Pustaka Ilmiah Universitas Padjadjaran

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Efek Tindakan Bedah Terhadap Kadar Laktat Darah dan Glasgow Outcome Scale Penderita Hematoma Subdural Akut Traumatik

Pendahuluan: Hematoma subdural merupakan salah satu cedera otak fokal yang menyebabkan defisit neurologis, memiliki gejala sisa bahkan kematian. Hematoma subdural akut traumatik memicu iskemia serebri melalui peningkatan tekanan intracranial akibat edema yang menyebabkan gangguan perfusi otak. Angka keberhasilan pengobatan dan perawatan hematoma subdural akut traumatik dinilai menggunakan Glasgow outcome scale yang sederhana, cepat dan mudah dilakukan. Metode: Studi akuasi eksperimental dengan one group pre-post test design dilakukan terhadap 40 penderita hematoma subdural akut traumatik yang masuk Unit Gawat Darurat RS Dr Hasan Sadikin Bandung periode Agustus-Oktober 2013. Penelitian ini menggunakan uji t-test berpasangan dan uji korelasi Spearman, Kemaknaan ditentukan berdasarkan nilai p.0,05 dan confidence interval sebesar 95%. Hasil: Hasil penelitian menunjukkan nilai rerata kadar laktat darah pra dan pasca bedah adalah 3,16 + 1,49 mmol/L dan 2,38+ 1,23 mmol/L, terdapat penurunan yang bermakna rerata kadar laktat pasca bedah (p.0,001). Uji korelasi Spearman didapatkan bahwa kadar laktat pra bedah memiliki korelasi negatif lemah dengan nilai glasgow outcome scale (r=-0,346; p = 0,026). Diskusi: Rerata kadar laktat darah pasca bedah mengalami penurunan yang bermakna dibandingkan rerata kadar laktat darah pra bedah. Semakin rendah kadar Iaktat darah pra bedah maka semakin tinggi nilai glasgow outcome scale penderita hematoma subdural akut traumatik, Pemeriksaan kadar laktat darah pra dan pasca bedah dapat dipertimbangkan sebagai salah satu pemeriksaan rutin dalam menentukan kerusakan seluler dan nilai glasgow outcome scale akibat hematoma subdural akut traumatik.(J I Bedah Indones. 2014:43 48-54).

Introduction: Subdural hematoma is one etiology of focal brain injury that may lead to neurologic deficit, leaving sequelae and even death. Acute traumatic subdural hematoma lead to cerebral ischemia through creased intracranial pressure that diminish cerebral perfusion. The success of treatment and management of acute traumatic subdural hematoma is then evaluated using Glasgow outcome scale, which is a simple, fast and easily performed. Methods: Aquasy experimental study with one group pre-post test design was perfomed in 40 patients with acute traumatic subdural hematoma who admitted in Emergency Unit Hasan Sadikin Hospital Bandung from August-October 2013. This study was performed using paired t-test and Spearmanfs correlation test. Significancy was determined by a p value .0,05 and confidence of interval of 95%. Results: The mean value of pre and post operative blood lactate level is 3.16 + 1.49 mmol/L and 2.38+ 1.23 mmol/L with significant decrease in post operative blood lactate level (p < 0.001). Spearman's correlation test showed that pre operative blood lactate level has a weak negative correlation with glasgow outcome sealevalue (r = -0.346; p = 0.026). Discussion: A significant decrease is demonstrated in post' operative blood lactate level compared with pre operative blood lactate level. Higher glasgow outcome scale value in acute traumatic subdural hematomaa patients is shown with lower pre operative blood lactate level. Pre operative blood lactate level measurement can be used as a routine monitoring tool to detect cellular injury and glasgow outcome scale value in acute traumatic subdural hematomaa patients. (J I Bedah Indones. 2014;43:48–54).