MAKALAH HIPERBILIRUBINEMIA

MAKALAH HIPERBILIRUBINEMIA

DISUSUN OLEH : CINDY FATIKASARI FATIKASARI YULIANA SUSANTI LAELU

1

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DAFTAR ISI

DAFTAR DAFTAR ISI ............................................ ................................................................... .............................................. .......................................... ................... 2 BAB I PENDAHULUAN ......................................................... ................................................................................. ................................ ........ 3 1.1. 1.2. 1.3.

LAT LATAR BELAKANG BELAKANG ...... ........... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... ..... 3 RUMUSAN RUMUSAN MASALAH MASALAH .......... ............... .......... .......... .......... ......... ......... .......... .......... .......... .......... .......... .......... ....... .. 4 TUJUAN TUJUAN ........ ............. .......... .......... .......... .......... ......... ......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... ......... .... 4

BAB II PEMBAHASAN ........................................................ ............................................................................... ................................. .......... 5 2.1. KONSEP HIPERBILIRUBINEMIA ................................................. .................................................... ... 5 1. 2. 3. 4. 5. '. ). -. .

Pengert!n ............................................. .................................................................... ........................................... .................... 5 An!t"# $%"&"g .............................................. ..................................................................... ............................... ........ ' Et"&"g ........................................... .................................................................. .............................................. ......................... .. 11 M!n$e%t!% (&n% ........................................... .................................................................. ................................ ......... 11 P!t"$%"&"g .............................................. ..................................................................... ..................................... .............. 12 K&!%$(!% .............................................. ..................................................................... ........................................ ................. 13 Pe#er(%!!n Pe#er(%!!n *en+n,!ng *en+n,!ng .......... ............... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... ..... 15 K"#*&(!% ............................................ ................................................................... ........................................ ................. 1' Pen!t!&!(%!n Pen!t!&!(%!n!!n !!n .......... ............... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... ....... 1-

BAB III PENUTUP ..................................................... ............................................................................ ......................................... .................. 2/ A. SIMPILAN .............................................. ..................................................................... ........................................... .................... 2/









1.1.

LATAR BELAKANG

Pe#0 Pe#0!n !ng+ g+n!n n!n (e%e (e%e!t! !t!n n !ng !ng te&! te&! &! &!(% (%!n !n!( !(!n !n %e&!# %e&!#!! n n 0ert+ 0ert+,+ ,+!n !n +nt+ +nt+( ( #enng #enng(!t (!t(!n (!n er!,!t er!,!t (e%e! (e%e!t!n t!n #!%!r!( #!%!r!(!t. !t. In(! In(!t"r t"r er!,!t er!,!t (e%e!t (e%e!t!n !n #!%!r!( #!%!r!(!t !t ("#*"nen (e%e!t!n!nt!r!n! !!&! Ang(! Ke#!t!n I0+ AKI6 !n Ang(! Ke#!t!n B! AKB6. In"ne%! #!% #en+! *re%ent!%  ASEAN A%%"7!t"n "$ S"+t E!%t A%! N!t"n%6 Ang(! (e#!t!n 0!  neg!r!8neg!r! ASEAN %e*ert Sng!*+r! 391/// *er (e&!r!n +* M!&!%! 5591/// *er (e&!r!n +* T!&!n 1)91/// *er (e&!r!n +* :etn!# 1-91/// *er (e&!r!n +* !n P&*n! 2'91/// *er (e&!r!n +*. Se!ng(!n !ng(! (e#!t!n 0!  In"ne%! 7+(+* tngg !(n 2'92/// *er (e&!r!n +*. Tng(!t (e%e!t!n 0+ !n !n!( #er+*!(!n %!&! %!t+ n(!t"r  %+!t+ Neg!r!. Ang(! (e#!t! (e#!t!n n M!tern M!tern!& !& !n Ne"n!t Ne"n!t!& !& #!% #!% tngg tngg %!&! %!&! %!t+ %!t+ $!(t"r $!(t"r *entn *entng g !&!# !&!# +*!! +*!! *en+r+n!n !ng(! ter%e0+t eng!n #e#0er(!n *e&!!n!n (e%e!t!n #!tern!& !n ne"n!t!& !ng

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ter&!(%!n!.

