Ppt Lapkas Uro
Transcript of Ppt Lapkas Uro
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NEFROLITHIASIS
ZULFANCUT MERRY
DENNY MUKHTAR
KHAIRUNNISA
PEMBIMBING:DR. DAHRIL, SP.U
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PENDAHULUAN
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PENYAKIT BATU SALURAN KEMIH SUDAH DIKENALSEJAK JAMAN BABILONIA DAN ZAMAN MESIR KUNO.
SEBAGAI SALAH SATU BUKTINYA ADALAHDIKETEMUKAN BATU PADA KANDUNG KEMIH SEORANGMUMI.
DI INDONESIA PENYAKIT BATU SALURAN KEMIH MASIHMENEMPATI PORSI TERBESAR DARI JUMLAH PASIEN DI
KLINIK UROLOGI.
TERBENTUKNYA BATU SALURAN KEMIH DIDUGA ADAHUBUNGANNYA DENGAN GANGGUAN ALIRAN URINE,GANGGUAN METABOLIK, INFEKSI SALURAN KEMIH,
DEHIDRASI DAN KEADAAN KEADAAN LAIN YANGMASIH BELUM TERUNGKAP (IDIOPATIK).
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LAPORAN KASUS
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IDENTITAS PASIEN
Nama Tn. KY
Umur Ta!un
J"n#$ K"%am#n La'%a
P"&"raan Sa$*a
A+ama I$%am
Su&u A"!
A%ama* P#-#"
N. R"&am M"-#& /'01'2'3/
Tan++a%P"m"r#&$aan
/2 a4r#% 20/5
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ANAMNESIS
KELUHAN UTAMA
K"n#n+ 6"r-ara!
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ANAMNESIS
RPS
Pa$#"n -a*an+ &" 4%# 6"-a! ur%+# -"n+an ruu&an -ar# ruma! $a* -#$#+%# -"n+an &"%u!an &"n#n+ 6"r-ara!, &"%u!an $u-a! -#ra$a&an $"a&5 6u%an 7an+ %a%u 7an+ !am4#r -#ra$a&an $"*#a4 !ar#. Dara! 7an+ &"%uar6"ram4ur -"n+an &"n#n+, $aa* BAK *"ra$a n7"r# -an 4a$#"n
m"n+"-an $aa* BAK. Pa$#"n u+a 4"rna! m"n+"%u!&an &"n#n+ *#-a&&"%uar !#n++a %"6#! &uran+ /2 am namun &"%u!an 6"r&uran+ $"*"%a!-#%a&u&an 4"ma$an+an $"%an+ &"n#n+ -# ruma! $a*. K"%u!an *"r$"6u**"ra-# / !ar# SMRS. Pa$#"n u+a m"n+"%u! n7"r# 4#n++an+ $"6"%a!&anan $"a& 6"6"ra4a 6u%an 7an+ %a%u, n7"r# $"man *"ra$a a4a6#%a$"*"%a! &"#n+ 6"r-ara!. N7"r# -#ra$a&an $"4"r*# -#*u$u&'*u$u& -anm"na%ar !#n++a &" 4#n++u%.
Pa$#"n u+a m"n+"%u!&an a-an7a -"mam, mua% 8 mua%, 4"ru*&"m6un+. Saa* #n# 4a$#"n m"ra$a&an $an+a* %"ma$ -an BAK $"6"n*ar 8$"6"n*ar. S"a& /0 !ar# *"ra&!#r 4a$#"n u+a m"n+"%u!&an a-an7a 6a*u&6"r-a!a& -an -an *"ra$a n7"r# -# -a-a $"6"%a! r# -an *"ra$a m"na%ar!#n++a &" %"!"r. S"%ama $a* 4a$#"n u+a m"n+a%am# $u%#* BAB
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ANAMNESIS
Pa$#"n m"m#%# r#a7a* 4"n7a* 6a*u -# &an-un+&"m#! 4a-a *a!un /991 -an $u-a! -# 4"ra$#, $aa*#*u 4a$#"n u+a -#&"*a!u# m"m#%# 6a*u -# +#na%namun 6"%um -# 4"ra$#. Dan *#-a& 4"rna! 6"r6a*$"ara *"ra*ur &ar"na *#-a& a-a &"%u!an. Pa$#"n
u+a m"n+"%u!&an r#a7a* DM $"a& 20/: -an4"rna! m"m#%# KGD m"na4a# 00 m+;-% -an*#-a& ru*#n 6"r6a*. R#a7a* HT('), A$ma ('),4"n7a* a$am ura* (').
K"%uar+a 4a$#"n mu%a# -ar# &a&"&, a7a!, !#n++a
a-#& 4a$#"n m"m#%# r#a7a* 6a*u -# +#na% -ana7a! 4a$#"n u+a m"m#%# r#a7a* -#a6"*"$m"%%#*u$.
