DIARE PADA ANAK
DISUSUN OLEH Naomi Besitimur NIM 11-2015-288
KEPANITERAAN KLINIK FAKULT AKULTAS KEDOKTERAN KEDOKTERA N UKRIDA SMF ILMU I LMU PENY PE NYAKIT AKIT ANAK RUMAH SAKIT PUSAT ANGKATAN UDARA DR. ESNAWAN ANTARIKSA
DAFTAR ISI 1
BAB I ................................................................................................................3 PENDAHULUAN ............................................................................................3 BAB II ...............................................................................................................4 DEFINISI .........................................................................................................4 EPIDEMIOLOGI .............................................................................................4 KLASIFIKASI .................................................................................................5 ETIOLOGI .......................................................................................................5 PATOFISIOLOGI ............................................................................................6 MANIFESTASI KLINIS .................................................................................7 PENATALAKSANAAN .................................................................................8 KOMPLIKASI ................................................................................................15 BAB III.............................................................................................................16 KESIMPULAN ...............................................................................................16 DAFTAR PUSTAKA .....................................................................................17
BAB I
2
Pendau!uan
Dia! "a#i$ "!%&a'a( #a)a$ #a*% &!(+!,a, %*a"a "-,i)i*a# a( "-*a)i*a# a(a' i (!/aa +a(/ #!a(/ ,!'!",a(/. Da)a" ,!,a/ai $a#i) S%0!i '!#!$a*a( R%"a$ Ta(//a ia! "!(!"&a*i 'i#aa( %%*a( '!2 a( '!3 ,!,a/ai &!(+!,a, '!"a*ia( ,a+i i I(-(!#ia1. S!,a/ia( ,!#a ia! a'%* i#!,a,'a( -)!$ i(!'#i. Ba(+a' a"&a' +a(/ *!ai 'a!(a i(!'#i #!)%a( !(a a(*aa )ai( &!(/!)%aa( *-'#i( +a(/ a&a* "!(i",%)'a( /a(//%a( #!'!#i a( !a,#-&#i aia( a( !)!'*-)i* !(/a( a'i,a* !$ia#i /a(//%a( '!#!i",a(/a( !)!'*-)i* a( '!#!i",a(/a( a#a" ,a#a. I(0a#i a( !#*%'#i #!) !&i*!) &!(!*a#i '! )a"i(a &-&ia #!*a '!%#a'a( "i'-0i)i a&a* "!(i",%)'a( '!aaa( "a)i/!# a( "a)a,#-&#i 2. Bi)a *ia' "!(a&a*'a( &!(a(/a(a( +a(/ a!'%a* &aa a'$i(+a a&a* "!(/a)a"i i(0a#i #i#*!"i' 2. S!aa %"%" &!(a(/a(a( ia! a'%* i*%%'a( %(*%' "!(!/a$ a*a% "!(a(//%)a(/i !$ia#i #!*a /a(//%a( '!#!i",a(/a( !)!'*-)i* a( a#a" ,a#a '!"%(/'i(a( *!ai(+a i(*-)!a#i "!(/-,a*i 'a%#a ia! +a(/ #&!#ii' "!(!/a$ a( "!(a(//%)a(/i /a(//%a( /ii #!*a "!(/-,a*i &!(+a'i* &!(+!*a. U(*%' "!)a'#a(a'a( *!a&i ia! #!aa '-"&!$!(#i !i#i!( a( !!'#*i $a%# i)a'%'a( #!aa a#i-(a). P!"a'aia( aia( !$ia#i -a) #!aa %"%" !!'*i a)a" "!(/'-!'#i !$ia#i. P!",!ia( aia( i(*a0!(a i&!)%'a( i'a *!a&a* '!/a/a)a( -)!$ 'a!(a *i(//i(+a !'%!(#i ia! "%(*a$ +a(/ *a' *!'-(*-) a( *!/a(//%(+a "a#%'a( -a) -)!$ 'a!(a i(!'#i. B!,!a&a aa &!(!/a$a( !(/a( 0a'#i(a#i #!*a &!"a'aia( &-,i-*i' *!)a$ ,a(+a' i%(/'a& a( &!(a(/a(a( "!(//%(a'a( a(*i,i-*i'a +a(/ #&!#ii' a( a(*i&aa#i* 2.
