Sakit Imanuel Way Halim

Bandar Lampung periode Januari-Desember 2015 dan disusun dalam bentuk tabel.

Hasil Penelitian didapatkan dari 4304 pasien dispepsia, sejumlah 402 pasien

menjalani EGD. Usia tersering 41-50 tahun (23,6%). Jenis kelamin terbanyak

adalah wanita (57,5%). Keluhan utama terbanyak adalah nyeri ulu hati (72,1%).

Faktor risiko utama yang ditemukan adalah infeksi H. pylori positif (81,6%).

Tanda bahaya dispepsia yang tersering adalah usia di atas 45 tahun (55,2%). Hasil

endoskopi SCBA terbanyak adalah Gastritis Erosiva Hemorrhagik (46,2%). Hasil

pemeriksaan histopatologi yang terbanyak adalah mild active gastritis (60,1%).

Kata kunci: dispepsia, endoskopi, histopatologi, Helicobacter pylori

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ABSTRACT

DESCRIPTION OF DYSPEPSIA PATIENTS WHO HAD UNDERGONE

ENDOSCOPY AT IMANUEL HOSPITAL WAY HALIM BANDAR

LAMPUNG IN 2015

Yosua Timotius Haryono, 2017

1st Tutor : dr. Sijani Prahastuti, M.Kes.

2nd Tutor : dr. Sylvia Soeng, M.Kes, PA(K)

Dyspepsia is a syndrome located in the epigastric area. Upper gastrointestinal

(UGI) tract endoscopy and histopathological examination are important

diagnostic tools for dyspepsia. The objective of this study is to review the

description of dyspepsia patients who had undergone UGI tract endoscopy at

Imanuel Hospital Way Halim Bandar Lampung from January to December 2015.

The design of this research was descriptive retrospective cross-sectional using

medical record data at Imanuel Hospital Way Halim Bandar Lampung in 2015

and viewed in table. The results showed that of 4304 patients with dyspepsia

symptoms, 402 patients underwent UGI tract endoscopy. The most common range

of age is 41-50 (23,6%). The most common gender is female (57,5%). The main

symptom was epigastric pain (72,1%). The most common risk factor was positive

H. pylori infection (81,6%).The most common finding of alarm sign was age over

45 years (55,2%). The most frequent results of UGI tract endoscopy was

hemorrhagic erosive gastritis (46,2%). The most common histopathological

finding was mild active gastritis (60,1%).

Keywords: dyspepsia, endoscopy, histopathological, Helicobacter pylori

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DAFTAR ISI

Halaman

JUDUL DALAM................................................................................................. i

LEMBAR PERSETUJUAN............................................................................... ii

SURAT PERNYATAAN.................................................................................. iii

ABSTRAK........................................................................................................ iv

PRAKATA........................................................................................................ vi

DAFTAR ISI................................................................................................... viii

DAFTAR TABEL.............................................................................................. x

DAFTAR GAMBAR........................................................................................ xi

DAFTAR LAMPIRAN.................................................................................... xii

BAB I PENDAHULUAN.................................................................................. 1

1.1..Latar Belakang.......................................................................................... 1

1.2..Identifikasi Masalah.................................................................................. 2

1.3..Maksud dan Tujuan................................................................................... 3

1.4..Manfaat Karya Tulis Ilmiah...................................................................... 3

1.5..Landasan Teori.......................................................................................... 4

BAB II TINJAUAN PUSTAKA........................................................................ 6

2.1..Anatomi dan Fisiologi Saluran Cerna Bagian Atas.................................. 6

2.2..Sindrom Dispepsia.................................................................................. 11

2.2.1... Definisi............................................................................................. 11

2.2.2... Epidemiologi.................................................................................... 12

2.2.3... Faktor risiko dan Etiologi................................................................ 14

2.2.4... Patofisiologi (Dispepsia Fungsional)............................................... 15

2.2.5... Kriteria Diagnosis dan Gejala Klinis............................................... 15

2.2.6... Pemeriksaan Penunjang.................................................................... 17

2.2.7... Penatalaksanaan................................................................................ 19

2.3..Endoskopi Saluran Cerna Bagian Atas................................................... 23

2.3.1... Definisi dan Prinsip Endoskopi....................................................... 24

2.3.2... Esofagogastroduodenoskopi (EGD)................................................ 24