Men+r+t Men+r+t P"&! *en!(t *ene0!0 (e#!t!n 0! #en+n,+((!n #en+n,+((!n 0!;! *r"*"r% *ene0!0 (e#!t!n ne"n!t!& (e&"#*"( +#+r /8) !r tertngg !!&! *re#!t+re !n Ber!t B!!n L!r Ren! Ren! 9 BBLR BBLR 35<6 35<6 (e#+ (e#+!n !n !%$(%! !%$(%! &!r &!r 33'< 33'<6. 6. Pen!(t Pen!(t *ene0 *ene0!0 !0 (e#!t! (e#!t!n n ne"n!t!& (e&"#*"( +#+r -82- !r tertngg !!&! n$e(% %e0e%!r 5)1< ter#!%+( tet!n+% 5< %e*%% *ne+#"n! !re6 (e#+!n $eeng $e eng *r"0&e# 143<6. Ber!%!r(!n !t! !r Te F$t S=t Se%%"n "$ Reg"n!& >"##ttee ?HO ?"r& He!&t Org!n@!t"n6 *!! t!+n 2//3 (e#!t!n 0! ter,! *!! +%! ne"n!t+% eng!n *ene0!0 n$e(% 33< !%$(%!9 tr!+#! 2-< BBLR 24< (e&!n!n 0!;!!n 1/< !n &!n8 &!n 5<. S!&! %!t+ *ene0!0 #"rt!&t!% *!! 0! 0!r+ &!r !!&! en%e$!&"*!t 0&!r% &e0 &e0 (en!& (en!& %e0!g! %e0!g! (ern( (ern(ter+ ter+%6. %6. En%e$!& En%e$!&"*! "*!t t 0&!r 0&!r%% #er+*! #er+*!(!n (!n ("#*& ("#*&(!% (!% (ter+ (ter+%% ne"n!t"r+# !ng *!&ng 0er!t. Se&!n #e#&( !ng(! #"rt!&t!% !ng tngg ,+g! !*!t #ene0!0(!n ge,!&! %%! 0er+*! 7ere0r!& *!&% t+& n!! tngg *!r!&%% !n %*&!%! ent!& !ng %!ng!t #e#*eng!r+ (+!&t!% +*. I(ter+% !!&! %+!t+ (e!!!n (+&t !n #e#0r!n #+&("%! !ng ;!rn!n! #en,! (+nng !(0!t *enng(!t!n ,+#&! *g#en e#*e+  !&!# !r! !r! !n ,!rng! ,!rng!n n t+0+. t+0+. H*er0 H*er0& &r+ r+0n 0n !!&! !!&! %+!t+ %+!t+ (e!!! (e!!!n n #!n! #!n! (!!r (!!r 0&r+ 0&r+0 0n n #en7 #en7!* !*! ! %+!t+ %+!t+ n&! n&! !ng !ng #e#* #e#*+n +n! ! *"te *"ten% n% #en #en#0 #0+& +&(! (!n n (ern (ern8 8(t (ter+ er+% % ,(! ,(! t! t!( (









I(ter+ I(ter+%% ter,! ter,! !*!0&! !*!0&! ter!*! ter!*!tt !(+#+ !(+#+&!% &!% 0&r+ 0&r+0n 0n !&!# !&!# !r! !r! *!! *!! %e0!g %e0!g!n !n ne"n!te% (ter+% !(!n  te#+(!n *!! #ngg+ *ert!#! !&!# (e+*!nn!. D (e#+(!(!n 0!;! !ng(! (e,!!n (ter+% ter!*!t *!! '/ < 0! 7+(+* 0+&!n !n -/ < *!! 0! (+r! (+r!ng ng 0+&! 0+&!n. n. I(te I(ter+ r+%% n n *!! *!! %e0!g %e0!g!n !n &!g &!g #+ng #+ng( (n n 0er% 0er%$! $!tt *!t" *!t"&" &"g g( ( !ng !ng !*! !*!tt #en#0+&(!n g!ngg+!n #enet!* !t!+ #ene0!0(!n (e#!t!n (!ren!n! %et!* 0! eng!n (ter+% !r+% #en!*!t *er!t!n ter+t!#! 0&! (ter+%  te#+(!n !&!# 24 ,!# *ert!#! (e+*!n 0!. Pr"%e% e#"&%% !r! n$e(% 0er!t (ter+% !ng 0er&!ng%+ng &e0 !r %!t+ #ngg+ #ngg+ %ert! %ert! 0&r+ 0&r+0n 0n re( &e0 &e0 !r !r 1/ #g9& #g9& ,+g! ,+g! (e!!! (e!!!n n !ng !ng #en+n, #en+n,+(! +(!n n (e#+ng(n!n !!n! (ter+% *!t"&"g(. 1.2.

