porto puskes gea
TRANSCRIPT
-
8/15/2019 Porto Puskes GEA
1/22
Diare Akut
Pembimbing:
dr.Kartika Putri Pertiwi
oleh:
dr. Ines Damayanti Octaviani
31 11!!11"1"#"3#
DOKTER INTERNSIP
RUMAH SAKIT UMUM PUSAT ANGKATAN UDARA
BERTUGAS DI PUSKESMAS TEBET
PERIODE 12 FEBRUARI 2015 – 12 JUNI 2015
-
8/15/2019 Porto Puskes GEA
2/22
I.P$%DA&'('A%
1.1 (atar )elakang
Diare masih mer !a"a# sa$ah sa% !e#&e'a' %ama m(r'i$i%as )a# m(r%a$i%as a#a" )i
#e*ara &a#* se)a#* 'er"em'a#*+ Da$am 'er'a*ai hasi$ S r,ei "eseha%a# R mah Ta#**a
)iare me#em!a%i "isara# r %a# "e-2 )a# "e-. 'er'a*ai !e#&e'a' "ema%ia# 'a&i )i
I#)(#esia 1+ Se'a*ia# 'esar )iare a" % )ise'a'"a# ($eh i#/e"si+ Ba#&a" )am!a" &a#* %er a)i
"are#a i#/e"si se$ ra# er#a a#%ara $ai# !e#*e$ ara# %("si# &a#* )a!a% me#im' $"a#
*a#** a# se"resi )a# rea's(r!si aira# )a# e$e"%r($i% )e#*a# a"i'a% )ehi)rasi *a#** a#"eseim'a#*a# e$e"%r($i% )a# "eseim'a#*a# asam 'asa+ I#,asi )a# )es%r "si se$ e!i%e$
!e#e%rasi "e $ami#a !r(!ria ser%a "er sa"a# mi"r(,i$i )a!a% me#im' $"a# "ea)aa# ma$)i*es
)a# ma$a's(r!si 2+ Bi$a %i)a" me#)a!a%"a# !e#a#*a#a# &a#* a)e" a% !a)a a"hir#&a )a!a%
me#*a$ami i#,asi sis%emi" 2+
Se ara m m !e#a#*a#a# )iare a" % )i% "a# #% " me# e*ah a%a me#a#** $a#*i
)ehi)rasi ser%a *a#** a# "eseim'a#*a# e$e"%r($i% )a# asam 'asa "em #*"i#a# %er a)i#&a
i#%($erasi me#*('a%i "a sa )iare &a#* s!esi/i" me# e*ah )a# me#a#** $a#*i *a#** a# *i3i
ser%a me#*('a%i !e#&a"i% !e#&er%a+ U#% " me$a"sa#a"a# %era!i )iare se ara "(m!rehe#si/
e/isie# )a# e/e"s%i/ har s )i$a" "a# se ara rasi(#a$+ Pema"aia# aira# rehi)rasi (ra$ se ara
m m e/e"%i/ )a$am me#*"(re"si )ehi)rasi+ Pem'eria# aira# i#%ra,e#a )i!er$ "a# i"a
%er)a!a% "e*a*a$a# ($eh "are#a %i#**i#&a /re" e#si )iare m #%ah &a#* %a" %er"(#%r($ )a#
%er*a#** #&a mas "a# (ra$ ($eh "are#a i#/e"si+ Be'era!a ara !e# e*aha# )e#*a# ,a"si#asi
ser%a !ema"aia# !r('i(%i" %e$ah 'a#&a" )i #*"a! )a# !e#a#*a#a# me#** #a"a# a#%i'i(%i"a
&a#* s!esi/i" )a# a#%i!arasi% . +
I.1 Tujuanma"a$ah i#i )i' a% )e#*a# % a# me#i#*"a%"a# !e#*e%ah a# %e#%a#* )iare a" % !a)a
a#a" m $ai )ari )e/i#isi e%i($(*i )ia*#(sis *e a$a !e#a%a$a"sa#aa# hi#**a !e# e*aha#+
II. (APO*A% KA+'+
-
8/15/2019 Porto Puskes GEA
3/22
DOKTER INTERNSIP
STATUS PO4I UMUM
PUSKESMAS KE AMATAN TEBET
JAKARTA SE4ATAN
Nama 6 )r+ I#es Dama&a#%i O %a,ia#i Ta#)a Ta#*a#
STR 6.1211001151575.7
Dr+ Pem'im'i#* 6 )r+Kar%i"a P %ri Per%i8i
ID$%,I,A+ PA+I$%
%ama lengka- 6A#+ Fa hri Peker aan 6 -/enis kelamin 6 4a"i - $a"i Pendidikan 6 -+uku bangsa 6 Be%a8i %o. registrasi 6 20092015
,anggal lahir 6 .0 Se!%em'er 201.,anggal datang 6 2. Fe'r ari 2015 07+.0
:IBAlamat 6 $+ E #(+20 RT 00.900; Asam Baris
Ke'(# Bar – Ja"ar%a Se$a%a#
Dokter yang memeriksa 6 )r+ I#es Dama&a#%i
O %a,ia#iAgama 6 Is$am +tatus -erkawinan 6 Be$ m me#i"ah%ama Ayah: T#+ Hasa#
A. A%A0%$+I+Diam'i$ )ari 6A$$(a#am#esis )e#*a# i' !asie#Ta#**a$ 62. Fe'r ari 2015Jam 6 10+00 :IB
Keluhan utama 6Diare se a" 1 hari se'e$ m )a%a#* "e P s"esmas
Keluhan tambahan 6
