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\pard\sb0\sl-240{\bkmkstart Pg1}{\bkmkend Pg1}\par\pard\ql \li8284\sb0\sl-276\sl
mult0 \par\pard\ql\li8284\sb175\sl-276\slmult0 \up0 \expndtw-5\charscalex100 \ul
0\nosupersub\cf1\f2\fs24 Panduan Praktik Klinis \par\pard\ql \li5875\sb0\sl-322\
slmult0 \par\pard\ql\li5875\sb124\sl-322\slmult0 \up0 \expndtw-2\charscalex100 \
ul0\nosupersub\cf2\f3\fs28 PARU\par\pard\sect\sectd\sbknone\cols2\colno1\colw584
9\colsr110\colno2\colw6141\colsr160\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \
li2016\sb89\sl-253\slmult0\tx2659\tx5719 \up0 \expndtw-3\charscalex100 \ul0\nosu
persub\cf3\f4\fs22 1.\tab \up0 \expndtw0\charscalex102 Nama Penyakit /Diagnosis\
tab \up0 \expndtw-3\charscalex100 :\par\pard\ql \li2016\sb0\sl-253\slmult0 \par\
pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\
pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\
pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\
pard\ql \li2016\sb1\sl-253\slmult0\tx2659\tx5719 \up0 \expndtw-3\charscalex100 2
.\tab \up0 \expndtw0\charscalex104 Kriteria Diagnosis\tab \up0 \expndtw-3\charsc
alex100 :\par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253
\slmult0 \par\pard\ql \li2016\sb251\sl-253\slmult0\tx2659\tx5719 \up0 \expndtw-3
\charscalex100 3.\tab \up0 \expndtw0\charscalex101 Diagnosis Diferensial\tab \up
0 \expndtw-3\charscalex100 :\par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql
\li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql
\li2016\sb1\sl-253\slmult0\tx2659\tx5719 \up0 \expndtw-3\charscalex100 4.\tab \
up0 \expndtw0\charscalex106 Pemeriksaan Penunjang\tab \up0 \expndtw-3\charscalex
100 :\par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slm
ult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slm

ult0 \par\pard\ql \li2016\sb252\sl-253\slmult0\tx2659\tx5719 \up0 \expndtw-3\cha

rscalex100 5.\tab \up0 \expndtw0\charscalex103 Konsultasi\tab \up0 \expndtw-3\ch
arscalex100 :\par\pard\ql \li2016\sb253\sl-253\slmult0\tx2659\tx5719 \up0 \expnd
tw-3\charscalex100 6.\tab \up0 \expndtw0\charscalex106 Perawatan RS\tab \up0 \ex
pndtw-3\charscalex100 :\par\pard\ql \li2016\sb253\sl-253\slmult0\tx2659\tx5719 \
up0 \expndtw-3\charscalex100 7.\tab \up0 \expndtw0\charscalex108 Terapi\tab \up0
\expndtw-3\charscalex100 :\par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql
\li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql
\li2016\sb253\sl-253\slmult0\tx2659\tx5719 \up0 \expndtw-3\charscalex100 8.\tab
\up0 \expndtw0\charscalex104 Penyulit\tab \up0 \expndtw-3\charscalex100 :\par\pa
rd\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pa
rd\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb1\sl-253\slmult0\tx2659\
tx5719 \up0 \expndtw-3\charscalex100 9.\tab \up0 \expndtw0\charscalex104 Inform
concent ( tertulis )\tab \up0 \expndtw-3\charscalex100 :\par\pard\ql \li2016\sb2
51\sl-253\slmult0\tx2659\tx5719 \up0 \expndtw-3\charscalex100 10.\tab \up0 \expn
dtw0\charscalex107 Lama Perawatan\tab \up0 \expndtw-3\charscalex100 :\par\pard\q
l \li2016\sb253\sl-253\slmult0\tx2659\tx5719 \up0 \expndtw-3\charscalex100 11.\t
ab \up0 \expndtw0\charscalex104 Masa pemulihan\tab \up0 \expndtw-3\charscalex100
:\par\pard\ql \li2016\sb253\sl-253\slmult0\tx2659\tx5719 \up0 \expndtw-3\charsc
alex100 12.\tab \up0 \expndtw0\charscalex109 Output\tab \up0 \expndtw-3\charscal
ex100 :\par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb253\sl-253
\slmult0\tx2659\tx5719 \up0 \expndtw-3\charscalex100 13.\tab \up0 \expndtw0\char
scalex101 PA\tab \up0 \expndtw-3\charscalex100 :\par\pard\ql \li2016\sb253\sl-25
3\slmult0\tx2659\tx5719 \up0 \expndtw-3\charscalex100 14.\tab \up0 \expndtw0\cha
rscalex104 Autopsi/Risalah Rapat\tab \up0 \expndtw-3\charscalex100 :\par\pard\co
lumn \ql \li5959\sb0\sl-253\slmult0 \par\pard\ql \li20\sb89\sl-253\slmult0 \up0
\expndtw0\charscalex102 BRONKITIS AKUT\par\pard\qj \li20\ri1472\sb248\sl-253\slm
ult0 \up0 \expndtw-2\charscalex100 Ialah proses radang akut pada saluran napas b
awah. \line \up0 \expndtw-1\charscalex100 Tidak dijumpai kelainan radiolog
ik. Penyebab \line \up0 \expndtw-1\charscalex100 tersering ialah virus. Bila b
erlangsung lebih dari 5-\par\pard\qj \li20\ri1473\sb0\sl-254\slmult0 \up0 \expnd
tw0\charscalex103 7 hari dan perubahan warna sputum perlu \up0 \expn
dtw-3\charscalex100 dipikirkan infeksi bakteri\par\pard\qj \li5959\sb0\sl-251\sl
mult0 \par\pard\qj \li20\ri1473\sb3\sl-251\slmult0\fi0\tx2420\tx3133 \up0 \expnd
tw0\charscalex100 Demam,
batuk-batuk\tab \up0 \expndtw-3\charscalex100 (dari\
tab \up0 \expndtw0\charscalex102 kering
sampai \line \up0 \expndtw-1\charscal
ex100 berdahak), kadang-kadang sesak napas dan disertai \line \up0 \expndtw-3\ch
arscalex100 nyeri dada.\par\pard\ql \li5976\sb0\sl-253\slmult0 \par\pard\ql \li3
7\sb1\sl-253\slmult0 \up0 \expndtw-2\charscalex100 -\ul0\nosupersub\cf4\f5\fs22
\ul0\nosupersub\cf3\f4\fs22 Infeksi akut saluran napas bagian atas\par\pard\ql
\li37\sb2\sl-253\slmult0 \up0 \expndtw0\charscalex101 -\ul0\nosupersub\cf4\f5\fs
22 \ul0\nosupersub\cf3\f4\fs22 Pneumonia\par\pard\ql \li37\sb1\sl-251\slmult0 \
up0 \expndtw0\charscalex102 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4
\fs22 TB Paru\par\pard\ql \li5976\sb0\sl-253\slmult0 \par\pard\ql \li37\sb1\sl-2
53\slmult0 \up0 \expndtw-1\charscalex100 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosu
persub\cf3\f4\fs22 Foto toraks PA dan lateral\par\pard\ql \li37\sb1\sl-251\slmul
t0 \up0 \expndtw-1\charscalex100 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\c
f3\f4\fs22 Laboratorium rutin darah :\par\pard\ql \li217\sb3\sl-253\slmult0 \up0
\expndtw-3\charscalex100 * Hitung leukosit meninggi\par\pard\qj \li217\ri1665\s
b1\sl-251\slmult0\tx392 \up0 \expndtw-3\charscalex100 * Pada hitung jenis, mungk
in terdapat dominasi \line\tab \up0 \expndtw-3\charscalex100 sel leukosit PMN\pa
r\pard\ql \li5959\sb0\sl-253\slmult0 \par\pard\ql \li20\sb1\sl-253\slmult0 \up0
\expndtw-3\charscalex100 Dokter Spesialis Paru\par\pard\ql \li20\sb253\sl-253\sl
mult0 \up0 \expndtw-3\charscalex100 -\par\pard\ql \li5959\sb0\sl-253\slmult0 \pa
r\pard\ql \li37\sb1\sl-253\slmult0 \up0 \expndtw-1\charscalex100 -\ul0\nosupersu
b\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Terapi medikamentosa :\par\pard\qj \l
i217\ri1519\sb0\sl-254\slmult0\fi24 \up0 \expndtw-3\charscalex100 Antibiotika bi
la ada tanda-tanda infeksi (leucosis \up0 \expndtw-3\charscalex100 tosis, demam,
dahak purulen).\par\pard\ql \li37\sb0\sl-251\slmult0 \up0 \expndtw-2\charscalex
100 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Terapi non medikam

entosa : istirahat\par\pard\ql \li5959\sb0\sl-253\slmult0 \par\pard\ql \li37\sb1

\sl-253\slmult0 \up0 \expndtw-1\charscalex100 -\ul0\nosupersub\cf4\f5\fs22 \ul0
\nosupersub\cf3\f4\fs22 Komplikasi : Pneumonia\par\pard\qj \li37\ri2673\sb0\sl-2
54\slmult0\tx1902 \up0 \expndtw-2\charscalex100 -\ul0\nosupersub\cf4\f5\fs22 \u
l0\nosupersub\cf3\f4\fs22 Karena penyakit : - abses, empiema \line\tab \up0 \ex
pndtw-3\charscalex100 - septikemia\par\pard\ql \li20\sb252\sl-253\slmult0 \up0 \
expndtw-3\charscalex100 Tidak perlu\par\pard\ql \li20\sb251\sl-253\slmult0 \up0
\expndtw-3\charscalex100 1 minggu\par\pard\ql \li20\sb253\sl-253\slmult0 \up0 \e
xpndtw-3\charscalex100 1 minggu\par\pard\qj \li5959\sb0\sl-251\slmult0 \par\pard
\qj \li20\ri4728\sb5\sl-251\slmult0 \up0 \expndtw-3\charscalex100 * Sembuh total
\line \up0 \expndtw-3\charscalex100 * Komplikasi\par\pard\ql \li5959\sb0\sl-253
\slmult0 \par\pard\ql \li20\sb1\sl-253\slmult0 \up0 \expndtw-3\charscalex100 -\p
ar\pard\ql \li20\sb253\sl-253\slmult0 \up0 \expndtw-3\charscalex100 -\par\pard\q
l \li10391\sb0\sl-276\slmult0 \par\pard\ql \li10391\sb0\sl-276\slmult0 \par\pard
\ql \li10391\sb0\sl-276\slmult0 \par\pard\ql \li4452\sb40\sl-276\slmult0 \up0 \e
xpndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs24 1 \par\pard\sect\sectd\fs24\p
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alex100 2.\tab \up0 \expndtw0\charscalex104 Kriteria Diagnosis\par\pard\column \
ql \li5757\sb0\sl-253\slmult0 \par\pard\ql \li197\sb213\sl-253\slmult0\tx562 \up
0 \expndtw-3\charscalex100 :\tab \up0 \expndtw0\charscalex101 TUBERKULOSISI PARU
NO. ICD 011.9\par\pard\qj \li557\ri1473\sb249\sl-253\slmult0 \up0 \expndtw-2\ch
arscalex100 Ialah penyakit infeksi di paru yang bersifat kronik \up0 \expndtw0\c
harscalex100 dan menular, disebabkan oleh Mycobacterium \up0 \expndtw-3\char
scalex100 tuberculosis.\par\pard\ql \li5757\sb0\sl-253\slmult0 \par\pard\ql \li1
97\sb3\sl-253\slmult0 \up0 \expndtw-3\charscalex100 :\par\pard\ql \li5580\sb0\sl
-253\slmult0 \par\pard\ql \li5580\sb0\sl-253\slmult0 \par\pard\ql \li20\sb11\sl253\slmult0 \up0 \expndtw0\charscalex104 Klasifikasi TB Paru \par\pard\sect\sect
d\sbknone \qj \li4104\ri1517\sb0\sl-260\slmult0 \up0 \expndtw0\charscalex102 Kas
us baru dengan sputum yang positip dan klinis penderita dengan \line \up0 \expnd
tw-2\charscalex100 keadaan yang berat seperti meningitis, tuberculosis militer,
perikarditis, \par\pard\ql \li2484\sb1\sl-226\slmult0\tx4104 \up0 \expndtw-3\cha
rscalex100 Kategori I \tab \up0 \expndtw0\charscalex102 peritonitis, pleuritis m
asif atau bilateral, spondilitis dengan gangguan \par\pard\qj \li4104\ri1510\sb6
\sl-260\slmult0 \up0 \expndtw-4\charscalex100 neurologik, penderita dengan sputu
m negatif tetapi dengan kelainan paru \up0 \expndtw-4\charscalex100 luas, tuberc
ulosis usus, saluran kemih dbs. \par\pard\li2484\sb0\sl-253\slmult0\par\pard\li2
484\sb9\sl-253\slmult0\fi0\tx4104 \up0 \expndtw-1\charscalex100 Kategori II\tab
\up0 \expndtw-1\charscalex100 Adalah kasus relaps atau gagal dengan sputum yang
tetap positif\par\pard\li2484\sb0\sl-253\slmult0\par\pard\li2484\sb10\sl-253\slm
ult0\fi1619 \up0 \expndtw-1\charscalex100 Adalah kasus demam dengan sputum yang
negatif dengan kelainan paru\par\pard\li2484\sb1\sl-251\slmult0\fi0\tx4104 \up0
\expndtw-1\charscalex100 Kategori III\tab \up0 \expndtw-1\charscalex100 yang tid
ak luas, kasus tuberkulosis ekstra pulmoner selain dari yang\par\pard\li2484\sb2
\sl-253\slmult0\fi1619 \up0 \expndtw-1\charscalex100 disebut dalam kategori I\pa
r\pard\li2484\sb0\sl-253\slmult0\par\pard\li2484\sb10\sl-253\slmult0\fi0\tx4104
\up0 \expndtw-1\charscalex100 Kategori IV\tab \up0 \expndtw-1\charscalex100 Adal
ah kasus tuberkulosis kronik\par\pard\li2362\sb0\sl-253\slmult0\par\pard\li2362\
sb0\sl-253\slmult0\par\pard\li2362\sb23\sl-253\slmult0\fi0\tx5559\tx8474 \up0 \e
xpndtw0\charscalex102 \ul0\nosupersub\cf5\f6\fs22 \u-3913?\ul0\nosupersub\cf4\f5
\fs22 \ul0\nosupersub\cf3\f4\fs22 Gejala klinis yang dianggap\tab \up0 \expnd
tw0\charscalex102 (+) adalah batuk dari ringan\tab \up0 \expndtw0\charscalex102
(tanpa dahak) sampai\par\pard\li2362\sb2\sl-253\slmult0\fi359 \up0 \expndtw0\cha
rscalex103 berat/batuk darah, gejala seperti flu yang hilang timbul dan semakin
sering dan demam\par\pard\li2362\sb1\sl-253\slmult0\fi359 \up0 \expndtw0\charsca
lex102 terutama senja hari\par\pard\ql \li2362\ri1541\sb5\sl-250\slmult0\tx2722\
tx2722 \up0 \expndtw0\charscalex108 \ul0\nosupersub\cf5\f6\fs22 \u-3913?\ul0\nos
upersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Foto toraks dianggap (+) bila
menggambarkan corakan yang bersifat infiltratre di \line\tab \up0 \expndtw-2\ch
arscalex100 puncak paru atau puncak lobus bawah paru dengan atau tanpa kavitas,
dan dapat disertai \line\tab \up0 \expndtw-3\charscalex100 corakan lainnya seper
ti kapur dan garis fibrotik. \par\pard\li2016\sb0\sl-253\slmult0\par\pard\li2016
\sb24\sl-253\slmult0\fi0\tx2532\tx5724\tx6084 \up0 \expndtw0\charscalex100 3.\ta
b \up0 \expndtw0\charscalex100 Diagnosis Diferensial\tab \up0 \expndtw0\charscal
ex100 :\tab \up0 \expndtw0\charscalex100 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosu