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2.4..Infeksi Helicobacter pylori..................................................................... 25

2.5..Patologi Anatomi Dispepsia.................................................................... 30

BAB III BAHAN DAN METODE PENELITIAN.......................................... 35

3.1 Bahan Penelitian....................................................................................... 35

3.2 Lokasi dan Waktu Penelitian................................................................... 35

3.3 Metode Penelitian..................................................................................... 35

3.4 Prosedur Kerja.......................................................................................... 35

3.5 Populasi dan Sampel................................................................................ 36

3.6 Definisi Operasional................................................................................. 36

3.7 Aspek Etik Penelitian............................................................................... 38

BAB IV HASIL DAN PEMBAHASAN.......................................................... 39

4.1 Distribusi berdasarkan Usia..................................................................... 39

4.2 Distribusi berdasarkan Jenis Kelamin...................................................... 40

4.3 Distribusi berdasarkan Keluhan Utama................................................... 41

4.4 Distribusi berdasarkan Faktor Risiko....................................................... 41

4.5 Distribusi berdasarkan Tanda Bahaya...................................................... 42

4.6 Distribusi berdasarkan Hasil Endoskopi.................................................. 43

4.7 Distribusi berdasarkan Hasil Histopatologi............................................. 44

4.8 Distribusi berdasarkan Hasil H. pylori..................................................... 45

BAB V SIMPULAN DAN SARAN................................................................ 47

5.1 Simpulan.................................................................................................. 47

5.2 Saran......................................................................................................... 48

DAFTAR PUSTAKA....................................................................................... 49

LAMPIRAN

RIWAYAT HIDUP

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DAFTAR TABEL

Tabel Halaman

2.1 Penyebab Dispepsia........................................................................................14

2.2 Pemeriksaan diagnostik dispepsia dengan kelebihan dan kekurangannya.....17

2.3 Perbandingan berbagai metode tes diagnosis infeksi H. pylori......................18

2.4 Terapi untuk gejala penyerta pada dispepsia..................................................19

4.1 Distribusi Pasien Sindrom Dispepsia Berdasarkan Usia................................39

4.2 Distribusi Pasien Sindrom Dispepsia Berdasarkan Jenis Kelamin................ 40

4.3 Distribusi Pasien Sindrom Dispepsia Berdasarkan Keluhan Utama.............. 41

4.4 Distribusi Pasien Sindrom Dispepsia Berdasarkan Faktor Risiko................. 41

4.5 Distribusi Pasien Sindrom Dispepsia Berdasarkan Tanda Bahaya................ 42

4.6 Distribusi Pasien Sindrom Dispepsia Berdasarkan Hasil Umum Endoskopi

Saluran Cerna Bagian Atas........................................................................... 43

4.7 Distribusi Pasien Sindrom Dispepsia Berdasarkan Hasil Spesifik Endoskopi

Saluran Cerna Bagian Atas........................................................................... 43

4.8 Distribusi Pasien Sindrom Dispepsia Berdasarkan Hasil Histopatologi........44

4.9 Distribusi Pasien Sindrom Dispepsia Berdasarkan Hasil H. pylori............... 45

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DAFTAR GAMBAR

Gambar Halaman

2.1 Anatomi bagian-bagian lambung................................................................. 7

2.2 Gambaran lapisan histologi lambung........................................................... 7

2.3 Kelenjar dan enzim-enzim lambung............................................................. 8

2.4 Prevalensi dispepsia berdasarkan kriteria Rome II di dunia...................... 12

2.5 Estimasi prevalensi infeksi Helicobacter pylori di dunia menurut

Helicobacter Foundation tahun 2014......................................................... 13

2.6 Alur diagnosis dispepsia belum diinvestigasi............................................. 16

2.7 Algoritme tata laksana dispepsia di berbagai tingkat layanan kesehatan... 21

2.8 Algoritme tata laksana dispepsia fungsional.............................................. 22

2.9 Algoritme tata laksana eradikasi infeksi H. pylori..................................... 23

2.10 Bakteri Helicobacter pylori.......................................................................25

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DAFTAR LAMPIRAN

Lampiran 1 Lembaran Persetujuan Etik Penelitian

Lampiran 2 Surat Tanggapan Instansi Terkait Penelitian

Lampiran 3 Data Rekam Medis

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