M #%ah se a" 5 am se'e$ m )a%a#* "e P s"esmas+
*iwayat Penyakit +ekarang 6
Pasie# )a%a#* )i 'a8a ($eh i' #&a "e !($i MTBS ! s"esmas "e ama%a# Te'e%
)e#*a# "e$ ha# )iare )iare )irasa"a# se a" 1 hari se'e$ m !asie# )a%a#* "e ! s"esmas
)iare )irasa"a# se%e$ah !asie# mi# m es %eh ma#is &a#* )i'e$i "a"a" !asie# )i 8ar #*+
OS *a me#*a$ami m #%ah se a" 5 am se'e$ m OS )a%a#* "e ! s"esmas+ Ti)a"
%er)a!a% )emam %i)a" %er)a!a% "e a#* %i)a" me#*i*a %i)a" me#**i*i$ )a# %i)a" a)a
%a#)a-%a#)a !er)araha#+ BAB " ra#* $e'ih
-
8/15/2019 Porto Puskes GEA
4/22
" #i#* %i)a" a)a $e#)ir ma ! # )arah+ BAK .-5 m+ 4i#*"ar "e!a$a
-
8/15/2019 Porto Puskes GEA
5/22
'er)iri 6 11 ' $a#
'er a$a# 6 1. ' $a#
Saa% i#i a#a" 'er sia 2. ' $a#+ Ti)a" a)a *a#** a# !er"em'a#*a# )a$am
me#%a$ )a# em(si+ I#%era"si )e#*a# (ra#* se"i%ar 'ai"+
Kesa#6 !er% m' ha# a#a" )a# !er"em'a#*a# a#a" ses ai m r
). *iwayat 0akanan
- Usia 0- < ' $a# 6 )i'eri"a# ASI sema 'a&i
- Usia < ' $a# – > ' $a# 6 S s F(rm $a ? ' ' r s s . = sehari "a)a#* #asi
%im )a# $a " !a "
- Usia > ' $a# - 1 %ah #6 s s /(rm $a ? ' ' r %im ? $a " !a "? r(%i s s . =
sehari+ Ka)a#*-"a)a#* a&am )a*i#* %e$ r+
- 1 %ah # – se"ara#*6 Nasi ? sa% r ? $a " !a "? s s /(rm $a "a)a#*-"a)a#*
a&am )a*i#* %e$ r i"a# .=sehari+
. *iwayat Imunisasi
4AK+I% DA+A* 5umur6 '(A%7A% 5umur6) 7 1 ' $a# - - - - -
DP,8 D, 2 ' $a# < ' $a# @ ' $a# - - -PO(IO 0 ' $a# 2 ' $a# < ' $a# @ ' $a# - -A0PAK 10 ' $a# - - - - -
&$PA,I,I+ ) 0 ' $a# 1 ' $a# < ' $a# @ ' $a# - -Kesa# 6 Im #isasi )asar $e#*"a! )a# se$a$ me#*i" %i a)8a$ im #isasi &a#* %er%era !a)a
KMSD. *iwayat Keluarga
(ra" Re!r() "si%o usia /enis
Kelamin
&idu- (ahir
0ati
Abortus 0ati Keterangan
1 @ %ah # !erem! a# Hi) ! - - - seha%
2. ' $a# 4a"i - $a"i Hi) ! Sa"i%
$. +ilsilah Keluarga
-
8/15/2019 Porto Puskes GEA
6/22
+ilsilah atau Ikhtisar Keturunan
Keterangan :
6 $a"i-$a"i
6 !erem! a#
6 me#i#**a$
6 !asie#
Kesa# 6 %i)a" a)a a#**(%a "e$ ar*a &a#* me#)eri%a "e$ ha# se!er%i !asie#+
). P$0$*IK+AA% 9I+IK
Pemeri"saa# /isi" )i$a" "a# %a#**a$ 2. Fe'r ari 2015 ! " $ 10+00 :IB )i !($i
MTBS+ a#a" $a"i - $a"i sia 2. ' $a# 'era% 'a)a# se"ara#* 12 "* !a# a#* 'a)a# >5 m
$i#*"ar "e!a$a
-
8/15/2019 Porto Puskes GEA
7/22
+tatus 7eneralis• Ke-ala
N(rm( he!a$i " ra# $i#*"ar "e!a$a
-
8/15/2019 Porto Puskes GEA
8/22
,ulang )elakang
Ti)a" a)a s!i#a 'i/i)a %i)a" a)a me#i#*( e$e
7enitalia
4a"i - $a"i %es%is me#**a#% #* r *ae "asar OUE %i)a" hi!eremis
Anorektal
A# s ? %i)a" hi!eremis
Anggota gerak
Keem!a% a#**(%a *era" $e#*"a! sem! r#a
$kstremitas
+u-erior In;erior
De/(rmi%as - 9- - 9-
A"ra$ )i#*i# - 9- -9-
A"ra$ sia#(sis - 9- - 9-
RT 2 )e%i" 2 )e%i"
T(# s N(rm(%(#i N(rm(%(#i
(e)em -9- -9-
Kulit
Sia#(%i" - i"%eri" - a#emis - % r*(r " $i% a')(me# "em'a$i 2 )e%i"+
. P$0$*IK+AA% K&'+'+
A. Data Anto-ometri
A#a" $a"i-$a"i sia 6 2. ' $a#
Bera% 'a)a# 6 12 "*
Pa# a#* 'a)a# 6 >5 m
-
8/15/2019 Porto Puskes GEA
9/22
Pemeri"saa# S%a% s Gi3i
BB9U 6 12911 = 100 100 'era% 'a)a# i)ea$
TB9U 6 >59>> = 100 7@ 5 %i#**i i)ea$
