KESIMPULAN DAN SARAN
6.1 Kesimpulan
Berdasarkan tujuan dan hasil penelitian, maka dapat diambil kesimpulan sebagai berikut:
1. Daripada 288 penderita TB paru di Departemen Paru di RSUP H.Adam Malik hanya didapati sebanyak 51 sampel yang lengkap dan angka kejadian hepatotoksisitas pada penderita Tuberkulosis paru akibat penggunaan Obat Anti Tuberkulosis (OAT) di RSUP H.Adam Malik daripada 51 sampel ialah sebanyak 21 penderita (41.2%). Data-data rekam medis yang tidak lengkap seperti yang tidak mempunyai kadar SGOT dan SGPT selepas mengkonsumsi OAT terutamanya bagi pasien rawat jalan terjadi mungkin karena penderita-penderita tersebut tidak mengalami apa-apa simptom yang mengindikasi hepatotoksisitas. Jadi mereka tidak mengunjungi dokter atau perawat-perawat di rumah sakit tidak mengambil tes darah untuk pasien sedemikian. Tidak semestinya pasien yang tidak mengalami simptom selepas mengkonsumsi OAT tidak menderita hepatotoksisitas. Jadi semua sebab sedemikian harus diperhatikan juga.
2. Distribusi umur pada penderita Tuberkulosis paru yang mengkonsumsi OAT paling banyak terdapat pada kelompok umur 41-60 tahun sebanyak 27 penderita (52.9%).
3. Distribusi jenis kelamin pada penderita Tuberkulosis paru yang mengkonsumsi OAT paling banyak adalah laki-laki sebanyak 46 penderita (90.2%).
6.2 Saran
Dari penelitian ini, terlihat bahawa secara keseluruhan:
Perlunya pihak rumah sakit melakukan pengawasan terhadap penderita Tuberkulosis paru yang mengkonsumsi OAT secara teratur dari segi kenaikan kadar SGOT dan SGPT penderita. Tes laboratorium juga harus diambil sekurang-kurangnya setiap 1 minggu untuk mengawasi kadar SGOT dan SGPT penderita terutamanya bagi pasien rawat jalan karena pasien rawat jalan biasanya tidak berkunjung ke dokter sewaktu pengobatan TB
paru dan mungkin pasien-pasien sedemikian tidak mengalami apa-apa simptom sewaktu pengobatan OAT. Jadi mereka tidak akan terpikir untuk mengambil tes darah. Tidak semestinya jika mereka tidak mengalami simptom makanya mereka tidak menderita hepatotoksisitas. Jadi dokter dan juga perawat rumah sakit haruslah menerangkan kepada pasien-pasien akan efek samping pengobatan OAT dan menyarankan mereka untuk menjalani follow-up yaitu sekurang-kurangya 2 minggu pertama setelah pengobatan OAT dan selepas itu setiap 1 minggu untuk memeriksa terjadinya elevasi SGOT dan SGPT. Penderita Tuberkulosis paru rawat jalan yang menkonsumsi OAT harus ke dokter untuk
pemeriksaan regular termasuk mengambil tes darah untuk menilai tahap SGOT dan SGPT untuk mengetahui jika terjadinya hepatotoksisitas dan mengambil langkah selanjutnya oleh dokter untuk memastikan tahapnya berada dalam keadaan normal dan terkontrol.
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Nama : Nitayini Govindan
Tempat / tanggal lahir : Kuala Lumpur / 4 September 1989 Pekerjaan : Mahasiswa
Agama : Hindu
Alamat : Jl. Dr. Mansur, Gg.Sehat No.26 Medan, 20155-Indonesia Nomor Telepon : 083199288919
Orang Tua : Govindan a/l K.K Pothuval
Riwayat Pendidikan : Sijil Pelajaran Menengah(SPM)-2006 Foundation in Science 2007/2008 Fakultas Kedokteran USU- sekarang
Kegiatan : Melakukan proposal penelitian yaitu angka kejadian
hepatotoksisitas pada penderita Tuberkulosis paru pengguna obat anti tuberkulosis lini pertama dalam RSUP Haji Adam Malik tahun 2010
