Professional Documents
Culture Documents
PDF Laporan Pendahuluan Colelitiasis - Compress
PDF Laporan Pendahuluan Colelitiasis - Compress
HAINIETEMSES
E. HABSNZ GNDES
M. ZNBONPTEMB
Hainiitimsis (hmihuius/hmihuii, `mtu ngpndu) `imsmbym tnr`nbtuh dmimg hmbdubo
ngpndu dmri ubsur-ubsur pmdmt ymbo gng`nbtuh cmirmb ngpndu8 `mtu
ngpndu gngiiihi uhurmb, `nbtuh dmb hagpasisi ymbo smbomt `nrvmrimsi.
(@rubbnr mbd Suddmrtf.0:=3).
@mtu ngpndu mdmimf pnbymhit dnbomb hnmdmmb digmbm tnrdmpmt mtmu tnr`nbtuh
`mtu ngpndu, `ism tnrdmpmt dmimg hmbdubo ngpndu (cfaincystaiitfimsis) mtmu dmimg
duhtus cfaindacfus (cfaindacfaiitfimsis). (Zmtrich C. D. Omoaim, dhh. 0:=>).
Hainiitimsis disn`ut juom `mtu ngpndu, omiistabns, `iiimry cmicuius.
Estiimf hainiitimsis digmhsudhmb ubtuh png`nbtuhmb `mtu di dmimg hmbdubo
ngpndu. @mtu hmbdubo ngpndu gnrupmhmb om`ubomb `n`nrmpm ubsur ymbo
gng`nbtuh sumtu gmtnrimi girip `mtu ymbo tnr`nbtuh di dmimg hmbdubo ngpndu.
@mtu ngpndu mdmimf tig`ubmb hristmi di dmimg hmbdubo ngpndu mtmu di dmimg
smiurmb ngpndu. @mtu ymbo ditnguhmb di dmimg hmbdubo ngpndu disn`ut
hainiitimsis, sndmbohmb `mtu di dmimg smiurmb ngpndu disn`ut haindahaiitimsis.
@. NTEAIAOE
Ntiaiaoi `mtu ngpndu gmsif `niug dihntmfui dnbomb sngpurbm bmgub ymbo
pmiibo pnbtibo mdmimf ombooumb gntm`aiisgn ymbo disn`m`hmb ainf pnru`mfmb
susubmb ngpndu, stmsis ngpndu dmb iblnhsi hmbdubo ngpndu. Sngnbtmrm itu,
hagpabnb utmgm dmri `mtu ngpndu mdmimf hainstnrai ymbo `imsmbym tntmp `nr`nbtuh
cmirmb. Kihm cmirmb ngpndu gnbjmdi jnbuf hmrnbm hainstnrai, gmhm hainstnrai `ism
gnbjmdi tidmh imrut dmb gng`nbtuh nbdmpmb di iumr ngpndu.
Hainiitimsis dmpmt tnrjmdi dnbomb mtmu tmbpm lmhtar rnsiha. Bmgub, sngmhib
`mbymh lmhtar rnsiha, sngmhib `nsmr puim hngubohibmb ubtuh tnrjmdibym hainiitimsis.
Lmhtar rnsiha tnrsn`ut mbtmrm imib;
=. Onbntih@mtu ngpndu gngpnriifmthmb vmrimsi onbntih.
Hncnbdnrubomb gng`nbtuh `mtu ngpndu `ism
`nrjmimb dmimg hniumrom.