3
BAB II De"inisi
Dia! a'%* "!(%%* -$!( 4 aa)a$ '!)%a(+a ,%a(/ ai ,!#a #!'a)i a*a% )!,i$ +a(/ ,!,!(*%' ai a)a" #a*% $ai a( ,!)a(/#%(/ '%a(/ 14 $ai. M!(%%* N-!a#i5 ia! a'%* ia)a$ ia! +a(/ *!ai #!aa "!(a'a' &aa ,a+i a( a(a' +a(/ #!,!)%"(+a #!$a*. S!a(/'a( American Academy of Pediatrics 9AAP: "!(!i(i#i'a( ia! !(/a( 'aa'*!i#*i' &!(i(/'a*a( !'%!(#i a(;a*a% &!%,a$a( '-(#i#*!(#i a&a* i#!*ai a*a% *a(&a /!a)a a( *a(a #!&!*i "%a) "%(*a$ !"a" a*a% #a'i* &!%* +a(/ ,!)a(/#%(/ #!)a"a 3 < 7 $ai. Dia! aa)a$ ,%a(/ ai ,!#a 9!!'a#i: !(/a( *i(a ,!,!(*%' ai a*a% #!*!(/a$ ai 9#!*!(/a$ &aa*: 'a(%(/a( ai *i(a )!,i$ ,a(+a' ai ,ia#a(+a )!,i$ ai 2==/ a*a% 2==");24 a". Dia! "!%&a'a( ,%a(/ ai ,!#a !(! )!,i$ ai 3 'a)i &! $ai. B%a(/ ai ,!#a !(! *!#!,%* a&a* ; *a(&a i#!*ai )!(i a( aa$.12 Dia! a'%* aa)a$ ,%a(/ ai ,!#a &aa ,a+i a*a% a(a' )!,i$ ai 3 'a)i &!$ai i#!*ai &!%,a$a( '-(#i#*!(#i *i(a "!(ai ai !(/a( a*a% *a(&a )!(i a( aa$ +a(/ ,!)a(/#%(/ '%a(/ ai #a*% "i(//%. Paa ,a+i +a(/ "!"i(%" ASI !'%!(#i ,%a(/ ai ,!#a(+a )!,i$ ai 34 'a)i &!$ai '!aaa( i(i *ia' ,i#a i#!,%* ia! *!*a&i "a#i$ ,!#ia* i#i-)-/i#. S!)a"a ,!a* ,aa( ,a+i "!(i(/'a* (-"a) $a) *!#!,%* *ia' *!/-)-(/ ia! *!*a&i "!%&a'a( i(*-)!a(#i )a'*-#a 'a!(a #a)%a( !(a ,!)%" ,!'!",a(/ !(/a( ,ai'. 12 E#idemio!o$i
S!*ia& *a$%( i&!i'ia'a( )!,i$ ai #a*% "i)+a 'a#%# ia! i %(ia !(/a( 33 %*a 'a#%# '!"a*ia( #!,a/ai a'i,a*(+a. Di&!'ia'a( a(/'a '!aia( i (!/aa ,!'!",a(/ ,!'i#a 35 < 7 !&i#-! &! a(a' &!*a$%( a)a" 2 *a$%( &!*a"a '!$i%&a( a( 2 < 5 !&i#-! &! a(a' &! *a$%( a)a" 5 *a$%( &!*a"a '!$i%&a(. Ha#i) #%0!i -)!$ D!&'!#. i&!-)!$ a(/'a '!#a'i*a( ia! *a$%( 2=== #!,!#a 3=1 &! 1=== &!(%%' a(/'a i(i "!(i(/'a* ,i)a i,a(i(/ #%0!i &aa *a$%( 2=1= #!,!#a 28= &! 1=== &!(%%'. Dia! "a#i$ "!%&a'a( &!(+!,a, %*a"a '!"a*ia( ,a+i a( ,a)i*a. Ha#i) S%'!#(a# 2=11 ia&a* &-&-#i '!"a*ia( ,a+i >4? !(/a( &!i(/'a* 3 a( &-&-#i '!"a*ia( ,a)i*a 132? !(/a( &!i(/'a* 2. Dia! &aa a(a' "!%&a'a( 4
&!(+a'i* +a(/ "a$a) +a(/ ,!$%,%(/a( #!aa )a(/#%(/ a*a% *ia' *!a&a* &!",ia+aa( a)a" "a#+aa'a*. Bia+a %(*%' i(!'#i -*a0i%# i*a'#i )!,i$ ai 63 %*a &-%(#*!)i(/ #!*ia& *a$%(+a i I(//i# a( 352 %*a -))a i A"!i'a S!i'a*. K!asi"i%asi
Dia! #!aa /ai# ,!#a i,a/i a*a# aa(/ a( (-( aa(/. Dia! aa(/ i,a/i )a/i a*a# i(!'#i a( (-( i(!'#i. Dia! (-( aa(/ ,i#a 'a!(a $-"-(a) a(a*-"i# -,a*-,a*a( a( )ai()ai(. P!(+!,a, i(!'#i ,i#a 0i%# ,a'*!i &aa#i* a( a"% #!a(/'a( (-( i(!'#i 'a!(a a)!/i aia#i.2 Etio!o$i
