DIAGNOSIS DAN TATALAKSANA HEPATOPULMONARY SYNDROME

• Main Author: Dwitya Elvira
• Format: Article
• Language: English
• Published: Faculty of Medicine Andalas University 2015-05-01
• Series: Majalah Kedokteran Andalas
• Subjects: sirosis hepatis; dispneu; hepatopulmonary syndrome; hepatic cirrhosis
• Online Access: http://jurnalmka.fk.unand.ac.id/index.php/art/article/view/188
• ISSN: 0126-2092; 2442-5230

<p>Abstrak<br />Sirosis hepatis dan penyakit hati kronik merupakan penyebab kematian terbanyak di seluruh dunia. Tingginya angka morbiditas dan mortalitas sirosis berhubungan dengan komplikasinya yang bersifat sistemik. Salah satu komplikasi sirosis dapat mengenai paru berupa sindrom hepatopulmonar atau hepatopulmonary syndrome. Hepatopulmonary syndrome (HPS) didefinisikan sebagai trias yang terdiri dari kegagalan hati stadium lanjut, hipoksemia arterial serta dilatasi intravaskular pulmonar tanpa disertai penyakit kardiopulmonar. Patogenesis HPS masih belum diketahui pasti, namun diduga terjadi gangguan metabolisme zat vasoaktif paru yang menimbulkan vasodilatasi vaskuler paru. Manifestasi klinis HPS berupa dispneu yang khas dengan tanda kegagalan hati dan hipertensi portal. Modalitas diagnostik HPS adalah radiologi thorax, analisa gas darah, contrast enhanced echocardiography (CEE), nuclear scanning dengan Tc-99m dan angiografi paru. Penatalaksanaan HPS terutama bertujuan menurunkan vasodilatasi intrapulmonar, meningkatkan oksigenasi arterial dan mengurangi keluhan. Deteksi dini terhadap komplikasi sirosis mutlak diperlukan dalam mencegah dan mengurangi angka morbiditas dan mortalitas.<br /><br />Abstract Liver cirrhosis and chronic liver disease are the leading cause of death worldwide. The high morbidity and mortality associated with their systemic complications. One of the complications of cirrhosis is hepatopulmonary syndrome. Hepatopulmonary syndrome (HPS) is defined as the triad of advanced-stage liver failure, arterial hypoxemia and pulmonary intravascular dilatation without cardiopulmonary disease. The pathogenesis of HPS is still not known for sure, but suspected metabolic disorder pulmonary vasoactive substances that cause pulmonary vascular vasodilatation. The clinical manifestations of HPS is typical dispneu with signs of liver failure and portal hypertension. HPS diagnostic modalities are radiology thorax, blood gas analysis, contrast enhanced echocardiography (CEE), nuclear scanning with Tc-99m and pulmonary angiography. HPS management aims primarily to lower intrapulmonar vasodilation, improving arterial oxygenation and reduce complaints. Early detection of complications of cirrhosis is absolutely necessary in preventing and reducing morbidity and mortality.<br /><br /></p>