persub\cf3\f4\fs22 Bronchopneumonia\par\pard\ql \li6084\sb1\sl-226\slmult0 \up0

\expndtw0\charscalex101 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs
22 Bronkiektasis \par\pard\ql \li6084\sb12\sl-253\slmult0 \up0 \expndtw0\charsc
alex101 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Keganasan Par
u \par\pard\li2016\sb0\sl-253\slmult0\par\pard\li2016\sb16\sl-253\slmult0\fi0\tx
2532\tx5724\tx6084 \dn2 \expndtw0\charscalex105 4.\tab \dn2 \expndtw0\charscalex
105 Pemeriksaan Penunjang\tab \dn2 \expndtw0\charscalex105 :\tab \up0 \expndtw0\
charscalex105 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Foto to
raks PA dan lateral (terutama bila lesi\par\pard\ql \li6336\sb1\sl-234\slmult0 \
up0 \expndtw-3\charscalex100 terletak dilapangan tengah). \par\pard\ql \li6084\s
b11\sl-253\slmult0 \up0 \expndtw-1\charscalex100 -\ul0\nosupersub\cf4\f5\fs22 \
ul0\nosupersub\cf3\f4\fs22 BTA sputum langsung dan biakan \par\pard\ql \li6084\
sb1\sl-237\slmult0 \up0 \expndtw-1\charscalex100 -\ul0\nosupersub\cf4\f5\fs22 \
ul0\nosupersub\cf3\f4\fs22 Laboratorium darah rutin : \par\pard\ql \li6429\sb30
\sl-253\slmult0 \up0 \expndtw-1\charscalex100 \ul0\nosupersub\cf5\f6\fs22 \u-391
3?\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Hitung jenis, biasa
nya dominasi limfosit \par\pard\ql \li6429\sb7\sl-253\slmult0 \up0 \expndtw-1\ch
arscalex100 \ul0\nosupersub\cf5\f6\fs22 \u-3913?\ul0\nosupersub\cf4\f5\fs22 \ul
0\nosupersub\cf3\f4\fs22 LED > 30 mm./jam \par\pard\ql \li6429\sb7\sl-253\slmu
lt0 \up0 \expndtw0\charscalex105 \ul0\nosupersub\cf5\f6\fs22 \u-3913?\ul0\nosupe
rsub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 PCR TB \par\pard\ql \li6429\sb27
\sl-253\slmult0 \up0 \expndtw0\charscalex103 \ul0\nosupersub\cf5\f6\fs22 \u-3913
?\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 IgG Anti TB \par\par
d\li2016\sb206\sl-253\slmult0\fi0\tx2532\tx5724\tx6084 \up0 \expndtw0\charscalex
103 5.\tab \up0 \expndtw0\charscalex103 Konsultasi\tab \up0 \expndtw0\charscalex
103 :\tab \dn4 \expndtw0\charscalex103 Dokter Spesialis Paru\par\pard\li2016\sb2
51\sl-253\slmult0\fi0\tx2532\tx5724\tx6084 \up0 \expndtw0\charscalex103 6.\tab \
up0 \expndtw0\charscalex103 Perawatan RS\tab \up0 \expndtw0\charscalex103 :\tab
\dn4 \expndtw0\charscalex103 Pada prinsipnya pasien TB Paru dapat berobat\par\pa
rd\ql \li6084\sb44\sl-253\slmult0 \up0 \expndtw-3\charscalex100 jalan, kecuali b
ila ada penyulit \par\pard\ql \li10391\sb0\sl-276\slmult0 \par\pard\ql\li10391\s
b0\sl-276\slmult0 \par\pard\ql\li10391\sb0\sl-276\slmult0 \par\pard\ql\li10391\s
b20\sl-276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs24 2 \
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0\nosupersub\cf1\f2\fs24 Panduan Praktik Klinis \par\pard\li2016\sb0\sl-253\slmu
lt0\par\pard\li2016\sb0\sl-253\slmult0\par\pard\li2016\sb0\sl-253\slmult0\par\pa
rd\li2016\sb214\sl-253\slmult0\fi0\tx2508\tx5724\tx6084 \up0 \expndtw-1\charscal
ex100 \ul0\nosupersub\cf3\f4\fs22 14.\tab \up0 \expndtw-1\charscalex100 Terapi\t
ab \up0 \expndtw-1\charscalex100 :\tab \up0 \expndtw-1\charscalex100 - Terapi no
n medikamentosa :\par\pard\ql \li6249\sb1\sl-225\slmult0 \up0 \expndtw-3\charsca
lex100 Perbaikan gizi, pendidikan kesehatan \par\pard\ql \li6084\sb12\sl-253\slm
ult0 \up0 \expndtw-3\charscalex100 - Terapi medikamentosa : \par\pard\ql \li4920
\sb0\sl-253\slmult0 \par\pard\ql\li4920\sb0\sl-253\slmult0 \par\pard\ql\li4920\s
b0\sl-253\slmult0 \par\pard\ql\li4920\sb248\sl-253\slmult0 \up0 \expndtw-3\chars
calex100 Pengobatan Tuberkulosis Paru \par\pard\ql \li8004\sb0\sl-253\slmult0 \p
ar\pard\ql\li8004\sb14\sl-253\slmult0 \up0 \expndtw-3\charscalex100 Alternatif P
anduan \par\pard\li2117\sb11\sl-253\slmult0\fi0\tx4620\tx8155 \up0 \expndtw-3\ch
arscalex100 Kategori\tab \up0 \expndtw-3\charscalex100 Pasien TB\tab \up0 \expnd
tw-3\charscalex100 Pengobatan TB\par\pard\li2117\sb11\sl-253\slmult0\fi5046\tx89
64 \up0 \expndtw-3\charscalex100 Fase awal\tab \up0 \expndtw-3\charscalex100 Fas
e Lanjutan\par\pard\li2117\sb8\sl-253\slmult0\fi347\tx3204\tx9391 \up0 \expndtw3\charscalex100 I\tab \up0 \expndtw-3\charscalex100 * Kasus baru TB Paru BTA +\t
ab \up0 \expndtw-3\charscalex100 4 R3H3\par\pard\li2117\sb2\sl-253\slmult0\fi108
7\tx9501 \up0 \expndtw-3\charscalex100 * Kasus baru TB paru TB - dengan\tab \up0
\expndtw-3\charscalex100 4 RH\par\pard\li2117\sb1\sl-251\slmult0\fi1252\tx7586\
tx9508 \up0 \expndtw-3\charscalex100 Kerusakan parenchyma yg luas\tab \up0 \expn
dtw-3\charscalex100 2 RHZE\tab \up0 \expndtw-3\charscalex100 6 HE\par\pard\li211
7\sb0\sl-253\slmult0\fi1087 \up0 \expndtw-3\charscalex100 * Kasusu baru dengan k
erusakan yang\par\pard\li2117\sb1\sl-253\slmult0\fi1252 \up0 \expndtw-3\charscal
ex100 Berat pada TB ekstra pulmoner\par\pard\li2117\sb9\sl-253\slmult0\fi311\tx3
204 \up0 \expndtw-3\charscalex100 II\tab \up0 \expndtw-3\charscalex100 * TB Paru
BTA dengan riwayat\par\pard\li2117\sb1\sl-253\slmult0\fi1252\tx7524\tx9268 \up0
\expndtw-3\charscalex100 Pengobatan sebelumnya\tab \up0 \expndtw-3\charscalex1
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\slmult0\fi1087\tx7495\tx9434 \up0 \expndtw-3\charscalex100 * Kambuh\tab \up0 \e
xpndtw-3\charscalex100 + 1 RHZE\tab \up0 \expndtw-3\charscalex100 5 RHE\par\pard

\li2117\sb3\sl-253\slmult0\fi1087 \up0 \expndtw-3\charscalex100 * Kegagalan peng

obatan\par\pard\li2117\sb1\sl-250\slmult0\fi1087 \up0 \expndtw-3\charscalex100 *
Pengobatan tidak selesai\par\pard\li2117\sb12\sl-253\slmult0\fi273\tx3204 \up0
\expndtw-3\charscalex100 III\tab \up0 \expndtw-3\charscalex100 * Kasus baru TB P
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\charscalex100 Diluar kategori I\tab \up0 \expndtw-3\charscalex100 4 R3H3\par\pa
rd\li2117\sb0\sl-253\slmult0\fi1087\tx7653\tx9501 \up0 \expndtw-3\charscalex100
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p0 \expndtw-3\charscalex100 4 HR\par\pard\li2117\sb2\sl-253\slmult0\fi1197\tx950
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0 6 HE\par\pard\li2117\sb8\sl-253\slmult0\fi268\tx3204 \up0 \expndtw-3\charscale
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setelah\tab \up0 \expndtw-3\charscalex100 Rujuk ke dokter spesialis Paru\par\pa
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\pard\sb0\sl-240{\bkmkstart Pg4}{\bkmkend Pg4}\par\pard\ql \li8284\sb0\sl-276\sl
mult0 \par\pard\ql\li8284\sb175\sl-276\slmult0 \up0 \expndtw-3\charscalex100 \ul
0\nosupersub\cf1\f2\fs24 Panduan Praktik Klinis \par\pard\ql \li2016\sb0\sl-253\
slmult0 \par\pard\ql\li2016\sb190\sl-253\slmult0 \up0 \expndtw-3\charscalex100 \
ul0\nosupersub\cf3\f4\fs22 Dosis obat berdasarkan berat badan : \par\pard\li2016
\sb0\sl-253\slmult0\par\pard\li2016\sb29\sl-253\slmult0\fi1739\tx8121 \up0 \expn
dtw-3\charscalex100 Setiap Hari\tab \up0 \expndtw-3\charscalex100 Intermitent\pa
r\pard\li2016\sb11\sl-253\slmult0\fi1651\tx5354\tx6931\tx9052 \up0 \expndtw-3\ch
arscalex100 Dewasa\tab \up0 \expndtw-3\charscalex100 Dewasa\tab \up0 \expndtw-3\
charscalex100 Dewasa &\tab \up0 \expndtw-3\charscalex100 Dewasa\par\pard\li2016\
sb8\sl-253\slmult0\fi1516\tx5155\tx5906\tx6909\tx8304\tx9681 \up0 \expndtw-3\cha
rscalex100 Anak-anak\tab \up0 \expndtw-3\charscalex100 B.\tab \up0 \expndtw-3\ch
arscalex100 Dosis\tab \up0 \expndtw-3\charscalex100 Anak-anak\tab \up0 \expndtw3\charscalex100 B. Badan\tab \up0 \expndtw-3\charscalex100 Dosis\par\pard\li2016
\sb1\sl-253\slmult0\fi1468\tx4975\tx6859 \up0 \expndtw-3\charscalex100 (mg/kg/BB
)\tab \up0 \expndtw-3\charscalex100 Badan\tab \up0 \expndtw-3\charscalex100 (mg/
kg/BB)\par\pard\li2016\sb0\sl-253\slmult0\par\pard\li2016\sb10\sl-253\slmult0\fi
0\tx3960\tx5217\tx5822\tx7281\tx8676\tx9398 \up0 \expndtw-3\charscalex100 Isonia
mid\tab \up0 \expndtw-3\charscalex100 5\tab \up0 \expndtw-3\charscalex100 -\tab
\up0 \expndtw-3\charscalex100 300 mg\tab \up0 \expndtw-3\charscalex100 15\tab \u
p0 \expndtw-3\charscalex100 -\tab \up0 \expndtw-3\charscalex100 600-900 mg\par\p
ard\li2016\sb0\sl-253\slmult0\par\pard\li2016\sb0\sl-253\slmult0\par\pard\li2016
\sb9\sl-253\slmult0\fi0\tx3905\tx4946\tx5822\tx7281\tx8676\tx9398 \up0 \expndtw3\charscalex100 Rifampicin\tab \up0 \expndtw-3\charscalex100 10\tab \up0 \expndt
w-3\charscalex100 <50 kg\tab \up0 \expndtw-3\charscalex100 450 mg\tab \up0 \expn
dtw-3\charscalex100 15\tab \up0 \expndtw-3\charscalex100 -\tab \up0 \expndtw-3\c
harscalex100 600-900 mg\par\pard\li2016\sb1\sl-251\slmult0\fi2901\tx5822 \up0 \e
xpndtw-3\charscalex100 > 50 kg\tab \up0 \expndtw-3\charscalex100 600 mg\par\pard
\li2016\sb0\sl-253\slmult0\par\pard\li2016\sb0\sl-253\slmult0\par\pard\li2016\sb
13\sl-253\slmult0\fi0\tx3758\tx4917\tx5822\tx7135\tx8376\tx9600 \up0 \expndtw-3\
charscalex100 Pyrazinamid\tab \up0 \expndtw-3\charscalex100 15-20\tab \up0 \expn
dtw-3\charscalex100 < 50 kg\tab \up0 \expndtw-3\charscalex100 750 mg\tab \up0 \e
xpndtw-3\charscalex100 15-20\tab \up0 \expndtw-3\charscalex100 < 50 kg\tab \up0
\expndtw-3\charscalex100 750 mg\par\pard\li2016\sb1\sl-251\slmult0\fi2901\tx6019
\tx8376\tx9794 \up0 \expndtw-3\charscalex100 > 50 kg\tab \up0 \expndtw-3\charsca
lex100 1 g\tab \up0 \expndtw-3\charscalex100 > 50 kg\tab \up0 \expndtw-3\charsca
lex100 1 g\par\pard\li2016\sb0\sl-253\slmult0\par\pard\li2016\sb11\sl-253\slmult
0\fi0\tx3905\tx4918\tx5937\tx7281 \up0 \expndtw-3\charscalex100 Ethambutol\tab \
up0 \expndtw-3\charscalex100 35\tab \up0 \expndtw-3\charscalex100 < 50 kg\tab \u
p0 \expndtw-3\charscalex100 1.5 g\tab \up0 \expndtw-3\charscalex100 50\par\pard\
li2016\sb1\sl-253\slmult0\fi2901\tx6019 \up0 \expndtw-3\charscalex100 > 50 kg\ta
b \up0 \expndtw-3\charscalex100 2 g\par\pard\li2016\sb1\sl-251\slmult0\fi6359\tx
9794 \up0 \expndtw-3\charscalex100 < 50 kg\tab \up0 \expndtw-3\charscalex100 2 g
\par\pard\li2016\sb0\sl-253\slmult0\fi4883 \up0 \expndtw-3\charscalex100 (3 x/mg
gu)\par\pard\li2016\sb1\sl-253\slmult0\fi6359\tx9712 \up0 \expndtw-3\charscalex1
00 > 50 kg\tab \up0 \expndtw-3\charscalex100 2,5 g\par\pard\li2016\sb0\sl-253\sl
mult0\par\pard\li2016\sb1\sl-253\slmult0\fi6359\tx9794 \up0 \expndtw-3\charscale
x100 < 50 kg\tab \up0 \expndtw-3\charscalex100 3 g\par\pard\li2016\sb1\sl-251\sl
mult0\fi4883 \up0 \expndtw-3\charscalex100 (2 x/mggu)\par\pard\li2016\sb0\sl-253
\slmult0\fi6361\tx9712 \up0 \expndtw-3\charscalex100 > 50 kg\tab \up0 \expndtw-3
\charscalex100 3,5 g\par\pard\li3343\sb0\sl-253\slmult0\par\pard\li3343\sb0\sl-2
53\slmult0\par\pard\li3343\sb11\sl-253\slmult0\fi0\tx5217\tx6120\tx6710\tx8676\t
x9895 \up0 \expndtw-3\charscalex100 25 (selama 2\tab \up0 \expndtw-3\charscalex1
00 -\tab \up0 \expndtw-3\charscalex100 -\tab \up0 \expndtw-3\charscalex100 30 (3
x/mggu)\tab \up0 \expndtw-3\charscalex100 -\tab \up0 \expndtw-3\charscalex100 \par\pard\li3343\sb1\sl-251\slmult0\fi0 \up0 \expndtw-3\charscalex100 bln)\par\p
ard\li3343\sb2\sl-253\slmult0\fi0\tx6710 \up0 \expndtw-3\charscalex100 15 bln be
rikut\tab \up0 \expndtw-3\charscalex100 45 (2 x/mggu)\par\pard\li3456\sb0\sl-253