0. ^sim
^sim rmtm-rmtm tnrsnribo tnrjmdibym `mtu ngpndu mdmimf 4:->: tmfub. Smbomt
sndihit pnbdnritm `mtu ngpndu ymbo dijugpmi pmdm usim rngmjm, sntnimf itu
dnbomb sngmhib `nrtmg`mfbym usim sngmhib `nsmr hngubohibmb ubtuh
gnbdmpmthmb `mtu ngpndu, snfiboom pmdm usim 5: tmfub hngubohibmbbym
C. GMBELNSTMSE HIEBES
=. Pmsm bynri dmb haiih `iiinr
Kihm duhtus sistihus tnrsug`mt ainf `mtu ngpndu, hmbdubo ngpndu mhmb
gnbomimgi distnbsi dmb mhfirbym iblnhsi. Zmsinb mhmb gnbdnritm pmbms dmb
gubohib tnrm`m gmssm pmdmt pmdm m`dagnb. Zmsinb dmpmt gnbomimgi haiih `iiinr
disnrtmi bynri fn`mt pmdm m`dagnb humdmrmb hmbmb mtms ymbo gnbjmimr hn
pubooubo mtmu `mfu hmbmb8 rmsm bynri ibi `imsmbym disnrtmi gumi dmb gubtmf dmb
`nrtmg`mf fn`mt dmimg gmhmb gmhmbmb dmimg parsi `nsmr. Zmdm sn`moimb pmsinb
rmsm bynri `uhmb `nrsilmt haiih gnimibhmb pnrsistnb. Snrmbomb haiih
`iiinr sngmcmg ibi disn`m`hmb habtrmhsi hmbdubo ngpndu ymbo tidmh
dmpmt gnbomiirhmb ngpndu hniumr mhi`mt tnrsug`mtbym smiurmb ainf `mtu.
Dmimg hnmdmmb distnbsi, `moimb lubdus hmbdubo ngpndu mhmb gnbynbtuf
dibdibo
m`dagnb pmdm dmnrmf hmrtiimoa hastm 5 dmb =: hmbmb. Snbtufmb ibi gnbig`uihmb
bynri tnhmb ymbo gnbcaiah pmdm humdrmb hmbmb mtms hntihm pmsinb gnimhuhmb
ibspirmsi dmimg dmb gnbofmg`mt pnbong`mbomb raboom dmdm.
0. Ehtnrus
A`struhsi pnbomiirmb ontmf ngpndu hn dmimg dudadnbug
mhmb gnbig`uihmb onjmim ymbo hfms, ymitu; omtmf ngpndu ymbo tidmh imoi
di`mwm hndmimg duadnbug mhmb disnrmp ainf dmrmf dmb pnbynrmpmb ngpndu ibi
gng`umt huiit dmb gnb`rmb guhasm `nrwmrbm hubibo. Hnmdmmb ibi snribo
disnrtmi dnbomb onjmi omtmi-omtmi pmdm huiit.
3. Znru`mfmb wmrbm uribn dmb lnsns.
Nhshrnsi piognb ngpndu ainf oibjmi mhmb gng`umt uribn `nrwmrbm smbomt
onimp. Lnsns ymbo tidmh imoi diwmrbmi ainf piognb ngpndu mhm tmgpmh hnim`u,
dmb `imsmbym pnhmt ymbo disn`ut ’Cimy-caiarnd‗.
4. Dnlisinbsi \itmgib.
A`struhsi miirmb ngpndu juom mhmb gnboomboou m`sar`si vitmgib M,D,N,H
ymbo imrut ingmh. Hmrnbm itu pmsinb dmpmt gngpnriifmthmb onjmim
dnlisinbsi vitmgib-vitmgib ibi jihm a`struhsi `iiinr `nrimbosubo imgm. Dnlisinbsi
vitmgib H dmpmt gnboomboou png`nhumb dmrmf ymbo bargmi.(Sgnitznr, 0::0).
>. Pnouroitmsi oms; limtus dmb snbdmwm
D. ZMTALESEAIAOE
Zng`nbtuhmb `mtu ngpndu di`moi gnbjmdi tiom tmfmp; (=) png`nbtuhmb
ngpndu ymbo supnrsmturmsi, (0) buhinmsi mtmu png`nbtuhmb ibti `mtu, dmb (3)
`nrhng`mbo hmrnbm `nrtmg`mfbym pnbonbdmpmb. Hnimrutmb hainstnrai gnrupmhmb
gmsmimf ymbo tnrpnbtibo dmimg png`nbtuhmb sngum `mtu, hncumii `mtu
piognb. Supnrsmturmsi ngpndu dnbomb hainstnrai tnrjmdi `iim pnr`mbdibomb msmg
ngpndu dmb laslaiipid (tnrutmgm insitib) dnbomb hainstnrai turub di `mwmf fmrom
tnrtnbtu. Sncmrm bargmi hainstnrai tidmh imrut dmimg gndim ymbo
gnbombdubo mir. Ngpndu dipnrtmfmbhmb dmimg `nbtuh cmir ainf png`nbtuhmb
haiaid ymbo gngpubymi ibti snbtrmi hainstnrai, dihniiiiboi ainf gmbtni ymbo
fidraliiih dmri omrmg ngpndu dmb insitib. Kmdi snhrnsi hainstnrai ymbo `nrin`ifmb,
mtmu hmdmr msmg ngpndu rnbdmf, mtmu
N. ZNGNPEHSMMB ZNB^BKMBO
=. Pmdiaiaoi
Zngnrihsmmb ^SO tnimf gnboombtihmb hainsistaormli armi sn`momi
prasndur dimobastih piiifmb hmrnbm pngnrihsmmb ibi dmpmt diimhuhmb dnbomb
cnpmt dmb mhurmt, dmb dmpmt dioubmhmb pmdm pnbdnritm dislubosi fmti dmb ihtnrus.
