Karakteristik pasien paska stroke dengan spastisitas yang diterapi dengan injeksi toksin botulinum di rumah sakit Siloam Karawaci Tangerang

Luih, Brigitta Stephanie (2023) Karakteristik pasien paska stroke dengan spastisitas yang diterapi dengan injeksi toksin botulinum di rumah sakit Siloam Karawaci Tangerang. Diploma thesis, Universitas Pelita Harapan.

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Abstract

Latar Belakang: Stroke adalah penyebab kematian tertinggi di seluruh dunia dan merupakan penyebab utama keempat hilangnya produktivitas (disability-adjusted life) menurut WHO. Terdapat dua jenis stroke, stroke iskemik menyumbang 85% dari seluruh kasus stroke, sedangkan stroke hemoragik menyumbang 15% kasus. Spastisitas diperkirakan terjadi pada 20-40% dari semua kasus stroke dimana hingga 97% dari mereka menderita gangguan motorik sedang hingga berat yang memuncak pada 1-3 bulan setelah stroke. Secara klinis, spastisitas paska stroke dikenali sebagai adanya peningkatan refleks tonus otot yang bergantung pada kecepatan dengan sentakan tendon yang berlebihan sehingga terjadi hipereksitabilitas sehingga mengganggu pemulihan fungsional ekstremitas. Toksin botulinum yang di produksi oleh Clostridium botulinum memiliki fitur biologis dan toksibiologikal yang penting untuk menjadi terapi gangguan pada saraf dan gangguan kesehatan lainnya. Spastistas paska stroke yang diinjeksi dengan toksin botulinum dapat menurunkan komplikasi dan memperbaiki fungsi motorik pada spastisitas ekstremitas atas dan bawah. Tujuan Penelitian: Mengetahui karakteristik pasien paska stroke dengan spastisitas yang diinjeksi dengan toksin botulinum. Metode: Penelitian ini dilakukan dengan menggunakan desain studi deskriptif dengan metode retrospektif non-probabilitas purposif. Data diperoleh dengan menggunakan 52 data rekam medis pasien dengan spastisitas paska stroke yang diterapi dengan injeksi tokin botulinum di Rumah Sakit Umum Siloam Karawaci Tangerang. Hasil: Hasil penelitian ini menunjukkan bahwa karakteristik pasien paska stroke dengan spastisitas yang diterapi dengan injeksi toksin botulinum di Rumah Sakit Umum Siloam Karawaci Tangerang, yaitu kelompok usia terbanyak adalah ≥ 55 tahun (63,5%), didominasi oleh jenis kelamin laki-laki (36,5%), 96% diantaranya mendertia stroke iskemik, 75% pasien telah menderita stroke >3 tahun, dengan lokasi stroke terbanyak pada subkortikal (76,9%). Kebanyakan pasien menerima injeksi pada 1 anggota tubuh (67,3%), dengan mayoritas dosis injeksi diberikan ≤100 U (69,2%) dan skala MAS ringan yaitu <3 (53,8%) setelah menerika injeksi toksin botulinum. Kata kunci: stroke, spastisitas paska stroke, injeksi toksin botulinum. Referensi:100 / Background: Stroke is the highest leading cause of death worldwide and is the fourth leading cause of loss of productivity (disability-adjusted life), according to WHO. There are two types of strokes, ischemic stroke accounts for 85% of all stroke cases, while hemorrhagic stroke accounts for 15% of cases. Spasticity is estimated to be present in about 20-40% of all stroke survivors, where up to 97% of them suffer moderate to severe motor impairment which peaks at 1-3 months after stroke. Clinically, post-stroke spasticity is recognized as a velocity-dependent increase in tonic stretch reflexes with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex which impairs functional recovery of the extremities. Botulinum toxin produced by Clostridium botulinum has important biological and toxibiological features to be used as a therapy for neurological disorders and other health problems. Injection of botulinum toxin in post-stroke spasticity patients can reduce complications and improve motor function in upper and lower extremities. Research Objectives: This study aims to determine the characteristics of post-stroke spasticity patients who were injected with toxin botulinum. Research Methods: This research was conducted using a retrospective descriptive study design with a non-probability purposive sampling method. Data was obtained using 52 medical records of patients with post-stroke spasticity who were treated with injection of botulinum toxin at Siloam Hospital Lippo Village. Results: The results of this study indicate that the characteristics of post-stroke patients with spasticity who were treated with botulinum toxin injection at Siloam Karawaci Tangerang General Hospital, namely the most age group was ≥ 55 years (63.5%), dominated by male sex (36, 5%), 96% of them suffered from ischemic stroke, 75% of patients had suffered a stroke >3 years, with the most stroke locations is subcortical (76.9%). Most patients received injections in 1 limb (67.3%), with the majority of injection doses being ≤100 U (69.2%) and mild MAS scale of <3 (53.8%) after receiving botulinum toxin injection.Keywords: Stroke, post-stroke spasticity, injection of toxin botulinum. References: 100

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