BB9TB 6 12911 = 100 100 *i3i 'ai"
Kesa# 6 Bera% 'a)a# i)ea$ %i#**i i)ea$ *i3i 'ai"
D. DIA7%O+I+
Diagnosis ker a dan dasar diagnosis
Dia*#(sis "er a 6
Diare a" %
Dasar )ia*#(sis6
- A#am#esis "e$ ha# %ama )iare- Pemeri"saa# /isi"6 )is%e#si a')(me# 'isi#* s s me#i#*"a%
$. P$0$*IK+AA% 2A%7 DIA%/'*KA%
Feses r %i#
9. P$%7$(O(AA%:
%on medikamentosa:
< Ra8a% a$a#
0edikamentosa:
< i# 1=1< $a %(B 1=1 sa he%
7. P*O7%O+I+ :
Passa*e 6 a) '(#am
Passa#*er 6 a) '(#am
P(8er 6 a) '(#am
-
8/15/2019 Porto Puskes GEA
10/22
III.,I%/A'A% P'+,AKA
De;inisi
Diare a" % me# r % (he#< a)a$ah "e$ ar#&a ' a#* air 'esar se"a$i a%a $e'ih &a#* 'er'e#% "
air )a$am sa% hari )a# 'er$a#*s #* " ra#* 1< hari+ Me# r % N(erasi) 5 )iare a" % ia$ah )iare
&a#* %er a)i se ara me#)a"a" !a)a 'a&i )a# a#a" &a#* se'e$ m#&a seha%+ Se)a#*"a#
American Academy of Pediatrics AAP me#)e/i#isi"a# )iare )e#*a# "ara"%eris%i"
!e#i#*"a%a# /re" e#si )a#9a%a !er 'aha# "(#sis%e#si )a!a% )iser%ai a%a %a#!a *e a$a )a#
%a#)a se!er%i m a$ m #%ah )emam a%a sa"i% !er % &a#* 'er$a#*s #* se$ama . – ; hari@+
$-idemiologi
Se%ia! %ah # )i!eri"ira"a# $e'ih )ari sa% mi$&ar "as s )iare )i ) #ia )e#*a# . . %a "as s
"ema%ia# se'a*ai a"i'a%#&a ; + Di!er"ira"a# a#*"a "e a)ia# )i #e*ara 'er"em'a#* 'er"isar . 5
– ; e!is()e !er a#a" !er%ah # )a$am 2 %ah # !er%ama "ehi) !a# )a# 2 – 5 e!is()e !er a#a"
!er %ah # )a$am 5 %ah # !er%ama "ehi) !a# >+ Hasi$ s r,ei ($eh De!"es+ )i!er($eh a#*"a
"esa"i%a# )iare %ah # 2000 se'esar .01 !er 1000 !e#) ) " a#*"a i#i me#i#*"a% 'i$a
)i'a#)i#* s r,ei !a)a %ah # 177@ se'esar 2>0 !er 1000 !e#) ) "+ Diare masih mer !a"a#
!e#&e'a' %ama "ema%ia# 'a&i )a# 'a$i%a+ Hasi$ S r"es#as 2001 )i)a!a% !r(!(rsi "ema%ia#
'a&i 7 < )e#*a# !eri#*"a% . )a# !r(!(rsi "ema%ia# 'a$i%a 1. 2 )e#*a# !eri#*"a% 2 7+ Diare
!a)a a#a" mer !a"a# !e#&a"i% &a#* maha$ &a#* 'erh ' #*a# se ara $a#*s #* a%a %i)a"
%er)a!a% !em'ia&aa# )a$am mas&ara"a%+ Bia&a #% " i#/e"si r(%a,ir s )i%a"sir $e'ih )ari @ .
%a !( #)s%er$i#* se%ia! %ah #&a )i I#**ris )a# .52 %a )($$ar )i Ameri"a Seri"a%+
Klasi;ikasi
Diare se ara *aris 'esar )i'a*i a%as ra)a#* )a# #(# ra)a#*+ Diare ra)a#* )i'a*i $a*i a%asi#/e"si )a# #(# i#/e"si+ Diare #(# ra)a#* 'isa "are#a h(rm(#a$ a#a%(mis ('a%-('a%a# )a#
-
8/15/2019 Porto Puskes GEA
11/22
$ai#-$ai#+ Pe#&e'a' i#/e"si 'isa ,ir s 'a"%eri !arasi% )a# am r se)a#*"a# #(# i#/e"si
"are#a a$er*i ra)iasi 10+
$tiologi
Pe#&e'a' )iare a" % !a)a a#a" se ara *aris 'esar )a!a% )ise'a'"a# ($eh *as%r(e#%eri%is
"era #a# ma"a#a# "are#a a#%i'i(%i"a )a# i#/e"si sis%emi"+ E%i($(*i )iare !a)a 25 %ah #
&a#* $a$ se'a*ia# 'esar 'e$ m )i"e%ah i a"a# %e%a!i "i#i %e$ah $e'ih )ari >0 !e#&e'a'#&a
)i"e%ah i+ Pa)a saa% i#i %e$ah )a!a% )ii)e#%i/i"asi %i)a" " ra#* )ari 25 e#is mi"r((r*a#isme
&a#* )a!a% me#&e'a'"a# )iare !a)a a#a" )a# 'a&i ; +
Pe#&e'a' %ama ($eh ,ir s &a#* %er %ama ia$ah R(%a,ir s
-
8/15/2019 Porto Puskes GEA
12/22
Se' ah s% )i %e#%a#* mas$ah )iare a" % &a#* %er a)i "are#a i#/e"si !a)a a#a" )i 'a8ah .