Dismgpibo itu, pngnrihsmmb ^SO tidmh gng`umt pmsinb tnrpmjmb rmdimsi ibismsi.
Zrasndur ibi mhmb gng`nrihmb fmsii ymbo pmiibo mhurmt jihm pmsinb sudmf
`nrpumsm pmdm gmimg fmribym snfiboom hmbdubo ngpndubym `nrmdm dmimg
hnmdmb distnbsi.
L. HAGZIEHMSE
=. Hainsistitis
Hainsistisis mdmimf Znrmdmbomb hmbdubo ngpndu ymbo disn`m`hmb ainf sug`mtmb
`mtu ngpndu, gnbyn`m`hmb iblnhsi dmb pnrmdmbomb hmbdubo ngpndu
0. Haimboitis
Haimboitis mdmimf pnrmdmbomb pmdm smiurmb ngpndu. Kihm `mtu ymbo gnbyug`mt
gniuhmi/gnbng`us dibdibo smiurmb ngpndu, gmhm dmpmt
gnbyn`m`hmb
pnrmdmbomb fn`mt di smiurmb ngpndu (haimboitis). Mhi`mtbym,`mhtnri mhmb tug`uf
dmb gnbig`uihmb iblnhsi di dmimg smiurmb. Eblnhsi dmpmt disn`m`hmb hugmb ymbo
`nrmsmi dmri gmhmbmb. Znbyn`m` pmiibo utmgm mdmimf iblnhsi di usus. Eblnhsi
=. Znbmtmimhsmbmmb Bab`ndmf
m. Znbmtmimhsmbmmb pnbduhubo dmb dint
Hurmbo in`if 6:% dmri pmsinb-pmsinb iblimgmsi mhut hmbdubo
ngpndu sng`uf dnbomb istirmfmt, cmirmb iblus, pnbofismpmb bmsaomstrih,
mbmionsih dmb mbti`iatih. Ebtnrvnbsi `ndmf fmrus ditubdm smgpmi onjmim mhut
gnrndm dmb nvmiusi ymbo inbohmp dmpmt diimhsmbmhmb, hncumii jihm habdisi
pmsinb.
=) Dint rnbdmf ingmh, tibooi hmiari, tibooi pratnib
0) Zngmsmbomb pipm img`ubo `iim tnrjmdi distnbsi pnrut.
3) A`snrvmsi hnmdmmb ugug dmb pngnrihsmmb vitmi siob
c. Disaiusi habtmh
Tnrmpi cabtmct dissaiutiabmdmimf sumtu cmrm ubtuh gnbofmbcurhmb
`mtu hainstnrai dnbomb gngmsuhmb sumtu cmirmb pnimrut hn dmimg
hmbdubo ngpndu gnimiui hmtntnr pnrhutmbnus gnimiui fnpmr mtmu mitnrbmtil
imib gnimiui hmtntnr bmsa`iiinr. Imrutmb ymbo dipmhmi mdmimf gntfyi tnr`utyi
ntnr . Imrutmb ibi digmsuhhmb dnbomb sumtu mimt hfusus hn dmimg hmbdubo
ngpndu dmb
`imsmbym gmgpu gnbofmbcurhmb `mtu hmbdubo ngpndu dmimg 04 jmg.
d. Hningmfmb tnhbih ibi fmbym gmgpu dioubmhmb ubtuh hmsus dnbomb
`mtu ymbo hainstnrai ymbo rmdiaiusnb.
