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Apa itu TB ( TUBERCULOSIS )
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APA ITU TB(TUBERCULOSIS)

 

TB adalah penyakit menular yang disebabkan oleh bakteri Mycobacterium Tubercolusis. Penyakit Tuberkolusis bukanlah hal baru, secara umum kita sudah mengenal penyakit ini. TB bukanlah penyakit keturunan, dan TB dapat disembuhkan dengan pengobatan yang tepat, lengkap dan teratur.

Penyakit ini dapat menyerang bukan saja pada dewasa, anak-anak bahkan bayi tergolong rentang terhadap penyakit ini sistem kekebalan tubuh yang belum sempurna, kualitas gizi yang buruk, dan orang dewasa penderita TB sebagai sumber penular merupakan salah satu penyebab anak-anak rentan terhadap infeksi TB.

Berdasarkan organ yang terserang. TB dapat dibedakan menjadi :

1. TB Paru, umumnya lebih banyak dijumpai.

2. TB Ekstra Paru, khususnya TB kelenjar getah bening sering dijumpai, yang paling sering terinfeksi adalah kelenjar getah bening di daerah leher, ketiak maupun lipatan paha.

Dengan jumlah penduduk lebih dari 200 juta jiwa, Indonesia termasuk peringkat ketiga setelah India dan China dalam jumlah penderita diantara 22 negara dengan masalah TB terbesar di dunia.

 

 

BAGAIMANA PENULARAN TB

Penderita TB dapat menularkan penyakitnya pada saat bersin atau batuk, bakterj tersebar ke udara melalui percikan dahak dan dapat bertahan di udara pada suhu kamar dalam beberapa jam. Individu di sekitar dapat terinfeksi apabila dahak yang emngandung bakteri tersebut terhirup dalam saluran pernafasan.

Umumnya bakteri ini menyerang organ paru-paru dan sebagian kecil pada organ tubuh lainnya. Bakteri ni di paru-paru berkembang biak membentuk kelompok sehingga jaringan paru-paru mengalami peradangan. Dari hasil pemeriksaan rogent thorax, akan terlihat sebagai bercak-barcak putih.

 

APASAJA GEJALA KLINIS TB

Gejala klinis TB adalah :

-Batuk berdahak + / - 3 minggu atau lebih (tidak sembuh setelah pengobatan penyebab batuk lainnya),

-Batuk darah atau pernah batuk darah,

-Demam lama atau berulang tanpa sebab jelas,

-Sesak napas dan nyeri dada,

-Berat badan terus turun tanpa sebab jelas dan tidak naik meski sudah mengkonsumsi gizi yang baik, .

-Rasa kurang enak badan,

-Berkeringat malam walau tanpa kegiatan,

-Pembesaran kelenjar limfe (seringkali didaerah leher, ketiak, lipatan paha).

 

BAGAIMANA MENDIAGNOSA TB

 

Untuk mendiagnosa TB harus dilakukan pemeriksaan dahak dengan miskroskop. seorang dipastikan menderita TB bila dalam dahaknya terdapat kuman TB.
Dahak yang diambil adalah dahak sewaktu-Pagi-Sewaktu :
1. Pada waktu datang pertama kali untuk periksa ke unit pelayanan kesehatan, disebut daha,k 5ewaktu pertama (S),
2. Dahak diambil pada pagi hari berikutnya segera setelah bangun tidur, kemudian dibawa dan diperiksa di unit pelayanan kesehatan, disebut dahak Pagi (P).
3. Dahak diambil di unit pelayanan kesehatan pada saat  penyerahan dahak pagi, disebut dahak sewaktu kedua (S).
Pemeriksaan Penunjang :
@ Tes mantoux / tuberkuli
Dilakukan dengan menyuntikkan PPD pada daerah kulit lengan bawah. Dinilai berdasarkan timbulnya reaksi alergi setelah penyuntikan PPD tersebut, hasil positif ditandai timbulnya warna kemerahan disertai penebalan pada kulit di daerah bekas suntikkan (diameter +/- 10mm atau lebih).
@ Laju endap darah
Pemeriksaan dilakukan melalui darah. Pemeriksaan ini tidak khusus untuk TB saja, tetapi juga untuk penyakit infeksi lainnya. Nilai pemeriksaan umumnya meningkat
@ Fungsi hati (`Ssgot`/sgpt`)
Untuk mengetahui efek samping pemakaian obat TB, mengingat obat-obat TB berpotensi merusak sel-sel hati.
@ Rontgent thorax
Merupakan pemeriksaan umum dilakukan untuk TB, ditandai adanya bercak putih di paru. Juga untuk mengetahui luas jaringan paru yang telah rusak dan ringan beratnya TB yang diderita.
 
