Ns. Ikeu - Adaptasi Fisiologis Sistem Digestif Pada Neonatus

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Transcript of Ns. Ikeu - Adaptasi Fisiologis Sistem Digestif Pada Neonatus

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    DGD]WDYE BEYEJLJOEYYEYW@F GEO@YWER@

    ]DGD N@JNDWPY

    Eh`u Nuraegdyda, F.H`p., Ns.,Yp.H`p.Dn

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    Yest`f Geo`stev`

    Yest`f geo`stev` dgdlda sest`f tukuaydno f`fpunyde p`rdndn p`nteno gdldf3

    ]`ny`geddn nutre`n kdoe tukua

    ]`no`ludrdn sesd p`ni`rnddn h`ludrtukua

    ]`rtdadndn tukua gdre fehrjjrodnesf`

    ydno fdsuh f`ldlue fdhdndn

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    Nutre`n f`rupdhdn zdt ydno sdnodt gekutuahdnjl`a tukua untuh p`fk`ntuhdn `n`roe ydno

    gep`rluhdn jl`a s`tedp cdrenodn gdldf f`ldhuhdndhtebetdsnyd.

    ]dgd fdsd entrdut`ren` p`f`nuadn h`kutuadnt`rs`kut geldhuhdn f`ldlue pldi`ntd

    K`oetu ldaer aukunodn g`nodn eku l`wdtplds`ntd geputus geodntehdn jl`a sest`fgeo`stev` k`h`rcdsdfd g`nodn sest`f

    idrgejvdshul`r gdn sest`f r`sperdse Kdye Kdru Ldaer adrus f`fulde untuh

    f`fdsuhhdn(f`n`ldn) , f`ni`rnd gdnf`nodksjrkse fdhdndn.

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    Jrodn p`ni`rnddn n`jndtus

    Yusundn sdlurdn p`ni`rnddn t`rgere gdre 3 -

    Jres (fulut) - Bdreno - @sjbdous(h`rjnohjnodn) - Psus adlus - Psus k`sdr -

    [`htuf - Dnus

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    ]`fk`ntuhdn `nzef sest`f

    p`ni`rnddn pdgd n`jndtus

    @nzef-`nzef p`nteno untuh f`ni`rnd

    hdrkjaegrdt, prjt`en, gdn l`fdh s`g`radnd

    dgd pdgd fenoou h`-92-91 used o`stdse.

    Kdye kdru ldaer iuhup kuldn fdfpu f`n`ldn,

    f`ni`rnd, f`f`tdkjlesf` gdn f`nodksjrkse

    prjt`en gdn hdrkjaegrdt s`g`radnd s`rtd

    f`no`fulse l`fdh (C`ns`n `t dl., ;==7).

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    @nzef p`ni`rnddn n`jndtus3

    Dfelds` pdnhr`ds f`nodldfe g`bese`nse s`ldfd 9-2 kuldnp`rtdfd s`t`lda ldaer, s`aenood KKL tegdh kesd f`ni`rnd

    c`nes hdrkjaegrdt ydno hjfpl`hs s`p`rte ydno t`rgdpdt

    pdgd s`r`dl.

    ]`rh`fkdnodn dhtebetds ldhtds` k`rldnosuno r`ldtebldfkdt gdn f`nidpde tenohdt dg`hudt pdgd used o`stdse

    92 fenoou.

    Y`lden etu KKL cuod f`nodldfe g`bese`nse lepds` pdnhr`ds.

    L`fdh ydno dgd ge gdldf DYE l`kea kesd gei`rnd gdn l`keas`sude untuh kdye gdre pdgd l`fdh ydno t`rgdpdt pdgd

    susu bjrfuld ( Ojrre`, `t dl., ;==1).

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    Ijnt

    Psus kdye kdru ldaer r`ldtev` tegdh fdtur.

    Yest`f jtjt ydno f`nyusun jrodn t`rs`kut l`kea tepes gdn

    hurdno `bese`n gekdngenohdn pdgd jrdno g`wdsd s`aenood

    o`ljfkdno p`restdlteh tegdh gdpdt gepr`gehsehdn.

    Lepdtdn gdn vele gengeno usus k`luf k`rh`fkdno s`fpurnd.

    Y`l `pet`l ydno f`ldpese usus adlus kdye kdru ldaer tegdh

    k`rodnte g`nodn i`pdt s`aenood f`nenohdthdn dksjrks ydno

    pdleno `b`hteb.

    Dwdl p`fk`redn fdhdn jrdl f`nstefuldse ldpesdn usus dodr

    fdtur g`nodn f`nenohdthdn p`rodntedn s`l ydno i`pdt gdn

    prjguh `nzef fehrjvelus, s`p`rte dfylds`, trepsen, gdn lepds`

    pdnir`ds.

