Penggunaan Bronkodilator Tunggal atau Bersama Kortikosteroid dapat Memperbaiki Parameter Sesak, w/h, dan r/h pada Pasien Rawat Inap dengan PPOK Eksaserbasi Akut di RS.X di Jember Tahun 2018
Abstract
Penyakit Paru Obstruktif Kronik (PPOK) merupakan penyebab utama kematian ke-empat di dunia yang ditandai dengan adanya hambatan aliran udara yang bersifat progresif dan berkaitan dengan respon inflamasi kronis pada saluran napas dan atau paru-paru akibat adanya partikel atau gas yang berbahaya. Penelitian ini bertujuan untuk mengetahui karakteristik pasien, pola pengobatan serta efek penggunaan bronkodilator dengan atau tanpa kortikosteroid terhadap perubahan nilai sesak, ronki (r/h), wheezing (w/h) dan SaO2 pasien rawat inap dengan PPOK eksaserbasi akut di RS.X di Jember. Penelitian ini bersifat deskriptif non eksperimental dengan pengumpulan data secara retrospektif dari data rekam medik elektronik pasien selama tahun 2018 dan pengambilan sampel menggunakan total sampling dengan jumlah pasien sebanyak 105 pasien. Analisis data yang digunakan yaitu analisis deskriptif dan analisis statistik berupa uji T berpasangan dan uji Wilcoxon dengan derajat kepercayaan sebesar 95%. Pasien PPOK eksaserbasi akut didominasi oleh laki-laki (64,8%), berdasarkan usia yang tertinggi adalah kelompok umur 45-64 tahun (50,5%), status pendidikan terbanyak pada kelompok tamat SD/sederajat (64,8%), dan berdasarkan pekerjaan pasien didominasi oleh petani (32,4%). Bronkodilator yang paling banyak digunakan adalah aminofilin (87,6%) dan kortikosteroid yang paling banyak digunakan yaitu metil prednisolone (63,8%). Hasil analisis berdasarkan parameter sesak, r/h dan w/h pada pasien yang menggunakan bronkodilator dengan atau tanpa kortikosteroid menunjukkan adanya perbedaan bermakna antara sebelum dan sesudah pengobatan (p<0,05). Parameter SaO2 menunjukkan hasil tidak ada perbedaan bermakna antara sebelum dan sesudah pengobatan bronkodilator dan ada perbedaan yang bermakna setelah pengobatan kortikosteroid. Kesimpulan dari penelitian ini adalah penggunaan bronkodilator dengan atau tanpa kortikosteroid dapat memperbaiki parameter sesak, r/h, dan w/h sesudah pengobatan.
Kata kunci: bronkodilator, kortikosteroid, PPOK eksaserbasi akut, ronki, sesak, wheezing
The Use of a Bronchodilator Alone or Combination with Corticosteroids Can Improve Shortness of Breath, w/h, and r/h Parameters in Patients with Acute
Abstract
Exacerbations of COPD at RS.X Jember in 2018
Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of death in the world, characterized by progressive airflow obstruction and is associated with a chronic inflammatory response to the airways and or lungs due to the presence of harmful particles or gases. The purpose of this study was to determine the characteristics of the patient, treatment patterns, and the effect of using bronchodilators with or without corticosteroid on changes in the value of spasms, rhonchi (r/h), wheezing (w/h), and SaO2 of inpatients with acute exacerbation of COPD in RS.X in Jember. This research was descriptive and non-experimental with retrospective data collection from the patient’s electronic medical records during 2018 and using a total sampling of 105 patients. The data analysis used descriptive analysis and statistical analysis with paired T-test and Wilcoxon test with a confidence degree of 95%. Acute exacerbation of COPD patients was dominated by males (64.8%), based on the highest age in the age group of 45-64 years old (50.5%), the most education status in the group graduated from elementary school/equivalent (64.8%), and based on the patient’s job is dominated by farmers (32.4%). The most widely used bronchodilator is aminophylline (87.6%) and the most widely used corticosteroid is methylprednisolone (63.8%). The results of the analysis based on the parameters of spasms, r/h, and w/h in patients using bronchodilators with or without corticosteroids showed a significant difference before and after treatment (p<0,05). However, based on the SaO2 parameter, there was no significant difference between before and after bronchodilator treatment and there were differences that play a role after corticosteroid treatment. The use of bronchodilators with or without corticosteroids could improve the parameters of spasms, r/h, and w/h after treatment.
Keywords: acute COPD exacerbation, a bronchodilator, corticosteroid, rhonchi, wheezing
Keywords
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DOI: https://doi.org/10.15416/ijcp.2022.11.3.198
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