!. 0. 7. . e. $. g. 1.3.

!. 0. 7. . e. $. g.

RUMUSAN MASALAH A*! *enger *engert!n t!n !r !r *e *er0& r0&r+ r+0n 0n  A*! *ene0!0 t#0+&n! *er0&r+0n *!! !n!(  B!g!#!n! B!g!#!n! *r"%e% ter,!n! ter,!n! *er0&r+ *er0&r+0n 0n *!! !n!(  B!g!#!n! B!g!#!n! t!n! t!n! !n ge,!&! !ng !ng t#0+& t#0+& !r !r *er0&r *er0&r+0n +0n *!! *!! !n!( !n!(  A*! %!,! %!,! *e#er(%!!n *e#er(%!!n !gn"%t7 !gn"%t7 +nt+( #enget!+ #enget!+ (!!r 0&r+0n 0&r+0n  B!g!# B!g!#!n! !n! *en!t *en!t!&!( !&!(%!n %!n!!n !!n *er *er0& 0&r+ r+0n 0n *!! *!! !n!( !n!(  B!g!# B!g!#!n! !n! !%+!n !%+!n (e*er!; (e*er!;!t!n !t!n !ng !ng !r+% !r+%  &!(+(! &!(+(!n n *!! *!%en *!%en !n!( !ng

ter(en! *er0&r+0n  TUJUAN M!!%% M!!%%;! ;! #enget! #enget!+ + *engert *engert!n !n !r *er0 *er0& &r+0 r+0n n M!!%%;! #enget!+ *ene0!0 t#0+&n! *er0&r+0n *!! *!! !n!( M!!%%;! M!!%%;! #enget! #enget!+ + *r"%e% *r"%e% ter,!n! ter,!n! *er0&r+0 *er0&r+0n n *!! *!! !n!( !n!( M!!%%;! M!!%%;! #enget!+ #enget!+ t!n! t!n! !n ge,!&! !ng !ng t#0+& t#0+& !r *er0 *er0&r+0 &r+0n n *!! !n!( !n!( M!!%%;! M!!%%;! #enget!+ #enget!+ *e#er( *e#er(%!!n %!!n !gn"%t7 !gn"%t7 +nt+( +nt+( #enget! #enget!+ + (!!r (!!r 0&r+0n 0&r+0n M!!%%;! M!!%%;! #enget!+ #enget!+ *en!t!&!(%!n *en!t!&!(%!n!!n !!n *er0&r+ *er0&r+0n 0n *!! !n!( M!!%% M!!%%;! ;! #enget! #enget!+ + !%+!n !%+!n (e*er!;!t (e*er!;!t!n !n !ng !r+% !r+%  &!(+(! &!(+(!n n *!! *!%en *!%en !n!( !ng ter(en! *er0&r+0n

BAB II PEMBAHASAN 2.1.

KONSEP HI HIPERBILIRUBINEMIA 1. Penger!"n

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H!t !ng #er+*!(!n "rg!n ter0e%!r t+0+ !*!t !ngg!* %e0!g! %e0+! *!0r( (#! !ng #e#0+!t #en#*!n #eng+0! !n #enge(%(re%(!n %e,+#&! 0e% !r %+0%t!n% !ng ter&0!t !&!# #et!0"&%#e. L"(!% !t %!ng!t *entng !&!# *e&!(%!n!!n $+ng% n (!ren! (!ren! !t !t #ener# #ener#!! !r! !r! !ng !ng (!! (!! n+tren n+tren &!ng%+ &!ng%+ng ng !r !r tr!(t+% tr!(t+% g!%tr" g!%tr"nte% nte%tn! tn!& & (e#+!n (e#+!n !t !(!n #en#*!n #en#*!n !t!+ #entr!n%$"r#!%(! #entr!n%$"r#!%(!n n %e#+! n+tren n #en,! #en,! @!t8@!t (# (#!! !ng !ng g+ g+n! n!(! (!n n  0!g 0!g!n !n &!n &!n !&!# !&!# t+0+ t+0+  +nt+ +nt+( ( (e*e (e*er&+ r&+!n !n #et! #et!0" 0"& &(. (. H!t H!t #er+*! #er+*!(!n (!n "rg!n "rg!n !ng !ng *entn *entng g (+%+%n (+%+%n! ! !&!# !&!# *eng!t *eng!t+r! +r!n n #et!0" #et!0"&%# &%#ee g&+("% g&+("%!! !n *r"ten. H!t #e#0+!t !n #enge(%re%(!n e#*e+ !ng #e#eg!ng *er!n!n +t!#! !&!# *r"%e% *en7ern!!n %ert! *ener!*!n &e#!( !&!# tr!(t+% g!%tr"nte%tn!&. Org!n n