P!(+!,a, ia! a'%* &aa a(a' #!aa /ai# ,!#a a&a* i#!,a,'a( -)!$ /a#*-!(*!i*i# '!a%(a( "a'a(a( 'a!(a a(*i,i-*i'a a( i(!'#i #i#*!"i'. E*i-)-/i ia! &aa 25 *a$%( +a(/ )a)% #!,a/ia( ,!#a ,!)%" i'!*a$%i a'a( *!*a&i 'i(i *!)a$ )!,i$ ai 8=? &!(+!,a,(+a i'!*a$%i. Paa #aa* i(i *!)a$ a&a* ii!(*ii'a#i *ia' '%a(/ ai 25 !(i# "i'--/a(i#"! +a(/ a&a* "!(+!,a,'a( ia! &aa a(a' a( ,a+i. P!(+!,a, %*a"a -)!$ 0i%# +a(/ *!%*a"a ia)a$ R-*a0i%# 94= < 6=?: #!a(/'a( 0i%# )ai(+a ia)a$ 0i%# N-@a)' A#*-0i%# ai0i%# --(a0i%# Mi(i-*a0i%#. 3 Ba'*!i +a(/ a&a* "!(+!,a,'a( ia! aa)a$ A!-"-(a# $+-&$i)ia Bai))%# !!%# -"&+)-,a*! !%(i )-#*ii%" !ii)!)-#*ii%" &!i(/!(# E -)i P)!i#i-"-(a# S$i/!))-i!# Sa)"-(!))a #&& #*a&$+)--%# a%!%# 0i,i$-)!a! a( Y!#i(ia !(*!--)i*ia S!a(/'a( &!(+!,a, ia! -)!$ &aa#i* aa)a$ Ba)a(*ii%" -)i a&i))aia &$i&)i&&i(!(#i# +&*-#&--i%" E(*a"-,a $+#*-)i*ia Giaia
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5
Dia! 'a!(a ,a'*!i *!ai "!)a)%i #a)a$ #a*% "!'a(i#"! +a(/ ,!$%,%(/a( !(/a( &!(/a*%a( *a(#&- i-( a)a" #!)#!) %#%# AMPGMP a( a !&!(!(. Pa*-/!(!#i# *!ai(+a ia! -)!$ #a)"-(!))a #$i/!))a E -)i a/a' ,!,!a !(/a( &a*-/!(!#i# ia! -)!$ 0i%# *!*a&i &i(#i&(+a $a"&i #a "a. B!a(+a ,!'*!i i(i a&a* "!(!",%# 9i(0a#i: #!) "%'-#a %#%# $a)%# #!$i(//a !&a* "!(+!,a'a( !a'#i #i#*!"i'.T-'#i( #$i/!))a %/a a&a* "a#%' '! a)a" #!a,%* #aa -*a' #!$i(//a "!(i",%)'a( '!a(/. Dia! -)!$ '!%a ,a'*!i i(i a&a* "!(+!,a,'a( aa(+a aa$ a)a" *i(a +a(/ i#!,%* i#!(*i. 23 S!,%a$ #*%i *!(*a(/ "a#)a$ ia! a'%* +a(/ *!ai 'a!(a i(!'#i &aa a(a' i ,a@a$ 3 *a$%( i i(a I(ia M!'#i'- M+a("a B%"a a( Pa'i#*a( $a(+a *i/a a/!( i(!'*i +a(/ #!aa '-(#i#*!( a*a% #!aa &-'-' i*!"%'a( "!(i(/'a* &aa a(a' &!(!i*a ia!. A/!( i(i aa)a$ R-*a0i%#S$i/!))a #&& a( E. -)i !(*!-*-'#i/!(i' R-*a0i%# !)a# "!%&a'a( &!(+!,a, ia! a'%* +a(/ &a)i(/ #!i(/ ii!(*ii'a#i &aa a(a' a)a" '-"%(i*a# *-&i# a( i')i" #!a(/. Dia! a&a* i#!,a,'a( -)!$ a)!/i a*a% i(*-)!a(#i "a'a(a( *!*!(*% #!&!*i #%#% &-%' #%#% "a'a(a( a#i(/ *!a&a* i(i0i% *!*!(*% +a(/ &!a# a*a% *ia' #!#%ai '-(i#i %#%# a&a* &%)a i#!,a,'a( -)!$ '!a%(a( "a'a(a( a( ,a$a(,a$a( 'i"ia. B!,!a&a "aa" -,a* *!%*a"a a(*i,i-*i'a a&a* %/a "!(ai &!(+!,a, ia!. A(*i,i-*i'a a'a( "!(!'a( )-a (-"a) %#%# #!$i(//a -/a(i#"! +a(/ *ia' ,ia#a a*a% +a(/ '!,a) a(*i,i-*i'a a'a( ,!'!",a(/ ,!,a#. Di #a"&i(/ i*% #ia* a"a'-'i(!*i' ai -,a* i*% #!(ii %/a "!"!/a(/ &!a(a( &!(*i(/. Dia! %/a ,!$%,%(/a( !(/a( &!(+a'i* )ai( "i#a)(+a "a)aia #$i#*-#-"ia#i# a"&a' a*a% &aa i(!'#i #i#*!"i' )ai((+a "i#a)(+a &(!%"-(ia aa(/ *!(//--'a( a( -*i*i# "!ia. 3 Pato"isio!o$i
