Aktivitas Bilirubin Serum pada Pasien Atresia Bilier Sebelum dan Sesudah Prosedur Kasai

Evi Rokhayati, Bagus Setyoboedi, Sjamsul Arief

Abstract

Pendahuluan: Atresia bilier merupakan kondisi yang mematikan sampai dengan diperkenalkannya prosedur Kasai. Periode bebas penyakit kuning,  usia pasien saat dilakukan prosedur Kasai, penting karena dapat digunakan untuk prediksi kelangsungan hidup hati asli. Penelitian ini bertujuan untuk mengetahui kadar serum bilirubin total dan bilirubin direk sebelum dan sesudah 7 hari prosedur Kasai pada bayi dengan atresia bilier.

Metode: Penelitian deskripsi analitik pada anak-anak dengan atresia bilier yang menjalani prosedur Kasai dari Januari 2014 hingga Juli 2020. Data laboratorium yang tidak lengkap dan/atau data klinis, data tindak lanjut setelah Prosedur Kasai tidak ada akan dieksklusi. Perubahan bilirubin sebelum dan sesudah Kasai menggunakan uji pair t test dan uji wilcoxom rank test, data disajikan dalam nilai mean +SD.

Hasil: Terdapat 30 pasien atresia bilier yang menjalani prosedur Kasai. Delapan belas (60%) adalah perempuan. Umur pada saat pengobatan Kasai berkisar antara 59 hingga 238 hari dengan median 152,5 hari. Rata-rata bilirubin total, bilirubin serum langsung sebelum Kasai adalah 11.03 +4.57 dan 8.58 +3.23, sedangkan setelah prosedur Kasai masing-masing adalah 12.03 +5.49 dan 9.75 +3.12. Sembilan kasus (30% dari total) mengalami penurunan bilirubin serum total dalam waktu 7 hari setelah prosedur Kasai, tujuh kasus dengan penurunan lebih dari 20%. Perbedaan bilirubin total sebelum dan sesudah prosedur Kasai sebesar 1,00 (95%CI =2.44 s/d -0.44). nilai p=0,082 (p>0,05), sedangkan bilirubin direk 1.18 (95%CI=2,06 s/d 0,29). nilai p=0,011 (p<0,05).

Kesimpulan: Penurunan total serum bilirubin sesudah prosedur Kasai pada anak dengan atresia bilier sangat penting untuk melihat periode bebas penyakit kuning.

 

Kata kunci: Bilirubin, prosedur Kasai, atresia bilier

Keywords

Bilirubin; prosedur kasai; atresia bilier

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References

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DOI: https://doi.org/10.13057/smj.v4i2.48380

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