Imrutmb ymbo dioubmhmb dmpmt
gnbyn`m`hmb iritmsi guhasm, sndmsi ribomb dmb mdmbym hnhmg`ufmb
tnr`nbtuhbym hng`mii `mtu hmbdubo ngpndu.
n. Iitatripsi Oniag`mbo Ninhtrasyah (NS_I)
Zrasndur bab ibvmsivn ibi gnbooubmhmb oniag`mbo hnjut
`nruimbo ( Pnpnmtnd Sfach _mvn) ymbo dimrmfhmb pmdm `mtu ngpndu
didmimg hmbdubo ngpndu mtmu duhtus haindahus dnbomb gmhsud
gngncmf `mtu tnrsn`ut gnbjmdi `n`nrmpm snjugimf lrmognb. NS_I
smbomt papuinr dioubmhmb
tnimf `nrfmsii diimhuhmb pmdm 5:% hmsus. Hurmbo dmri 4 dmri sntimp =.:::
pnbdnritm ymbo gnbiboomi dmb 3-7% gnbomimgi hagpiihmsi, snfiboom
prasndur ibi in`if mgmb di`mbdibohmb png`ndmfmb pnrut. NPCZ smjm
`imsmbym nlnhtil diimhuhmb pmdm pnbdnritm `mtu smiurmb ngpndu ymbo
in`if tum, ymbo hmbdubo ngpndubym tnimf dimbohmt
0. Znbmtmimhsmbmmb @ndmf
m. Hainsistnhtagi tnr`uhm
Apnrmsi ibi gnrupmhmb stmbdmr tnr`mih ubtuh pnbmbombmb pmsinb dnbom
hainiitimsis sigtagmtih. Hagpiihmsi ymbo pmiibo `nrgmhbm ymbo dmpmt tnrjmdi
mdmimf cndnrm duhtus `iiimris ymbo tnrjmdi pmdm :,0% pmsinb. Mbohm gartmiitms
ymbo diimparhmb ubtuh prasndur ibi hurmbo dmri :,>%. Ebdihmsi ymbo pmiibo
ugug ubtuh hainsistnhtagi mdmimf haiih `iiimris rnhurnb, diihuti ainf
hainsistitis mhut.
`. Hainsistnhtagi impmrmshapi
Hainsistnhtagi impmrashapih guimi dipnrhnbmihmb pmdm tmfub =55:
dmb snhmrmbo ibi snhitmr 5:% hainsistnhtagi diimhuhmb sncmrm impmrashapi.
6:- 5:% `mtu ngpndu di Ebooris di`umbo dnbomb cmrm ibi hmrnbm
gngpnrhncii rnsiha hngmtimb di`mbdibo apnrmsi bargmi (:,=-:,>% ubtuh
apnrmsi bargmi)
pmsinb dnbomb `mtu duhtus haindahus. Sncmrm tnaritis hnubtubomb tibdmhmb ibi
di`mbdibohmb prasndur habvnbsiabmi mdmimf dmpmt gnbourmboi pnrmwmtmb di
rugmf smhit dmb `imym ymbo dihniumrhmb, pmsinb dmpmt cnpmt hng`mii `nhnrjm,
bynri gnburub dmb pnr`mihmb hasgntih. Gmsmimf ymbo `niug tnrpncmfhmb
mdmimf hnmgmbmb dmri prasndur ibi, `nrfu`ubomb dnbomb ibsidnb hagpiihmsi
snpnrti cndnrm duhtus `iiimris ymbo gubohib dmpmt tnrjmdi in`if snribo snimgm
hainsistnhtagi impmrashapi.
m. Hniufmb ^tmgm
Gnrupmhmb hniufmb ymbo pmiibo utmgm ymbo dirmsmhmb ainf hiinb smmt
pnbohmjimb. @imsmbym hniufmb utmgm ymbo hiinb rmsmhmb mdmimf bynri
m`dagnb pmdm humdrmb hmbmb mtms, dmb gumi gubtmf.