(!n+ng e#*e+ Ce%(! Ce&e!6 %!#*! (e#+!n 0+t+(!n +nt+( *r"%e% *en7ern!!n *!! %!!t n (!n+ng e#*e+ !(!n #eng"%"ng(!n %n! !n e#*e+ #e#!%+( nte%tn+# +%+%6. Br+nner S+!rt 2//1 2//1  115/6. 115/6. E#%#re%! B!'!r*(!n

B&r+0n !!&! *g#en !ng 0er!%!& !r *e#e7!!n e#"g&"0n "&e %e&8%e& *!! %%te# ret(+&"en"te&!& !ng #en7!(+* %e&8%e& K+*$$er !r !t. He*!t"%t #enge&+!r(!n 0&r+0n !r !&!# !r! !n #e&!&+ re!(% (#! #eng+0!n! &e;!t ("n,+g!% #en,! !%!# g&+(+r"n!t !ng #e#0+!t 0&r+0n &e0 !*!t &!r+t  !&!# &!r+t!n !ng en7er. B&r+0n ter("n,+g!% %e(re%(!n "&e e*!t"%t (e !&!# (!n!&(+&+% e#*e+  e(!tn! !n !(rn! 0!;! !&!# e#*e+ e #*e+ (e +"en+#.Br+nner  S+!rt 2//1  11526. D!&!# +%+% !&+% 0&r+0n ("nCer%(!n #en,! +r"0&n"gen !ng %e0!g!n !(!n e(%(re%(!n (e !&!# $e%e% !n %e0!g!n &!g !0%"r*% &e;!t #+("%! nte%tn!& (e !&!# !r! *"rt!&. Se0!g!n 0e%!r !r +r"0&n"gen !ng %er!* (e#0!& n (e&+!r(!n "&e e*!t"%t !n %e(re%(!n %e(!& &!g (e !&!# e#*e+ %r(+&!% enter"e*!t(6. Se0!g!n +r"0& +r"0&n" n"gen gen #e#!%+ #e#!%+( ( %r(+&! %r(+&!% % %%te# %%te#( ( !n e(%r e(%re%( e%(!n !n "&e "&e gn,!& gn,!& (e !&!# !&!# +rn. +rn. E&#n!% 0&r+0n !&!# e#*e+ #engg!#0!r(!n ,!&+r +t!#! e(%(re% 0!g %en!;! n. Br+nner  S+!rt 2//1  11526. K"n%entr!% 0&r+0n !&!# !r! !*!t #enng(!t ,(! ter!*!t *en!(t !t 0&! !&r!n e#*e+ ter!&!ng !t+ "&e 0!t+ e#*e+ !&!# %!&+r!n e#*e+6 !t!+ 0&! ter,! *eng!n7+r!n %e&8%e& !r! #er! !ng 0er&e0!n. P!! "0%tr+(% %!&+r!n e#*e+ 0&r+0n t!( #e#!%+( nte%tn+# !n %e0!g! !(0!tn! +r"0&n"gen t!( ter!*!t !&!# +rn. Br+nner  S+!rt 2//1  11526.