RPD
RPK
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ANAMNESIS
Pa$#"n m"m#%# r#a7a* m"r&& !#n++a 2 8 36un+&u$ r&& $"*#a4 !ar#, -an m#num &4# $"!ar#2 +"%a$, $"!ar# 8 !ar# 4a$#"n aran+ ma&an 6ua!-an $a7ur, -an $"6"%um -#&"*a!u# a-an7a 6a*u-#+#na%, 4a$#"n m"n+a&u &uran+ m#num a#r 4u*#!
$"!ar# 8 !ar#.
RKS
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PEMERIKSAAN FISIK
VITAL SIGN
K"a-aan Umum Sa* r#n+an
G @:./03U;L /0':0./03U;L
H"&+2 1*+"$
Eo$"+o3'2 0'5
Ba$o3'0 0'2
N*&ro3' S*2)*+52 '>0
N*&ro3' Baa+20 2 8 5
L")4o$"/> 20':0
Mo+o$"1 2'1
ELEKTROLIT
Nar"&) 5Na6/3> mm%;L /3'/: mm%;L
Ka'"&) 5K6:,1 mm%;L 3,: 8 :, mm%;L
K'or"!a 5C'6/02 mm%;L 90 8 //0 mm%;L
D"a(**$
G'&o$a Darah P&a$a
255 m+;D% 50 8 //0 m+;-L
F&+2$" G"+7a'
Ur*&) 33 m+;-L /3':3 m+;-L
Kr*a"+"+0,1 m+;-L 0,5>'/,/> m+;-L
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PEMERIKSAAN
PENUN1ANGBNO
OPASITAS SETINGGIL / KANAN.PREPERITONEAL FATLINE BAIK.DISTRIBUSI UDARAUSUS MEN
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PEMERIKSAAN
PENUN1ANGUSG
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PEMERIKSAAN
PENUN1ANGCTSCAN 8D
TAMPAK LITHIASISPADA SETINGGI L/'L2 (GINJAL KANAN).
TIDAK TAMPAKLITHIASIS PADAPROYEKSI TRAKTUS
URINARIUS LAINNYA.KESANNEFROLITHIASISKANAN
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PEMERIKSAAN
PENUN1ANGCTSCAN
Tam4a& ma$$a !#4-"n$-"n+an *"4# #r"+u%"r 4a-a6a+#an an*"r#r 6u%#'6u%#.Pr$*a* -an r"*um
nrma%, ar#n+an %una&4"r"$#a -an 4"r#r"*a%6a#&.T#-a& *am4a& %#a-"n4a*##%#4"%#& -an #n+u#na%&anan r#.K"$an $u$4. Ma$$a 6u%#'6u%#
L#*!#a$#$ mu%*#4%" 4a-a+#na% &anan -#am"*"r 0,3'
2,0 m. S#$*"m4"%#&a%#$"$ &anan *#-a&m"%"6ar. G#na% r#nrma%. H"4ar, %#"n,&an-un+ "m4"-u,4anr"a$ nrma%.
K"$an N"r%#*#a$#$mu%*#4%" &anan
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DIAGNOSIS BANDING
' N"r%#*!#a$#$
' G%m"ru%n"r#*#$
'
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DIAGNOSIS
' N"r%#*!#a$#$ &anan
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TERAPI
M"-#&a m"n*$a I=FD RL 20 +**;#In.
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TINJAUAN PUSTAKA
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BSK
S&!aha!a
$*7a!&'&
9;
59
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ANATOMI
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DEFINISI
Ba*u +#na% a-a%a! ma$$a &"ra$ $"4"r*# 6a*u 7an+6"ra-a -# +#na% -an $a%urann7a -an -a4a*m"n7"6a6&an n7"r#, 4"r-ara!an, 4"n7um6a*ana%#ran &"m#!, a*au #n"&$#.
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ETIOLOGIFaor I+r"+$":
a. H"r"-#*"r(&"*urunan)
6. Umur (30'0*a!un)
.J"n#$ &"%am#n
( )
Faor*$r"+$":
a. G"+ra
6. I&%#m *"m4"ra*ur
. A$u4an a#r
-. D#"*
". P"&"raan
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INSIDENSI UROLITHIASISPembentukan Batu India USA Jepang UK
Calcium Oxalate
Murni
86. !! ".# !$.#
Calcium Oxalate
bercampur P%&'p%ate
#.$ !# ().8 *).*
Magne'ium
Amm&nium P%&'p%ate
+Stru,ite -
*." ( ".# (.#
A'am Urat .* 8.) #.# 8.)