Statistics
jenis kelamin Umur kelompok SGOT kelompok SGPT kelompok
N Valid 51 51 51 51
jenis kelamin
Frequency Percent Valid Percent
Cumulative Percent Valid laki-laki 46 90.2 90.2 90.2 perempuan 5 9.8 9.8 100.0 Total 51 100.0 100.0 Umur kelompok
Frequency Percent Valid Percent
Cumulative Percent Valid <20 2 3.9 3.9 3.9 21-40 15 29.4 29.4 33.3 41-60 27 52.9 52.9 86.3 >60 7 13.7 13.7 100.0 Total 51 100.0 100.0 SGOT kelompok
Frequency Percent Valid Percent
Cumulative Percent
Valid <35 39 76.5 76.5 76.5
51-300 3 5.9 5.9 100.0
Total 51 100.0 100.0
SGPT kelompok
Frequency Percent Valid Percent
Cumulative Percent Valid <40 40 78.4 78.4 78.4 41-50 7 13.7 13.7 92.2 51-215 4 7.8 7.8 100.0 Total 51 100.0 100.0 Statistics
jenis kelamin umur tahap SGOT tahap SGPT
N Valid 51 51 51 51
Missing 0 0 0 0
jenis kelamin
Frequency Percent Valid Percent
Cumulative Percent
Valid laki-laki 46 90.2 90.2 90.2
jenis kelamin
Frequency Percent Valid Percent
Cumulative Percent Valid laki-laki 46 90.2 90.2 90.2 perempuan 5 9.8 9.8 100.0 Total 51 100.0 100.0 umur
Frequency Percent Valid Percent
Cumulative Percent Valid 4 1 2.0 2.0 2.0 19 1 2.0 2.0 3.9 24 1 2.0 2.0 5.9 27 2 3.9 3.9 9.8 28 1 2.0 2.0 11.8 29 2 3.9 3.9 15.7 30 1 2.0 2.0 17.6 31 3 5.9 5.9 23.5 32 2 3.9 3.9 27.5 39 2 3.9 3.9 31.4 41 2 3.9 3.9 35.3 42 1 2.0 2.0 37.3 43 1 2.0 2.0 39.2 45 3 5.9 5.9 45.1 48 1 2.0 2.0 47.1 49 2 3.9 3.9 51.0 50 2 3.9 3.9 54.9 51 2 3.9 3.9 58.8 52 1 2.0 2.0 60.8
53 4 7.8 7.8 68.6 54 2 3.9 3.9 72.5 56 2 3.9 3.9 76.5 57 1 2.0 2.0 78.4 58 1 2.0 2.0 80.4 59 1 2.0 2.0 82.4 60 2 3.9 3.9 86.3 61 2 3.9 3.9 90.2 64 1 2.0 2.0 92.2 65 1 2.0 2.0 94.1 68 1 2.0 2.0 96.1 69 1 2.0 2.0 98.0 71 1 2.0 2.0 100.0 Total 51 100.0 100.0 tahap SGOT
Frequency Percent Valid Percent
Cumulative Percent Valid 10.00 1 2.0 2.0 2.0 12.00 1 2.0 2.0 3.9 13.00 1 2.0 2.0 5.9 14.00 1 2.0 2.0 7.8 17.00 1 2.0 2.0 9.8 18.00 2 3.9 3.9 13.7 19.00 1 2.0 2.0 15.7 20.00 3 5.9 5.9 21.6
21.00 3 5.9 5.9 27.5 22.00 2 3.9 3.9 31.4 23.00 1 2.0 2.0 33.3 25.00 2 3.9 3.9 37.3 26.00 1 2.0 2.0 39.2 28.00 1 2.0 2.0 41.2 29.00 1 2.0 2.0 43.1 30.00 1 2.0 2.0 45.1 31.00 5 9.8 9.8 54.9 32.00 2 3.9 3.9 58.8 33.00 6 11.8 11.8 70.6 34.00 2 3.9 3.9 74.5 36.00 2 3.9 3.9 78.4 37.00 2 3.9 3.9 82.4 38.00 2 3.9 3.9 86.3 38.50 1 2.0 2.0 88.2 40.00 1 2.0 2.0 90.2 48.00 1 2.0 2.0 92.2 49.00 1 2.0 2.0 94.1 85.00 1 2.0 2.0 96.1 92.00 1 2.0 2.0 98.0 125.00 1 2.0 2.0 100.0 Total 51 100.0 100.0 tahap SGPT
Frequency Percent Valid Percent
Cumulative Percent
Valid 5.00 1 2.0 2.0 2.0
10.00 1 2.0 2.0 7.8 14.00 3 5.9 5.9 13.7 16.00 1 2.0 2.0 15.7 18.00 2 3.9 3.9 19.6 19.00 2 3.9 3.9 23.5 20.00 1 2.0 2.0 25.5 21.00 1 2.0 2.0 27.5 25.00 4 7.8 7.8 35.3 26.00 1 2.0 2.0 37.3 27.80 1 2.0 2.0 39.2 28.00 1 2.0 2.0 41.2 30.00 3 5.9 5.9 47.1 32.00 2 3.9 3.9 51.0 35.00 2 3.9 3.9 54.9 36.00 2 3.9 3.9 58.8 38.00 2 3.9 3.9 62.7 39.00 7 13.7 13.7 76.5 40.00 1 2.0 2.0 78.4 42.00 2 3.9 3.9 82.4 43.00 1 2.0 2.0 84.3 45.00 2 3.9 3.9 88.2 48.00 1 2.0 2.0 90.2 49.00 1 2.0 2.0 92.2 65.00 2 3.9 3.9 96.1 91.00 1 2.0 2.0 98.0 118.00 1 2.0 2.0 100.0 Total 51 100.0 100.0
Derajat hepatotoksisitas di kalangan 51 penderita yang menderita TB paru yang mengkonsumsi OAT ALT/SGOT (IU/L) AST/SGPT (IU/L) Nilai normal 39 penderita 40 penderita