%ah # )i i#a I#)ia Me"si"( M&a#mar B rma )a# Pa"is%a# ha#&a %i*a a*e# i#/e"%i/ &a#*
se ara "(#sis%e# a%a se ara !("(" )i%em "a# me#i#*"a% !a)a a#a" !e#)eri%a )iare+ A*e# i#i
a)a$ah R(%a,ir s Shi*e$$a s!! )a# E+ ($i e#%er(%("si*e#i" R(%a,ir s e$as mer !a"a#
!e#&e'a' )iare a" % &a#* !a$i#* seri#* )ii)e#%i/i"asi !a)a a#a" )a$am "(m #i%as %r(!is )a#
i"$im se)a#*+ 1. Diare )a!a% )ise'a'"a# ($eh a$er*i a%a i#%($era#si ma"a#a# %er%e#% se!er%i
s s !r() " s s ma"a#a# asi#* %er)a!a% i#)i,i) %er%e#% &a#* !e)as a%a %i)a" ses ai
"(#)isi s s )a!a% ! $a )ise'a'"a# ($eh "era #a# ma"a#a# )a# 'aha#-'aha# "imia+
Be'era!a ma am ('a% %er %ama a#%i'i(%i"a )a!a% *a me# a)i !e#&e'a' )iare+ A#%i'i(%i"a
a"a# me#e"a# /$(ra #(rma$ s s sehi#**a (r*a#isme &a#* %i)a" 'iasa a%a &a#* "e'a$
a#%i'i(%i"a a"a# 'er"em'a#* 'e'as+ ; 1< Di sam!i#* i% si/a% /arma"("i#e%i" )ari ('a% i%
se#)iri *a meme*a#* !era#a# !e#%i#*+ Diare *a 'erh ' #*a# )e#*a# !e#&a"i% $ai#
misa$#&a ma$aria s his%(s(miasis am!a" a%a !a)a i#/e"si sis%emi" $ai##&a misa$#&a
!#e m(#ia ra)a#* %e#**(r("a# )a# (%i%is me)ia+ < ;
Pato;isiologi
Me# r % !a%(/isi($(*i#&a )iare )i'e)a"a# )a$am 'e'era!a "a%e*(ri &ai% )iare (sm(%i"
se"re%(ri" )a# )iare "are#a *a#** a# m(%i$i%as s s+ Diare (sm(%i" %er a)i "are#a %er)a!a%#&a
'aha# &a#* %i)a" )a!a% )ia's(r!si ($eh s s a"a# )i/erme#%asi ($eh 'ah%eri s s sehi#**a
%e"a#a# (sm(%i" )i $ me# s s me#i#*"a% &a#* a"a# me#ari" aira#+ Diare se"re%(ri" %er a)i
"are#a %(=i# )ari 'a"%eri a"a# me#s%im $asi AMP )a# GMP &a#* a"a# me#s%im $asi
se"resi aira# )a# e$e"%r($i%+ Se)a#*"a# )iare "are#a *a#** a# m(%i$i%as s s %er a)i a"i'a%
a)a#&a *a#** a# !a)a "(#%r($ (%(#(mi" misa$ !a)a )ia'e%i" #e r(!a%hi !(s% ,a*(%(mi !(s%
rese"si s s ser%a hi!er%ir(i)+ ;
0ani;estasi kinis
Diare me#&e'a'"a# hi$a#*#&a se m$ah 'esar air )a# e$e"%r($i% )a# seri#* )iser%ai )e#*a#
asi)(sis me%a'($i" "are#a "ehi$a#*a# 'asa+ Dehi)rasi )a!a% )i"$asi/i"asi"a# 'er)asar"a#
)e/isi% air )a# a%a "eseim'a#*a# e$e"%r($i%+ Dehi)rasi ri#*a# 'i$a !e# r #a# 'era% 'a)a#
" ra#* )ari 5 )ehi)rasi se)a#* 'i$a !e# r #a# 'era% 'a)a# a#%ara 5 -10 )a# )hi)rasi
'era% 'i$a !e# r #a# $e'ih )ari 10 + ; 15
Dera a% Dehi)rasi
Ge a$a Kea)aa# Ma%a M $ %9 Rasa Ha s K $i% BB Es%imasi
-
8/15/2019 Porto Puskes GEA
13/22
Ta#)a Um m 4i)ah)e/+
aira#Ta#!a
Dehi)rasiBai" Sa)ar N(rma$ Basah
Mi# m N(rma$
Ti)a" Ha sT r*(r 'ai" 5 50
Dehi)rasi
Ri#*a#
-Se)a#*
Ge$isah Re8e$ e" #* Keri#*Tam!a"
Keha sa#
T r*(r
$am'a%5 – 10
50–100
Dehi)rasi
Bera%
4e%ar*i"
Kesa)ara#
Me# r #
Sa#*a%
e" #* )a#
"eri#*
Sa#*a%
"eri#*
S $i% %i)a" 'isa
mi# m
T r*(r
sa#*a%
$am'a%
10 100
S m'er 6 Sa#)h 2001 1@
Ber)asar"a# "(#se#%rasi Na%ri m !$asma %i!e )ehi)rasi )i'a*i . &ai% 6 )ehi)rasihi!(#a%remia 1.0 mE*94 )ehi)rasi is(-#a%rema 1.0m – 150 mE*94 )a# )ehi)rasi
hi!er#a%remia 150 mE*94 + Pa)a m #&a )ehi)rasi &a#* %er a)i a)a$ah %i!e is( –
#a%remia >0 %a#!a )iser%ai *a#** a# (sm($a$i%as aira# % ' h sisa#&a 15 a)a$ah )iare
hi!er#a%remia )a# 5 a)a$ah )iare hi!(#a%remia+
Kehi$a#*a# 'i"ar'(#a% 'ersama )e#*a# )iare )a!a% me#im' $"a# asi)(sis me%a'($i" )e#*a#