*r"+( !ng 0er%$!t t"(%( !n !r+% (e&+!r(!n "&e t+0+. Se0!g!n 0e%!r 0&r+0n ter%e0+t 0er!%!& !r egre!% e#"g&"0n !r! !n %e0!g!n &!g !r e# 0e0!% !t!+ ertr"*"e%% !ng t!( e$e(t$. Pe#0ent+(!n 0&r+0n t! #+&! eng!n *r"%e% "(%!% !ng #eng!%&(!n 0&Cern %ert! 0e0er!*! @!t &!n. B&Cern B&Cern n&! !ng #eng!&!# #eng!&!# re+(% !n #en,! 0&r+0n 0e0!% !t!+ 0&r+0n I !&$!. !t n %+&t &!r+t !&!# !r tet!* &!r+t !&!# &e#!( (!ren!n! #e#*+n! %$!t &*"$&( !ng %+&t e(%(re% !n #+! #e&!&+ #e#0r!n 0"&"g( %e*ert *&!%ent! !n %!;!r !r! "t!(. B&r+0n 0e0!% ter%e0+t (e#+!n 0er%en!;! eng!n !&0+#n !n 0!;! (e e*!r. D !&!# e*!r ter,! #e(!n%#e !#0&!n %engg! 0&r+0n ter(!t "&e re%e*t"r #e#0r!n %e& !t !n #!%+( (e !&!# %e& !t. Seger! %ete&! !! !&!# %e& !t ter,! *er%en!;!!n eng!n &g!nn *r"ten86 *r"ten  !n g&+t!t"n !t &!n !ng #e#0!;!n! (e ret(+&+# en"*&!%#! !t te#*!t ter,!n! *r"%e% ("n,+g!%. Pr"%e+ Pr"%e+rr n t#0+ t#0+&& 0er(!t 0er(!t !!n !!n!! en@# en@# g&+("t g&+("t"n "n&& tr!n%$ tr!n%$er!% er!%ee !ng !ng (e#+ (e#+!n !n #eng!%&(!n 0ent+( 0&r+0n nre(. Jen% 0&r+0n n !*!t &!r+t !&!# !r !n *!! (!!r tertent+ !*!t e(%(re%(!n #e&!&+ gn,!&. Se0!g!n 0e%!r 0&r+0n !ng ter("n,+g!% n (e%(re% #e&!&+ +(t+% e*!t(+% (e !&!# %!&+r!n *en7ern!!n !n %e&!n,+tn! #en,! +r"0&n"gen !n (e&+!r eng!n tn,! %e0!g! %ter("0&n. D!&!# +%+% %e0!g!n !0%"r0% (e#0!& "&e #+("%! +%+% !n ter0ent+(&! *r"%e% !0%"r0% enter"e*!t(. Se0!g!n 0e%!r ne"n!t+% #eng!&!# *enngg!n (!!r 0&r+0n nre( *!! !r8!r *ert!#! (e+*!n. H!& n ter,! (!ren! ter!*!tn! *r"%e% $%"&"g( tertent+ *!! ne"n!t+%. Pr"%e% ter%e0+t !nt!r! &!n (!ren! tnggn! (!!r ertr"%t ne"n!t+% #!%! +* ertr"%t !ng &e0 *ene( -/8/ !r6 !n 0e&+# #!t!ngn! $+ng% e*!r. Penngg!n Penngg!n (!!r 0&r+0n n ter,! *!! !r (e 283 !n #en7!*! *+n7!(n! *!! !r (e 58) (e#+!n !(!n #en+r+n (e#0!& *!! !r (e 1/814 (!!r 0&r+0n *+n 0!%!n! t!( #e&e0 1/









Eritrosit

Hemoglobin Hem

Besi/FE

Globin

Bilirubin Indirek (tidk lrut dlm ir!

"er#di "er#di $d %im$&' kro)g

Bilirubin Bilirubin beriktn dengn lbumin "er#di "er#di dlm $lsm dr&

ellui &ti

Hti Bilirubin beriktn dengn Glukoront/gul residu bilirubin direk (lrut dlm ir!

Bilirubin direk diekskresi ke kndung em$edu elui +uktus Billiris *ndung *ndung em$edu ke duodenum









3. E!&'&g!

Et"&"g *!! 0! eng!n *er0&r+0ne#! !nt!r!n!  1. Pr" Pr"+( +(% % 0& 0&r+ r+0 0n n 0er&e 0er&e0 0! !n n !ng !*!t !*!t ter,! ter,!  (!ren (!ren! ! polycethemia, issoimun, hemolyt hemolytic ic disease, disease, (e&!n (e&!n!n !n %tr+(t+ %tr+(t+rr !n en@# en@# %e& !r! !r! #er! #er! (er!7+ (er!7+n!n n!n "0!t "0!t e#"&%% (#!  %!&%&!t ("rt("%ter" (&"r!#*en("&6 e#"&%% e(%tr!C!%(+&er cephalhematoma, ecchymosis. 2. G!ngg+ G!ngg+!n !n $+ng% $+ng% !t "0%tr+ "0%tr+(% (% e#*e+9! e#*e+9!tre% tre%! ! 0&!r 0&!r n$e(% n$e(%  #!%!&! #!%!&! #et!0"&( #et!0"&( 3. 4. 5. '.

hypothyroidisme, jaundice ASI. G!ngg+!n G!ngg+!n *eng!#0 *eng!#0&!n &!n !n !n *eng!ng( *eng!ng(+t!n +t!n 0&r+0 0&r+0n n !&!# !&!# e*!t"%t. e*!t"%t. G!g!&n! G!g!&n! *r"%e% *r"%e% ("n,+ ("n,+g!% g!% !&!# #(r"%"# #(r"%"# e*!r. e*!r. G!ng G!ngg+ g+!n !n !&! !&!# # e(%( e(%(re re%. %. Penng(!t!n Penng(!t!n re!0%"r*% re!0%"r*% *!! *!! %!&+r!n %!&+r!n 7ern! 7ern! %(&+% %(&+% enter"e*!t enter"e*!t(6. (6.

