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"ABSTRAKLatar BelakangPenelitian ini membahas tentang hubungan antara posisi kerja berdiri dengan varises tungkai pada perawat perempuan. Kejadian varises tungkai diduga berkaitan dengan posisi kerja berdiri dan lebih sering terjadi pada perempuan (dalam populasi umumnya) serta berdampak cukup besar secara ekonomi pada perusahaan untuk pengobatan penyakit ini.TujuanTujuan penelitian ini untuk mengetahui prevalensi varises tungki di kalangan perawat perempuan dan mengetahui hubungan antara posisi kerja berdiri dengan kejadian varises tungkai serta status demografi seperti umur, riwayat varises dalam keluarga, status gizi, penggunaan KB hormonal, jumlah anak dan lama kerja pada perawat perempuan di RS X.MetodePenelitian ini dilakukan dengan menggunakan metode potong lintang. Data yang dikumpulkan pada bulan Maret-April 2016. Subyek penelitian 171 orang perawat perempuan di RS X yang dipilih berdasarkan kriteria inklusi. Data dikumpulkan dengan wawancara, pemeriksaan fisik tungkai bawah dan observasi posisi kerja berdiri selama waktu bekerja.HasilPrevalensi varises tungkai sebanyak 63,16%. Masa kerja (ORa=4,84 95%CI= 1,67-14,01), lokasi kerja (ORa=4,02 95%CI= 1,82-8,89) dan jumlah anak lebih dari satu (ORa=3,60 95%CI=1,13-11,43) merupakan faktor dominan terhadap kejadian varises tungkai.KesimpulanPrevalensi varises tungkai pada perawat perempuan adalah 63,16%. Jumlah anak dan masa kerja menjadi faktor dominan terhadap kejadian varises tungkai. Bagi karyawan yang menderita varises tungkai disarankan melakukan modifikasi gaya hidup untuk memperbaiki kualitas hidup dengan cara melakukan elevasi tungkai pada saat beristirahat, mengurangi berat badan dengan diet tinggi serat dan olah raga teratur serta menghindari posisi berdiri statis yang terlalu lama. Pencegahan primer terhadap semua derajat varises dengan menggunakan stoking kompresi.

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ABSTRACT

Background

This study discussed about correlation between standing work position and varicose veins in female nurses. Varicose veins was assumed to be associated with long standing work positions which risks in women are higher than men. Varicose veins also contributed in company budgeting for the treatment.

Purpose

Focus on this study was to know about prevalence of varicose veins in female nurses in hospital and correlation between standing work positions, ages, family history of varicose veins, nutrient, hormonal contraseptives, number of children, places of works and years of services.

Method

This study was held in one of hospital with design of study was cross sectional survey. Data were collected to 171 respondents from March to April 2016 which choosen by inclution criteria; by interviewed, leg physical examination and observation of standing work positions.

Result

There was 63,16% prevalence of varicose veins. Years of services (ORa=4,84 95%CI= 1,67-14,01), places of work (ORa=4,02 95%CI= 1,82-8,89) and has more than one children (ORa=3,60 95%CI=1,13-11,43) are dominant factors of varicose veins.

Conclusion

The prevalence of varicose veins in female nurses are 63,16%. Years of services, places of work and number of children are suggested to be dominant factors in varicose veins. Employees that have varicose veins are suggested to modified their life style to improved quality of life condition such as elevated leg at rest, reduce weight by consumpt high fiber diet, regularly exercise and avoid long standing position in long period. Primary prevention in all degree of varicose veins are using pressure stocking."