\slmult0\par\pard\li3456\sb0\sl-253\slmult0\par\pard\li3456\sb9\sl-253\slmult0\f
i0\tx4637 \up0 \expndtw-2\charscalex100 Keterangan\tab \up0 \expndtw-2\charscale
x100 : R : Rifampisin\par\pard\li3456\sb1\sl-251\slmult0\fi1439 \up0 \expndtw2\charscalex100 H : INH\par\pard\qj \li4896\ri5698\sb2\sl-250\slmult0 \up0 \expn
dtw-3\charscalex100 E : Ethambutol \line \up0 \expndtw-3\charscalex100 Z : Piraz
inamid \line \up0 \expndtw-3\charscalex100 S : Streptomosin \par\pard\ql \li6084
\sb8\sl-253\slmult0 \up0 \expndtw-4\charscalex100 Bedah : \par\pard\ql \li6084\r
i1699\sb0\sl-260\slmult0\tx6305 \up0 \expndtw-3\charscalex100 * BTA persisten p
ositif dengan/tanpa resistensi \line\tab \up0 \expndtw-3\charscalex100 kuman \p
ar\pard\ql \li6084\sb0\sl-214\slmult0 \up0 \expndtw-3\charscalex100 * Batuk dar
ah massif atau berulang \par\pard\li2016\sb0\sl-253\slmult0\par\pard\li2016\sb31
\sl-253\slmult0\fi0\tx2532\tx5724\tx6084 \up0 \expndtw0\charscalex100 15.\tab \u
p0 \expndtw0\charscalex100 Tempat Pelayanan\tab \up0 \expndtw0\charscalex100 :\t
ab \up0 \expndtw0\charscalex100 Kelas D atau Puskesmas\par\pard\li2016\sb249\sl253\slmult0\fi0\tx2532\tx5724\tx6084 \up0 \expndtw0\charscalex100 16.\tab \up0 \
expndtw0\charscalex100 Penyulit\tab \up0 \expndtw0\charscalex100 :\tab \up0 \exp
ndtw0\charscalex100 Karena penyakit :\par\pard\ql \li6084\sb0\sl-248\slmult0 \up
0 \expndtw-3\charscalex100 * Penyebaran milier, TB ekstrapulmonal \par\pard\ql \
li6084\sb0\sl-239\slmult0 \up0 \expndtw-3\charscalex100 * \u8220? Destroyed lung
/ (Lobe)\u8221?, batuk darah masif \par\pard\li2016\sb0\sl-253\slmult0\par\pard\
li2016\sb0\sl-253\slmult0\par\pard\li2016\sb26\sl-253\slmult0\fi0\tx2532\tx5724\
tx6084 \dn2 \expndtw0\charscalex103 17.\tab \dn2 \expndtw0\charscalex103 Inform
Concent ( tertulis )\tab \dn2 \expndtw0\charscalex103 :\tab \up0 \expndtw0\chars
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dtw0\charscalex100 -\par\pard\li2016\sb253\sl-253\slmult0\fi0\tx2532\tx5724\tx60
84 \up0 \expndtw0\charscalex100 20.\tab \up0 \expndtw0\charscalex100 Masa pemuli
han\tab \up0 \expndtw0\charscalex100 :\tab \up0 \expndtw0\charscalex100 Bila tan
pa penyulit dapat bekerja biasa\par\pard\li2016\sb251\sl-253\slmult0\fi0\tx2532\
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67 \up0 \expndtw0\charscalex100 * Komplikasi\par\pard\li2016\sb1\sl-253\slmult0\
fi4067 \up0 \expndtw0\charscalex100 * Meninggal\par\pard\li2016\sb0\sl-253\slmul
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arscalex100 22.\tab \up0 \expndtw0\charscalex100 PA\tab \up0 \expndtw0\charscale
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\pard\sb0\sl-240{\bkmkstart Pg6}{\bkmkend Pg6}\par\pard\ql \li8284\sb0\sl-276\sl
mult0 \par\pard\ql\li8284\sb175\sl-276\slmult0 \up0 \expndtw-3\charscalex100 \ul
0\nosupersub\cf1\f2\fs24 Panduan Praktik Klinis\par\pard\sect\sectd\sbknone\cols
2\colno1\colw5924\colsr160\colno2\colw6016\colsr160\ql \li2016\sb0\sl-253\slmult
0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb212\sl-253\slmu
lt0\tx2503\tx5719 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf3\f4\fs22 1.\t
ab \up0 \expndtw0\charscalex102 Nama Penyakit /Diagnosis\tab \up0 \expndtw-3\cha
rscalex100 :\par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb253\s
l-253\slmult0\tx2503\tx5719 \up0 \expndtw-3\charscalex100 2.\tab \up0 \expndtw0\

charscalex104 Kriteria Diagnosis\tab \up0 \expndtw-3\charscalex100 :\par\pard\ql

\li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql
\li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb1\sl-253\slmult0\tx2503\tx571
9 \up0 \expndtw-3\charscalex100 3.\tab \up0 \expndtw0\charscalex101 Diagnosis Di
ferensial\tab \up0 \expndtw-3\charscalex100 :\par\pard\ql \li2016\sb0\sl-253\slm
ult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb253\sl-253\s
lmult0\tx2503\tx5719 \up0 \expndtw-3\charscalex100 4.\tab \up0 \expndtw0\charsca
lex105 Pemeriksaan Penunjang\tab \up0 \expndtw-3\charscalex100 :\par\pard\ql \li
2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li
2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li
2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li
2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li
2016\sb253\sl-253\slmult0\tx2503\tx5719 \up0 \expndtw-3\charscalex100 5.\tab \up
0 \expndtw0\charscalex103 Konsultasi\tab \up0 \expndtw-3\charscalex100 :\par\par
d\ql \li2016\sb253\sl-253\slmult0\tx2503\tx5719 \up0 \expndtw-3\charscalex100 6.
\tab \up0 \expndtw0\charscalex106 Perawatan RS\tab \up0 \expndtw-3\charscalex100
:\par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult
0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult
0 \par\pard\ql \li2016\sb252\sl-253\slmult0\tx2503\tx5719 \up0 \expndtw-3\charsc
alex100 7.\tab \up0 \expndtw0\charscalex108 Terapi\tab \up0 \expndtw-3\charscale
x100 :\par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\sl
mult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\sl
mult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\sl
mult0 \par\pard\ql \li2016\sb252\sl-253\slmult0\tx2503\tx5719 \up0 \expndtw-3\ch
arscalex100 8.\tab \up0 \expndtw0\charscalex105 Tempat Pelayanan\tab \up0 \expnd
tw-3\charscalex100 :\par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016
\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016
\sb253\sl-253\slmult0\tx2503\tx5719 \up0 \expndtw-3\charscalex100 9.\tab \up0 \e
xpndtw0\charscalex104 Penyulit\tab \up0 \expndtw-3\charscalex100 :\par\pard\colu
mn \ql \li6084\sb0\sl-253\slmult0 \par\pard\ql \li6084\sb0\sl-253\slmult0 \par\p
ard\ql \li20\sb212\sl-253\slmult0 \up0 \expndtw0\charscalex100 PNEUMONIA No. ICD
486\par\pard\qj \li20\ri1472\sb249\sl-254\slmult0 \up0 \expndtw0\charscalex100
Ialah infeksi akut pada parenkim paru yang dapat \up0 \expndtw-3\charscalex100 d
isebabkan oleh bakteri, virus maupun parasit.\par\pard\qj \li92\ri1472\sb251\sl253\slmult0\fi0 \up0 \expndtw0\charscalex102 Demam, batuk-batuk (dari batuk keri
ng sampai \up0 \expndtw0\charscalex101 berdahak). Sesak nafas yang semakin membe
rat \up0 \expndtw-3\charscalex100 dan kadang-kadang disertai nyeri dada.\par\par
d\ql \li20\sb253\sl-253\slmult0 \up0 \expndtw0\charscalex104 -\ul0\nosupersub\cf
4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 TB Paru\par\pard\ql \li20\sb1\sl-251\slm
ult0 \up0 \expndtw0\charscalex102 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\
cf3\f4\fs22 Mikosis paru\par\pard\ql \li20\sb2\sl-253\slmult0 \up0 \expndtw0\ch
arscalex102 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Tumor Par
u\par\pard\ql \li6084\sb0\sl-253\slmult0 \par\pard\ql \li20\sb1\sl-253\slmult0 \
up0 \expndtw-1\charscalex100 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f
4\fs22 Foto Toraks PA + Lateral\par\pard\ql \li20\sb1\sl-251\slmult0 \up0 \expn
dtw-1\charscalex100 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 L
aboratorium darah rutin :\par\pard\ql \li241\sb2\sl-253\slmult0 \up0 \expndtw-3\
charscalex100 * Hitung leukosit\par\pard\qj \li241\ri1472\sb1\sl-251\slmult0\tx
462 \up0 \expndtw0\charscalex103 * Pada hitung jenis, terdapat dominasi se
l \line\tab \up0 \expndtw-3\charscalex100 leukosit PMN\par\pard\ql \li20\sb2\sl253\slmult0 \up0 \expndtw-1\charscalex100 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nos
upersub\cf3\f4\fs22 Bronkoskopi (Aspirasi transbronkial)\par\pard\ql \li20\sb1\
sl-251\slmult0\tx1383\tx2847\tx3990 \up0 \expndtw0\charscalex104 -\ul0\nosupersu
b\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Aspirasi\tab \up0 \expndtw-3\charsca
lex100 transtorakal,\tab \up0 \expndtw-3\charscalex100 terutama\tab \up0 \expndt
w-3\charscalex100 untuk\par\pard\ql \li272\sb3\sl-253\slmult0 \up0 \expndtw-3\ch
arscalex100 pemeriksaan bakteriologi\par\pard\ql \li20\sb1\sl-251\slmult0 \up0 \
expndtw0\charscalex101 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22
Photo Thorax\par\pard\ql \li6084\sb0\sl-253\slmult0 \par\pard\ql \li20\sb1\sl253\slmult0 \up0 \expndtw-3\charscalex100 Dokter Spesialis Paru\par\pard\qj \li6

084\sb0\sl-251\slmult0 \par\pard\qj \li20\ri1472\sb4\sl-251\slmult0 \up0 \expndt

w0\charscalex100 Rawat inap, terutama pada penderita yang secara \line \up0 \exp
ndtw0\charscalex103 nyata
membutuhkan
O\ul0\sub\cf6\f7\fs21 2\ul0\nosupers
ub\cf3\f4\fs22
atau
mengalami \line \up0 \expndtw-2\charscalex100 komplik
asi, terlihat dari frekwensi nafas lebih dari\par\pard\qj \li20\ri1472\sb4\sl-25
1\slmult0 \up0 \expndtw0\charscalex103 2 x/m dan dangkal, demam tinggi (lebih da
ri 38 \up0 \expndtw-3\charscalex100 derajat C), dehidrasi, septicemia.\par\pard\
ql \li6084\sb0\sl-253\slmult0 \par\pard\ql \li20\sb1\sl-253\slmult0 \up0 \expndt
w-3\charscalex100 Terapi medikamentosa :\par\pard\ql \li20\sb1\sl-251\slmult0 \u
p0 \expndtw-3\charscalex100 Anti biotika sesuai hasil bakteriologi\par\pard\ql \
li6084\sb0\sl-253\slmult0 \par\pard\ql \li20\ri2562\sb1\sl-253\slmult0\fi0 \up0
\expndtw-3\charscalex100 Terapi non medikamentosa : \line \up0 \expndtw-3\charsc
alex100 * Istirahat, O\ul0\sub\cf6\f7\fs21 2\ul0\nosupersub\cf3\f4\fs22 hidrasi
(terapi cairan) \line \up0 \expndtw-3\charscalex100 * Pengisapan lendir, bila p
erlu dengan\par\pard\ql \li185\sb1\sl-251\slmult0 \up0 \expndtw-3\charscalex100
bronkoskopi\par\pard\ql \li6139\sb0\sl-253\slmult0 \par\pard\ql \li75\sb1\sl-253
\slmult0 \up0 \expndtw-3\charscalex100 RS. Klas D\par\pard\qj \li75\ri1469\sb2\s
l-253\slmult0 \up0 \expndtw0\charscalex102 RS. C/B dengan Spesialis Paru khususn
ya pada \up0 \expndtw0\charscalex105 kasus yang mengalami komplikasi atau tanda\line \up0 \expndtw-3\charscalex100 tanda ke arah gagal napas.\par\pard\ql \li20
\sb251\sl-253\slmult0 \up0 \expndtw-3\charscalex100 Komplikasi\par\pard\ql \li10
391\sb0\sl-276\slmult0 \par\pard\ql \li10391\sb0\sl-276\slmult0 \par\pard\ql \li
10391\sb0\sl-276\slmult0 \par\pard\ql \li10391\sb0\sl-276\slmult0 \par\pard\ql \
li10391\sb0\sl-276\slmult0 \par\pard\ql \li10391\sb0\sl-276\slmult0 \par\pard\ql
\li4327\sb109\sl-276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\
f2\fs24 6 \par\pard\sect\sectd\fs24\paperw12240\paperh15840{\shp
{\*\shpinst\shpleft1700\shptop3600\shpright10560\shpbottom12520\shpwr3\shpfblwtx
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0\nosupersub\cf1\f2\fs24 Panduan Praktik Klinis \par\pard\ql \li6084\sb0\sl-253\
slmult0 \par\pard\ql\li6084\sb190\sl-253\slmult0 \up0 \expndtw-3\charscalex100 \
ul0\nosupersub\cf3\f4\fs22 Karena penyakit : \par\pard\li2016\sb18\sl-253\slmult
0\fi4427\tx6804 \up0 \expndtw0\charscalex100 -\tab \up0 \expndtw0\charscalex100
Abses Paru, Empisema\par\pard\li2016\sb1\sl-253\slmult0\fi4427\tx6804 \up0 \expn
dtw0\charscalex100 -\tab \up0 \expndtw0\charscalex100 Septikemia\par\pard\li2016
\sb1\sl-251\slmult0\fi4427\tx6804 \up0 \expndtw0\charscalex100 -\tab \up0 \expnd
tw0\charscalex100 Gagal Nafas\par\pard\li2016\sb0\sl-253\slmult0\par\pard\li2016
\sb1\sl-253\slmult0\fi4067 \up0 \expndtw0\charscalex100 Karena tindakan :\par\pa
rd\li2016\sb1\sl-251\slmult0\fi4427\tx6804 \up0 \expndtw0\charscalex100 -\tab \u
p0 \expndtw0\charscalex100 Perdarahan\par\pard\li2016\sb3\sl-253\slmult0\fi4427\
tx6804 \up0 \expndtw0\charscalex100 -\tab \up0 \expndtw0\charscalex100 Empiema\p

