Pustaka Ilmiah Universitas Padjadjaran

Abstrak

Status Gizi dan Rasio Mc Goon pada Tetralogi Fallot

<p>Manifestasi klinis tetralogi Fallot bergantung pada derajat stenosis pulmonalis. Saat ini digunakan rasio Mc Goon untuk pemilihan tindakan bedah pada tetralogi Fallot. Tujuan penelitian ini untuk mengetahui hubungan antara status gizi dan rasio Mc Goon pada tetralogi Fallot. Penelitian merupakan deskriptif analitik pada penderita penyakit jantung bawaan yang datang ke Departemen Ilmu Kesehatan Anak RS Dr. Hasan Sadikin Bandung periode 2006 sampai Januari 2011. Subjek penelitian penderita tetralogi Fallot yang belum dilakukan operasi. Diagnosis tetralogi Fallot ditegakkan berdasarkan anamnesis, pemeriksaan fisis, elektrokardiografi, foto toraks, dan ekokardiografi. Status gizi diukur dengan menggunakan kurva pertumbuhan berdasarkan World Health Organization (WHO) berat badan/usia. Rasio Mc Goon merupakan jumlah diameter arteri pulmonalis kanan dan kiri dibagi diameter aorta. Pengukuran diameter arteri pulmonalis kanan dan kiri serta aorta dilakukan dengan ekokardiografi pada pandangan sumbu pendek parasternal. Selama periode penelitian didapatkan 70 anak tetralogi Fallot, perempuan lebih banyak dibandingkan dengan laki- laki. Usia termuda 2 hari dan tertua 14 tahun. Sebagian besar mengalami status gizi kurang. Wasting lebih sering ditemukan dibandingkan dengan stunting. Ditemukan perbedaan yang bemakna diameter aorta, arteri pulmonalis utama, dan arteri pulmonalis kanan antara kelompok gizi baik serta gizi kurang dan buruk (p=0,03). Diameter aorta, arteri pulmonalis utama, dan arteri pulmonalis kiri lebih besar pada kelompok gizi baik. Disimpulkan bahwa rasio Mc Goon yang rendah berhubungan dengan status gizi lebih buruk yang pada akhirnya akan berpengaruh pada prognosis pascabedah. [MKB. 2011;43(4S):83S–7].</p>

<p>Clinical manifestation of tetralogy of Fallot depends on pulmonal stenosis level. Nowadays, choice of surgery on tetralogy of Fallot is based on Mc Goon ratio. The aim of this study was to find out the association of nutritional status and Mc Goon ratio in tetralogy of Fallot. This was a descriptive analytical study in patients with congenital heart disease who came to the Department of Child Health of Dr. Hasan Sadikin Hospital Bandung, during the period 2006 to January 2011. The subjects were patients with tetralogy of Fallot without surgery. The diagnosis of tetralogy of Fallot was based on the history taking, physical examination, electrocardiography, chest X-ray, and echocardiography. Nutritional status was measured based on the World Health Organization (WHO) growth curve, body/age. Mc Goon ratio means the diameter of right and left pulmonal arteries by aortic diameter. The diameter of right and left pulmonary arteries and aorta were measured through echocardiography on short axis parasternal view. During the study period 70 children were collected, female patients were more than males. The youngest was 2 days old and the oldest was 14 years old. Most of the patients were malnourished. We found more wasting compared to stunting. There was a significant difference in the diameter of aorta, main pulmonary arteries and right pulmonary arteries among well-nourished and undernourished/malnourished groups (p=0.03). The diameter of aorta, main pulmonary arteries and left pulmonary arteries were bigger in good nutritional group. In conclusions, low Mc Goon ration is associated with worse nutritional status, that in the end will effect the after-surgery prognosis. [MKB. 2011;43(4S):83S–7].</p>