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B!a#a'a( '-(#!(*a#i Na*i%" &)a#"a *i&! !$ia#i i,a/i 3 +ai*% !$ia#i $i&-(a*!"ia 9 C 13= "E/;L : !$ia#i i#-(a*!"a 913=" < 15= "E/;L: a( !$ia#i $i&!(a*!"ia 9 15= "E/;L :. Paa %"%(+a !$ia#i +a(/ *!ai aa)a$ *i&! i#- < (a*!"ia 98=?: *a(&a i#!*ai /a(//%a( -#"-)a)i*a# aia( *%,%$ #i#a(+a 15 ? aa)a$ ia! $i&!(a*!"ia a( 5? aa)a$ ia! $i&-(a*!"ia. K!$i)a(/a( ,i'a,-(a* ,!#a"a !(/a( ia! a&a* "!(i",%)'a( a#i-#i# "!*a,-)i' !(/a( a(i-( /a& +a(/ (-"a) 9 816 "E/;L: ,ia#a(+a i#!*ai $i&!')-!"ia. S!)ai( &!(%%(a( ,i'a,-(a* #!%" *!a&a* &%)a &!(%%(a( &H aa$ 7
'!(ai'a( &O2. Ha) i(i a'a( "!a(/#a(/ &%#a* &!(a&a#a( %(*%' "!(i(/'a*'a( '!!&a*a( &!(a&a#a( #!,a/ai %&a+a "!(i(/'a*'a( !'#!#i O2 "!)a)%i &a% 9&!(a&a#a( K%##"a%): U(*%' &!"!(%$a( '!,%*%$a( 'a)-i *!ai &!"!a$a( &-*!i( a( )!"a' +a(/ "!(/a'i,a*'a( "!(i(/'a*(+a &-%'#i a#a" #!$i(//a "!(+!,a,'a( *%%((+a (a#% "a'a( ,a+i. K!aaa( !$ia#i ,!a* !(/a( $i&-&!%#i /i(a) #!*a !'#!#i a#a" +a(/ "!(%%( a( a'%"%)a#i a(i-( a#a" #!aa ,!#a"aa( "!(+!,a,'a( ,!)a(%*(+a '!aaa( a#i-#i#. Kaa 'a)i%" &)a#"a i&!(/a%$i -)!$ '!#!i",a(/a( a#a" ,a#a #!$i(//a &aa '!aaa( a#i-#i# "!*!,-)i' a&a* *!ai $i&-'a)!"ia. K!$i)a(/a( 'a)i%" %/a "!)a)%i aia( *i(a a( &!&i(a$a( K '! a)a" #!) &aa #aa* '-!'#i a#i-#i# a&a* &%)a "!(i",%)'a( $i&-'a)!"ia. K!)!"a$a( -*-* "!%&a'a( "a(i!#*a#i a@a) ai $i&-'a)!"ia &!*a"a 'a)i &aa -*-* a(//-*a ,aa( a( -*-* &!(a&a#a(. Da&a* *!ai a!)!'# &aa)i#i# a( '!"a*ia( 'a!(a '!/a/a)a( &!(a&a#a(. Di#%(/#i -*-* $a%# "!(i",%)'a( i)!%# &aa)i*i' a( i)a*a#i )a",%(/. EKG "(%(%''a( /!)-",a(/ T +a(/ "!(a*a a*a% "!(%%( !(/a( "%(%)(+a /!)-",a(/ U. Paa /i(a) '!'%a(/a( K "!(/a'i,a*'a( &!%,a$a( 0a'%-)a a( !&i*!) *%,%)%# a( "!(i",%)'a( #')!-#i# /i(a) +a(/ ,!)a(%* "!(ai -)i/%ia a( /a/a) /i(a). Penata!a%sanaan
P!(/a(*ia( aia( a( !)!'*-)i* "!%&a'a( !)!"!( +a(/ &!(*i(/ a)a" *!a&i !!'*i ia! a'%*. B!a*(+a !$ia#i #!aa a'%a* i(i)ai ,!a#a'a( ,!a* ,aa( +a(/ $i)a(/ #!,a/ai &!#!(*a#i '!$i)a(/a( *-*a) ,!a* ,aa( i,a(i(/'a( ,!a* ,aa( #!,!)%"(+a #!,a/ai ,a'% !"a#. P!",!ia( *!a&i aia( a&a* i)a'%'a( #!aa -a) a*a% &aa*!a). P!",!ia( #!aa -a) a&a* i)a'%'a( %(*%' !$ia#i i(/a( #a"&ai #!a(/ a&a* "!(//%(a'a( &i&a (a#-/a#*i' @a)a%&%( &aa !$ia#i i(/a( a( #!a(/. Bi)a ia! &-%# !(/a( &!(/!)%aa( ai *i(a +a(/ ,a(+a' 9 1== ");'/BB;$ai : a*a% "%(*a$ $!,a* 9#!0!! 0-"i*i(/: #!$i(//a &!(!i*a *a' a&a* "i(%" #a"a #!'a)i a*a% '!",%(/ +a(/ #a(/a* $!,a* 90i-)!(* "!*!-i#": #!$i(//a %&a+a !$ia#i -a) *!*a& a'a( *!ai !i#i* "a'a a&a* i)a'%'a( !$ia#i &a!(*!a) @a)a%&%( #!,!(a(+a !$ia#i &a!(*!a) i)a'%'a( $a(+a %(*%' !$ia#i ,!a* !(/a( /a(//%a( #i'%)a#i. K!%(*%(/a( %&a+a *!a&i -a) 'a!(a "%a$ a( a&a* i,!i'a( i"a(a"a(a. AAP 8
"!!'-"!(a#i'a( aia( !$ia#i -a) 9ORS: %(*%' !$ia#i !(/a( 'aa (a*i%" ,!'i#a a(*aa 75>= "E;L a( %(*%' &!(!/a$a( a( &!"!)i$aaa( !(/a( (a*i%" a(*aa 4=6="E;L.