ar\pard\li2016\sb1\sl-251\slmult0\fi4427\tx6804 \up0 \expndtw0\charscalex100 -\t

ab \up0 \expndtw0\charscalex100 Septikemia\par\pard\li2016\sb0\sl-253\slmult0\pa
r\pard\li2016\sb6\sl-253\slmult0\fi0\tx2508\tx5724\tx6084 \up0 \expndtw0\charsca
lex100 10.\tab \up0 \expndtw0\charscalex100 Inform Concent ( tertulis )\tab \up0
\expndtw0\charscalex100 :\tab \up0 \expndtw0\charscalex100 Perlu, karena kemung
kinan diperlukan tindakan\par\pard\li2016\sb1\sl-245\slmult0\fi4067 \up0 \expndt
w0\charscalex100 diagnostik\par\pard\li2016\sb3\sl-253\slmult0\fi4067 \up0 \expn
dtw0\charscalex100 Invasif atau pemasangan ventilator mekanik\par\pard\li2016\sb
0\sl-253\slmult0\par\pard\li2016\sb5\sl-253\slmult0\fi0\tx2508\tx5724\tx6156\tx6
516 \up0 \expndtw0\charscalex100 11.\tab \up0 \expndtw0\charscalex100 Tenaga Sta
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up0 \expndtw0\charscalex100 Dokter Umum\par\pard\li2016\sb1\sl-246\slmult0\fi413
9\tx6516 \up0 \expndtw0\charscalex100 -\tab \up0 \expndtw0\charscalex100 Dokter
Spesialis Paru, khususnya pada\par\pard\li2016\sb3\sl-253\slmult0\fi4499
\up0 \expndtw0\charscalex100 pasien dengan penyulit atau terdapat tanda ke\par\
pard\li2016\sb1\sl-251\slmult0\fi4499 \up0 \expndtw0\charscalex100 arah gagal na
pas\par\pard\li2016\sb0\sl-253\slmult0\par\pard\li2016\sb6\sl-253\slmult0\fi0\tx
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alex100 1-2 minggu\par\pard\li2016\sb0\sl-253\slmult0\par\pard\li2016\sb1\sl-253
\slmult0\fi0\tx2508\tx5724\tx6084 \up0 \expndtw0\charscalex100 13.\tab \up0 \exp
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expndtw0\charscalex100 1 minggu\par\pard\li2016\sb250\sl-253\slmult0\fi0\tx2508\
tx5724\tx6084 \dn2 \expndtw0\charscalex100 14.\tab \dn2 \expndtw0\charscalex100
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\pard\li2016\sb249\sl-253\slmult0\fi0\tx2508\tx5724\tx6084 \up0 \expndtw0\charsc
alex100 15.\tab \up0 \expndtw0\charscalex100 PA\tab \up0 \expndtw0\charscalex100
:\tab \up0 \expndtw0\charscalex100 -\par\pard\li2016\sb0\sl-253\slmult0\par\par
d\li2016\sb5\sl-253\slmult0\fi0\tx2508\tx5724\tx6084 \up0 \expndtw0\charscalex10
0 16.\tab \up0 \expndtw0\charscalex100 Autopsi /Risalah Rapat\tab \up0 \expndtw0
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\pard\sb0\sl-240{\bkmkstart Pg8}{\bkmkend Pg8}\par\pard\ql \li8284\sb0\sl-276\sl
mult0 \par\pard\ql\li8284\sb175\sl-276\slmult0 \up0 \expndtw-3\charscalex100 \ul
0\nosupersub\cf1\f2\fs24 Panduan Praktik Klinis\par\pard\sect\sectd\sbknone\cols
2\colno1\colw5924\colsr160\colno2\colw6016\colsr160\ql \li2016\sb0\sl-253\slmult
0 \par\pard\ql \li2016\sb213\sl-253\slmult0\tx2527\tx5719 \up0 \expndtw-3\charsc
alex100 \ul0\nosupersub\cf3\f4\fs22 1.\tab \up0 \expndtw0\charscalex102 Nama Pen
yakit/ Diagnosis\tab \up0 \expndtw-3\charscalex100 :\par\pard\ql \li2016\sb0\sl253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb252\s
l-253\slmult0\tx2527\tx5719 \up0 \expndtw-3\charscalex100 2.\tab \up0 \expndtw0\
charscalex104 Kriteria Diagnosis\tab \up0 \expndtw-3\charscalex100 :\par\pard\ql
\li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql
\li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb253\sl-253\slmult0\tx2527\tx5
719 \up0 \expndtw-3\charscalex100 3.\tab \up0 \expndtw0\charscalex101 Diagnosis
Diferensial\tab \up0 \expndtw-3\charscalex100 :\par\pard\ql \li2016\sb0\sl-253\s
lmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\s
lmult0 \par\pard\ql \li2016\sb1\sl-253\slmult0\tx2527\tx5719 \up0 \expndtw-3\cha
rscalex100 4.\tab \up0 \expndtw0\charscalex106 Pemeriksaan Penunjang\tab \up0 \e
xpndtw-3\charscalex100 :\par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li
2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li
2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li
2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb252\sl-253\slmult0\tx2527\tx5719
\up0 \expndtw-3\charscalex100 5.\tab \up0 \expndtw0\charscalex103 Konsultasi\tab
\up0 \expndtw-3\charscalex100 :\par\pard\ql \li2016\sb253\sl-253\slmult0\tx2527
\tx5719 \up0 \expndtw-3\charscalex100 6.\tab \up0 \expndtw0\charscalex106 Perawa
tan RS\tab \up0 \expndtw-3\charscalex100 :\par\pard\ql \li2016\sb0\sl-253\slmult
0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult
0 \par\pard\ql \li2016\sb1\sl-253\slmult0\tx2527\tx5719 \up0 \expndtw-3\charscal
ex100 7.\tab \up0 \expndtw0\charscalex108 Terapi\tab \up0 \expndtw-3\charscalex1
00 :\par\pard\column \ql \li6084\sb0\sl-253\slmult0 \par\pard\ql \li20\sb213\sl253\slmult0 \up0 \expndtw0\charscalex100 ASMA BRONKIAL No. ICD 493.9\par\pard\qj
\li20\ri1484\sb249\sl-253\slmult0\fi0 \up0 \expndtw-3\charscalex100 Ialah penya
kit saluran napas dengan karakterisktik \up0 \expndtw-3\charscalex100 berupa pen
ingkatan reaktivitas trakea dan bronkus \up0 \expndtw-3\charscalex100 penyempita
n umum saluran napas, yang dapat\par\pard\qj \li20\ri1616\sb1\sl-251\slmult0 \up
0 \expndtw-3\charscalex100 hilang oleh pengaruh obat-obatan maupun secara \up0 \
expndtw-3\charscalex100 spontan.\par\pard\qj \li6084\sb0\sl-252\slmult0 \par\par
d\qj \li20\ri1472\sb4\sl-252\slmult0 \up0 \expndtw-2\charscalex100 Riwayat batuk
-batuk disertai sesak nafas berulang \line \up0 \expndtw0\charscalex101 akibat f
aktor pencetus disertai mengi (wheezing) \line \up0 \expndtw0\charscalex105 dapa
t ditemukan penggunaan otot bantu napas, \line \up0 \expndtw-3\charscalex100 dap
at hilang/sembuh dengan atau tanpa penyebab\par\pard\ql \li6156\sb0\sl-253\slmul
t0 \par\pard\ql \li92\sb1\sl-253\slmult0 \up0 \expndtw0\charscalex103 -\ul0\nosu
persub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 PPOK\par\pard\ql \li92\sb2\sl-25
3\slmult0 \up0 \expndtw0\charscalex100 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupe
rsub\cf3\f4\fs22 Pneumotoraks\par\pard\ql \li92\sb1\sl-251\slmult0 \up0 \expndtw
0\charscalex100 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Asma K
ardiale\par\pard\qj \li6084\sb0\sl-251\slmult0 \par\pard\qj \li20\ri2478\sb4\sl251\slmult0 \up0 \expndtw-3\charscalex100 * Laboratorium : darah, kadar eosinofi
l \up0 \expndtw-3\charscalex100 * Foto thoraks\par\pard\qj \li20\ri2252\sb3\sl-2
51\slmult0\tx195 \up0 \expndtw-3\charscalex100 * Spirometri dan pengukuran arus
puncak \line\tab \up0 \expndtw-3\charscalex100 ekspirasi\par\pard\ql \li20\ri373
3\sb4\sl-251\slmult0 \up0 \expndtw-3\charscalex100 * Uji bronkodilator \line \up
0 \expndtw-3\charscalex100 * Pemeriksaan kadar IgE \line \up0 \expndtw-3\charsca
lex100 * Uji provokasi bronkus\par\pard\ql \li6084\sb0\sl-253\slmult0 \par\pard\

ql \li20\sb1\sl-253\slmult0 \up0 \expndtw-3\charscalex100 Dokter Spesialis Paru\

par\pard\ql \li20\sb253\sl-253\slmult0 \up0 \expndtw-3\charscalex100 * Rawat jal
an\par\pard\qj \li20\ri1879\sb0\sl-254\slmult0\tx195 \up0 \expndtw-3\charscalex1
00 * Rawat inap segera, bila serangan asma berat \line\tab \up0 \expndtw-3\chars
calex100 atau asmatikus.\par\pard\qj \li6084\sb0\sl-251\slmult0 \par\pard\qj \li
20\ri3425\sb3\sl-251\slmult0 \up0 \expndtw-3\charscalex100 Terapi non medikament
osa : \up0 \expndtw-3\charscalex100 * Oksigen\par\pard\ql \li20\sb1\sl-251\slmul
t0 \up0 \expndtw-3\charscalex100 * Fisioterapi\par\pard\qj \li20\ri3808\sb4\sl-2
51\slmult0 \up0 \expndtw-3\charscalex100 * Pendidikan Kesehatan \line \up0 \expn
dtw-3\charscalex100 Terapi medikamentosa\par\pard\ql \li20\sb3\sl-253\slmult0 \u
p0 \expndtw-1\charscalex100 1.\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f
4\fs22 Bronkodilator\par\pard\ql \li272\ri4298\sb1\sl-251\slmult0 \up0 \expndtw3\charscalex100 * Adrenalin \line \up0 \expndtw-3\charscalex100 * Beta 2 agonis\
par\pard\qj \li296\ri2740\sb3\sl-251\slmult0 \up0 \expndtw-3\charscalex100 * Gol
ongan Xantin ( Aminofilin) \up0 \expndtw-3\charscalex100 * Antikolinergik\par\pa
rd\ql \li296\sb3\sl-253\slmult0 \up0 \expndtw-3\charscalex100 * Nebulizer\par\pa
rd\ql \li20\sb1\sl-251\slmult0\tx1894\tx2960 \up0 \expndtw-1\charscalex100 2.\ul
0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Kortikosteroid\tab \up0 \e
xpndtw-3\charscalex100 sistemik\tab \up0 \expndtw0\charscalex105 pada
seranga
n\par\pard\ql \li272\sb2\sl-253\slmult0 \up0 \expndtw-3\charscalex100 kortikoste
roid inhalasi pada asma kronik\par\pard\ql \li20\sb1\sl-251\slmult0 \up0 \expndt
w-2\charscalex100 3.\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Sod
ium kromoglikat\par\pard\qj \li20\ri1472\sb0\sl-254\slmult0\tx282 \up0 \expndtw0
\charscalex106 4.\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Antibi
otika, mukolitik, ekspektoran atas \line\tab \up0 \expndtw-3\charscalex100
indikasi\par\pard\ql \li20\sb0\sl-251\slmult0 \up0 \expndtw-3\charscalex100 Cat
atan :\par\pard\qj \li365\ri1473\sb16\sl-254\slmult0\tx735 \up0 \expndtw0\charsc
alex104 \ul0\nosupersub\cf5\f6\fs22 \u-3913?\ul0\nosupersub\cf4\f5\fs22 \ul0\no
supersub\cf3\f4\fs22 B2 Agonis dan kortikosteroid inhalasi \line\tab \up0
\expndtw-3\charscalex100 merupakan pilihan utama\par\pard\qj \li365\ri1473\sb13\
sl-254\slmult0\tx735 \up0 \expndtw0\charscalex102 \ul0\nosupersub\cf5\f6\fs22 \u
-3913?\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Obat oral dig
unakan bila obat inhalasi \line\tab \up0 \expndtw-3\charscalex100 tidak dapat
diberikan\par\pard\ql \li4327\sb215\sl-276\slmult0 \up0 \expndtw-3\charscalex10
0 \ul0\nosupersub\cf1\f2\fs24 8 \par\pard\sect\sectd\fs24\paperw12240\paperh1584
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slmult0 \par\pard\ql\li8284\sb175\sl-276\slmult0 \up0 \expndtw-3\charscalex100 \
ul0\nosupersub\cf1\f2\fs24 Panduan Praktik Klinis\par\pard\sect\sectd\sbknone\co
ls2\colno1\colw5924\colsr160\colno2\colw6016\colsr160\ql \li2016\sb0\sl-253\slmu
lt0 \par\pard\ql \li2016\sb213\sl-253\slmult0\tx2527\tx5719 \up0 \expndtw-3\char
scalex100 \ul0\nosupersub\cf3\f4\fs22 1.\tab \up0 \expndtw0\charscalex102 Nama P
enyakit/ Diagnosis\tab \up0 \expndtw-3\charscalex100 :\par\pard\ql \li2016\sb0\s
l-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\s
l-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\s
l-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\s
l-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\s
l-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb253
\sl-253\slmult0\tx2527\tx5719 \up0 \expndtw-3\charscalex100 2.\tab \up0 \expndtw
0\charscalex104 Kriteria Diagnosis\tab \up0 \expndtw-3\charscalex100 :\par\pard\
ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\
ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\
ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb253\sl-253\slmult0\tx2527\t
x5719 \up0 \expndtw-3\charscalex100 3.\tab \up0 \expndtw0\charscalex101 Diagnosi
s Diferensial\tab \up0 \expndtw-3\charscalex100 :\par\pard\ql \li2016\sb0\sl-253
\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb251\sl-2
53\slmult0\tx2527\tx5719 \up0 \expndtw-3\charscalex100 4.\tab \up0 \expndtw0\cha
rscalex106 Pemeriksaan Penunjang\tab \up0 \expndtw-3\charscalex100 :\par\pard\ql
\li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb1\sl-253\slmult0\tx2527\tx571
9 \up0 \expndtw-3\charscalex100 5.\tab \up0 \expndtw0\charscalex103 Konsultasi\t
ab \up0 \expndtw-3\charscalex100 :\par\pard\ql \li2016\sb253\sl-253\slmult0\tx25
27\tx5719 \up0 \expndtw-3\charscalex100 6.\tab \up0 \expndtw0\charscalex106 Pera
watan RS\tab \up0 \expndtw-3\charscalex100 :\par\pard\ql \li2016\sb0\sl-253\slmu
lt0 \par\pard\ql \li2016\sb253\sl-253\slmult0\tx2527\tx5719 \up0 \expndtw-3\char
scalex100 7.\tab \up0 \expndtw0\charscalex108 Terapi\tab \up0 \expndtw-3\charsca
lex100 :\par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\
slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\
slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\
slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\
slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\
slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\
slmult0 \par\pard\ql \li2016\sb253\sl-253\slmult0\tx2527\tx5719 \up0 \expndtw-3\
charscalex100 8.\tab \up0 \expndtw0\charscalex105 Tempat Pelayanan\tab \up0 \exp
ndtw-3\charscalex100 :\par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li20
16\sb252\sl-253\slmult0\tx2527\tx5719 \up0 \expndtw-3\charscalex100 9.\tab \up0
\expndtw0\charscalex104 Penyulit\tab \up0 \expndtw-3\charscalex100 :\par\pard\co
lumn \qj \li6084\sb0\sl-251\slmult0 \par\pard\qj \li20\ri4089\sb217\sl-251\slmul
t0 \up0 \expndtw0\charscalex102 BRONKIEKTASIS \up0 \expndtw-1\charscalex100 No.
ICD 494\par\pard\qj \li20\ri1472\sb250\sl-253\slmult0\fi0 \up0 \expndtw0\charsca
lex106 Ialah penyakit paru yang ditandai oleh dilatasi \line \up0 \expndtw0\char
scalex102 yang disertai destruksi dinding bronkus yang \line \up0 \expndtw0
\charscalex107 kronik dan menetap. Keadaan ini dapat terjadi \line \up0 \expndtw
0\charscalex102 akibat kelainan congenital, infeksi menahun dan \line \up0 \expn
dtw0\charscalex102 berulang, faktor mekanik, gangguan oleh karena \line \up0 \ex
pndtw-3\charscalex100 kelainan yang mendahului cabang-cabang terakhir \line \up0
\expndtw0\charscalex105 di a. bronkialis maupun gangguan saraf perifer \line \u
p0 \expndtw-3\charscalex100 otot-otot bronkus.\par\pard\qj \li6084\sb0\sl-251\sl
mult0 \par\pard\qj \li20\ri1472\sb4\sl-251\slmult0\tx282 \up0 \expndtw0\charscal
ex104 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Kelainan anatom
is berupa pelebaran bronkus \line\tab \up0 \expndtw0\charscalex100 yang terlihat