Mt!!n 2/12  116 !n S+r! !n Rt! 2//1  1446 . M"n! M"n!$e $e% %"% "%!! K'!n K'!n!# !#

M!n$e%t!% (&n( !ng %erng ,+#*! *!! 0! eng!n *er0&r+0ne#! !nt!r!n!  1. I(ter+% I(ter+% *!! (+&t !n !n ("n,+ngtC ("n,+ngtC! ! #+("%! #+("%! !n !&!t8!&!t !&!t8!&!t t+0+ t+0+ &!nn!. &!nn!. B&! te(!n te(!n !(!n t#0+& (+nng. 2. B&r+0n B&r+0n re( re( t!n! t!n! eng!n eng!n (+&t (+nng (+nng (e,!+! (e,!+!n n !n (er+ (er+ *!! (ter+% (ter+% 0er!t. 3. B&r+0n B&r+0n nre( nre( t!n! t!n! eng!n eng!n (+&t (+&t (+nng (+nng ter!ng ter!ng *!! *!! (ter+% (ter+% 0er!t. 0er!t. 4. B! B! #en #en,! ,!  &e%+ &e%+.. 5. B! B! #en #en,! ,! #!&! #!&!%% #n+ #n+#. #. '. T!n!8 !n!8t!n t!n! ! (&n% (&n% (ter+% (ter+% ,!r!ng ,!r!ng #+n7+ #+n7+&. &. ). Let!rg. -. T"n+% n+% "t"t "t"t #en #enn ng( g(!t !t.. . Leer er (!(+. 1/. O*%t"t"n+% O*%t"t"n+%.. 11. 11. M+nt! M+nt! !n"re=! !n"re=! $!tg+e ;!rn! +rne ge&!* ;!rn! tn,! *+7!t. Mt!!n Mt!!n 2/12 









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8 8 8 8

D!r! r! te* te* &eng(!*. !*. G"&" G"&"ng ng!n !n !r! !r!  0+ 0+ !n !n 0! 0!. Te%t >""#0%. Pe#er( Pe#er(%!!n %!!n %(rnn %(rnng g e$%e e$%en% n% G'PD G'PD 0!( 0!(!n !n !r! !r! !t!+ !t!+ 0"*% 0"*% He*!r He*!r

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8 8 8

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8 8 8

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t"(%"*&!%#"%% %$&% r+0e&! e*!tt% 5. (e&!n!n (e&!n!n #et!0"&( #et!0"&( *"g&(e# *"g&(e#! ! g!&!(t"%e#! g!&!(t"%e#! '. "0!t2! "0!t2!n n !ng !ng #engg! #engg!nt nt(!n (!n (!t!n (!t!n 0&r+ 0&r+0n 0n eng!n eng!n !&0+#n !&0+#n %e*ert %e*ert  %+&$"n %+&$"n!# !#  %!&%&!t %"+# 0en@"!t gent!#%n. ). Pr!+ enter"*!t enter"*!t( ( !ng #enngg #enngg  "0%tr+(% "0%tr+(% +%+% &et!( &et!( tngg tngg *en!(t *en!(t r%7%*r+n r%7%*r+ng g %ten"%% *&"r( #e("n+# &e+% %0. 4. Pe,e Pe,er! r!#% #%"" ""n n Pen*n Pen*n5" 5"ng ng Pe#er(%!!n !ng !*!t &!(+(!n !nt!r!n!  1. Te% >""# >""#0 0 *!! *!! t!& t!& *+%! *+%!tt 0! 0! 0!r+ 0!r+ &! &!rr. H!% H!%&& *"% *"%t t$$ te% te% >""# >""#0 0 n nre re( ( #en!n!(!n !!n! !nt0" R8*"%t$ !nt8A !t!+ !nt8B !&!# !r! 0+. H!%& *"%t$ !r te% >""#0 re( #en!n!(!n !!n! %ent%!% R8*"%t$ !nt8A !nt8B6