BAGAIMANA PENGOBATAN TB
 
TB diobati dengan dua tahap pengobatan, yaitu : tahap awal (intensif) dan tahap lanjutan, lama pengobatan 6-9 bulan, tergantung berat ringannya penyakit. Penderita harus minum obat secara lengkap dan teratur sesuai jadual berobat sampai dinyatakan sembuh. Dilakukan tiga kali pemeriksaan ulang dahak untuk mengetahui perkembangan kemajuan pengobatan, yaitu pada akhir pengobatan tahap awal, sebulan sebelum akhir pengobatan dan pada akhir pengobatan.Salah satu faktor berpengaruh pada keberhasilan pengobatan TB adalah kesadaran penderita selama proses pengobatan yakni motivasi hidup sehat dan kepatuhan pemakaian obat.
 
Banyak penderita yang tidak patuh terhadap pengobatan, misalnya disebabkan jangka waktu pengobatan yang relatif lama, jumlah obat cukup banyak, dan ukuran obat relatif besar.Penderita TB yang telah menjalani terapi 2 bulan, akan menunjukan perbaikan gejala klinis, namun banyak penderita yang berfikir bahwa gejala klinisnya sudah tidak ada, menganggap sudah sembuh. Penghentian dari jangka waktu seharusnya dapat menimbulkan resistensi terhadap obat TB dan pada akhirnya menimbulkan kerugian bagi penderita dan lingkungan terutama individu yang rentang
 
Penderita TB membutuhkan makanan yang mengandung banyak protein untuk mempercepat perbaikan sel-sel yang rusak dan jaringan yang rusak karena TB. Makanan tinggi protein ini diperlukan untuk membantu obat TB bekerja efektif dalam tubuh. Untuk bisa sampai ke jaringan, obat harus berikatan dengan senyawa albumin (salah satu kandungan dalam protein) untuk dapat bekerja sampai ke sel-sel jaringan tubuh yang rusak ,untuk memperbaikinya. Bila kandungan protein kurang, albumin kurang, proses penyembuhan terhambat.
 
Pengobatan TB pada anak sama dengan pada dewasa, yakni membutuhkan waktu 6-9 bulan. Sama seperti pada dewasa , pada anak-anak pun tanda terinfeksi bakteri ini dapat dilihat dari pemeriksaan rogent thorax yang ditandai bercak putih. Jika diobati dengan tepat dan segera, disertai perbaikan gizi anak, bercak tersebut akan berkurang bahkan hilang dalam waktu 6-9 bulan, bila tidak, maka kerusakan jaringan paru-paru akan meluas, dan lebih jauh dapat menimbulkan batuk berdahak serta kematian pada anak.
 
Mengurangi resiko terinfeksi TB dapat dilakukan dengan upaya menjaga kesehatan tubuh dan lingkungan, misalnya : mengatur rumah agar memperoleh cahaya matahari karena bakteri ini cepat mati dengan sinar matahari langsung, mengkonsumsi makanan bergizi, tidak meludah /bersin/batuk sembarangan.
 
Beberapa hal yang perlu dipahami penderita TB, antara lain:
1. Pemakaian obat yang cukup lama (6-9 bulan).
2. Kepatuhan mengkonsumsi obat sangat berpengaruh terhadap kesembuhan,
3. Pengobatan dipengaruhi pula oleh konsumsi gizi yang baik khususnya protein,
4. Masalah lingkungan tempat tinggal penderita yang sehat dan kebisaan hidup sehat.

Pengobatan segera, kepatuhan selama proses pengobatan, dan menjaga kesehatan tubuh dan lingkungan, merupakan langkah¬langkah yang dapat kita lakukan dalam memutus penularan TB di lingkungan sekitar kita.

APA AKIBATNYA BILA MINUM OBAT TIDAKTERATUR

Bila minum obat tidak teratur akan mengakibatkan:
@ Penyakit tidak akan sembuh bahkan menjadi lebih kuat,
@ Penderita tetap dapat menularkan penyakitnya pada orang lain,.
@ Penyakit menjadi semakin sukar diobati karena ada kemungkinan bakteri TB menjadi kebal, sehingga diperlukan obat yang lebih kuat dan lebih mahal. Obat untuk kuman yang kebal tidak tersedia di semua fasilitas kesehatan,
@ Perlu waktu lebih lama untuk sembuh,
@ Penderita dapat juga menularkan kuman yang sudah kebal obat pada orang lain.
 
 

 


 

 

 
 

 


Published in : Penyakit Dalam, Penyakit Paru-paru
Keywords : sgpt
Apa itu TB ( TUBERCULOSIS )
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