a#i(# *a! &a#* #(rma$ >-1@ mE*94 'iasa#&a )iser%ai hi!er"$(remia+ Se$ai# !e# r #a#
'i"ar'(#a% ser m %er)a!a% ! $a !e# r #a# !H )arah "e#ai"a# ! O2+ Ha$ i#i a"a#mera#*sa#* ! sa% !er#a!asa# #% " me#i#*"a%"a# "e e!a%a# !er#a!asa# se'a*ai !a&a
me#i#*"a%"a# e"sresi O2 me$a$ i !ar !er#a!asa# K ssma $ U#% " !eme# ha#
"e' % ha# "a$(ri %er a)i !eme aha# !r(%ei# )a# $ema" &a#* me#*a"i'a%"a# me#i#*"a%#&a
!r() "si asam sehi#**a me#&e'a'"a# % r ##&a #a/s ma"a# 'a&i+ Kea)aa# )ehi)rasi 'era%
)e#*a# hi!(!er/ si *i# a$ ser%a e"sresi asam &a#* me# r # )a# a" m $asi a#i(# asam se ara
'ersamaa# me#&e'a'"a# 'er$a# %#&a "ea)aa# asi)(sis+ 1;
Ka)ar "a$i m !$asma )i!e#*ar hi ($eh "eseim'a#*a# asam 'asa sehi#**a !a)a "ea)aa#
asi)(sis me%e'($i" )a!a% %er a)i hi!("a$emia+ Kehi$a#*a# "a$i m *a me$a$ i aira# %i# a )a#
!er!i#)aha# K? "e )a$am se$ !a)a saa% "(re"si asi)(sis )a!a% ! $a me#im' $"a#
hi!("a$emia+ Ke$emaha# (%(% mer !a"a# ma#i/es%asi a8a$ )ari hi!("a$emia !er%ama "a$i
!a)a (%(% a#**(%a 'a)a# )a# (%(% !er#a!asa#+ Da!a% %er a)i are/$e"s !ara$isis )a# "ema%ia#
"are#a "e*a*a$a# !er#a!asa#+ Dis/ #*si (%(% har s me#im' $"a# i$e s !ara$i%i" )a# )i$a%asi
$am' #*+ EKG m# # ""a# *e$(m'a#* T &a#* me#)a%ar a%a me# r # )e#*a# m # $#&a
*e$(m'a#* U+ Pa)a *i# a$ "e" ra#*a# K? me#*a"i'a%"a# !er 'aha# ,a" ($a )a# e!i%e$
% ' $ s )a# me#im' $"a# s"$er(sis *i# a$ &a#* 'er$a# % me# a)i ($i* ria )a# *a*a$ *i# a$+ ;
-
8/15/2019 Porto Puskes GEA
14/22
Penatalaksanaan
Pe#*a#%ia# aira# )a# e$e"%r($i% mer !a"a# e$eme# &a#* !e#%i#* )a$am %era!i e/e"%i/ )iare
a" %+@ Bera%#&a )ehi)rasi se ara a" ra% )i#i$ai 'er)asar"a# 'era% 'a)a# &a#* hi$a#* se'a*ai
!erse#%asi "ehi$a#*a# %(%a$ 'era% 'a)a# )i'a#)i#*"a# 'era% 'a)a# se'e$ m#&a se'a*ai 'a"
emas+1>
Pem'eria# %era!i aira# )a!a% )i$a" "a# se ara (ra$ a%a !ara%era$+ Pem'eria# se ara (ra$
)a!a% )i$a" "a# #% " )ehi)rasi ri#*a# sam!ai se)a#* )a!a% me#** #a"a# !i!a #as(*as%ri"
8a$a ! # !a)a )ehi)rasi ri#*a# )a# se)a#*+ Bi$a )iare !r(/ s )e#*a# !e#*e$ ara# air %i# a
&a#* 'a#&a" 100 m$9"*BB9hari a%a m #%ah he'a% se,ere ,(mi%i#* sehi#**a !e#)eri%a
%a" )a!a% mi# m sama se"a$i a%a "em' #* &a#* sa#*a% he'a% ,i($e#% me%e(rism sehi#**a
!a&a rehi)rasi (ra$ %e%a! a"a# %er a)i )e/isi% ma"a )a!a% )i$a" "a# rehi)rasi !are#%era$
8a$a ! # se'e#ar#&a rehi)rasi !are#%era$ )i$a" "a# ha#&a #% " )ehi)rasi 'era% )e#*a#
*a#** a# sir" $asi 15+ Ke #% #*a# !a&a %era!i (ra$ "are#a m rah )a# )a!a% )i'eri"a#
)ima#a-ma#a+ AAP mere"(me#)asi"a# aira# rehi)rasi (ra$ ORS #% " rehi)rasi )e#*a#
"a)ar #a%ri m 'er"isar a#%ara ;5-70 mE 94 )a# #% " !e# e*aha# )a# !eme$iharaa# )e#*a#
#a%ri m a#%ara
-
8/15/2019 Porto Puskes GEA
15/22
;+ ASI )i%er s"a#
>+ S !$eme# )#e*a# RO RO r ma%a#
7+ A#%i )iare %i)a" )i!er$ "a#
Dehidrasi )erat
Pe#)eri%a )e#*a# )ehi)rasi 'era% &ai% )ehi)rasi $e'ih )ari 10 #% " 'a&i )a# a#a" )a#
me# # ""a# *a#** a# %a#)a-%a#)a ,i%a$ % ' h s(m#($e#-"(ma !er#a/asa# K ssma $
*a#** a# )i#ami" sir" $asi memer$ "a# !em'eria# aira# e$e"%r($i% !are#%era$+ Pe#**a#%ia#
aira# !are#%era$ me# r % !a#) a# :HO )i'eri"a# se'a*ai 'eri" % 12 15 1; 6
Usia 12 '$#6 .0m$9"*''91 am se$a# %#&a ;0m$9"*''95 am