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    Dgdptdse Besejljoes Yest`f]`ni`rnddn N`jndtdl4. ]`rukdadn Ajrfjndl 3

    Ijrtesjl

    Idta`ijldfen

    ;. F`tdkjlesf` `n`roy

    9. ]`rukdadn dndtjfe & bunose

    sest`f i`rnd

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    Entrdut`ren`

    Beljrus gdn bungus, odst`r, t`rk`ntuh used o`stdse47 fenoou. Ypenht`r `sjbdodl t`rk`ntuh used o`stdse ;1

    fenoou, usus t`rk`ntuh used ;= fenoou, pdncdnousus ;0=-9==if ky t`rf, hdpdsetds odst`rs`hetdr 9= fl.

    r`bl`hs f`n`ldn sugda fulde t`rleadt gdreh`oedtdn f`n`ldn gdn f`noaesdp dfnejn

    O`rdhdn f`noaesdp dhteb tdfpdh pdgd ;2-;1

    fenoou. Iderdn `fp`gu fulde geprjguhse s`cdh dhaer

    tref`st`r p`rtdfd, geehute g`nod s`lurua `nzef-`nzef p`ni`rnddn ldennyd.

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    PO ;1 fenoouhdpdsetds kejhefed gdn besejljoesuntuh geo`steb & dksjrpse sugda dgd.

    @nzef-`nzef p`nteno untuh f`ni`rnd hdrkjaegrdt,

    prjt`en, gdn l`fdh s`g`radnd (pjlep`pteg`3 odstren,fjtelen, hjl`sestjhenen, pdnir`dtei` pjlyp`pteg`,sjfdtjstdten) dgd pdgd fenoou h`-92-91 used o`stdsesugda fulde gek`ntuh untuh f`fp`rsedphdnh`ldaerdn (h`aegupdn cdnen `hstrdut`ren)

    Wrdnspjrt ent`stendl dsdf dfenj (47 fenoou), oluhjsd(41 fenoou), BBD (;7 fenoou)

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    Ldhtjsdsufk`r hdrkjaegrdt pr`gjfendn

    ydno t`rgdpdt pdgd DYE/bjrfuld. Dhtevetdsldhtds` (f`rukda lditjsdoluhjsd) t`rleadtpdgd PO 5 fenoou, gdn PO ;7 fenoouf`nidpde ldhtds` pg n`jndtdl, p`nenohdtdn

    grdfdtes t`rcdge pdgd PO 9;-97 fenoou. Gesdhdregds` (dfelds`, fuhjsdl oluhjdfelds`)

    dhteb sddt PO ;?-;1 fenoou

    Y`hr`se `fp`gu t`rcdge pdgd PO ;; fenoou Y`hr`se dsdf ldfkuno t`rcdge pdgd PO ;=

    fenoou

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    ]rjs`s p`ni`rnddn cdnen k`luf t`rcdge s`idrd dhteb(endhteb), h`kutuhdn cdnen dhdn nutrese tegdh gep`nuaeg`nodn sest`f p`ni`rnddnnyd t`tdpe gep`rjl`a gdre

    plds`ntd. [`bl`hs fdhdn pdgd cdnen gegdldf hdngunodn sugda

    fulde t`rleadt gdre h`oedtdn f`n`ldn dfnejn gdnf`noaesdp.

    Hjjrgendse Njn nutretev` suiheno t`rleadt pdgd PO ;1fenoou, suih-swdlljw ijjrgendtejn t`rcdge pdgd PO97-92 fenoou (Kldihkurn, ;=49).

    Fjteletds OEhjntrdhse rdngjf t`rleadt PO ;0-9=fenoou, fjteletds f`nenohdt PO 9=-9; fenoou,fjteletds l`kea t`rjrodneser > 97 fenoou ldaer(Kdihkurn, ;=498 Geffet & Yekl`y, ;=4;).

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    Ijnt F`hjneuf, f`rupdhdn ese ydno utdfd t`rutdfd

    pdgd sdlurdn p`ni`rnddn cdnen, tdfpdh fulde used

    42 fenoou, f`hjneuf tegdh geh`ludrhdn s`ldfd cdnenk`rdgd gegdldf ut`rus (tegdh t`rcdge prjs`s g`b`hdse)hdr`nd p`restdlteh k`luf dhteb h`iudle pdgd b tdlgestr`s.

    ]dgd cdnen ydno f`nodldfe b`tdl gestr`s,t`rcdge p`n`hdndn pdgd dkgjf`n gdn spenot`r dndlf`nodldfe r`ldhsdse s`aenood f`hjneuf ydnot`rsefpdn gdldf usus h`ludr gdn k`ridfpur der

    h`tukdn. Jhseo`ndse cdnen utdfd t`tdp k`rdsdl gdre serhuldse

    fdt`rndl-b tdl f`ldlue plds`ntd gdn tdle pusdt.