`. Piwmymt Hniufmb ^tmgm
Gnrupmhmb pnbong`mbomb diri dmri hniufmb utmgm gnimiui gntadn Z]PST,
pmiimtil mtmu pravahmtil (Z) ymitu lacus utmgm hniufmb hiinb, qumiity mtmu
humiitms (]) ymitu `momigmbm bynri/omtmi dirmsmhmb ainf hiinb, rnoiabmi (P)
ymitu bynri/omtmi gnbjmimr hngmbm, Smlnty (S) ymitu pasisi ymbo `momigmbm
ymbo dmpmt gnbourmboi bynri/omtmi mtmu hiinb gnrmsm bymgmb dmb Tign (T)
ymitu snjmh hmpmb hiinb gnrmsmhmb bynri/omtmi tnrsn`ut. Hiinb
snribo
gnbomimgi bynri di uiu fmti ymbo gnbjmimr hn pubooubo , dmb `nrtmg`mf
`nrmt sntnimf gmhmb disnrtmi dnbomb gumi dmb gubtmf.
c. Piwmymt Znbymhit dmfuiu
Znriu dihmji mpmhmf hiinb pnrbmf gnbdnritm pnbymhit smgm mtmu pnrbmf di
riwmymt sn`niugbym. Hiinb gngiiihi @ady Gmss Ebdnx (@GE)
tibooi,
4. Znbohmjimb Znrsistng
m. Hnmdmmb ^gug
`. TT\
c. @rnmtf (@=)
d. @iaad (@0)
n. @rmib (@3)
l. @imddnr (@4)
o. @awni (@>)
f. @abn (@<)
@. DEMOBASM HNZNPM_MTMB
C. EBTNP\NBSE
DV = Hntidmhnlnhtilmb Zaim bmlms `nrfu`ubomb dnbomb fipnrvnbtiimsi
BAC BEC
- Stmtus Znrbmlmsmb Gabitar Znrbmlmsmb
- Stmtus pnrbmlmsmb ; pnrtuhmrmb oms =. Gabitar tmbdm-tmbdm vitmi
- Stmtus Znrbmlmsmb ; \ 0. Gabitar hncnpmtmb, irmgm,
nbtiimsi Dnbomb Hritnrim fmsii ; hndmimgmb, dmb hnsuiitmb `nrbmlms
- Dyspbnu smmt istirmfmt 3. Gabitar sumrm bmlms tmg`mfmb
dipnrtmfmbhmb
pmdm shmim 4 (`nrmt) ditibohmthmb
Gmbmjngnb Msgm
hn shmim 4 (ribomb)
4. Ednbtilihmsi Zngicu ymbo dihntmfui
- Dyspbnu dnbomb mhtivitms ribomb
>. Mjmrhmb tnhbih pnboa`mtmb ymbo
dipnrtmfmbhmb hn shmim 3
tnpmt (Gis, Ebfminr, Bn`uiiznr)
(cuhup) ditibohmthmb hn shmim > (tidmh
mdm)
Tnrmpi Ahsionb
- Simbasis dipnrtmfmbhmb pmdm shmim
<. @nrihmb tnrmpi ahsionb snsumi
3 (cuhup) ditibohmthmb hn shmim >
hn`utufmb
(tidmh mdm)
- Sumrm bmlms tmg`mfmb
dipnrtmfmbhmb
pmdm shmim 0 (`nrmt) ditbohmthmb
hn shmim > (tidmh mdm)
- Znbooubmmb atat `mbtu pnrbmpmsmb
dipnrtmfmbhmb pmdm shmim 0
(`nrmt) ditibohmthmb hn shmim > (tidmh
mdm)
DV 0 Bynri mhut `nrfu`ubomb dnbomb monb cndnrm `iaiaois (Eblnhsi)
BAC BEC
- Habtrai bynri Gmbmjngnb Bynri
Ebdihmtar ; =. Imhuhmb pnbohmjimb bynri sncmrm
- Gnbonbmii hmpmb bynri hagprnfnbsil
tnrjmdi
0. A`snrvmsi mdmbym pntubjuh
dipnrtmfmbhmb pmdm shmim 3 (hmdmbo-
bab vnr`mi