Usia 12 '$#6 .0m$9"*''9192-1 am se$a# %#&a ;0m$9"*''92-2L am
:a$a ! # !a)a )iare %era!i aira# !are#%era$ %i)a" " ! 'a*i "e' % ha# !e#)eri%a a"a#
"a$(ri #am # ha$ i#i %i)a"$ah me# a)i masa$ah 'esar "are#a ha#&a me#&a#*" % 8a"% &a#*
!e#)e"+ A!a'i$a !e#)eri%a %e$ah "em'a$i )i'eri"a# )ie% se'a*aima#a 'iasa#&a + Se*a$a
"e" ra#*a# % ' h a"a# "ar'(hi)ra% $ema" )a# !r(%ei# a"a# se*era )a!a% )i!e# hi+ I% $ah
se'a'#&a me#*a!a !a)a !em'eria# %era!i aira# )i saha"a# a*ar !e#)eri%a 'i$a
mem #*"i#"a# e!a% me#)a!a%"a# ma"a#a# 9 mi# ma# se'a*ai 'iasa#&a 'ah"a# !a)a
)ehi)rasi ri#*a# se)a#* &a#* %i)a" memer$ "a# %era!i aira# !are#%era$ ma"a# )a# mi# m
%e%a! )a!a% )i$a# %"a#+1>
Pemilihan enis cairan
aira# Pare#%era$ )i' % h"a# %er %ama #% " )ehi)rasi 'era% )e#*a# a%a %a#!a s&("
sehi#**a )a!a% me#*em'a$i"a# )e#*a# e!a% ,($ me )arah#&a ser%a mem!er'ai"i re# a%a#
hi!(,($emi"#&a+ aira# Ri#*er 4a"%a% R4 a)a$ah aira# &a#* 'a#&a" )i!er)a*a#*"a# )a#
me#*a#) #* "(#se#%rasi #a%ri m &a#* %e!a% ser%a " ! $a"%a% &a#* a"a# )ime%a'($isme
me# a)i 'i"ar'(#a%+ Nam # )emi"ia# "(se#%rasi "a$i m#&a re#)ah )a# %i)a" me#*a#) #*
*$ "(sa #% " me# e*ah hi!(*$i"emia+ aira# Na 4 )e#*a# a%a %a#!a )e"s%r(sa )a!a%
)i!a"ai %e%a!i %i)a" me#*a#) #* e$e"%r($i% &a#* )i' % h"a# )a$am m$ah &a#* " !+ Je#is
aira# !are#%era$ &a#* saa% i#i 'ere)ar )a# )a!a% meme# hi "e' % ha# se'a*ai aira#
!e#**a#%i )iare )e#*a# )ehi)rasi a)a$ah Ka-EN .B+1@ Se m$ah aira# rehi)rasi (ra$ )e#*a#
(sm($a$i%i 210 – 2@> mm($91 )e#*a# Na 'er"isar 50 – ;5 mE*94 mem!er$iha%"a# e/i"asi
!a)a )iare a#a" )e#*a# "($era a%a %a#!a "($era+ 17
-
8/15/2019 Porto Puskes GEA
16/22
-
8/15/2019 Porto Puskes GEA
17/22
K(m!(sisi e$e"%r($i% !a)a )iare a" % 6
Ma amK(m!(sisi ra%a-ra%a e$e"%r($i% mm($94
Na K $ H O .Diare K($era
De8asa 1
K($era 6
Te%rasi"$i# 50m*9"*9hari )i'a*i < )(sis 2 hari
F ras($i)(# 5m*9"*9hari )i'a*i < )(sis . hari
Shi*e$$a 6
Trime%r(!rim 5-10m*9"*9hari
S $/ame%("sas($ 25m*9"*9hari Dia'*i 2 )(sis 5 hari
Asam Na$i)i"sa% 6 55m*9"*9hari )i'a*i < 5 hari
Ame'iasis6
-
8/15/2019 Porto Puskes GEA
18/22
Me%r(#i)as($ .0m*9"*9hari )i'ari < )(sis 7 5-10 hari
U#% " "as s 'era% 6 Dehi)r( eme%i# hi)r("h$(ri)a 1-1 5 m*9"* ma"s 70m* im s9) 5 hari
%er*a#% #* rea"si #% " sem a m r
Giar)iasis 6
Me%r(#i)as($ 15m*+"*9hari )i'a*i < )(sis 5 hari
A#%ise"re%(ri" - A#%i)iare
Sa$a3er–$i#)( E )"" 22 )ari De!ar%me#% (/ Pe)i%%ri s H(s!i%a$ Na i(#a$ a&e%a#( Here)ia
4ima Per me$a!(r"a# 'ah8a !ema"aia# Ra e a)(%ri$ a e%(r!ha# &a#* mer !a"a#
e#"e!ha$i#a e i#hi'i%(r )e#*a# e/e" a#%i se"re%(ri" ser%a a#%i )iare %er#&a%a " ! e/e"%i/ )a#
ama# 'i$a )i'eri"a# !a)a a#a" )e#*a# )iare a" % ($eh "are#a %i)a" me#**a#** m(%i$i%as
s s sehi#**a !e#)eri%a %i)a" "em' #* +Bi$a )i'eri"a# 'ersamaa# )e#*a# aira# rehi)rasi
(ra$ a"a# mem'eri"a# hasi$ &a#* $e'ih 'ai" 'i$a )i'a#)i#*"a# )e#*a# ha#&a mem'eri"a#
aira# rehi)rasi (ra$ sa a +Hasi$ &a#* sama *a )i)a!a%"a# ($eh ( ( ar )"" )a# e ar)
)""+ #% " !ema"aia# &a#* $e'ih $ as masih memer$ "a# !e#e$i%ia# $e'ih $a# % &a#* 'ersi/a%
m $%i se#%er )a# me$i'a%"a# sam!e$ &a#* $e'ih 'esar+ 2.