"Kejadian varises vena banyak terjadi pada profesi perawat. Salah satu faktor penyebabnya adalah akibat berdiri lama. Saat berdiri lama terjadi peningkatan tekanan vena dan disfungsi katup-katup vena yang dapat menimbulkan varises vena. Penelitian ini merupakan penelitian cross-sectional yang melibatkan 92 perawat poliklinik sebagai responden. Instrumen yang digunakan adalah kuesioner yang dimodifikasi dari kuesioner penelitian Tuchsen (2005) serta dilakukan pemeriksaan varises vena dengan Venous Clinical Severity Score (VCSS). Hasil penelitian menunjukkan bahwa 70.7% responden menunjukkan aktivitas berdiri lama dan 72.8% responden mengalami varises vena. Hasil uji chi-square menunjukkan adanya hubungan antara berdiri lama dengan kejadian varises vena dengan p value = 0.001 (OR= 9.051). Deteksi dini varises vena pada perawat perlu dilakukan untuk menekan peningkatan prevalensi varises vena.

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Incidence of varicose veins often occurs on outpatient nurse. Prolonged standing at work is associated with a high prevalence of varicose veins. In the standing position, the venous and capillary pressures increases and damages function of venous valves can leads to incidence of varicose veins. This study was a cross-sectional study that used 92 outpatient nurses for the sample. The instrument of this research was a questionnaire modified from a Tuchsen’s questionnaire (2005) and lower extremity examination using Venous Clinical Severity Score (VCSS).

The result shows that 70.7% of respondents indicated a prolonged standing activity and 72.8% of respondents experienced varicose veins on the lower limbs. The results of chi-square test shows the relationship between prolonged standing and the incidence of varicose veins on the lower limbs with the p value = 0.001 (OR = 9,051). Early detection varicose veins on nurses needs to be done to decrease prevalence of varicose veins."

"Laser telah menjadi teknologi yang bermanfaat dalam tatalaksana inkompetensi katup vena terutama pada vena-vena superfisial. Ablasi termal endovena menggunakan teknologi laser yang dipandu oleh ultrasonografi memberikan alternatif terapi selain tindakan bedah vena saphena. Tingkat keberhasilan yang tinggi, komplikasi kecil, dan teknik invasif minimal merupakan kelebihan dari teknik ini dibandingkan dengan pengobatan terdahulu. Pada ilustrasi kasus ini, kami jabarkan terapi laser endovena untuk pengobatan varises vena saphena magna. Pengembangan terapi laser endovena masih diperlukan,melalui pemantauan jangka panjang dan sistem pelaporan yang seragam maka hal ini dapat terwujud.

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Laser has become a useful technology in treating venous incompetence especially superficial venous disease. Introduction of endovenous thermal ablation through endovenous laser therapy helped by duplex ultrasound guidance has provided an alternative for traditional saphenous vein stripping. High success rate, minor complications, and minimally invasive technique provide the advantages over traditional treatment. In this case illustrated, the endovenous laser therapy used for great saphenous varicose vein. Yet, future development in endovenous laser therapy is still needed and only long term follow-up and uniform reporting standards will provide the answers."