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    @hstrdut`ren` N`jndtus dt`rf fdfpu f`ni`rnd gdn dksjrkse DYE s`cdh

    ldaer Bdhtjr p`rtufkuadn sp`sebeh-sp`se`s ge der susu p`nteno untuh

    f`ngjrjno p`rh`fkdnodn p`ni`rnddn pdsid ndtdl.

    Psus n`jndtus f`felehe hdpdsetds p`ni`rnddn gdn p`ny`rdpdn ydnoefdtur t`tdpe t`rgdpdt s`cuflda f`hdnesf` hjfp`nsdse, t`rutdfduntuh kdye ydno f`gdpdt der susu eku (L`k`ntadl & L`uno, ;==1).

    Ypenot`r idrgedi dntdrd `sjpadous gdn ldfkuno pdgd n`jndtus fdseaeffdtur` (Jlgs, `t dl., ;=4=), f`nodldfe r`ldhsdse s`aenood gdpdtf`ny`kdkhdn r`ouroetdse fdhdndn s`o`rd s`t`lda gek`rehdn (Ojrre`, `tdl., ;==1).

    [`ouroetdse cuod gdpdt t`rcdge hdr`nd hjntrjl p`rsdrdbdn pdgd ldfkunok`luf s`fpurnd (Jlgs, `t dl., ;==1).

    Yddt ldaer hdpdsetds ldfkuno KKL s`hetdr 2 fl/ho KK, dtdu rdtd-rdtds`hetdr 0=-2= ii, t`tdpe s`o`rd k`rtdfkda sdfpde s`hetdr 5= fl s`ldfdk`k`rdpd adre p`rtdfd h`aegupdn.

    Ldfkuno dhdn hjsjno gdldf 9 cdf (Jlgs, `t dl., 451=) untuhp`fdsuhdn fdhdndn gdn hjsjno s`fpurnd gdldf ; sdfpde 7 cdf.

    (Ojrre`, `t dl., 4551).

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    @hstrdut`ren` N`jndtdl funohen f`nodldfe h`t`rldfkdtdn

    gdldf odstei `fptyeno hdr`nd hjntrdhse p`rsetdltehfdsea k`rsebdt rdngjf, r`spjn gjug`nuftradgdp fdhdndn fdsea efdtur, hjntrdhsegujg`ndl efdtur g`ldy`g odstrei `fptyeno.

    ]`restdlteh f`ncdge l`kea t`rjrodneser, gujg`ndlr`spjns`s & odstrei `ftyeno tef` efprjv`ss`cdldn go f`nenohdtnyd o`stdsejndl do`, r`ourdl`nt`rdl b``geno (4= adre) f`felehe `b`h fdturdsepjseteb t`radgdp gujg`ndl r`spjn (Kldihkurn,;=498 Geffet & Yekl`y, ;=4;).

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    @hstrdut`ren`

    KKL f`fpunyde usus ydno l`kea pdncdno gdldf

    uhurdnnyd t`radgdp k`sdr kdye gdn cehd

    gekdngenohdn g`nodn jrdno g`wdsd.H`dgddn ene

    f`ny`kdkhdn dr`d p`rfuhddn untuh dksjrkse

    l`kea luds (Ojrre`, `t dl., 4551). Keseno usus pdgd h`dgddn njrfdl gdpdt geg`nodr

    pdgd 7 hudgrdn dkgjf`n gdldf cdf p`rtdfd

    s`t`lda ldaer dhekdt kdye f`n`ldn ugdrd sddtf`ndnoes gdn syst`f sdrdb sefpdtes f`rdnosdno

    p`restdltei (Yefpsjn & Ir``adn, ;==4).

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    @hstrdut`ren`

    Yddt ldaer sdlurdn i`rnd st`rel. Y`hdle kdye t`rpdpdr g`nodn lenohunodn ludr gdn

    iderdn fulde fdsuh, kdht`re fdsuh h` sdlurdn i`rnd.

    Bljrd njrfdl usus dhdn t`rk`ntuh gdldf k`k`rdpd

    adre p`rtdfd h`aegupdn (Ojrre`, `t dl., 4551)

    s`aenood f`shepun sdlurdn i`rnd st`rel sddt ldaer,

    pdgd h`kdnydhdn kdye kdht`re gdpdt gehultur gdldf

    0 cdf s`t`lda ldaer. Kdht`re ene p`nteno untuh p`ni`rnddn gdn untuh

    sent`sd vetdfen H (Jlgs, `t dl., 451=).

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    [`bl`hs Fdhdn

    Y`cdh ldaer, s`jrdno kdye njrfd