pada bronkografi atau foto toraks\par\pard\ql \li272\sb3\sl-253\slmult0 \up0 \e

xpndtw-3\charscalex100 biasa.\par\pard\qj \li20\ri1472\sb0\sl-254\slmult0\tx282
\up0 \expndtw-1\charscalex100 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\
f4\fs22 Gejala klinis dapat tidak ditemukan atau berupa \line\tab \up0 \expndtw
-2\charscalex100 batuk produktif atau batuk darah. Pada keadaan\par\pard\ql \li2
72\sb0\sl-251\slmult0 \up0 \expndtw-3\charscalex100 lanjut dapat disertai sesak
napas.\par\pard\ql \li6084\sb0\sl-253\slmult0 \par\pard\ql \li92\sb1\sl-253\slm
ult0 \up0 \expndtw0\charscalex102 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\
cf3\f4\fs22 TB Paru\par\pard\ql \li92\sb1\sl-251\slmult0 \up0 \expndtw0\charscal
ex100 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Bronkitis kronik
\par\pard\ql \li92\sb3\sl-253\slmult0 \up0 \expndtw0\charscalex100 -\ul0\nosuper
sub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Fibrosis kistik\par\pard\qj \li20\r
i1879\sb42\sl-506\slmult0\tx102 \up0 \expndtw-3\charscalex100 Foto toraks, bronk
ografi untuk diagnosis pasti \line\tab \up0 \expndtw-3\charscalex100 Dokter Spes
ialis Paru\par\pard\qj \li20\ri1472\sb211\sl-251\slmult0 \up0 \expndtw-3\charsca
lex100 Rawat inap, pada bronkiektasis terinfeksi berulang \up0 \expndtw-3\charsc
alex100 dan bila batuk darah\par\pard\qj \li20\ri3425\sb254\sl-254\slmult0 \up0
\expndtw-3\charscalex100 Terapi non medikamentosa : \up0 \expndtw-3\charscalex10
0 * Oksigen\par\pard\ql \li20\sb1\sl-251\slmult0 \up0 \expndtw-3\charscalex100 *
Fisioterapi\par\pard\ql \li6084\sb0\sl-251\slmult0 \par\pard\ql \li20\ri3312\sb
4\sl-251\slmult0\tx282 \up0 \expndtw-3\charscalex100 Terapi medikamentosa \line\
tab \up0 \expndtw-3\charscalex100 * Antibiotik bila da infeksi\par\pard\qj \li24
1\ri2031\sb4\sl-251\slmult0 \up0 \expndtw-3\charscalex100 * Bronkodilator, bila
ada gejala obstruksi \line \up0 \expndtw-3\charscalex100 * Mukolitik dan ekspekt
oran atas indikasi\par\pard\ql \li6084\sb0\sl-253\slmult0 \par\pard\ql \li20\sb1
\sl-253\slmult0 \up0 \expndtw-3\charscalex100 Pembedahan :\par\pard\qj \li20\ri1
472\sb0\sl-253\slmult0 \up0 \expndtw0\charscalex101 Lobektomi atau pneumonekto
mi bila kelainan \up0 \expndtw-3\charscalex100 unilateral dan keluhan infeksi
berulang, atau batuk \up0 \expndtw-3\charscalex100 darah (berulang)\par\pard\ql
\li20\sb252\sl-253\slmult0 \up0 \expndtw-3\charscalex100 RS. Klas D atau Puskesm
as\par\pard\qj \li6084\sb0\sl-254\slmult0 \par\pard\qj \li20\ri4908\sb251\sl-254
\slmult0 \up0 \expndtw-3\charscalex100 Komplikasi \up0 \expndtw-3\charscalex100
* Sepsis\par\pard\qj \li20\ri4689\sb1\sl-251\slmult0 \up0 \expndtw-3\charscalex1
00 * Hemoptisis \line \up0 \expndtw-3\charscalex100 * Gagal napas\par\pard\ql \l
i10271\sb0\sl-276\slmult0 \par\pard\ql \li4207\sb225\sl-276\slmult0 \up0 \expndt
w-3\charscalex100 \ul0\nosupersub\cf1\f2\fs24 10 \par\pard\sect\sectd\fs24\paper
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\pard\sb0\sl-240{\bkmkstart Pg12}{\bkmkend Pg12}\par\pard\ql \li8284\sb0\sl-276\
slmult0 \par\pard\ql\li8284\sb175\sl-276\slmult0 \up0 \expndtw-3\charscalex100 \
ul0\nosupersub\cf1\f2\fs24 Panduan Praktik Klinis\par\pard\sect\sectd\sbknone\co
ls2\colno1\colw5924\colsr160\colno2\colw6016\colsr160\ql \li2016\sb0\sl-253\slmu
lt0 \par\pard\ql \li2016\sb213\sl-253\slmult0\tx2527\tx5719 \up0 \expndtw-3\char
scalex100 \ul0\nosupersub\cf3\f4\fs22 1.\tab \up0 \expndtw0\charscalex102 Nama P
enyakit/ Diagnosis\tab \up0 \expndtw-3\charscalex100 :\par\pard\ql \li2016\sb0\s
l-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\s
l-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\s
l-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\s
l-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\s
l-253\slmult0 \par\pard\ql \li2016\sb252\sl-253\slmult0\tx2527\tx5719 \up0 \expn
dtw-3\charscalex100 2.\tab \up0 \expndtw0\charscalex104 Kriteria Diagnosis\tab \
up0 \expndtw-3\charscalex100 :\par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\
ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\
ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\
ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\
ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\
ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb1\sl-253\slmult0\tx2527\tx5
719 \up0 \expndtw-3\charscalex100 3.\tab \up0 \expndtw0\charscalex101 Diagnosis
Diferensial\tab \up0 \expndtw-3\charscalex100 :\par\pard\ql \li2016\sb0\sl-253\s
lmult0 \par\pard\ql \li2016\sb252\sl-253\slmult0\tx2527\tx5719 \up0 \expndtw-3\c
harscalex100 4.\tab \up0 \expndtw0\charscalex106 Pemeriksaan Penunjang\tab \up0
\expndtw-3\charscalex100 :\par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \
li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \
li2016\sb253\sl-253\slmult0\tx2527\tx5719 \up0 \expndtw-3\charscalex100 5.\tab \
up0 \expndtw0\charscalex103 Konsultasi\tab \up0 \expndtw-3\charscalex100 :\par\p
ard\qj \li2016\ri57\sb44\sl-506\slmult0\tx2527\tx5719\tx2521\tx5713 \up0 \expndt
w-3\charscalex100 6.\tab \up0 \expndtw0\charscalex106 Perawatan RS\tab \up0 \exp
ndtw-3\charscalex100 : \line \up0 \expndtw-3\charscalex100 7. \tab \up0 \expndtw
0\charscalex108 Terapi \tab \up0 \expndtw-3\charscalex100 :\par\pard\column \qj
\li6084\sb0\sl-251\slmult0 \par\pard\qj \li20\ri1577\sb217\sl-251\slmult0 \up0 \
expndtw0\charscalex102 PENYAKIT PARU OBSTRUKTIF KRONIK/ \up0 \expndtw0\charscale
x101 PPOK No. ICD 496\par\pard\qj \li20\ri1472\sb250\sl-253\slmult0\fi0\tx2397 \
up0 \expndtw0\charscalex102 Ialah kelompok penyakit paru kronik yang tidak \line
\up0 \expndtw0\charscalex101 diketahui
etiloginya, \tab \up0 \expndtw0\chars
calex101 yang
mengakibatkan \line \up0 \expndtw-3\charscalex100 obstruksi jal
an napas yang ireversibel dan ditandai \line \up0 \expndtw0\charscalex101 oleh d
engan peningkatan tahanan aliran udara di \line \up0 \expndtw0\charscalex103 jal
an napas penyakit paru kronik yang termasuk \line \up0 \expndtw0\charscalex102 P
POK ialah empisema, bronchitis kronik dan \line \up0 \expndtw-3\charscalex1
00 penyakit jalan napas.\par\pard\ql \li20\sb251\sl-253\slmult0 \up0 \expndtw0\c
harscalex103 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Bronkiti
s kronik \up0 \expndtw0\charscalex101 : batuk-batuk produktif \up0 \expndtw
-3\charscalex100 3\par\pard\ql \li272\sb1\sl-253\slmult0 \up0 \expndtw-1\charsca
lex100 bulan dalam setahun, minimal 2 tahun berturut\par\pard\ql \li272\sb1\sl-2
51\slmult0 \up0 \expndtw-2\charscalex100 turut.\par\pard\qj \li272\ri1472\sb3\sl
-253\slmult0\fi0 \up0 \expndtw0\charscalex103 Mungkin tidak disertai kelainan pe
meriksaan \line \up0 \expndtw0\charscalex103 jasmani atau ditemukan ronki basah
di kedua \line \up0 \expndtw-3\charscalex100 paru.\par\pard\qj \li20\ri1472\sb1\
sl-251\slmult0\tx282 \up0 \expndtw0\charscalex100 -\ul0\nosupersub\cf4\f5\fs22
\ul0\nosupersub\cf3\f4\fs22 Empisema : sesak napas menetap dan progresif \line\
tab \up0 \expndtw0\charscalex104 Pada pemeriksaan fisik dada cembung, hiper\par\
pard\qj \li272\ri1473\sb3\sl-251\slmult0 \up0 \expndtw0\charscalex107 sonor, s
uara napas melemah, mungkin \up0 \expndtw-3\charscalex100 terdengar mengi.
\par\pard\ql \li6084\sb0\sl-253\slmult0 \par\pard\ql \li92\sb2\sl-253\slmult0 \u
p0 \expndtw0\charscalex100 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\

fs22 Asma bronchial\par\pard\ql \li92\sb1\sl-251\slmult0 \up0 \expndtw-1\charsca

lex100 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Sindrom obstruk
si pasca TB\par\pard\qj \li20\ri1473\sb253\sl-254\slmult0\tx282 \up0 \expndtw0\c
harscalex107 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Foto to
raks PA dan lateral, inspirasi dan \line\tab \up0 \expndtw-3\charscalex100
ekspirasi\par\pard\ql \li20\sb1\sl-251\slmult0 \up0 \expndtw0\charscalex102 -\ul
0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Spirometri\par\pard\ql \l
i20\ri3957\sb0\sl-402\slmult0\tx102 \up0 \expndtw0\charscalex100 -\ul0\nosupersu
b\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Uji bronkodilator \line\tab \up0 \ex
pndtw-3\charscalex100 Dokter Spesialis Paru\par\pard\ql \li20\sb209\sl-253\slmul
t0 \up0 \expndtw-3\charscalex100 Rawat inap, pada eksaserbasi akut\par\pard\qj \
li6084\sb0\sl-251\slmult0 \par\pard\qj \li20\ri3425\sb5\sl-251\slmult0 \up0 \exp
ndtw-3\charscalex100 Terapi non medikamentosa : \up0 \expndtw-3\charscalex100 *
Oksigen\par\pard\ql \li20\sb3\sl-253\slmult0 \up0 \expndtw-3\charscalex100 * Fis
ioterapi\par\pard\qj \li20\ri1933\sb1\sl-251\slmult0\tx195 \up0 \expndtw-3\chars
calex100 * Pendidikan kesehatan kepada penderita dan \line\tab \up0 \expndtw-3\c
harscalex100 keluarganya.\par\pard\ql \li20\sb2\sl-253\slmult0 \up0 \expndtw-3\c
harscalex100 Terapi medikamentosa\par\pard\ql \li20\sb1\sl-251\slmult0 \up0 \exp
ndtw-3\charscalex100 1. Bronkodilator\par\pard\qj \li241\ri3428\sb4\sl-251\slmul
t0\fi31 \up0 \expndtw-3\charscalex100 * Aminofilin atau teofilin \up0 \expndtw-3
\charscalex100 * Beta 2 agonis\par\pard\ql \li241\sb2\sl-253\slmult0 \up0 \expnd
tw-3\charscalex100 * Anti kolinergik\par\pard\qj \li20\ri2073\sb1\sl-251\slmult0
\tx251 \up0 \expndtw-3\charscalex100 2. Kortikosteroid pada eksaserbasi akut ata
s \line\tab \up0 \expndtw-3\charscalex100 indikasi\par\pard\ql \li20\sb2\sl-253\
slmult0 \up0 \expndtw-3\charscalex100 3. Mukolitik dan ekspektoran\par\pard\ql \
li20\sb1\sl-251\slmult0 \up0 \expndtw-3\charscalex100 4. Anti biotik bila ada in
feksi\par\pard\qj \li6084\sb0\sl-251\slmult0 \par\pard\qj \li20\ri2251\sb5\sl-25
1\slmult0 \up0 \expndtw-3\charscalex100 * Bronkodilator, bila ada gejala obstruk
si \line \up0 \expndtw-3\charscalex100 * Mukolitik dan ekspektoran atas indikasi
\par\pard\ql \li10271\sb0\sl-276\slmult0 \par\pard\ql \li4207\sb225\sl-276\slmul
t0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs24 12 \par\pard\sect\s
ectd\fs24\paperw12240\paperh15840{\shp
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\pard\sb0\sl-240{\bkmkstart Pg14}{\bkmkend Pg14}\par\pard\ql \li8284\sb0\sl-276\
slmult0 \par\pard\ql\li8284\sb175\sl-276\slmult0 \up0 \expndtw-3\charscalex100 \
ul0\nosupersub\cf1\f2\fs24 Panduan Praktik Klinis\par\pard\sect\sectd\sbknone\co
ls2\colno1\colw5924\colsr160\colno2\colw6016\colsr160\ql \li2016\sb0\sl-253\slmu
lt0 \par\pard\ql \li2016\sb213\sl-253\slmult0\tx2527\tx5719 \up0 \expndtw-3\char
scalex100 \ul0\nosupersub\cf3\f4\fs22 1.\tab \up0 \expndtw0\charscalex102 Nama P
enyakit/ Diagnosis\tab \up0 \expndtw-3\charscalex100 :\par\pard\ql \li2016\sb0\s
l-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\s
l-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\s
l-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\s
l-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb1\s
l-253\slmult0\tx2527\tx5719 \up0 \expndtw-3\charscalex100 2.\tab \up0 \expndtw0\
charscalex104 Kriteria Diagnosis\tab \up0 \expndtw-3\charscalex100 :\par\pard\ql
\li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql
\li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql
\li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql
\li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb251\sl-253\slmult0\tx2527\tx5
719 \up0 \expndtw-3\charscalex100 3.\tab \up0 \expndtw0\charscalex101 Diagnosis
Diferensial\tab \up0 \expndtw-3\charscalex100 :\par\pard\ql \li2016\sb0\sl-253\s
lmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\s
lmult0 \par\pard\ql \li2016\sb252\sl-253\slmult0\tx2527\tx5719 \up0 \expndtw-3\c
harscalex100 4.\tab \up0 \expndtw0\charscalex106 Pemeriksaan Penunjang\tab \up0
\expndtw-3\charscalex100 :\par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \
li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \
li2016\sb253\sl-253\slmult0\tx2527\tx5719 \up0 \expndtw-3\charscalex100 5.\tab \
up0 \expndtw0\charscalex103 Konsultasi\tab \up0 \expndtw-3\charscalex100 :\par\p
ard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\p
ard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb1\sl-253\slmult0\tx2527
\tx5719 \up0 \expndtw-3\charscalex100 6.\tab \up0 \expndtw0\charscalex106 Perawa
tan RS\tab \up0 \expndtw-3\charscalex100 :\par\pard\ql \li2016\sb0\sl-253\slmult
0 \par\pard\ql \li2016\sb252\sl-253\slmult0\tx2527\tx5719 \up0 \expndtw-3\charsc
alex100 7.\tab \up0 \expndtw0\charscalex108 Terapi\tab \up0 \expndtw-3\charscale
x100 :\par\pard\ql \li2532\sb0\sl-253\slmult0 \par\pard\ql \li2532\sb0\sl-253\sl
mult0 \par\pard\ql \li2532\sb0\sl-253\slmult0 \par\pard\ql \li2532\sb0\sl-253\sl
mult0 \par\pard\ql \li2532\sb0\sl-253\slmult0 \par\pard\ql \li2532\sb0\sl-253\sl
mult0 \par\pard\ql \li2532\sb0\sl-253\slmult0 \par\pard\ql \li2532\sb0\sl-253\sl
mult0 \par\pard\ql \li2532\sb0\sl-253\slmult0 \par\pard\ql \li2532\sb0\sl-253\sl
mult0 \par\pard\ql \li2532\sb253\sl-253\slmult0 \up0 \expndtw0\charscalex105 Tem
pat Pelayanan\par\pard\column \qj \li6084\sb0\sl-251\slmult0 \par\pard\qj \li20\
ri4029\sb217\sl-251\slmult0 \up0 \expndtw0\charscalex102 PNEUMOTORAKS \up0 \expn
dtw-1\charscalex100 No. ICD 512\par\pard\qj \li20\ri1472\sb250\sl-253\slmult0\fi
0 \up0 \expndtw0\charscalex100 Ialah adanya udara bebas di dalam rongga pleura \
up0 \expndtw0\charscalex105 antara dinding dada dan paru, yang disebabkan \up0 \
expndtw0\charscalex105 oleh trauma dada, maupun penyakit paru dapat \up0 \expndt
w0\charscalex102 terjadi secara spontan. Kadang-kadang terjadi \up0 \expndtw
-3\charscalex100 pada wanita akibat endometrioasis.\par\pard\qj \li6084\sb0\sl-2
51\slmult0 \par\pard\qj \li20\ri1472\sb4\sl-251\slmult0\tx282 \up0 \expndtw0\cha
rscalex106 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Pneumotora
ks spontan sesak napas dan atau \line\tab \up0 \expndtw-1\charscalex100 nyeri da
da yang terjadi mendadak dan semakin\par\pard\ql \li272\sb1\sl-251\slmult0 \up0
\expndtw-3\charscalex100 memberat.\par\pard\qj \li272\ri1472\sb2\sl-253\slmult0
\up0 \expndtw0\charscalex101 Pada pneumotoraks tekan (venti), sesak napas \up0 \
expndtw0\charscalex107 semakin hebat, nadi lebih cepat, gelisah, \up0 \expn
dtw-3\charscalex100 keringat dingin dan sianosis.\par\pard\qj \li272\ri1473\sb0\
sl-254\slmult0 \up0 \expndtw0\charscalex104 Pneumotoraks pada endometriosis
sering \up0 \expndtw-3\charscalex100 terjadi bersamaan dengan menstruasi.\par\
pard\ql \li92\sb250\sl-253\slmult0 \up0 \expndtw0\charscalex101 -\ul0\nosupersub