hmdmbo gnbubjuhmb)
3. Mbjurhmb gntadn lmrgmhaiaoi
- Gnbooubmhmb tibdmhmb
ubtuh gnburubhmb bynri
bynri dipnrtmfmbhmb pmdm shmim 0
(jmrmbo gnbubjuhmb) ditibohmthmb hn
Zng`nrimb Mbmiontih
shmim 4 (snribo gnbubjuhmb)
4. Cnh mdmbym riwmymt minroi a`mt
- Gnimparhmb bynri
>. @nrihmb mbmiontih snsumi dnbomb
tnrhabtrai dipnrtmfmbhmb pmdm shmim
rnsnp dahtnr
0 (jmrmbo gnbubjuhmb) ditibohmthmb
hn shmim 4 (snribo gnbubjuhmb)
BAC BEC
- Tainrmbsi tnrfmdmp mhtivitms Mhtivity Tfnrmpy
- Dmym Tmfmb =. Hmji mhtivitms ymbo gmgpu diimhuhuhmb
Dnbomb Hritnrim fmsii ; ainf pmsinb
- Mhtilitms lisih dipnrtmfmbhmb pmdm 0. @mbtu pmsinb ubtuh gngiiif
shmim 0 (`mbymh tnromboou) mhtivitms snsumi dnbomb hngmgpumb
ditibohmthmb hn
3. Mbjurhmb pmsinb ubtuh `mbymh
shmim > (tidmh tnromboou) `nristirmfmt
- Gnimhuhmb mhtivitms rutib 4. Mbjurhmb hniumrom ubtuh gng`mbtu
dipnrtmfmbhmb hn shmim 3 (cuhup pmsinb dmimg gnimhuhmb mhtivitms
tnromboou) ditibohmthmb hn shmim >
(tidmh tnromboou
- Hninimfmb dipnrtmfmbhmb pmdm shmim
3 (sndmbo) ditibohmthmb hn shmim >
(tidmh mdm)
D. EGZINGNBTMSE
Egpingnbtmsi mdmimf snrmbohmimb hnoimtmb ymbo diimhuhmb ainf pnrmwmt ubtuh
gng`mbtu hiinb dmimg gmsmimf stmtus hnsnfmtmb ymbo difmdmpi hn stmtus hnsnfmtmb
ymbo in`if `mih.
N. N\MI^MSE
Nvmiumsi mdmimf pnr`mbdibomb ymbo sistngmtih dmb tnrnbcmbm tnbtmbo hnsnfmtmb
hiinb dnbomb tujumb ymbo tnimf ditntmphmb.
DMLTMP Z^STMHM
@uincfnh, O. G., @utcfnr, F. H., Dacftnrgmb, K. G., & _mobnr, C. G. (0:=7). Bursibo
Ebtnrvnbtiab Cimssilicmtiab (BEC) (Ndisi Hnnbmg nd.). (@. Ebdabnsim, Nd.) Nisnvinr
Gacagndim.
Zmtrich CDO, dhh., 0:=>. Omg`mrmb ^itrmsabaormli @mtu Ngpndu pmdm Zrim & _mbitm di
@moimb Pmdiaiaoi LH ^BSPMT @I^ PS^Z ZPAL. DP. P. D. Hmbdau Gmbmda
Znriadn Ahta`nr 0:=0 – Ahta`nr 0:=4. Gmbmda ; Kurbmi n-Ciibic ( nCE ), \ai.3 Ba.=,
Kmbumri – Mprii 0:=>.
Sgnitznr, SC dmb @mrn, @O. 0:=3. @uhu Mjmr Hnpnrmwmtmb Gndihmi @ndmf. Ndisi 6. \ai.0.
ZNBUEGZMBOMB HDG
Znbupuhmb hagpabnb dmb gmsuhbym nscfnricim caii
dmri smiurmb usus hn dmimg smiurmb dmb hmbtubo ngpndu
Fipnrvnbtiimsi
Ombooumb
Mbsintms
gntm`aiisgn
Dyspbnu
Nbnroy ymbo
difmsiihmb
Hntidmhnlnhtilm
`nrhurmbo
b Zaim Bmlms
Hninmimfmb, tirmf
`mribo
Ebtainrmbsi mhtivitms