C'tine ).# !.) .) *.8
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PATOFISIOLOGI
BATU
Or2a+"
A+or2a+"
M*+*)-*' !" *-"*'$a'. *)"h
Baha+ 'a"+ !"*+!a-a+
M*)(*+& (a& 2
%&&- (*$ar
M*+&)(a $a'. *)"h
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1ENIS BATUBa*uS*ur#
*
Ba*uKa%$#u
m
Ba*uA$amUra*
J"n#$%a#n
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GE1ALA KLINISB"r+an*un+
/. P$#$# a*au %"*a& 6a*u
2. B"$ar 6a*u
3. P"n7u%#* 7an+ *"%a! *"ra-#
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G"a%a 4a%#n+ $"r#n+ n7"r# 4#n++an+ (6"r$#a* &%#&a*au nn&%#&)
K%#& *"ra-# aa* 4"n#n+&a*an a&*##*a$ 4"r#$*a%*#&** 4%$ $#$*"m &a%#$"$ -a%am u$a!a un*u&m"n+"%uar&an 6a*u -ar# $a%uran &"m#! *"&.In*ra%um#na% m"n#n+&a* 4"r"+an+an *"rm#na% $aran7"r#
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Nn&%#& aa* 4"r"+an+an &a4$u% +#na% &ar"na*"ra-# !#-rn"r$#$ a*au #n"&$# 4a-a +#na%.
Pa-a 4"m"r#&$aan $#& mun+n -#-a4a*&an n7"r#&"*& 4a-a -a"ra! &$*'"r*"6ra, *"ra6a +#na% 4a-a$#$# $a* aa* !#-rn"r$#$, *"r%#!a* *an-a'*an-a+a+a% +#na%, r"*"n$# ur#n", -an #&a -#$"r*a# #n"&$#-#-a4a*&an -"mam'm"n++#+#%.
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H"ma*ur#a
N7"r# $aa* 6"r&"m#!
BAK $"-#*
Mua% -an mun*a!
P"n#n+&a*an $u!u *u6u!
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DIAGNOSISAnamn"$#$
P"m"r#&$aan $#&
P"m"r#&$aan 4"nunan+
a. La6ra*r#um
6. Ra-#%+#
. USG (m"n"n*u&an ruan+ %um"n $a%. K"m#!)
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DIAGNOSIS BANDINGP"n7a* &%#& $a%uran 4"n"rnaan
A4"n-#$#*#$ a&u*
A-n"&$#*#$ (4a-a an#*a)
K"+ana$an (Tumr G#na%, Tumr Gra#*C,
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PENATALAKSANAANT"ra4# &n$"ra*# , -"n+an
a. M#num a#r 2 L; !ar#
6. B ' 6%&"r
. NSAID
Ba*a$ %ama *"ra4# &n$"ra*# a-a%a! 5 m#n++u
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ESL5*xra
%or-or*a'$ho%0a#
*L"hor"-$
6
E+!o&ro'o2",*r!"r" aa$:
PNL
L"hor"-$"
Ur**ro$o-"aa&
&r**ror*+o$o-"
E$ra$"Dor)"a
B*!ahT*r(&a
B*!ahLa-aro$o
-"
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PENCEGAHAN
M"n+!#n-ar# -"!#-ra$# -"n+an m#num u&u4 -an-#u$a!a&an 4r-u&$# ur#n 2'3 %#*"r 4"r !ar#.
D#"* un*u& m"n+uran+# &a-ar Ca*'Ca* &m4n"n4"m6"n*u& 6a*u. (-#"* 4r*"#n r"n-a!, "n-a! &$a%a*,r"n-a! +aram, r"n-a! 4ur#n)
A&*##*a$ !ar#an 7an+ u&u4.
P"m6"r#an m"-#&am"n*$a.
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PROGNOSIS
B"r+an*un+ 4a-a
'U&uran 6a*u
'L"*a& 6a*u
'A-an7a #n"&$#
'A-an7a 6$*ru&$#
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KESIMPULAN
Ba*u +#na% m"ru4a&an $a%a! $a*u 4"n7a* 4a-a$a%uran &"m#! *"ru*ama 4a-a 6a+#an +#na%. P"n7a*#n# m"ru4a&an $a%a! $a*u 4"n7a* *"r6an7a& 7an+-#*"mu&an 4a-a 6#-an+ ur%+#.
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T"muan &%#n#$, %a6ra*r#$, -an ra-#%+#$ m"ru4a&anm-a%#*a$ 7an+ $an+a* -#4"r%u&an un*u& 4"n"+a&an-#a+n$#$ 6a*u +#na%. P"nan+anan 7an+ *"4a* un*u&6a*u +#na% #n# a&an -a4a* m"n#n+&a*&an &ua%#*a$ !#-u4$"$"ran+ m"na-# %"6#! 6a#&.
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TERIMA KASIH