"ABSTRAK Latar belakang Tindakan ablasi endovenous untuk varises tungkai di Indonesia mulai dikerjakan tahun 2010 EVLT dikerjakan di RSCM tahun 2013 dan MOCA dikerjakan di RSUP Fatmawati tahun 2014 Belum ada evaluasi terhadap rekanalisasi pasca tindakan MOCA dan EVLT di Indonesia Metode Studi ini merupakan penelitian deskriptif analitik dengan desain cross sectional Subjek pasca MOCA atau EVLT dengan rentang waktu 3 18 bulan pasca tindakan diwawancara dan dilakukan pemeriksaan USG vaskular pada tungkai yang dioperasi untuk menilai rekanalisasi Data sekunder praoperasi diambil dari rekam medis Dicari karakteristik klinis subjek membandingkan kecenderungan rekanalisasi pasca tindakan MOCA dan EVLT dicari hubungan antara karakteristik klinis subjek dengan kejadian rekanalisasi Data diolah dengan SPSS ver 20 0 Hasil Didapatkan 43 sampel tungkai terdiri dari 24 tungkai pasca MOCA dan 19 tungkai pasca EVLT Karakteristik subjek MOCA terbanyak usia 7 mm 13 19 tungkai Pada MOCA rekanalisasi total didapatkan 2 24 dan partial 8 24 tungkai sedangkan pada EVLT rekanalisasi total 1 19 dan partial 3 19 tungkai Hubungan antara karakteristik klinis subjek dengan kejadian rekanalisasi p 0 05 Kesimpulan Kecenderungan rekanalisasi MOCA lebih tinggi dibandingkan EVLT Tidak ada hubungan bermakna antara karakteristik klinis subjek dengan kejadian rekanalisasi secara statistik namun diameter terbesar VSM 7 mm sebelum operasi secara proporsional lebih tinggi MOCA 3 4 tungkai dibandingkan EVLT 3 13 tungkai ABSTRACT Background Endovenous ablation for varicose vein of the limb in Indonesia has been done since 2010 EVLT has been done in RSCM since 2013 and MOCA in RSUP Fatmawati in 2014 There has not any evaluation been done for recanalization post MOCA and EVLT procedure in Indonesia Method This study was descriptive analytic with cross sectional design Subjects post MOCA or EVLT with time span 3 18 months post procedure are interviewed and USG vascular examination is done on operated limb in order to evaluate the recanalization Secondary data pre surgery are taken from medical records Clinical characteristics of the subjects are seek comparing possibility of recanalization post MOCA and EVLT procedure in order to see the correlation between clinical characteristics of subjects and recanalization Data is treated using SPSS ver 20 0Results Forty three samples were collected consists of 24 extremities post MOCA samples and 19 extremities post EVLT samples Most subjects on MOCA group were 7mm were 13 19 extremities On MOCA group total recanalization were 2 24 extremities and partial were 8 24 extremities EVLT group total recanalization were 1 19 extremities and partial were 3 19 extremities Relationship between subjects clinical characteristics with recanalization event p 0 05 Conclusion Recanalization tendency in MOCA is higher compared to EVLT There is no statistically significant assosiation between clinical characteristic of the subjects and recanalization but the highest diameter VSM 7 mm pre surgery proportionally is higher in MOCA 3 4 extremities compared to EVLT 3 13 extremities ;Background Endovenous ablation for varicose vein of the limb in Indonesia has been done since 2010 EVLT has been done in RSCM since 2013 and MOCA in RSUP Fatmawati in 2014 There has not any evaluation been done for recanalization post MOCA and EVLT procedure in Indonesia Method This study was descriptive analytic with cross sectional design Subjects post MOCA or EVLT with time span 3 18 months post procedure are interviewed and USG vascular examination is done on operated limb in order to evaluate the recanalization Secondary data pre surgery are taken from medical records Clinical characteristics of the subjects are seek comparing possibility of recanalization post MOCA and EVLT procedure in order to see the correlation between clinical characteristics of subjects and recanalization Data is treated using SPSS ver 20 0Results Forty three samples were collected consists of 24 extremities post MOCA samples and 19 extremities post EVLT samples Most subjects on MOCA group were 7mm were 13 19 extremities On MOCA group total recanalization were 2 24 extremities and partial were 8 24 extremities EVLT group total recanalization were 1 19 extremities and partial were 3 19 extremities Relationship between subjects clinical characteristics with recanalization event p 0 05 Conclusion Recanalization tendency in MOCA is higher compared to EVLT There is no statistically significant assosiation between clinical characteristic of the subjects and recanalization but the highest diameter VSM 7 mm pre surgery proportionally is higher in MOCA 3 4 extremities compared to EVLT 3 13 extremities ;Background Endovenous ablation for varicose vein of the limb in Indonesia has been done since 2010 EVLT has been done in RSCM since 2013 and MOCA in RSUP Fatmawati in 2014 There has not any evaluation been done for recanalization post MOCA and EVLT procedure in Indonesia Method This study was descriptive analytic with cross sectional design Subjects post MOCA or EVLT with time span 3 18 months post procedure are interviewed and USG vascular examination is done on operated limb in order to evaluate the recanalization Secondary data pre surgery are taken from medical records Clinical characteristics of the subjects are seek comparing possibility of recanalization post MOCA and EVLT procedure in order to see the correlation between clinical characteristics of subjects and recanalization Data is treated using SPSS ver 20 0Results Forty three samples were collected consists of 24 extremities post MOCA samples and 19 extremities post EVLT samples Most subjects on MOCA group were 7mm were 13 19 extremities On MOCA group total recanalization were 2 24 extremities and partial were 8 24 extremities EVLT group total recanalization were 1 19 extremities and partial were 3 19 extremities Relationship between subjects clinical characteristics with recanalization event p 0 05 Conclusion Recanalization tendency in MOCA is higher compared to EVLT There is no statistically significant assosiation between clinical characteristic of the subjects and recanalization but the highest diameter VSM 7 mm pre surgery proportionally is higher in MOCA 3 4 extremities compared to EVLT 3 13 extremities "

