Kadar Laktat Darah sebagai Prediktor Kontaminasi Bakteri pada Hernia Inguinalis Lateralis Strangulata

Abstract

AbstrakHernia inguinalis lateralis strangulata merupakan salah satu kasus akut abdomen yang harus segera ditangani. Hernia yang mengalami strangulasi akan mengalami kerusakan integritas sel dan barier mukosa usus sehingga terjadi kontaminasi bakteri. Selain itu, sel usus yang strangulasi akan mengalami metabolisme anaerob yang menyebabkan peningkatan kadar laktat darah. Oleh sebab itu dilakukan penelitian untuk menilai hubungan antara kadar laktat darah dan kontaminasi bakteri pada keadaan strangulasi hernia. Metode penelitian bersifat potong lintang, data prospektif, penderita dengan hernia inguinalis lateralis strangulata yang datang ke Rumah Sakit Dr. Hasan Sadikin Bandung periode Mei 2011-April 2012. Dilakukan pengukuran kadar laktat darah saat penderita datang dan cairan peritoneum yang berasal dari kantung hernia diambil saat operasi. Dilakukan analisis data dengan uji regresi logistik. Subjek penelitian berjumlah 30 orang, terdiri atas 28 lakilaki dan 2 perempuan. Usia rata-rata subjek penelitian 58,5±12,86 tahun. Nilai kadar laktat darah rata-rata 1,76±0,36 mmol/L. Hasil kultur kuman cairan peritoneum terbanyak Escherichia coli. Terdapat hubungan sangat kuat dan sangat bermakna antara kadar laktat darah dan kejadian kontaminasi bakteri, nilai r=0,817 dan p=0,007 (p<0,01). Simpulan, kadar laktat darah dapat dijadikan sebagai alat ukur untuk memperkirakan kontaminasi bakteri pada penderita hernia inguinalis lateralis strangulata. [MKB. 2013;45(1):44-9] Kata kunci: Hernia inguinalis lateralis strangulata, kadar laktat darah, kontaminasi bakteri Blood Lactate Levelas Predictor of Bacterial Contamination in Strangulated Groin Hernia AbstractStrangulated groin hernia is one of the acute abdomen and have to be treated immediately. Strangulated hernia will cause damage of cell integrity and barrier of intestinal mucous, which make bacterial contamination occur. Strangulated intestinal cells will have anaerobic metabolism which make the blood lactate level increased. Therefore study was conducted to know the correlation between blood lactate level and bacterial contamination in strangulated groin hernia. The study method was cross-sectional with prospective data, patients with strangulated groin hernia who came to Dr. Hasan Sadikin Hospital Bandung during May 2011-April 2012. Blood lactate level was measured when the patient came to hospital and the peritoneal fluid which came from the hernial sac was taken intraoperatively. The data were analyzed with regression logistic test. There were 30 subjects in this study, 28 males and 2 females. The average age was 58.5±12.86 years old. The average blood lactate level was 1.76±0.36 mmol/L. The most found bacterial culture was Escherichia coli. There was strong and very significance correlation between blood lactate level and bacterial contamination, r=0.817 and p=0.007 (p<0.01). In conclusion, blood lactate level can be a predictor for bacterial contamination occurrence in patient with strangulated groin hernia. [MKB. 2013;45(1):44-9]