Probiotik
Pr('i(%i" mer !a"a# 'a"%eri hi) ! &a#* mem! #&ai e/e" &a#* me#* #% #*"a# !a)a h(s%
)e#*a# ara me#i#*"a%"a# "($(#isasi 'a"%eri !r('i(%i" )i)a$am $ me# sa$ ra# er#a sehi#**a
se$ r h e!i%e$ m "(sa s s %e$ah )i) ) "i ($eh 'a"%eri !r('i(%i" me$a$ i rese!%(r )a$am se$
e!i%e$ s s+ De#*a# me# erma%i !e#(me#a %erse' % 'a"%eri !r('i(%i" )a!a% )i!a"ai )e#*a#
ara #% " !e# e*aha# )a# !e#*('a%# )iare 'ai" &a#* )ise'a'"a# ($eh R(%a,ir s ma ! #
mi"r((r*a#isme $ai# s!e )(mem'ra# ($i%is ma ! # )iare &a#* )ise'a'"a# ($eh "are#a
!ema"aia# a#%i'i(%i"a &a#* %i)a" rasi(#a$ rasi(#a$ a#%i'i(%i" as( ia%e" )iarrhea )a#
%ra,e$$ers s )iarrhea+1< 15 2<
Ter)a!a% 'a#&a" $a!(ra# %e#%a#* !e#** #aa# !r('i(%i" )a$am %a%a$a"sa#a )iare a" % !a)a
a#a"+ Hasi$ me%a a#a$isa a# Nie$ )"" 25 me#&a%a"a# $a %('a i$$ s ama# )a# e/e"%i/ )a$am
!e#*('a%a# )iare a" % i#/e"si !a)a a#a" me# r #"a# $ama#&a )iare "ira-"ira 29. $ama#&a
)iare )a# me# r #"a# /re" e#si )iare !a)a hari "e ) a !em'eria# se'a#&a" 1 – 2 "a$i+
Kem #*"i#a# me"a#isme e/e"!r('i(%i" )a$am !e#*('a%a# )iare a)a$ah 6 Per 'aha#
$i#*" #*a# mi"r( $ me# s s !r() "si 'aha# a#%i mi"r('a %erha)a! 'e'era!a !a%(*e#
"(m!e%isi # %rie# me# e*ah a)hesi !a%(*e# !a)a a#%er(si% m()i/i"asi %("si# a%a rese!%(r
%("si# e/e"%r(/i" !a)a m "(sa s s )a# im ##( m() $asi+1< 2<
0ikronutrien
-
8/15/2019 Porto Puskes GEA
19/22
Dasar !emi"ira# !e#* #aa# mi"r(# %rie# )a$am !e#*('a%a# )iare a" % )i)asar"a# "e!a)a
e/e"#&a %erha)a! / #*si im # a%a %erha)a! s%r "% r )a# / #*si sa$ ra# er#a )a# %erha)a!
!r(ses !er'ai"a# e!i%e$ se$ ra# er#a se$ama )iare+ Se#* %e$ah )i"e#a$i 'er!era# )i )a$am
me%a$$( – e#3&mes !($&ri'(s(mes se$a! % se$ )a# / #*si se$ *a 'er!era# !e#%i#* )i
)a$am !er% m' ha# se$ )a# / #*si "e"e'a$a# + 17 Sa3a8a$ S )"" 2@ me$a!(r"a# !a)a 'a&i )a#
a#a" $e'ih "e i$ )e#*a# )iare a" % s !$eme#%asi se#* se ara "$i#is !e#%i#* )a$am
me# r #"a# $ama )a# 'era%#&a )iare+ S%ra#) 2; Me#&a%a"a# e/e" !em'eria# se#* %i)a"
)i!e#*ar hi a%a me#i#*"a% 'i$a )i'eri"a# 'ersama )e#*a# ,i% A+ Pe#*('a%a# )iare a" %
)e#*a# ,i%ami# A %i)a" mem!er$iha%"a# !er'ai"a# 'ai" %erha)a! $ama#&a )iare ma ! #
/re" e#si )iare+ 17 Bha#)ari )"" 2> me#)a!a%"a# !em'eria# ,i%ami# A @0m* )i'a#)i#*
)e#*a# !$ase'( se$ama )iare a" % )a!a% me# r #"a# 'era%#&a e!is()e )a# risi"( me# a)i
)iare !ersis%e# !a)a a#a" &a#* %i)a" me#)a!a%"a# ASI %a!i %i)a" )emi"ia# !a)a &a#*
me#)a!a% ASI+
0encegah 8 0enanggulangi 7angguan 7i>i
Ama%$ah !e#%i#* #% " %e%a! mem'eri"a# # %risi &a#* " ! se$ama )iare %er %ama !a)a
a#a" )e#*a# *i3i &a#* " ra#*+ Mi# ma# )a# ma"a#a# a#*a# )ihe#%i"a# $e'ih )ari 2< am
"are#a ! $ih#&a m "(sa s s %er*a#% #* )ari # %risi &a#* " !+Bi$a %i)a" ma"a$ah i#i a"a#
mer !a"a# /a"%(r &a#* mem )ah"a# %er a)i#&a )iare "r(#i" 27 Pem'eria# "em'a$i ma"a#a#
a%a mi# ma# re/ee)i#* se ara e!a% sa#*a%$ah !e#%i#* 'a*i a#a" )e#*a# *i3i " ra#* &a#*
me#*a$ami )iare a" % )a# ha$ i#i a"a# me# e*ah 'er" ra#*#&a 'era% 'a)a# $e'ih $a# % )a#
mem!er e!a% "esem' ha#+ Air s s i' )a# s s /(rm $a ser%a ma"a#a# !a)a m m#&a
har s )i$a# %"a# !em'eria##&a se$ama )iare !e#e$i%ia# &a#* )i$a" "a# ($eh 4ama m(re RA