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#!/!a &!",!ia( "a'a(a((+a #!#%ai %"% 34. Deidrasi Rin$an & Sedan$
R!$ia#i &aa !$ia#i i(/a( a( #!a(/ a&a* i)a'%'a( !(/a( &!",!ia( -a) #!#%ai !(/a( !i#i* +a(/ *!ai (a"%( i'a /a/a) a&a* i,!i'a( #!aa i(*a0!(a #!,a(+a' 75 ");'/ ,,;3a". P!",!ia( aia( -a) a&a* i)a'%'a( #!*!)a$ a(a' a&a* "i(%" #!,a(+a' 5");'/,,;a". Bia#a(+a a&a* i)a'%'a( #!*!)a$ 34 a" &aa ,a+i a( 12 a" &aa a(a' . P!(//a(*ia( aia( ,i)a "a#i$ aa ia! a*a% "%(*a$ a&a* i,!i'a( #!,a(+a' 1=");'/,, #!*ia& ia! a*a% "%(*a$. S!aa i(/'a# '!)-"&-' A$)i /a#*-!(*!-)-/i %(ia "!",!i'a( > &i)a +a(/ &!)% i&!$a*i'a( a)a" &!(a*a)a'#a(aa( ia! a'%* !$ia#i i(/a( #!a(/ &aa a(a' +ai*% 1. M!(//%(a'a( RO 9 aia( !$ia#i -a) : 2. aia( $i&-*-(i' 3. R!$ia#i -a) !&a* 3 < 4 a" 4. R!a)i"i(a#i !&a* !(/a( "a'a(a( (-"a) 5. Tia' i,!(a'a( "!",!i'a( #%#% -"%)a '$%#%# 6. Tia' i,!(a'a( "!",!i'a( #%#% +a(/ i!(!'a( 7. ASI i*!%#'a( 8. S%&)!"!( (!/a( RO 9 RO %"a*a( : >. A(*i ia! *ia' i&!)%'a( Deidrasi Berat
P!(!i*a !(/a( !$ia#i ,!a* +ai*% !$ia#i )!,i$ ai 1=? %(*%' ,a+i a( a(a' a( "!(%(%''a( /a(//%a( *a(a*a(a 0i*a) *%,%$ 9 #-"(-)!('-"a &!(aa#a( K%##"a%) /a(//%a( i(a"i' #i'%)a#i : "!"!)%'a( &!",!ia( aia(
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!)!'*-)i* &a!(*!a). P!(//a(*ia( aia( &a!(*!a) "!(%%* &a(%a( WHO i,!i'a( #!,a/ai ,!i'%* U#ia C12 ,)( 3=");'/,,;1a" #!)a(%*(+a 7=");'/,,;5a" U#ia 12 ,)( 3=");'/,,;1;21a" #!)a(%*(+a 7=");'/,,;22 a" Wa)a%&%( &aa ia! *!a&i aia( &a!(*!a) *ia' %'%& ,a/i '!,%*%$a( &!(!i*a a'a( 'a)-i (a"%( $a) i(i *ia')a$ "!(ai "a#a)a$ ,!#a 'a!(a $a(+a "!(+a(/'%* @a'*% +a(/ &!(!'. A&a,i)a &!(!i*a *!)a$ '!",a)i i,!i'a( i!* #!,a/ai"a(a ,ia#a(+a . S!/a)a '!'%a(/a( *%,%$ a'a( 'a,-$ia* )!"a' a( &-*!i( a'a( #!/!a a&a* i&!(%$i. I*%)a$ #!,a,(+a "!(/a&a &aa &!",!ia( *!a&i aia( i%#a$a'a( a/a &!(!i*a ,i)a "!"%(/'i('a( !&a* "!(a&a*'a( "a'a(a( ; "i(%"a( #!,a/ai ,ia#a(+a ,a$'a( &aa !$ia#i i(/a( #!a(/ +a(/ *ia' "!"!)%'a( *!a&i aia( &a!(*!a) "a'a( a( "i(%" *!*a& a&a* i)a(%*'a(. 5 Pemi!ian 'enis (airan
aia( Pa!(*!a) i,%*%$'a( *!%*a"a %(*%' !$ia#i ,!a* !(/a( a*a% *a(&a #+-' #!$i(//a a&a* "!(/!",a)i'a( !(/a( !&a* 0-)%"! aa$(+a #!*a "!"&!,ai'i !(a*a( $i&-0-)!"i'(+a. aia( Ri(/! La'*a* 9RL: aa)a$ aia( +a(/ ,a(+a' i&!a/a(/'a( a( "!(/a(%(/ '-(#!(*a#i (a*i%" +a(/ *!&a* #!*a %'%& )a'*a* +a(/ a'a( i"!*a,-)i#"! "!(ai ,i'a,-(a*. Na"%( !"i'ia( '-#!(*a#i 'a)i%"(+a !(a$ a( *ia' "!(/a(%(/ /)%'-#a %(*%' "!(!/a$ $i&-/)i'!"ia. aia( NaL !(/a( a*a% *a(&a !'#*-#a a&a* i&a'ai *!*a&i *ia' "!(/a(%(/ !)!'*-)i* +a(/ i,%*%$'a( a)a" %")a$ +a(/ %'%&. !(i# aia( &a!(*!a) +a(/ #aa* i(i ,!!a a( a&a* "!"!(%$i '!,%*%$a( #!,a/ai aia( &!(//a(*i ia! !(/a( !$ia#i aa)a$ KaEN 3B.16 S!%")a$ aia( !$ia#i -a) !(/a( -#"-)a)i*i 21= < 268 ""-);1 !(/a( Na ,!'i#a 5= < 75 "E/;L "!"&!)i$a*'a( !i'a#i &aa ia! a(a' !(/a( '-)!a a*a% *a(&a '-)!a. 45 Komposisi elektrolit pada diare akut :