\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Empisema\par\pard\ql \li92\sb1\sl-253\

slmult0 \up0 \expndtw0\charscalex100 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupers
ub\cf3\f4\fs22 Asma bronchial\par\pard\ql \li92\sb1\sl-251\slmult0 \up0 \expndtw
-1\charscalex100 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 IMA (
Infark Miokard Akut)\par\pard\ql \li92\sb3\sl-253\slmult0 \up0 \expndtw0\charsca
lex101 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Emboli Paru\par
\pard\qj \li20\ri1472\sb251\sl-253\slmult0\fi0\tx824\tx1810\tx3548 \up0 \expndtw
-2\charscalex100 Foto\tab \up0 \expndtw-3\charscalex100 toraks,\tab \up0 \expndt
w-3\charscalex100 kadang-kadang\tab \up0 \expndtw-3\charscalex100 diperlukan \up
0 \expndtw0\charscalex105 pembuatan dalam ekspirasi maksimal bila \up0 \
expndtw0\charscalex105 dicurigai pneumotoraks ringan atau foto lateral \up0 \exp
ndtw-3\charscalex100 bila diduga disertai efusi pleura.\par\pard\ql \li22\sb251\
sl-253\slmult0 \up0 \expndtw-3\charscalex100 Dokter Spesialis Paru\par\pard\qj \
li20\ri2006\sb4\sl-251\slmult0 \up0 \expndtw-3\charscalex100 Bila diduga endomet
riosis : Dokter Spesialis \up0 \expndtw-3\charscalex100 Kebidanan kandungan\par\
pard\qj \li6084\sb0\sl-251\slmult0 \par\pard\qj \li20\ri1472\sb4\sl-251\slmult0
\up0 \expndtw0\charscalex106 Rawat inap, setiap pasien pneumotoraks harus \up0 \
expndtw-3\charscalex100 segera dirawat\par\pard\ql \li6084\sb0\sl-253\slmult0 \p
ar\pard\ql \li20\sb1\sl-253\slmult0 \up0 \expndtw-3\charscalex100 Terapi medikam
entosa :\par\pard\qj \li20\ri1470\sb4\sl-251\slmult0 \up0 \expndtw0\charscalex10
2 Jika disebabkan oleh TB Paru, diperlukan obat -\line \up0 \expndtw-3\charscale
x100 obatan anti TB (OAT).\par\pard\ql \li6084\sb0\sl-253\slmult0 \par\pard\ql \
li20\ri1980\sb1\sl-253\slmult0 \up0 \expndtw-3\charscalex100 Terapi non medikam
entosa \line \up0 \expndtw-3\charscalex100 * Istirahat fisioterapi (bila ringan)
\line \up0 \expndtw-3\charscalex100 * Pemasangan WSD atau WSD mini, O\ul0\sub\c
f6\f7\fs21 2\ul0\nosupersub\cf3\f4\fs22 bila\par\pard\ql \li185\sb0\sl-251\slmu
lt0 \up0 \expndtw-3\charscalex100 pneumotoraks sedang berat\par\pard\qj \li20\ri
2245\sb4\sl-251\slmult0 \up0 \expndtw-3\charscalex100 * Pleurodesis bila pneumot
oraks berulang \up0 \expndtw-3\charscalex100 * Terapi hormone untuk endometriosi
s\par\pard\ql \li20\sb1\sl-251\slmult0 \up0 \expndtw-3\charscalex100 * Kadang-ka
dang dibutuhkan pembedahan\par\pard\ql \li6084\sb0\sl-253\slmult0 \par\pard\ql \
li20\sb1\sl-253\slmult0 \up0 \expndtw-3\charscalex100 RS. Klas D\par\pard\ql \li
20\sb2\sl-253\slmult0 \up0 \expndtw-3\charscalex100 RS. Klas C/B dengan Spesiali
s Paru\par\pard\ql \li10271\sb0\sl-276\slmult0 \par\pard\ql \li10271\sb0\sl-276\
slmult0 \par\pard\ql \li10271\sb0\sl-276\slmult0 \par\pard\ql \li4207\sb176\sl-2
76\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f2\fs24 14 \par\par
d\sect\sectd\fs24\paperw12240\paperh15840{\shp
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\pard\sb0\sl-240{\bkmkstart Pg15}{\bkmkend Pg15}\par\pard\ql \li8284\sb0\sl-276\
slmult0 \par\pard\ql\li8284\sb175\sl-276\slmult0 \up0 \expndtw-3\charscalex100 \
ul0\nosupersub\cf1\f2\fs24 Panduan Praktik Klinis \par\pard\li2016\sb0\sl-253\sl

mult0\par\pard\li2016\sb213\sl-253\slmult0\fi0\tx2532\tx5724\tx6084 \dn2 \expndt

w-1\charscalex100 \ul0\nosupersub\cf3\f4\fs22 8.\tab \dn2 \expndtw-1\charscalex1
00 Penyulit\tab \dn2 \expndtw-1\charscalex100 :\tab \up0 \expndtw-1\charscalex10
0 Komplikasi\par\pard\li2016\sb0\sl-253\slmult0\par\pard\li2016\sb1\sl-253\slmul
t0\fi3707\tx6084 \up0 \expndtw-1\charscalex100 :\tab \up0 \expndtw-1\charscalex1
00 Karena Penyakit :\par\pard\qj \li6084\ri4094\sb0\sl-260\slmult0 \up0 \expndtw
-3\charscalex100 * Empisema subkutis \up0 \expndtw-3\charscalex100 * Efusi pleur
a \par\pard\ql \li6084\sb1\sl-226\slmult0 \up0 \expndtw-3\charscalex100 * Empiem
a \par\pard\ql \li6084\ri1951\sb0\sl-260\slmult0 \up0 \expndtw-3\charscalex100 *
Pada pneumotoraks tekan dapat terjadi torsi \up0 \expndtw-3\charscalex100 jantu
ng dan pembuluh darah besar \par\pard\li2016\sb253\sl-253\slmult0\fi0\tx2532\tx5
724\tx6084 \dn2 \expndtw0\charscalex101 9.\tab \dn2 \expndtw0\charscalex101 Info
rm Concent ( tertulis)\tab \dn2 \expndtw0\charscalex101 :\tab \up0 \expndtw0\cha
rscalex101 Perlu terutama akan dilakukan pemasangan WSD\par\pard\ql \li6084\sb1\
sl-236\slmult0 \up0 \expndtw-3\charscalex100 dan atau pembedahan. \par\pard\li20
16\sb0\sl-253\slmult0\par\pard\li2016\sb16\sl-253\slmult0\fi0\tx2532\tx5724\tx60
84 \up0 \expndtw0\charscalex101 10.\tab \up0 \expndtw0\charscalex101 Tenaga Stan
dar\tab \up0 \expndtw0\charscalex101 :\tab \up0 \expndtw0\charscalex101 Dokter U
mum :\par\pard\ql \li6156\ri1511\sb19\sl-240\slmult0 \up0 \expndtw0\charscalex1
09 \ul0\nosupersub\cf5\f6\fs22 \u-3913?\ul0\nosupersub\cf4\f5\fs22 \ul0\nosuper
sub\cf3\f4\fs22 Terutama dalam keadaan akut sampai \up0 \expndtw-3\chars
calex100 pemasangan WSD mini \par\pard\ql \li6084\sb0\sl-253\slmult0 \par\pard\q
l\li6084\sb17\sl-253\slmult0 \up0 \expndtw-3\charscalex100 Dokter Spesialis Paru
: \par\pard\ql \li6156\ri1507\sb2\sl-260\slmult0 \up0 \expndtw0\charscalex103 \
ul0\nosupersub\cf5\f6\fs22 \u-3913?\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\
cf3\f4\fs22 Bila diperlukan pemasangan WSD pada \up0 \expndtw-3\charscal
ex100 pneumotoraks berulang bila terjadi penyulit \par\pard\li2016\sb228\sl-253\
slmult0\fi0\tx2532\tx5724\tx6084 \up0 \expndtw0\charscalex102 11.\tab \up0 \expn
dtw0\charscalex102 Lama Perawatan\tab \up0 \expndtw0\charscalex102 :\tab \dn2 \e
xpndtw0\charscalex102 Sampai 3 hari setelah WSD divcabut dan tidak\par\pard\li20
16\sb28\sl-253\slmult0\fi4067 \up0 \expndtw0\charscalex102 terjadi lagi Pneumoto
raks berulang.\par\pard\li2016\sb224\sl-253\slmult0\fi0\tx2532\tx5724\tx6084 \up
0 \expndtw0\charscalex102 12.\tab \up0 \expndtw0\charscalex102 Masa Pemulihan\ta
b \up0 \expndtw0\charscalex102 :\tab \dn2 \expndtw0\charscalex102 1 minggu\par\p
ard\li2016\sb0\sl-253\slmult0\par\pard\li2016\sb1\sl-253\slmult0\fi0\tx2532\tx57
24\tx6084 \up0 \expndtw0\charscalex102 13.\tab \up0 \expndtw0\charscalex102 Outp
ut\tab \up0 \expndtw0\charscalex102 :\tab \dn3 \expndtw0\charscalex102 * Sembuh
total\par\pard\qj \li6249\ri1792\sb15\sl-260\slmult0 \up0 \expndtw-3\charscalex1
00 Tanpa keluhan tapi pengembangan paru tidak \up0 \expndtw-3\charscalex100 semp
urna \par\pard\qj \li6084\ri4784\sb0\sl-260\slmult0 \up0 \expndtw-3\charscalex10
0 * Komplikasi \line \up0 \expndtw-3\charscalex100 * Meninggal \par\pard\li2016\
sb212\sl-253\slmult0\fi0\tx2532\tx5724\tx6084 \up0 \expndtw0\charscalex102 14.\t
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\pard\sb0\sl-240{\bkmkstart Pg16}{\bkmkend Pg16}\par\pard\ql \li8284\sb0\sl-276\
slmult0 \par\pard\ql\li8284\sb175\sl-276\slmult0 \up0 \expndtw-3\charscalex100 \
ul0\nosupersub\cf1\f2\fs24 Panduan Praktik Klinis\par\pard\sect\sectd\sbknone\co
ls2\colno1\colw5924\colsr160\colno2\colw6016\colsr160\ql \li2016\sb0\sl-253\slmu
lt0 \par\pard\ql \li2016\sb213\sl-253\slmult0\tx2527\tx5719 \up0 \expndtw-3\char
scalex100 \ul0\nosupersub\cf3\f4\fs22 1.\tab \up0 \expndtw0\charscalex102 Nama P
enyakit/ Diagnosis\tab \up0 \expndtw-3\charscalex100 :\par\pard\ql \li2016\sb0\s
l-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\s
l-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb252
\sl-253\slmult0\tx2527\tx5719 \up0 \expndtw-3\charscalex100 2.\tab \up0 \expndtw
0\charscalex104 Kriteria Diagnosis\tab \up0 \expndtw-3\charscalex100 :\par\pard\
ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\
ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb253\sl-253\slmult0\tx2527\t
x5719 \up0 \expndtw-3\charscalex100 3.\tab \up0 \expndtw0\charscalex101 Diagnosi
s Diferensial\tab \up0 \expndtw-3\charscalex100 :\par\pard\ql \li2016\sb0\sl-253
\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253
\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253
\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253
\slmult0 \par\pard\ql \li2016\sb253\sl-253\slmult0\tx2527\tx5719 \up0 \expndtw-3
\charscalex100 4.\tab \up0 \expndtw0\charscalex106 Pemeriksaan Penunjang\tab \up
0 \expndtw-3\charscalex100 :\par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql
\li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql
\li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql
\li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb252\sl-253\slmult0\tx2527\tx5
719 \up0 \expndtw-3\charscalex100 5.\tab \up0 \expndtw0\charscalex103 Konsultasi
\tab \up0 \expndtw-3\charscalex100 :\par\pard\ql \li2016\sb0\sl-253\slmult0 \par
\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb2\sl-253\slmult0\tx25
27\tx5719 \up0 \expndtw-3\charscalex100 6.\tab \up0 \expndtw0\charscalex106 Pera
watan RS\tab \up0 \expndtw-3\charscalex100 :\par\pard\ql \li2016\sb0\sl-253\slmu
lt0 \par\pard\ql \li2016\sb252\sl-253\slmult0\tx2527\tx5719 \up0 \expndtw-3\char
scalex100 7.\tab \up0 \expndtw0\charscalex108 Terapi\tab \up0 \expndtw-3\charsca
lex100 :\par\pard\ql \li5724\sb0\sl-253\slmult0 \par\pard\ql \li5724\sb0\sl-253\
slmult0 \par\pard\ql \li5724\sb0\sl-253\slmult0 \par\pard\ql \li5724\sb0\sl-253\
slmult0 \par\pard\ql \li5724\sb0\sl-253\slmult0 \par\pard\ql \li5724\sb0\sl-253\
slmult0 \par\pard\ql \li5724\sb0\sl-253\slmult0 \par\pard\ql \li5724\sb0\sl-253\
slmult0 \par\pard\ql \li5724\sb0\sl-253\slmult0 \par\pard\ql \li5724\sb0\sl-253\
slmult0 \par\pard\ql \li5724\sb0\sl-253\slmult0 \par\pard\ql \li5724\sb0\sl-253\
slmult0 \par\pard\ql \li5724\sb0\sl-253\slmult0 \par\pard\ql \li5724\sb0\sl-253\
slmult0 \par\pard\ql \li5724\sb0\sl-253\slmult0 \par\pard\ql \li5724\sb253\sl-25
3\slmult0 \up0 \expndtw-3\charscalex100 :\par\pard\column \ql \li6084\sb0\sl-253
\slmult0 \par\pard\ql \li20\sb213\sl-253\slmult0 \up0 \expndtw0\charscalex105 HE
MOPTOE\par\pard\qj \li20\ri1472\sb249\sl-253\slmult0\fi0 \up0 \expndtw-1\charsca
lex100 Ialah suatu batuk yang mengeluarkan darah. Pada \up0 \expndtw0\charscalex