. J+#&! ret(+&" ret(+&"%t %t  *enng(!t!n *enng(!t!n ret(+&"% ret(+&"%t t #en!n!(!n #en!n!(!n *enng(!t *enng(!t!n !n *r"+(% *r"+(% SDM !&!# re%*"n% ter!!* e#"&%% !ng 0er(en!!n eng!n *en!(t R. 1/. S#e!r !r! *er$er  !*!t #en+n,+((!n #en+n,+((!n SDM !0n"r#!& !0n"r#!& !t!+ #!t+r #!t+r ertr"0&!%t"%% ertr"0&!%t"%% *!! *en!(t R !t!+ %$er"%t% *!! n("#*!0&t!% ABO. 11. Te% Te% Bet(e8K&e!+er eC!&+!% %#e!r !r! #!tern!& ter!!* ertr"%t ,!nn. 6. K&,0' ,0'!#"%!

K"#*&(!% !ng 0!%! ter,! !!&! %e0!g! 0er(+t  1. I(te I(ter r( ( ASI. 2. Kern( Kern( (te (ter+% r+% 0&r 0&r+0 +0n n en%e$!& en%e$!&t% t%6. 6. Meng&!ng(!n 0&r+0n !ng ter("nt!#n!% #engg!nt(!n $!(t"r ("!g+&!% *!! (ern( (ter+% #eng&!ng(!n !nt0" R ABO6 !n e#"&%% !ng #eng!%&(!n %e& !r! !r! #er! #er! %ert! %ert! ter%en% ter%en%tt! tt!% % !r !r %e& !r! !r! #er! #er! &!(+ &!(+(!n (!n eng!n eng!n 7!r! 0er(+t n. !. Meng&!ng( Meng&!ng(!n !n 0!!n 0!!n !ng (+r!ng (+r!ng !&!# *r"%e% #et!0"&%#e #et!0"&%#e 0&r+0 0&r+0n n #%!&n! #%!&n! #en!#0!(!n #en!#0!(!n g&+("%! *!! (e!!!n (e!!!n *"g&(e# *"g&(e#!6 !6 !t!+ #en!#0!(! #en!#0!(!n n 0!!n +nt+( +nt+( #e#*er0 #e#*er0!( !( tr!n%*" tr!n%*"rt! rt!% % 0&r+ 0&r+0n 0n #%!&n #%!&n! ! !&0+# !&0+#n6. n6. Pen!#0 Pen!#0!! !!n n !&0+#n &!(+(!n ;!&!+*+n t!( ter!*!t *"!&0+#ne#! tet!* *er&+ ng!t !!n! @!t8@!t !ng #er+*!(!n ("#*ett"r !&0+#n !ng ,+g! !*!t #eng(!t 0&r+0n #%!&n! %+&$"n!# !t!+ "0!t8"0!t!n &!nn!6. 0!!n !&0+#n ,+g! !*!t #e#*er#+! #e#*er#+!

e(%tr!% e(%tr!% 0&r+0n 0&r+0n









re!(% !ng #enet!* *!! %#er 0&r+0n %tr+(t+r!& !ng e(%(re% "&e gn,!& *!! (e!!!n !ng t!( ter("n,+g!%. In(! In(!% % tr!n$+ tr!n$+% % +nt+( +nt+( #engg! #engg!nt nt !r! !r! 0! 0! !*!t !*!t &!(+ &!(+(!n (!n *!! *!! (e!!! (e!!!n n 0er(+t n  1. Hr"*%. 2. A!n A!n!! r;! r;!!t !t *en!( *en!(tt 0er!t 0er!t.. 3. A!n A!n! ! r;! r;!!t !t %en% %en%t t%! %!% %.. T+,+!n &!(+(!nn! &!(+(!nn! tr!n%$+% !!&! %e0!g! 0er(+t  1. Meng Meng"r "re( e(% % !ne !ne# #!. !. 2. Meng Menge ent nt( (!n !n e# e#"& "&% %%. %. 3. Men7eg! Men7eg! *enng( *enng(!t!n !t!n 0&r+0 0&r+0n. n. Mt! Mt!!n !n 2/12 2/12  136 136 7. Pen" Pen"" "'" '"#% #%"n "n"" ""n n ". Me#*er7e*!t *r"%e% ("n,+g!% #%!&n! eng!n *e#0er!n $en"0!r0t!&. Peng"0!t!n eng!n 7!r! n t!( 0egt+ e$e(t$ !n #e#0+t+(!n ;!(t+ 4- ,!# 0!r+ ter,! *en+r+n!n 0&r+0n !ng0er!rt. M+ng(n &e0 0er#!n$!!t 0&! 0er(!n *!! 0+ (r!8(r! 2 !r %e0e&+# #e&!r(!n. (. Me#0er(!n %+0%tr!t !ng (+r!ng +nt+( tr!n%*"rt!% !t!+ ("n,+g!%. >"nt"n!  *e#0er!n !&0+#n +nt+( #eng(!t 0&r+0n !ng 0e0!%. A&0+#n !*!t g!nt eng!n *&!%#! "%% 15  2/ #&9(g00. Pe#e0r!n g&+("%! *er&+ +nt+( (",+g!% e*!r %e0!g! %+#0er energ. /. Me&!(+(!n e("#*en%!% 0&r+0n eng!n $"t"ter!*