"Latar Belakang: Dalam diagnosis varises vena tungkai bawah (VVTB), venous clinical severity score (VCSS) merupakan alat bantu diagnosis VVTB yang praktis, cepat, dan dapat dikerjakan oleh semua tenaga kesehatan termasuk perawat. Hingga saat ini belum ada peneliti yang melakukan validasi eksterna penilaian VCSS yang dikerjakan oleh perawat di Indonesia.Tujuan: Mengetahui tingkat ketepatan metode skor VCSS oleh perawat dibandingkan dengan komponen klinis (C) klasifikasi clinical-etiology-anatomy-pathophysiology (CEAP) oleh dokter spesialis bedah vaskular.Metode: Studi cross-sectional ini mengikutsertakan 63 orang perawat instalasi bedah pusat RS Dr. Cipto Mangunkusumo tanpa varises sebelum menjadi perawat sebagai sampel yang diambil secara consecutive Penilaian VCSS dilakukan dengan komponen klinis klasifikasi CEAP sebagai pembanding. Variabel dianalisis dengan uji Chi-square, dilanjutkan dengan uji nilai sensitivitas, spesifisitas, nilai duga positif (NDP), nilai duga negatif (NDN), likelihood ratio dan akurasi skor diagnostik, termasuk analisis uji diagnostik menggunakan indeks Youden.Hasil: Prevalensi VVTB pada studi ini berdasarkan skor VCSS adalah 9,5%. Korelasi antara klasifikasi CEAP dan VCSS ditemukan bermakna (p<0,05). Derajat VVTB antara klasifikasi CEAP dan VCSS berhubungan secara signifikan (p <0,05). Pada cut-offVCSS 2 didapatkan nilai sensitivitas 66,67%, spesifisitas 66,67 %, NDP 32,0%, NDN 89,47%, likelihood ratio (+) sebesar 2,00, likelihood ratio (-) sebesar 0,50, dan akurasi 66,67%.Kesimpulan: Skor VCSS memiliki akurasi lemah terhadap komponen klinis (C) klasifikasi CEAP untuk menegakkan diagnosis VVTB.

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Background: In the diagnosis of lower leg varicose veins (LLVV), the venous clinical severity score (VCSS) is practical, fast, and can be done by all health workers including nurses. Until now there has been no researcher who has conducted external validation of the VCSS assessment carried out by nurses in Indonesia.

Aim: To determine the accuracy of the VCSS scoring method by nurses compared to clinical component (C) of the clinical-etiology-anatomy-pathophysiology (CEAP) classification by vascular surgeons.

Method: This cross-sectional study included 63 nurses at the central surgical installation of Cipto Mangunkusumo Hospital without varicose veins before becoming a nurse as a consecutive sample. The VCSS assessment was carried out with the clinical component of CEAP classification as a comparison. Variables were analyzed by the Chi-square test. Followed by testing the value of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), likelihood ratio, and accuracy of diagnostic scores, along with the ROC analysis using Youden Index.