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Tia' aa ,%'*i ')i(i# ai a(*i ia! a( a(*i "-*i)i*i# ai ,!,!a&a %i ')i(i#. O,a* a(*i ia! $a(+a #i"*-"a*i# ,%'a( #&!#ii' %(*%' "!(/-,a*i 'a%#a *ia' "!"&!,ai'i '!$i)a(/a( ai a( !)!'*-)i* #!*a "!(i",%)'a( !!' #a"&i(/ +a(/ *ia' ii(/i('a(. A(*i,i-*i' +a(/ *ia' i#!a& %#%# #!&!*i #*!&*-"i#i( (!-"i#i( $i-'#i'%i(-)-( a( #%)-(a"i a&a* "!"&!,!a* +a(/ !#i#*!( a( "!(+!,a,'a( "a)a,#-&#i. S!,a/ia( ,!#a 'a#%# ia! *ia' "!"!)%'a( &!(/-,a*a( !(/a( a(*i,i-*i'a -)!$ 'a!(a &aa %"%"(+a #!",%$ #!(ii 9#!) )i"i*i(/:. A(*i,i-*i' $a(+a i&!)%'a( &aa #!,a/ia( '!i) &!(!i*a ia! "i#a)(+a '$-)!a #$i/!))a 'a!(a &!(+!,a, *!,!#a ai ia! &aa a(a' aa)a$ 0i%# 9R-*a0i%#:. K!%a)i &aa ,a+i ,!%#ia i ,a@a$ 2 ,%)a( 'a!(a &-*!(#i *!ai(+a #!&#i# -)!$ 'a!(a ,a'*!i "%a$ "!(/aa'a( *a(#)-'a#i '!a)a" #i'%)a#i a*a% &aa a(a';,a+i +a(/ "!(%(%''a( #!aa ')i(i# /aa)a +a(/ ,!a* #!*a ,!%)a(/ a*a% "!(%(%''a( /!a)a ia! !(/a( aa$ a( )!(i +a(/ !)a# a*a% #!/a)a #!&#i#. A(*i "-*i)i*i# #!&!*i i!(-#i)a* a( )-&!a"i a&a* "!(i",%)'a( &aa)i#i# -,#*%'#i #!$i(//a *!ai ,a*!ia) -0!/-@*$ /a(//%a( a,#-&#i a( #i'%)a#i. Be/era#a antimi%ro/a an$ serin$ men'adi etio!o$i diare #ada ana% Ko!era
T!*a#i')i( 5="/;'/;$ai i,a/i 4 -#i# 92 $ai: F%a#-)i-( 5"/;'/;$ai i,a/i 4 -#i# 93 $ai: Si$e!!a
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M!*-(ia#-) 15"/.'/;$ai i,a/i 4 -#i# 9 5 $ai : Antise%retori% - Antidiare
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"!(/%(*%(/'a( &aa $-#* !(/a( aa "!(i(/'a*'a( '-)-(i#a#i ,a'*!i &-,i-*i' ia)a" )%"!( #a)%a( !(a #!$i(//a #!)%%$ !&i*!) "%'-#a %#%# *!)a$ i%%'i -)!$ ,a'*!i &-,i-*i' "!)a)%i !#!&*- a)a" #!) !&i*!) %#%#. D!(/a( "!(!"a*i &!(-"!(a *!#!,%* ,a'*!i &-,i-*i' a&a* i&a'ai !(/a( aa %(*%' &!(!/a$a( a( &!(/-,a*( ia! ,ai' +a(/ i#!,a,'a( -)!$ R-*a0i%# "a%&%( "i'--/a(i#"! )ai( #&!%-"!",a( -)i*i# "a%&%( ia! +a(/ i#!,a,'a( -)!$ 'a!(a &!"a'aia( a(*i,i-*i'a +a(/ *ia' a#i-(a) a#i-(a) 9a(*i,i-*i' a#-ia*!' ia$!a : a( *a0!))!## ia$!a. 5 T!a&a* ,a(+a' )a&-a( *!(*a(/ &!(//%(aa( &-,i-*i' a)a" *a*a)a'#a(a ia! a'%* &aa a(a'. Ha#i) "!*a a(a)i#a a( Ni!) '' "!(+a*a'a( )a*-,ai))%# a"a( a( !!'*i a)a" &!(/-,a*a( ia! a'%* i(!'#i &aa a(a' "!(%%('a( )a"a(+a ia! 'ia'ia 2;3 )a"a(+a ia! a( "!(%%('a( !'%!(#i ia! &aa $ai 12
'! %a &!",!ia( #!,a(+a' 1 < 2 'a)i. K!"%(/'i(a( "!'a(i#"! !!'&-,i-*i' a)a" &!(/-,a*a( ia! aa)a$ P!%,a$a( )i(/'%(/a( "i'- )%"!( %#%# &-%'#i ,a$a( a(*i "i'-,a *!$aa& ,!,!a&a &a*-/!( '-"&!*i#i (%*i!( "!(!/a$ a$!#i &a*-/!( &aa a(*!-#i* "-ii'a#i *-'#i( a*a% !#!&*- *-'#i( !!'*-i' &aa "%'-#a %#%# a( i"%((- "-%)a#i. 5 Mi%ronutrien
