Studi Penggunaan Laktulosa Pada Pasien Sirosis Hati dengan Hepatik Ensefalopati Di RSUD Iskak Tulungagung

Cirrhosis is a chronic liver injury characterized by serious damage to normal liver tissue that becomes abnormal as a result of increased fibrosis and the formation of regenerative nodules in liver structures that can interfere with the synthetic function of the liver. Hepatic encephalopathy is one of the common neurological complications of cirrhosis which is estimated to occur in 30-70% of patients with liver cirrhosis. Hepatic encephalopathy is defined as brain dysfunction caused by hepatic insufficiency and/or porto-systemic shunt that manifests as a wide spectrum of neurological or psychiatric disorders ranging from subclinical changes to coma. Management of hepatic encephalopathy is primarily focused on reducing blood ammonia concentrations through drug therapy aimed at inhibiting ammonia production. Non-absorbable disaccharides such as lactulose as the first line of therapy cause recovery in 70-90% of HE patients.
Objective: This study aims to determine the pattern of using lactulose as a therapy for hepatic encephalopathy in liver cirrhosis patients at the Iskak Tulungagng Hospital for the period January-December 2022.
Method: An observational study with a retrospective and descriptive approach with a time limit sampling method in liver cirrhosis patients with hepatic encephalopathy for the period January-December 2022.
Results and Conclusions: The Health Medical Record samples that met the inclusion criteria were 60 patients. The pattern of the use of single lactulose therapy was 20 patients (34%), while the combination was 40 patients (66%). The pattern of using single lactulose therapy was the most (3x10cc) po as many as 18 patients (30%). The pattern of using combination lactulose therapy was the combination of lactulose (3x10 cc) po + (BCAA 12.5g) iv as many as 33 patients (55%). The pattern of using lactulose is in accordance with guidelines.