103 umunya penderita batuk darah telah menpunyai \up0 \expndtw-3\charscalex100 p

enyakit dasar\par\pard\qj \li20\ri1472\sb251\sl-253\slmult0\fi0 \up0 \expndtw0\c
harscalex101 Batuk-batuk, berdarah ( dari Bloodstreak sampai \up0 \expndtw0\char
scalex101 Massive 500-1000 cc atau lebih) dan perdarahan \up0 \expndtw0\charscal
ex102 yang terjadi harus berasal dari saluran napas \up0 \expndtw-3\charsc
alex100 bagian bawah ( dari glottis ke bawah).\par\pard\ql \li92\sb251\sl-253\sl
mult0 \up0 \expndtw-1\charscalex100 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersu
b\cf3\f4\fs22 CA Bronkogenik\par\pard\ql \li92\sb1\sl-253\slmult0 \up0 \expndtw0
\charscalex100 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Bronkie
ktasis\par\pard\ql \li92\sb1\sl-251\slmult0 \up0 \expndtw0\charscalex100 -\ul0\n
osupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Tuberkolosis paru\par\pard\ql
\li92\sb3\sl-253\slmult0 \up0 \expndtw0\charscalex101 -\ul0\nosupersub\cf4\f5\f
s22 \ul0\nosupersub\cf3\f4\fs22 Abses paru\par\pard\ql \li92\sb1\sl-251\slmult0
\up0 \expndtw-1\charscalex100 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3
\f4\fs22 Adenoma Bronchial\par\pard\ql \li92\sb2\sl-253\slmult0 \up0 \expndtw-1\
charscalex100 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Eksaserb
asi PPOK\par\pard\ql \li92\sb1\sl-251\slmult0 \up0 \expndtw0\charscalex100 -\ul0
\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Kardiovaskuler\par\pard\ql
\li92\sb1\sl-251\slmult0 \up0 \expndtw0\charscalex110 -\ul0\nosupersub\cf4\f5\fs
22 \ul0\nosupersub\cf3\f4\fs22 dll\par\pard\qj \li20\ri3481\sb253\sl-254\slmult
0 \up0 \expndtw-3\charscalex100 Foto Toraks PA dan Lateral \up0 \expndtw-3\chars
calex100 Bronkoskopi\par\pard\ql \li20\sb1\sl-251\slmult0 \up0 \expndtw-3\charsc
alex100 Pemeriksaan Laboratorium :\par\pard\ql \li20\sb1\sl-251\slmult0 \up0 \e
xpndtw0\charscalex100 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22
HB dan Faal Hemostatis\par\pard\ql \li20\sb2\sl-253\slmult0 \up0 \expndtw0\char
scalex101 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Sputum BTA\
par\pard\ql \li20\sb1\sl-251\slmult0 \up0 \expndtw0\charscalex105 -\ul0\nosupers
ub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Jamur\par\pard\ql \li20\ri4026\sb0\
sl-401\slmult0 \up0 \expndtw0\charscalex100 -\ul0\nosupersub\cf4\f5\fs22 \ul0\n
osupersub\cf3\f4\fs22 Setologi Sputum \line \up0 \expndtw-3\charscalex100 Dokte
r Spesialis Paru\par\pard\ql \li6084\sb0\sl-253\slmult0 \par\pard\ql \li20\sb212
\sl-253\slmult0 \up0 \expndtw-3\charscalex100 Rawat inap setiap pasien batuk dar
ah\par\pard\ql \li6156\sb0\sl-253\slmult0 \par\pard\ql \li92\sb253\sl-253\slmult
0 \up0 \expndtw-5\charscalex100 a.\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\c
f3\f4\fs22 Konservatif\par\pard\ql \li380\sb0\sl-251\slmult0\tx745 \up0 \expndtw
-3\charscalex100 -\tab \up0 \expndtw-2\charscalex100 Menenangkan dan memberitahu
penderita\par\pard\qj \li740\ri1475\sb4\sl-251\slmult0 \up0 \expndtw0\charscale
x101 agar jangan takut untuk membatukkan \up0 \expndtw-3\charscalex100 darah
nya\par\pard\ql \li380\sb1\sl-251\slmult0\tx745 \up0 \expndtw-3\charscalex100 -\
tab \up0 \expndtw0\charscalex104 Penderita diminta berbaring pada posisi\par\par
d\qj \li740\ri1472\sb2\sl-253\slmult0 \up0 \expndtw0\charscalex109 bagian paru
yang sakit atau sedikit \up0 \expndtw0\charscalex108 trendelenberg, teruta
ma bila reflek \up0 \expndtw-3\charscalex100 batuknya tidak adekuat.\par\par
d\ql \li380\sb1\sl-251\slmult0\tx745 \up0 \expndtw-3\charscalex100 -\tab \up0 \e
xpndtw0\charscalex105 Jaga agar jalan napas tetap terbuka bila\par\pard\qj \li74
0\ri1472\sb3\sl-251\slmult0 \up0 \expndtw0\charscalex101 diperlukan dilakukan
pemasangan pipa \up0 \expndtw-3\charscalex100 endotrakeal.\par\pard\ql \li380\s
b1\sl-251\slmult0\tx745 \up0 \expndtw-3\charscalex100 -\tab \up0 \expndtw0\chars
calex103 Pemasangan IV line, untuk penggantian\par\pard\ql \li740\sb2\sl-253\slm
ult0 \up0 \expndtw-3\charscalex100 cairan /jalur pemberian obat parenteral.\par\
pard\ql \li380\sb1\sl-251\slmult0\tx745 \up0 \expndtw-3\charscalex100 -\tab \up0
\expndtw0\charscalex104 Pemberian obat Hemostatik belum jelas\par\pard\ql \li74
0\sb3\sl-253\slmult0 \up0 \expndtw-3\charscalex100 manfaatnya.\par\pard\ql \li38
0\sb1\sl-251\slmult0\tx745 \up0 \expndtw-3\charscalex100 -\tab \up0 \expndtw-1\c
harscalex100 Obat-obat dengan efek sedasi ringan\par\pard\qj \li740\ri14
72\sb0\sl-254\slmult0 \up0 \expndtw0\charscalex102 dapat diberikan bila pende
rita gelisah. \line \up0 \expndtw0\charscalex105 Obat - obat penekan reflek bat
uk hanya\par\pard\ql \li4207\sb245\sl-276\slmult0 \up0 \expndtw-3\charscalex100
\ul0\nosupersub\cf1\f2\fs24 16 \par\pard\sect\sectd\fs24\paperw12240\paperh15840
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\pard\sb0\sl-240{\bkmkstart Pg17}{\bkmkend Pg17}\par\pard\ql \li8284\sb0\sl-276\
slmult0 \par\pard\ql\li8284\sb175\sl-276\slmult0 \up0 \expndtw-3\charscalex100 \
ul0\nosupersub\cf1\f2\fs24 Panduan Praktik Klinis \par\pard\qj \li6804\sb0\sl-26
0\slmult0 \par\pard\qj\li6804\ri1505\sb178\sl-260\slmult0 \up0 \expndtw0\charsca
lex104 \ul0\nosupersub\cf3\f4\fs22 diberikan bila terdapat batuk berlebihan \lin
e \up0 \expndtw-3\charscalex100 dan merangsang perdarahan lebih banyak. \par\par
d\li6444\sb11\sl-253\slmult0\fi0\tx6804\tx9890 \up0 \expndtw0\charscalex103 -\ta
b \up0 \expndtw0\charscalex103 Transfusi darah bila hematokrit\tab \up0 \expndtw
0\charscalex103 < 25 -\par\pard\li6444\sb1\sl-251\slmult0\fi359\tx8400\tx8709 \u
p0 \expndtw0\charscalex103 20% atau Hb\tab \up0 \expndtw0\charscalex103 <\ta
b \up0 \expndtw0\charscalex103 10 gram% sedang\par\pard\ql \li6804\sb0\sl-24
2\slmult0 \up0 \expndtw-3\charscalex100 perdarahan masih berlangsung. \par\pard\
ql \li6156\sb249\sl-253\slmult0 \up0 \expndtw-6\charscalex100 b.\ul0\nosupersub\
cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Terapi Bedah \par\pard\ql \li6377\sb7\s
l-253\slmult0 \up0 \expndtw-3\charscalex100 Indikasi tidakan bedah : \par\pard\q
l \li6444\sb7\sl-253\slmult0\tx6804 \up0 \expndtw-3\charscalex100 -\tab \up0 \ex
pndtw0\charscalex101 Batuk darah > 600 cc/24 jam dan dalam \par\pard\ql \li6804\
sb1\sl-237\slmult0 \up0 \expndtw-3\charscalex100 pengamatan batuk darah tidak be
rhenti. \par\pard\ql \li6444\sb10\sl-253\slmult0\tx6804 \up0 \expndtw-3\charscal
ex100 -\tab \up0 \expndtw-1\charscalex100 Batuk darah 250-600 cc/24 jam, Hb < 10
\par\pard\qj \li6804\ri1515\sb18\sl-240\slmult0 \up0 \expndtw-3\charscalex100 g
ram% dan batuk darah berlangsung \line \up0 \expndtw-3\charscalex100 ter
us. \par\pard\li2016\sb16\sl-253\slmult0\fi4427\tx6804 \up0 \expndtw0\charscalex
101 -\tab \up0 \expndtw0\charscalex101 Batuk darah 250 - 600 cc/24 jam, Hb >\par
\pard\li2016\sb2\sl-253\slmult0\fi4787 \up0 \expndtw0\charscalex101 10 gram% dan
dalam pengamatan 48 jam\par\pard\li2016\sb1\sl-251\slmult0\fi4787 \up0 \expndtw
0\charscalex101 perdarahan tidak berhenti.\par\pard\li2016\sb0\sl-253\slmult0\pa
r\pard\li2016\sb6\sl-253\slmult0\fi0\tx2532\tx5724\tx6084 \dn2 \expndtw0\charsca
lex101 8.\tab \dn2 \expndtw0\charscalex101 Standard RS\tab \dn2 \expndtw0\charsc
alex101 :\tab \up0 \expndtw0\charscalex101 Tipe C dan B\par\pard\li2016\sb0\sl-2
53\slmult0\par\pard\li2016\sb252\sl-253\slmult0\fi0\tx2532\tx5724\tx6156 \dn2 \e
xpndtw0\charscalex102 9.\tab \dn2 \expndtw0\charscalex102 Penyulit\tab \dn2 \exp
ndtw0\charscalex102 :\tab \up0 \expndtw0\charscalex102 -\ul0\nosupersub\cf4\f5\f
s22 \ul0\nosupersub\cf3\f4\fs22 Asfiksia\par\pard\ql \li6156\sb1\sl-234\slmult0
\up0 \expndtw0\charscalex100 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\
f4\fs22 Sufokasi \par\pard\ql \li6156\ri1516\sb22\sl-240\slmult0 \up0 \expndtw0\
charscalex100 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Kegagala
n sirkulasi akibat banyak kehilangan \line \up0 \expndtw-3\charscalex100 darah \
par\pard\ql \li6156\sb10\sl-253\slmult0 \up0 \expndtw-4\charscalex100 -\ul0\nosu
persub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Penyebaran penyakit ke sisi paru

yang sehat \par\pard\ql \li6156\sb7\sl-253\slmult0 \up0 \expndtw-1\charscalex10

0 -\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs22 Atelektasis \par\par
d\li2016\sb0\sl-253\slmult0\par\pard\li2016\sb7\sl-253\slmult0\fi0\tx2532\tx5724
\tx6084 \up0 \expndtw0\charscalex100 10.\tab \up0 \expndtw0\charscalex100 Inform
Concent ( tertulis)\tab \up0 \expndtw0\charscalex100 :\tab \up0 \expndtw0\chars
calex100 Perlu bila dilakukan operasi\par\pard\li2016\sb0\sl-253\slmult0\par\par
d\li2016\sb253\sl-253\slmult0\fi0\tx2532\tx5724\tx6084 \up0 \expndtw0\charscalex
101 11.\tab \up0 \expndtw0\charscalex101 Tenaga Standar\tab \up0 \expndtw0\chars
calex101 :\tab \up0 \expndtw0\charscalex101 Dokter Umum\par\pard\li2016\sb1\sl-2
48\slmult0\fi4067 \up0 \expndtw0\charscalex101 Dokter Spesialis Paru\par\pard\li
2016\sb0\sl-253\slmult0\par\pard\li2016\sb4\sl-253\slmult0\fi0\tx2532\tx5724\tx6
084 \up0 \expndtw0\charscalex101 12.\tab \up0 \expndtw0\charscalex101 Lama Peraw
atan\tab \up0 \expndtw0\charscalex101 :\tab \up0 \expndtw0\charscalex101 1-2 min
ggu\par\pard\li2016\sb0\sl-253\slmult0\par\pard\li2016\sb0\sl-253\slmult0\par\pa
rd\li2016\sb2\sl-253\slmult0\fi0\tx2532\tx5724\tx6084 \up0 \expndtw0\charscalex1
01 13.\tab \up0 \expndtw0\charscalex101 Masa Pemulihan\tab \up0 \expndtw0\charsc
alex101 :\tab \up0 \expndtw0\charscalex101 2 minggu\par\pard\li2016\sb0\sl-253\s
lmult0\par\pard\li2016\sb252\sl-253\slmult0\fi0\tx2532\tx5724\tx6084 \up0 \expnd
tw0\charscalex100 14.\tab \up0 \expndtw0\charscalex100 Output\tab \up0 \expndtw0
\charscalex100 :\tab \up0 \expndtw0\charscalex100 Sembuh Parsial\par\pard\li2016
\sb1\sl-245\slmult0\fi4067 \up0 \expndtw0\charscalex100 Sembuh total\par\pard\li
2016\sb4\sl-253\slmult0\fi4067 \up0 \expndtw0\charscalex100 Meninggal\par\pard\l
i2016\sb0\sl-253\slmult0\par\pard\li2016\sb5\sl-253\slmult0\fi0\tx2532\tx5724\tx
6084 \dn2 \expndtw0\charscalex100 15.\tab \dn2 \expndtw0\charscalex100 PA\tab \d
n2 \expndtw0\charscalex100 :\tab \up0 \expndtw0\charscalex100 -\par\pard\li2016\
sb0\sl-253\slmult0\par\pard\li2016\sb252\sl-253\slmult0\fi0\tx2532\tx5724\tx6084
\dn2 \expndtw0\charscalex100 16.\tab \dn2 \expndtw0\charscalex100 Autopsi/Risal
ah Rapat\tab \dn2 \expndtw0\charscalex100 :\tab \up0 \expndtw0\charscalex100 -\p
ar\pard\ql \li10271\sb0\sl-276\slmult0 \par\pard\ql\li10271\sb0\sl-276\slmult0 \
par\pard\ql\li10271\sb0\sl-276\slmult0 \par\pard\ql\li10271\sb0\sl-276\slmult0 \
par\pard\ql\li10271\sb0\sl-276\slmult0 \par\pard\ql\li10271\sb108\sl-276\slmult0
\up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf1\f2\fs24 17 \par\pard\sect\sec
td\fs24\paperw12240\paperh15840{\shp
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\pard\sb0\sl-240{\bkmkstart Pg18}{\bkmkend Pg18}\par\pard\ql \li8284\sb0\sl-276\
slmult0 \par\pard\ql\li8284\sb175\sl-276\slmult0 \up0 \expndtw-3\charscalex100 \
ul0\nosupersub\cf1\f2\fs24 Panduan Praktik Klinis\par\pard\sect\sectd\sbknone\co
ls2\colno1\colw5871\colsr160\colno2\colw6069\colsr160\ql \li2016\sb0\sl-253\slmu
lt0 \par\pard\ql \li2016\sb213\sl-253\slmult0\tx2527\tx5719 \up0 \expndtw-3\char
scalex100 \ul0\nosupersub\cf3\f4\fs22 1.\tab \up0 \expndtw0\charscalex102 Nama P
enyakit/ Diagnosis\tab \up0 \expndtw-3\charscalex100 :\par\pard\ql \li2016\sb0\s