Da#a &!"i'ia( &!(/%(aa( "i'-(%*i!( a)a" &!(/-,a*a( ia! a'%* ia#a'a( '!&aa !!'(+a *!$aa& %(/#i i"%( a*a% *!$aa& #*%'*% a( %(/#i #a)%a( !(a a( *!$aa& &-#!# &!,ai'a( !&i*!) #!)%a( !(a #!)a"a ia!. S!(/ *!)a$ i'!(a)i ,!&!a( i a)a" "!*a))- < !(+"!# &-)+i,-#-"!# #!)a&%* #!) a( %(/#i #!) %/a ,!&!a( &!(*i(/ i a)a" &!*%",%$a( #!) a( %(/#i '!'!,a)a( .Paa ,a+i a( a(a' )!,i$ '!i) !(/a( ia! a'%* #%&)!"!(*a#i #!(/ #!aa ')i(i# &!(*i(/ a)a" "!(%%('a( )a"a a( ,!a*(+a ia!. S*a( M!(+a*a'a( !!' &!",!ia( #!(/ *ia' i&!(/a%$i a*a% "!(i(/'a* ,i)a i,!i'a( ,!#a"a !(/a( 0i* A. P!(/-,a*a( ia! a'%* !(/a( 0i*a"i( A *ia' "!"&!)i$a*'a( &!,ai'a( ,ai' *!$aa& )a"a(+a ia! "a%&%( !'%!(#i ia!. &!",!ia( 0i*a"i( A 6="/ i,a(i(/ !(/a( &)a#!,- #!)a"a ia! a'%* a&a* "!(%%('a( ,!a*(+a !&i#-! a( i#i'- "!(ai ia! &!#i#*!( &aa a(a' +a(/ *ia' "!(a&a*'a( ASI *a&i *ia' !"i'ia( &aa +a(/ "!(a&a* ASI.45 Men(e$a ) Menan$$u!an$i an$$uan i3i
A"a*)a$ &!(*i(/ %(*%' *!*a& "!",!i'a( (%*i#i +a(/ %'%& #!)a"a ia! *!%*a"a &aa a(a' !(/a( /ii +a(/ '%a(/. Mi(%"a( a( "a'a(a( a(/a( i$!(*i'a( )!,i$ ai 24 a" 'a!(a &%)i$(+a "%'-#a %#%# *!/a(*%(/ ai (%*i#i +a(/ %'%&.Bi)a *ia' "a'a)a$ i(i a'a( "!%&a'a( a'*- +a(/ "!"%a$'a( *!ai(+a ia! '-(i' P!",!ia( '!",a)i "a'a(a( a*a% "i(%"a( 9!!!i(/: #!aa !&a* #a(/a*)a$ &!(*i(/ ,a/i a(a' !(/a( /ii '%a(/ +a(/ "!(/a)a"i ia! a'%* a( $a) i(i a'a( "!(!/a$ ,!'%a(/(+a ,!a* ,aa( )!,i$ )a(%* a( "!"&!!&a* '!#!",%$a(. Ai #%#% i,% a( #%#% -"%)a #!*a "a'a(a( &aa %"%"(+a $a%# i)a(%*'a( &!",!ia((+a #!)a"a ia! &!(!)i*ia( +a(/ i)a'%'a( -)!$ La"a "-! RA '' "!(%(%''a( ,a$@a #%&)!"!( (%')!-*ia &aa #%#% -"%)a #!aa #i/(ii'a( "!(/%a(/i )a"a a( ,!a*(+a ia! &aa a(a' -)!$ 'a!(a (%)!-*i! 13
aa)a$ ,a$a( +a(/ #a(/a* i&!)%'a( %(*%' !&)i'a#i #!) *!"a#%' #!) !&i*!) %#%# a( #!) i"%(-'-"&!*!(. Paa a(a' )!,i$ ,!#a "a'a(a( +a(/ i!'-"!(a#i'a( "!)i&%*i *ai( 9 ,!a# '!(*a(/ "i a( &i#a(/: a( /a(%" 9 ,!a# /a(%" a( !!a):. Ma'a(a( +a(/ $a%# i$i(a'a( aa)a$ "a'a(a( !(/a( 'a(%(/a( *i(//i /%)a #!!$a(a +a(/ a&a* "!"&!,%%' ia! #!&!*i "i(%"a( 'a)!(/ a( #ai ,%a$ a&!). %/a "a'a(a( *i(//i )!"a' +a(/ #%)i* i*-)!a(#i 'a!(a 'a!(a "!(+!,a,'a( )a",a*(+a &!(/-#-(/a( )a",%(/. P!",!ia( #%#% !(a$ )a'*-#a a*a% ,!,a# )a'*-#a i,!i'a( &aa &!(!i*a +a(/ "!(%(%''a( /!a)a ')i(i' a( )a,-a*-i%" i(*-)!a(#i )a'*-#a. I(*-)!a(#i )a'*-#a ,!#&!'*%" ai +a(/ i(/a( #a"&ai +a(/ ,!a* a( '!,a(+a'a( aa)a$ *i&! +a(/ i(/a( #!$i(//a %'%& "!",!i'a( -"%)a #%#% ,ia#a(+a i"i(%" !(/a( &!(/!(!a( -)!$ 'a!(a i(*-)!a(#i )a'*-#a i(/a( ,!#ia* #!"!(*aa a( a)a" @a'*% 2 < 3 $ai a'a( #!",%$ *!