bronkie kt as is

BRONKIEKTASIS Sumardi SMF Paru Sub Bagian Pulmonologi Bagian IPD FK UGM/RS Dr. Sardjito

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Bronkie Kt as Is

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BRONKIEKTASIS

SumardiSMF ParuSub Bagian Pulmonologi Bagian IPD FK UGM/RS Dr. Sardjito

SINDROME BRONKIEKTASIS

Batuk kronis > 3 minggu Dahak campur darah Sesak nafas Riwayat TBC paru Sianosis Pulsasi epigastrik Auskultasi : ronkhi, krepitasi dibasal paru

DIAGNOSTIK

CXR : Honeycomb appearance dibasal paru (klasik)

Bekas TBC, sering honeycomb di apex paru dan medial

Gold standard: High Resolution CT Scan paru

PATOLOGI

Kelainan struktur anatomis bronkus diameter kurang dari 2 mm

Kerusakan jaringan elastis bronkus Terjadi ektasis/kantung pada dinding

bronkus Kelainan irreversibel Berlanjut memberat bila sering terjadi infeksi

KELAINAN STRUKTUR ANATOMIS

INFECTED BRONCHIECTASIS

Diferential Diagnosis

MANAJEMEN

Atasi infeksi : antibiotik Atasi perdarahan : koagulan Mukolitik : NAC, GG, OBH Drainage sputum: fisioterapi, postural drainage Diet tinggi protein, tinggi kalori, rendah gugus

karbon Chest exercise

MANAJEMEN (lanjut)

Oksigenasi kontinue 2-3 l/menit 12-16 jam per hari bila AGD PO2 <60; PCO2>40

Sildenafil, vardenafil 5-10 mg/hari Bosentan 3-4 kali sehari

KOMPLIKASI

Perdarahan hebat : operatif Korpulmonale Gagal nafas : asfiksi, sianosis berat

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