Results and Discussion: The prevalence of LLVV in this study is 9,5%. Bivariate analysis of CEAP and VCSS has a significant correlation (p <0,05). The degree of LLVV with CEAP and VCSS is related significantly (p <0,05). With VCSS cut off at scores of 2, the sensitivity is 66.67%, the specificity is 66.67%, the PPV is 32,0%, the NPV is 89.47%, the positive and negative likelihood ratio are 2.00 and 0.50, and the accuracy value is 66.67%.

Conclusion: The VCSS score has weak level of accuracy against the clinical component (C)  of CEAP classification for diagnosing VVTB."

"Latar Belakang: Penderita sirosis hati sering mengalami gangguan sistem hemostasis yang kompleks dan komplikasi perdarahan akut varises gastroesofageal. Peran gangguan sistem hemostasis dalam perdarahan akut varises gastroesofageal penderita sirosis hati masih belum jelas.Tujuan: Mengetahui perbedaan jumlah trombosit, nilai PT, nilai APTT dan kadar protein C penderita sirosis hati yang mengalami dan yang tidak mengalami perdarahan akut varises gastroesofageal. Metode: Penelitian ini merupakan studi potong lintang pada penderita sirosis hati. Subjek penelitian diperoleh dari penderita yang berobat di RS Cipto Mangunkusumo, Jakarta. Seluruh penderita dilakukan pemeriksaan jumlah trombosit, nilai PT, nilai APTT dan kadar protein C. Penderita dengan gejala perdarahan akut saluran cerna bagian atas dilakukan pemeriksaan Esofago-Gastro-Duodenoskopi EGD. Diagnosis perdarahan akut varises gastroesofageal ditentukan dari hasil pemeriksaan EGD. Untuk mengetahui perbedaan jumlah trombosit, nilai PT, nilai APTT dan kadar protein C penderita sirosis hati yang mengalami dan yang tidak mengalami perdarahan akut varises gastroesofageal dipakai uji T indepedent dan uji Mann-Whitney. Hasil: Terdapat total 63 penderita sirosis hati yang ikut serta dalam penelitian, 21 penderita mengalami perdarahan akut varises gastroesofageal dan 42 penderita tidak mengalami perdarahan akut varises gastroesofageal. Perbedaan jumlah trombosit penderita sirosis hati yang mengalami perdarahan dan yang tidak mengalami perdarahan akut varises gastroesofageal mempunyai nilai p>0,05. Jumlah trombosit.

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Background Patients with liver cirrhosis have complex hemostatic system disturbances and acute gastroesophageal varices bleeding frequently. The role of hemostatic system disturbances in acute gastroesophageal varices bleeding has not been yet clear in liver cirrhosis.Objective To know the difference of thrombocyte count, PT, APTT and protein C level in liver cirrhosis patients with and without acute gastroesophageal varices bleeding.

Methods: This was a cross sectional study. Patients with liver cirrhosis were enrolled from Cipto Mangunkusumo Hospital, Jakarta. All patients underwent examination for thrombocyte count, PT, APTT and protein C level. Patients with acute upper gastrointestinal bleeding underwent examination for esophago gastro duodenoscopy EGD. Diagnosis of acute gastroesophageal varices bleeding based on the result of EGD examination. To know the difference of thrombocyte count, PT, APTT and protein C level in liver cirrhosis patients with and without acute gastroesophageal varices bleeding, T independent test and Mann Whitney test were used for statistical analysis.

Results There are 63 patients with liver cirrhosis in this study, 21 patients with acute gastroesophageal varices bleeding and 42 patients without acute gastroesophageal varices bleeding. The difference of thrombocyte count in liver cirrhosis patients with and without acute gastroesophageal bleeding has p value 0,05. Thrombocyte count. "

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Latar Belakang: Penyakit insufisiensi vena merupakan kondisi terganggunya aliran balik darah dari tungkai menuju ke jantung. Kondisi ini dapat terjadi secara jangka panjang atau kronik sehingga sering dikenal sebagai chronic venous insufficiency (CVI).