%*a"a &aa a(a' /ii +a(/ ,ai'. Na"%( ,i)a *!a&a* i(*-)!a(#i )a'*-#a +a(/ ,!a* a( ,!'!&a(a(/a( *!*a& i&!)%'a( #%#% -"%)a ,!,a# )a'*-#a %(*%' @a'*% +a(/ )!,i$ )a"a. U(*%' i(*-)!a(#i )a'*-#a i(/a( a( #!a(/ #!,ai'(+a i,!i'a( -"%)a #%#% !(a$ )a'*-#a. Sa,a/ai"a(a $a)(+a i(*-)!a(#i )a'*-#a "a'a i(*-)!a(#i )!"a' &aa ia! a'%* #ia*(+a #!"!(*aa a( ,ia#a(+a *ia' *!)a)% ,!a* #!$i(//a *ia' "!"!)%'a( -"%)a '$%#%#.Paa #i*%a#i +a(/ "!"!)%'a( ,a(+a' !(!/i #!&!*i &aa a#! &!(+!",%$a( ia! i!* !(a$ )!"a' %#*% a&a* "!"&!,%%' '!aaa( "a)(%*i#i a( a&a* "!(i",%)'a( ia! '-(i'. Menan$$u!an$i Pena%it Penerta
A(a' +a(/ "!(!i*a ia! "%(/'i( %/a i#!*ai !(/a( &!(+a'i* )ai(. S!$i(//a a)a" "!(a(/a(i ia!(+a %/a &!)% i&!$a*i'a( &!(+a'i* &!(+!*a +a(/ aa. B!,!a&a &!(+a'i* &!(+!*a +a(/ #!i(/ *!ai ,!#a"aa( !(/a( ia! a(*aa )ai( i(!'#i #a)%a( (aa# i(!'#i #%#%(a( #aa &%#a* i(!'#i #a)%a( '!"i$ i(!'#i #i#*!"i' )ai( 9#!&#i#a"&a' : '%a(/ /ii &!(+a'i* a(*%(/ a( &!(+a'i* /i(a) .
Kom#!i%asi
K-"&)i'a#i %*a"a a'i,a* &!(+a'i* /a#*-!(*!i*i# i(i aa)a$ !$ia#i a( "a#a)a$ 'ai-0a#'%)a a'i,a* $i&-0-)!"ia !(/a( !aa* ,!a*. A&a,i)a ia! i*% i#!,a,'a( 14
-)!$ S$i/!))a !"a" *i(//i a( '!a(/ ,i#a *i",%). A,#!# &aa #a)%a( %#%# %/a a&a* *i",%) a'i,a* i(!'#i #$i/!))a a( #a)"-(!))a *!%*a"a &aa !"a" *i-i +a(/ a&a* "!(+!,a,'a( &!-a#i &aa #a)%a( %#%#. Ha) i(i #a(/a* ,!,a$a+a a( "!(/a(a" (+a@a. M%(*a$ +a(/ ,!a* a&a* "!(+!,a,'a( a#&ia#i a( -,!'a( &aa !#-a/%#
15
BAB III KESIMP4*AN
Dia! "a#i$ "!%&a'a( #a)a$ #a*% "a#a)a$ '!#!$a*a( "a#+aa'a* +a(/ %*a"a 'a!(a "a#i$ *i(//i(+a a(/'a '!#a'i*a( a( '!"a*ia(. P!(+!,a, %*a"a ia! a'%* aa)a$ i(!'#i R-*a0i%# +a(/ ,!#ia* #!) )i"i*i(/ #!$i(//a *ia' "!"!)%'a( &!(/-,a*a( !(/a( a(*i,i-*i'a. P!"a'aia( a(*i,i*i'a $a(+a %(*%' 'a#%#'a#%# +a(/ ii(i'a#i'a(.Ma#a)a$ %*a"a ia! a'%* &aa a(a' ,!'ai*a( !(/a( i#i'- *!ai(+a !$ia#i. U&a+a !$ia#i "!(//%(a'a( aia( !$ia#i -a) "!%&a'a( #a*%#a*%(+a &!(!'a*a( *!a&i +a(/ &a)i(/ ia(%'a(. P!(//a(*ia( aia( a( !)!'*-)i* "!%&a'a( !)!"!( +a(/ &!(*i(/ a)a" *!a&i ia! a'%*. P!"a'aia( a(*i #!'!*-i'&-,i-*i' a( "i'-(%*i!( a&a* "!"&!,ai'i !'%!(#i a( )a"a(+a ia!. Ha) )ai( +a(/ &!)% i&!$a*i'a( aa)a$ &!",!ia( "a'a(a( a*a% (%*i#i +a(/ %'%& #!)a"a ia! a( "!(/-,a*i &!(+a'i* &!(+!*a.
16
DAFTAR P4STAKA
1.
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2.
Ba'i( RM F)%i a( E)!*-)+*! P-,)!"#. P-,)!" Oi!(*! P!ia*i Dia/(-#i# Li**)! B-@( a( -"&a(+ 2=11J2= < 23.
3.
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4.
Fi"a(#+a$ A. T!a&i &-,i-*i' a( &!,i-*i' &aa &!(+a'i* #a)%a( !(a. a)a" Sai &!ia*i -) 2N-. 4 "a!* 2=11
5.
S%,ia(*- MSRa(%$ R D%&i L" S-!&a*- P. Ma(a/!"!( ia! &aa ,a+i a( a(a'. Di'%*i& ai URL $**&;;@@@.&!ia*i'.-";
17