3. P"%% 0! 0! %e0!(n! %e0!(n! +0! +0! +0! te&ent!ng te&ent!ng teng(+r teng(+r!* !* %et!* ' ,!# 0&! 0&! #+ng(n #+ng(n !g!r %n!r #er!t!. 4. Pert!!n(!n Pert!!n(!n %++ %++ 0! 0! !g!r %e&!&+ %e&!&+ 3'583) 3'583) > !n !n "0%erC!% "0%erC!% %++ %++ t!* 48 48 ' ,!# %e(!&. %e(!&. J(! ter,! (en!(!n %++ #!t(!n %e0ent!r &!#*+n! !n 0! 0er(!n 0!n!( #n+#. Sete&! 1 ,!# ("ntr"& (e#0!& %++n!. J(! tet!* +0+ng "(ter. 5. Per!t Per!t(! (!n n !%+*!n !%+*!n 7!r!n 7!r!n !g!r !g!r t!( t!( ter,! ter,! er er!% !% !n #enng(! #enng(!t(! t(!n n %++ %++ t+0+ t+0+ 0!. '. P!! P!! ;!(t ;!(t+ + #e#0 #e#0er er 0! 0! #n+ #n+# # (e& (e&+! +!r( r(!n !n *! *!ng ng(+ (+ *en+ *en+t+ t+* * #!t! #!t! 0+ 0+(! (!.. Per!t(!n !*!(! ter,! rt!% !t!+ t!(. ). K!!r 0&r+0 0&r+0n n *er(%! *er(%! %et!* %et!* - ,!# %ete&! %ete&! *e#0er!n *e#0er!n ter!* 24 24 ,!# -. B&! B&! (!!r (!!r 0&r+0 0&r+0n n te&! t+r+n t+r+n #en,! #en,! )5 #g < !t!+ !t!+ (+r!ng (+r!ng ter!* ter!* ent( ent(!n !n ;!&!+*+n 0e&+# 1// ,!#. . J(! %ete&! %ete&! ter!* ter!* %e&!#! 1// 1// ,!# 0&r+0n 0&r+0n tet!* tngg tngg 9 (!!r (!!r 0&r+0n 0&r+0n !&!# !&!# %er+# ter+% n!( 7"0! &!t (e#0!& !*!(! &!#*+ 0e&+# #e&e0 5// ,!# g+n!(!n. Se&!n,+tn! +0+ng "(ter. M+ng(n *er&+ tr!n%$+% t+(!r.









T+,+! T+,+!n n tr!n%$+% tr!n%$+% t+(!r t+(!r !!&! !!&! #engg! #engg!nt nt ertr"% ertr"%t t !ng !ng !*!t !*!t #en,! #en,! e#"& e#"&%% %% #e#0+!ng n!t0" !ng #ene0!0(!n e#"&%% #en+r+n(!n (!!r 0&r+0n nre( !n #e#*er0!( !ne#!.

BAB III PENUTUP A. SIM SIMPUL PULAN

H*er0&r+0n !!&! %+!t+ (e!!!n #!n! (!!r 0&r+0n %er+# t"t!& !n &e0 !r 1/ #g < *!! #ngg+ *ert!#! !ng t!n! eng!n (ter+% *!! (+&t %7&er! !n "rg!n &!n. Ke!!!n n #e#*+n! *"ten% #enng(!t(!n (ern (ter+% !t+ (e!!!n (er+%!(!n *!!

MAKALAH HIPERBILIRUBINEMIA

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