Tujuan: Menganalisis dan membandingkan pengaruh penggunaan stoking kompresi selama 1 minggu dan 2 minggu pada pasien CVI pasca tindakan EVTA di RSUP Nasional Dr. Cipto Mangunkusumo Jakarta dan RS jejaring pendidikan.

Metode: Penelitian ini bersifat studi kohort.

Hasil: Populasi yang diambil adalah pasien yang berobat dari bulan Maret  –  Mei  2024 di RSCM dan RS jejaring. Distribusi komplikasi akut pasca pemasangan stoking kompresi selama 1 minggu dan 2 minggu. Iritasi kulit dialami oleh 3 orang (9,7%) pasien pada kelompok 1 dan 11 orang (37,9%) pada kelompok 2. Nyeri dialami oleh 9 orang (31%) pasien pada kelompok 1 dan pada 9 orang (29%) pasien pada kelompok 2. Edema hanya ditemukan pada kelompok 2 yaitu sebanyak 2 kasus (6,5%). Selanjutnya, hematoma dialami oleh 4 orang (13,8%) pasien pada kelompok 1 dan 4 orang (12,9%) pada kelompok 2 Hasil analisis bivariat mendapatkan bahwa jenis intervensi berpengaruh terhadap oklusi vena dengan  nilai odds ratio sebesar 1,203 (95% CI: 0,537 – 2,694) namun dengan nilai yang tidak signifikan berdasarkan uji Fischer’s Exact Test (p=0,77). Sebagai kesimpulan, penggunaan stoking kompresi selama 2 minggu tidak memiliki pengaruh yang bermakna dengan penggunaan selama 1 minggu saja. nilai korelasi sebesar -0,010 dengan nilai p=0,937. Nilai -0,01 termasuk dalam hubungan korelasi kuat (kurang dari 0,1).

Simpulan: Penggunaan stoking kompresi selama 2 minggu tidak memiliki pengaruh yang bermakna dengan penggunaan selama 1 minggu saja. nilai korelasi sebesar -0,010 dengan nilai p=0,937. Nilai -0,01 termasuk dalam hubungan korelasi kuat (kurang dari 0,1).

Kata kunci: Penyakit vena kronis,venous clinical severty score, medical compresi.

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Background: Venous insufficiency is a condition where the return of blood from the legs to the heart is disrupted. This condition can occur long-term or chronically so it is often known as chronic venous insufficiency (CVI).

Objective: This study will compare vein occlusion and Venous Clinical Severity Score (VCSS) in CVI patients after the EVTA procedure who were given compression therapy with stockings for one week compared with use for two weeks.

Methods: This research is a cohort study

Results:  The population taken were patients seeking treatment from March – May 2024 at RSCM and network hospitals. Distribution of acute complications after installation of compression stockings for 1 week and 2 weeks. Skin irritation was experienced by 3 (9.7%) patients in group 1 and 11 people (37.9%) in group 2. Pain was experienced by 9 (31%) patients in group 1 and 9 people (29%) patients in group 2. Edema was only found in group 2, namely 2 cases (6.5%). Furthermore, hematomas were experienced by 4 (13.8%) patients in group 1 and 4 people (12.9%) in group 2. The results of bivariate analysis showed that the type of intervention had an effect on vein occlusion with an odds ratio of 1.203 (95% CI : 0.537 – 2.694) but with a value that is not significant based on Fischer's Exact Test (p=0.77). In conclusion, the use of compression stockings for 2 weeks does not have a significant effect compared to use for just 1 week. The correlation value is -0.010 with a p value = 0.937. The value -0.01 is included in a strong correlation relationship (less than 0.1).

Conclusion: the use of compression stockings for 2 weeks does not have a significant effect compared to use for just 1 week. The correlation value is -0.010 with a p value = 0.937. The value -0.01 is included in a strong correlation relationship (less than 0.1).

Keywords: Chronic venous disease, venous clinical severity score, medical compression."