l-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\s

l-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\s
l-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\s
l-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\s
l-253\slmult0 \par\pard\ql \li2016\sb252\sl-253\slmult0\tx2527\tx5719 \up0 \expn
dtw-3\charscalex100 2.\tab \up0 \expndtw0\charscalex104 Kriteria Diagnosis\tab \
up0 \expndtw-3\charscalex100 :\par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\
ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\
ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\
ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\
ql \li2016\sb253\sl-253\slmult0\tx2527\tx5719 \up0 \expndtw-3\charscalex100 3.\t
ab \up0 \expndtw0\charscalex101 Diagnosis Diferensial\tab \up0 \expndtw-3\charsc
alex100 :\par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253
\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253
\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb253\sl-2
53\slmult0\tx2527\tx5719 \up0 \expndtw-3\charscalex100 4.\tab \up0 \expndtw0\cha
rscalex106 Pemeriksaan Penunjang\tab \up0 \expndtw-3\charscalex100 :\par\pard\ql
\li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql
\li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql
\li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb253\sl-253\slmult0\tx2527\tx5
719 \up0 \expndtw-3\charscalex100 5.\tab \up0 \expndtw0\charscalex105 Pemeriksaa
n Khusus\tab \up0 \expndtw-3\charscalex100 :\par\pard\ql \li2016\sb0\sl-253\slmu
lt0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmu
lt0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmu
lt0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb252\sl-253\sl
mult0\tx2527\tx5719 \up0 \expndtw-3\charscalex100 6.\tab \up0 \expndtw0\charscal
ex103 Konsultasi\tab \up0 \expndtw-3\charscalex100 :\par\pard\ql \li2016\sb0\sl253\slmult0 \par\pard\ql \li2016\sb0\sl-253\slmult0 \par\pard\ql \li2016\sb0\sl253\slmult0 \par\pard\ql \li2016\sb1\sl-253\slmult0\tx2527\tx5719 \up0 \expndtw3\charscalex100 7.\tab \up0 \expndtw0\charscalex106 Perawatan RS\tab \up0 \expnd
tw-3\charscalex100 :\par\pard\column \ql \li6084\sb0\sl-253\slmult0 \par\pard\ql
\li73\sb213\sl-253\slmult0 \up0 \expndtw0\charscalex101 KANKER PARU\par\pard\qj
\li73\ri1472\sb249\sl-253\slmult0\fi0\tx4476 \up0 \expndtw0\charscalex108 Kanke
r paru dalam arti luas adalah semua \line \up0 \expndtw0\charscalex105 pen
yakit keganasan di paru, mencakup \tab \up0 \expndtw-3\charscalex100 : \
line \up0 \expndtw0\charscalex100 keganasan yang berasal dari paru sendiri maupu
n \line \up0 \expndtw0\charscalex102 keganasan dari luar paru metastasis tu
mor di \line \up0 \expndtw-1\charscalex100 paru). Dalam pedoman ini yang dimaks
ud dengan \line \up0 \expndtw-3\charscalex100 kanker paru ialah kanker paru prim
er, yakni tumor \line \up0 \expndtw0\charscalex105 ganas yang berasal dari e
pitel bronkus atau \line \up0 \expndtw-3\charscalex100 karsinoma bronkus (Bron
chogenic Carcinoma).\par\pard\qj \li73\ri2868\sb251\sl-254\slmult0 \up0 \expndtw
-3\charscalex100 Batuk-batuk dengan /tanpa dahak : \up0 \expndtw-3\charscalex100
Batuk darah ;\par\pard\qj \li73\ri4750\sb0\sl-253\slmult0 \up0 \expndtw-3\chars
calex100 Sesak napas : \line \up0 \expndtw-3\charscalex100 Sakit dada :\par\pard
\ql \li73\ri3669\sb0\sl-254\slmult0 \up0 \expndtw-3\charscalex100 Sulit /sakit m
enelan \line \up0 \expndtw-3\charscalex100 Benjolan di pangkal leher\par\pard\qj
\li73\ri1472\sb0\sl-251\slmult0 \up0 \expndtw0\charscalex102 Sembab muka dan le
her kadang-kadang disertai \up0 \expndtw-3\charscalex100 lengan dengan rasa nyer
i .\par\pard\qj \li73\ri4854\sb253\sl-254\slmult0 \up0 \expndtw-3\charscalex100
Benda asing \up0 \expndtw-3\charscalex100 Jamur\par\pard\qj \li73\ri3407\sb1\sl251\slmult0 \up0 \expndtw-3\charscalex100 Tuberkolisis/ Tuberkolomo ; \up0 \expn
dtw-3\charscalex100 Hamartoma;\par\pard\ql \li73\ri4055\sb3\sl-251\slmult0 \up0
\expndtw-3\charscalex100 Tumor Metastasis ; \line \up0 \expndtw-1\charscalex100
Penyakit Auto -imun\par\pard\ql \li6084\sb0\sl-253\slmult0 \par\pard\ql \li145\s
b1\sl-253\slmult0 \up0 \expndtw-2\charscalex100 a.\ul0\nosupersub\cf4\f5\fs22 \
ul0\nosupersub\cf3\f4\fs22 Foto Toraks PA dan Lateral\par\pard\ql \li145\sb1\s
l-251\slmult0 \up0 \expndtw-2\charscalex100 b.\ul0\nosupersub\cf4\f5\fs22 \ul0\
nosupersub\cf3\f4\fs22 CT Scan Toraks\par\pard\qj \li145\ri2772\sb4\sl-251\slm
ult0\tx443\tx792 \up0 \expndtw-2\charscalex100 c.\ul0\nosupersub\cf4\f5\fs22 \u

l0\nosupersub\cf3\f4\fs22 Pemeriksaan Radiologik Lain : \line\tab \up0 \expndt

w-3\charscalex100 -\tab \up0 \expndtw-3\charscalex100 Brain CT\par\pard\ql \li43
3\sb2\sl-253\slmult0\tx798 \up0 \expndtw-3\charscalex100 -\tab \up0 \expndtw-3\c
harscalex100 Bon Scan /Bone Survey\par\pard\ql \li433\sb1\sl-251\slmult0\tx798 \
up0 \expndtw-3\charscalex100 -\tab \up0 \expndtw-3\charscalex100 USG Abdomen\par
\pard\ql \li6084\sb0\sl-253\slmult0 \par\pard\ql \li73\sb1\sl-253\slmult0 \up0 \
expndtw-3\charscalex100 Bronkoskopi\par\pard\ql \li73\sb1\sl-251\slmult0 \up0 \e
xpndtw-3\charscalex100 Biopsi aspirasi jarum ;\par\pard\qj \li73\ri1473\sb4\sl-2
51\slmult0 \up0 \expndtw-1\charscalex100 Trans Bronchial Needle Aspiration
\up0 \expndtw-3\charscalex100 (TBNA); \up0 \expndtw-3\charscalex100 Trans bron
chial Lung Biopsy (TBLB) ;\par\pard\qj \li73\ri1708\sb0\sl-254\slmult0 \up0 \exp
ndtw-3\charscalex100 Biopsi lain ( Biopsi jarum halus, biopsi Daniel); \up0 \exp
ndtw-3\charscalex100 Torakoskopi Medik\par\pard\ql \li73\sb0\sl-251\slmult0 \up0
\expndtw-3\charscalex100 Sitologi Sputum\par\pard\ql \li6031\sb0\sl-253\slmult0
\par\pard\ql \li20\sb2\sl-253\slmult0 \up0 \expndtw-3\charscalex100 Dokter Spes
ialis Paru\par\pard\qj \li20\ri2177\sb3\sl-251\slmult0 \up0 \expndtw-3\charscale
x100 Dokter bedah torak, bila dilakukan operasi; \line \up0 \expndtw-3\charscale
x100 Dokter radiologi bila dilakukan radioterapi\par\pard\qj \li6031\sb0\sl-251\
slmult0 \par\pard\qj \li20\ri1472\sb4\sl-251\slmult0\tx155 \up0 \expndtw0\charsc
alex101 Rawat inap, bila dilakukan pembedahan dan \line\tab \up0 \expndt
w-3\charscalex100 kemoterapi\par\pard\ql \li75\sb3\sl-253\slmult0 \up0 \expndtw3\charscalex100 KU jelek\par\pard\ql \li10271\sb0\sl-276\slmult0 \par\pard\ql \l
i10271\sb0\sl-276\slmult0 \par\pard\ql \li10271\sb0\sl-276\slmult0 \par\pard\ql
\li4260\sb176\sl-276\slmult0 \up0 \expndtw-3\charscalex100 \ul0\nosupersub\cf1\f
2\fs24 18 \par\pard\sect\sectd\fs24\paperw12240\paperh15840{\shp
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\pard\sb0\sl-240{\bkmkstart Pg19}{\bkmkend Pg19}\par\pard\ql \li8284\sb0\sl-276\
slmult0 \par\pard\ql\li8284\sb175\sl-276\slmult0 \up0 \expndtw-3\charscalex100 \
ul0\nosupersub\cf1\f2\fs24 Panduan Praktik Klinis \par\pard\li2016\sb0\sl-253\sl
mult0\par\pard\li2016\sb213\sl-253\slmult0\fi0\tx2532\tx5724\tx6084 \dn2 \expndt
w0\charscalex100 \ul0\nosupersub\cf3\f4\fs22 8.\tab \dn2 \expndtw0\charscalex100
Terapi\tab \dn2 \expndtw0\charscalex100 :\tab \up0 \expndtw0\charscalex100 Pemb
edahan ;\par\pard\li2016\sb1\sl-246\slmult0\fi4067 \up0 \expndtw0\charscalex100
Kemoterapi\par\pard\li2016\sb3\sl-253\slmult0\fi4067 \up0 \expndtw0\charscalex10
0 Radioterapi\par\pard\li2016\sb0\sl-253\slmult0\par\pard\li2016\sb5\sl-253\slmu
lt0\fi0\tx2532\tx5724\tx6084 \up0 \expndtw0\charscalex100 9.\tab \up0 \expndtw0\
charscalex100 Standard RS\tab \up0 \expndtw0\charscalex100 :\tab \up0 \expndtw0\
charscalex100 Tipe C dan B\par\pard\li2016\sb0\sl-253\slmult0\par\pard\li2016\s
b252\sl-253\slmult0\fi0\tx2532\tx5724\tx6084 \up0 \expndtw0\charscalex100 10.\ta
b \up0 \expndtw0\charscalex100 Penyulit\tab \up0 \expndtw0\charscalex100 :\tab \
up0 \expndtw0\charscalex100 Batuk darah ;\par\pard\li2016\sb1\sl-246\slmult0\fi4

067 \up0 \expndtw0\charscalex100 Pleural Effusion :\par\pard\li2016\sb3\sl-253\s

lmult0\fi4067 \up0 \expndtw0\charscalex100 Metastase\par\pard\li2016\sb0\sl-253\
slmult0\par\pard\li2016\sb3\sl-253\slmult0\fi0\tx2532\tx5724\tx6084 \up0 \expndt
w0\charscalex100 11.\tab \up0 \expndtw0\charscalex100 Inform Concent ( tertulis)
\tab \up0 \expndtw0\charscalex100 :\tab \up0 \expndtw0\charscalex100 Perlu\par\p
ard\li2016\sb0\sl-253\slmult0\par\pard\li2016\sb0\sl-253\slmult0\par\pard\li2016
\sb1\sl-253\slmult0\fi0\tx2532\tx5724\tx6084 \up0 \expndtw0\charscalex100 12.\ta
b \up0 \expndtw0\charscalex100 Tenaga Standar\tab \up0 \expndtw0\charscalex100 :
\tab \up0 \expndtw0\charscalex100 Dokter Umum\par\pard\li2016\sb1\sl-246\slmult0
\fi4067 \up0 \expndtw0\charscalex100 Dokter Spesialis Paru\par\pard\li2016\sb0\s
l-253\slmult0\par\pard\li2016\sb7\sl-253\slmult0\fi0\tx2532\tx5724\tx6084 \dn2 \
expndtw0\charscalex100 13.\tab \dn2 \expndtw0\charscalex100 Lama Perawatan\tab \
dn2 \expndtw0\charscalex100 :\tab \up0 \expndtw0\charscalex100 Tidak terbatas/ t
idak dapat ditentukan\par\pard\li2016\sb0\sl-253\slmult0\par\pard\li2016\sb252\s
l-253\slmult0\fi0\tx2532\tx5724\tx6084 \dn2 \expndtw0\charscalex100 14.\tab \dn2
\expndtw0\charscalex100 Masa Pemulihan\tab \dn2 \expndtw0\charscalex100 :\tab \
up0 \expndtw0\charscalex100 -\par\pard\li2016\sb0\sl-253\slmult0\par\pard\li2016
\sb252\sl-253\slmult0\fi0\tx2532\tx5724\tx6084 \dn2 \expndtw0\charscalex101 15.\
tab \dn2 \expndtw0\charscalex101 Output\tab \dn2 \expndtw0\charscalex101 :\tab \
up0 \expndtw0\charscalex101 Komplikasi\par\pard\qj \li6084\ri5025\sb0\sl-260\slm
ult0 \up0 \expndtw-3\charscalex100 Metastase \line \up0 \expndtw-3\charscalex100
Meninggal \par\pard\li2016\sb241\sl-253\slmult0\fi0\tx2532\tx5724\tx6156 \up0 \
expndtw-1\charscalex100 16.\tab \up0 \expndtw-1\charscalex100 PA\tab \up0 \expnd
tw-1\charscalex100 :\tab \up0 \expndtw-1\charscalex100 a.\ul0\nosupersub\cf4\f5\
fs22 \ul0\nosupersub\cf3\f4\fs22 Karsinoma Squamosa\par\pard\ql \li6156\sb1\s
l-245\slmult0 \up0 \expndtw-4\charscalex100 b.\ul0\nosupersub\cf4\f5\fs22 \ul0\
nosupersub\cf3\f4\fs22 Karsinoma Sel Kecil \par\pard\ql \li6156\sb1\sl-238\slm
ult0 \up0 \expndtw-3\charscalex100 c.\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersu
b\cf3\f4\fs22 Adeno Karsinoma \par\pard\ql \li6156\sb10\sl-253\slmult0 \up0 \e
xpndtw-4\charscalex100 d.\ul0\nosupersub\cf4\f5\fs22 \ul0\nosupersub\cf3\f4\fs2
2 Karsinoma Sel Besar \par\pard\li2016\sb0\sl-253\slmult0\par\pard\li2016\sb12
\sl-253\slmult0\fi0\tx2532\tx5724\tx6084 \up0 \expndtw0\charscalex103 17.\tab \u
p0 \expndtw0\charscalex103 Autopsi /Risalah Rapat\tab \up0 \expndtw0\charscalex1
03 :\tab \up0 \expndtw0\charscalex103 -\par\pard\ql \li10271\sb0\sl-276\slmult0
\par\pard\ql\li10271\sb0\sl-276\slmult0 \par\pard\ql\li10271\sb0\sl-276\slmult0
\par\pard\ql\li10271\sb0\sl-276\slmult0 \par\pard\ql\li10271\sb0\sl-276\slmult0
\par\pard\ql\li10271\sb0\sl-276\slmult0 \par\pard\ql\li10271\sb0\sl-276\slmult0
\par\pard\ql\li10271\sb0\sl-276\slmult0 \par\pard\ql\li10271\sb0\sl-276\slmult0
\par\pard\ql\li10271\sb0\sl-276\slmult0 \par\pard\ql\li10271\sb0\sl-276\slmult0
\par\pard\ql\li10271\sb0\sl-276\slmult0 \par\pard\ql\li10271\sb0\sl-276\slmult0
\par\pard\ql\li10271\sb0\sl-276\slmult0 \par\pard\ql\li10271\sb0\sl-276\slmult0
\par\pard\ql\li10271\sb0\sl-276\slmult0 \par\pard\ql\li10271\sb0\sl-276\slmult0
\par\pard\ql\li10271\sb0\sl-276\slmult0 \par\pard\ql\li10271\sb62\sl-276\slmult0
\up0 \expndtw-5\charscalex100 \ul0\nosupersub\cf1\f2\fs24 19 \par\pard\sect\sec
td\fs24}