)"" .0 me# # ""a# 'ah8a s !$eme# # "$e(%i)a !a)a s s /(rm $a se ara si*#i/i"a#
me#* ra#*i $ama )a# 'era%#&a )iare !a)a a#a" ($eh "are#a # $e(%i)e a)a$ah 'aha# &a#*
sa#*a% )i!er$ "a# #% " re!$i"asi se$ %ermas " se$ e!i%e$ s s )a# se$ im #("(m!e%e#+ Pa)a
a#a" $e'ih 'esar ma"a#a# &a#* )ire"(me#)asi"a# me$i! %i %a i# 'eras "e#%a#* mi )a#
!isa#* )a# *a#) m 'eras *a#) m )a# erea$ + Ma"a#a# &a#* har s )ihi#)ar"a# a)a$ah
ma"a#a# )e#*a# "a#) #*a# %i#**i * $a se)erha#a &a#* )a!a% mem!er' r " )iare se!er%i
mi# ma# "a$e#* )a# sari ' ah a!e$+ J *a ma"a#a# %i#**i $ema" &a#* s $i% )i%($era#si "are#a
"are#a me#&e'a'"a# $am'a%#&a !e#*(s(#*a# $am' #*+ .1
Pem'eria# s s re#)ah $a"%(sa a%a 'e'as $a"%(sa )i'eri"a# !a)a !e#)eri%a &a#*
me# # ""a# *e a$a "$i#i" )a# $a'(ra%(ri m i#%($era#si $a"%(sa+ I#%($era#si $a"%(sa 'ers!e"%r m )ari &a#* ri#*a# sam!ai &a#* 'era% )a# "e'a#&a"a# a)a$ah %i!e &a#* ri#*a#
-
8/15/2019 Porto Puskes GEA
20/22
sehi#**a " ! mem'eri"a# /(rm $a s s 'iasa#&a )imi# m )e#*a# !e#*e# era# ($eh
"are#a i#%($era#si $a"%(sa ri#*a# 'ersi/a% seme#%ara )a# )a$am 8a"% 2 – . hari a"a# sem' h
%er %ama !a)a a#a" *i3i &a#* 'ai"+ Nam # 'i$a %er)a!a% i#%($era#si $a"%(sa &a#* 'era% )a#
'er"e!a# a#*a# %e%a! )i!er$ "a# s s /(rm $a 'e'as $a"%(sa #% " 8a"% &a#* $e'ih $ama+
U#% " i#%($era#si $a"%(sa ri#*a# )a# se)a#* se'ai"#&a )i'eri"a# /(rm $a s s re#)ah $a"%(sa+
Sa'a*aima#a ha$#&a i#%($era#si $a"%(sa ma"a i#%($era#si $ema" !a)a )iare a" % si/a%#&a
seme#%ara )a# 'iasa#&a %i)a" %er$a$ 'era% sehi#**a %i)a" memer$ "a# /(rm $a "h s s+Pa)a
si% asi &a#* memer$ "a# 'a#&a" e#er*i se!er%i !a)a /ase !e#&em' ha# )iare )ie% re#)ah
$ema" s%r )a!a% mem!er' r " "ea)aa# ma$# %risi )a# )a!a% me#im' $"a# )iare "r(#i" .2
Me#a#** $a#*i Pe#&a"i% Pe#&er%a
A#a" &a#* me#)eri%a )iare m #*"i# *a )iser%ai )e#*a# !e#&a"i% $ai#+ Sehi#**a )a$am
me#a#*a#i )iare#&a *a !er$ )i!erha%i"a# !e#&a"i% !e#&er%a &a#* a)a+ Be'era!a !e#&a"i%
!e#&er%a &a#* seri#* %er a)i 'ersamaa# )e#*a# )iare a#%ara $ai# 6 i#/e"si sa$ ra# #a/as
i#/e"si s s #a# sara/ ! sa% i#/e"si sa$ ra# "emih i#/e"si sis%emi" $ai# se!sis am!a"
" ra#* *i3i !e#&a"i% a#% #* )a# !e#&a"i% *i# a$..+
-
8/15/2019 Porto Puskes GEA
21/22
DA9,A* P'+,AKA
1+ Ka#) # NI+ U!a&a !e# e*aha# )iare )i%i# a )ari as!e" "eseha%a# mas&ara"a% )a$am
" m! $a# ma"a$ah K(#*res #asi(#a$ II BKGAI $i 200. ha$ 27
2+ Bar"i# RM F$ i) a#) E$e %r($&%e Pr('$ems+ Pr('$em Orie#%e) Pe)ia%ri Dia*#(sis
4i%%$e Br(8# a#) (m!a#& 1770 20 – 2.+
.+ B((%h I: %%i#*:AM+ rre#% (# e!% i# The Ma#a*em#% (/ A %e i# hi$)re#
P(s%*raa) D( % Asia 17>< 6 De 6 2@> – 2;<
! 1..-1.>
;+ De!ar%eme# "eseha%a# RI Pr(/i$ Keseha%a# I#)(#esia 2001+ Ja"ar%a 2002
>+ 4 #* E+ A %e )iarrhea$ Diseases )a$am rre#% )ia*#(sis a') %rea%me#% i#
*as%r(e#%er($(*&+E)+Frie)ma# S e)isi "e 2 Ne8 T(r" 200. 6M Gra8 Hi$$ ha$ 1.1-
-
8/15/2019 Porto Puskes GEA
22/22
15+ S har&(#(+Tera!i # %risi )iare "r(#i" Pe#)i)i"a# Ke)("%era# Ber"e$a# %a# i$m
Keseha%a# A#a" "e I Fa" $%as Ke)("%era# U#i,ersi%as I#)(#esia 177<
1@+ Di% e# PPM P4P De!"es RI+Ta%a$a"sa#a Kas s Diare Bermas$ah+ De!"es RI 1777
.1