Perbedaan Kualitas Hidup pada Penderita Refluks Laringofaring Sebelum dan Sesudah Pemberian Omeprazole di RSUP H. Adam Malik Medan

Abstract

Background: Laryngopharyngeal reflux disease has a negative impact on quality of life. The treatment of laryngopharyngeal reflux disease with PPIs may take up to 6 months. Omeprazole is one of the most commonly used PPIs. Objective: To find out the differences in quality of life of patients with laryngopharyngeal reflux before and after the administration of omeprazole. Methods: This study used a pre- and post-test design from May 2013 until March 2014 in which 36 samples were assessed for quality of life scores, RFI and RFS at 5 times of observations. Each subject was given omeprazole 20 mg twice daily before meals for 12 weeks. Results: 24 women (66.7%) and 12 men (33.3%) were obtained from 36 samples. The largest age groups were between 45-64 years old (50%) and most of them possessed higher education (52.5%). Patients with laryngopharyngeal reflux symptoms in this study mostly had normal weight (55.6%) with mean BMI = 26.1 ± 4.6. The most main complaint found was the sensation of mountainous lump within the throat (50%). The most common symptom was throat clearing (97.5 %). Ventricular obliteration and posterior commissure hypertrophy were the most common pathological signs of the larynx found (97.2%). There were significant differences between the mean RSI scores before treatment = 18.47 ± 4.35 and 3 months after treatment = 2.75 ± 2.36 (p=0.0001; p<0.05). Significant differences in the mean RSI scores were also obtained in each observation. There were significant differences between the mean RFS scores before treatment = 10.81 ± 2.73 and 3 months after treatment = 3.31 ± 1.31 (p=0.0001; p<0.05). Significant differences in the mean RFS scores were also obtained in each observation. The improvement of quality of life after treatment with omeprazole for 3 months were obtained as there were significant differences between the values of quality of life before treatment = 47.57 ± 8.93 and 3 months after treatment = 83.17 ± 6.16 (p=0.0001; p<0.05). Significant differences in the quality of life were also obtained in each observation. Conclusion : There were significant differences in the quality of life of patients with laryngopharyngeal reflux regarding the increased values of quality of life of patients after the administration of omeprazole.

Latar Belakang: Penyakit refluks laringofaring sangat penting untuk dikenali dimana jika tidak terdiagnosis dapat menurunkan kualitas hidup dan menjadi penyebab perkembangan penyakit-penyakit di traktus aerodigestif yang dapat mengancam nyawa. Tujuan: Mengetahui perbedaan kualitas hidup pasien penyakit refluks laringofaring sebelum dan sesudah pemberian omeprazole Metode: Penelitian ini menggunakan pre and post test design dari Mei 2013 hingga Maret 2014, terdapat 36 subjek penelitian yang dinilai skor kualitas hidup, RSI dan RFS pada 5 kali pengamatan. Setiap subjek diberikan omeprazole 20 mg dua kali sehari sebelum makan selama 12 minggu. Hasil: Dari 36 subjek penelitian ditemukan wanita sebanyak 24 subjek (66,7%) dan pria 12 subjek (33,3%). Kelompok umur yang terbanyak adalah kelompok umur 45-64 tahun (50%) serta lebih banyak penderita dengan pendidikan tinggi (52,5%). Penderita dengan gejala refluks laringofaring pada penelitian ini kebanyakan dengan berat badan normal sebesar 55,6%, dengan rerata BMI 26,1±4,6. Keluhan utama yang paling banyak ditemukan adalah rasa menganjal ditenggorokan sebesar 50%. Mendehem atau throat clearing merupakan gejala yang paling banyak ditemukan sebesar 97,2%. Ventikular obliterasi dan hipertrofi komisura posterior merupakan tanda patologis laring yang paling sering ditemukan yaitu 97,2%. Terdapat perbedaan yang signifikan antara rerata skor RSI sebelum terapi 18,47±4,35 dan rerata RSI sesudah terapi selama 3 bulan yaitu 2,75±2,36 (p=0,0001, p<0,05). Perbedaan rerata yang signifikan juga dijumpai pada skor RSI setiap pengamatan. Terdapat perbedaan yang signifikan antara rerata skor RFS sebelum terapi 10,81±2,73 menjadi 3,31±1,31 setelah pengobatan selama 3 bulan (p=0,0001, p<0,05). Perbedaan rerata skor RFS yang signifikan juga ditemui pada setiap pengamatan. Terdapat perbaikan kualitas hidup setelah pengobatan dengan omeprazole selama 3 bulan dimana terdapat perbedaan yang signifikan antara nilai kualitas hidup sebelum terapi 47,57±8,93 menjadi 83,17±6,16 (p=0,0001, p<0,05). Perbedaan kualitas hidup yang signifikan ini juga terlihat pada setiap pengamatan kualitas hidup. Kesimpulan: Terdapat perbedaan kualitas hidup penderita refluks laringofaring dengan peningkatan nilai kualitas hidup pasien setelah pemberian omeprazole.