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8/14/2019 referat Karsinoma-Nasofaring(1)
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REFERAT
KARSINOMA NASOFARING
Disusun Oleh :
Antonius Silalahi (07 - )
Putu Gede Ary Sanjaya (07 - )
Myske Mona Tresnalia Bakara (07 !7")
KEPANITERAAN KLINIK ILMU PENYAKIT THT
PERIODE 9 JULI 4 AGUSTUS 2012
FAKULTAS KEDOKTERAN
UNIVERSITAS KRISTEN INDONESIA
JAKARTA
1
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DAFTAR ISI
KATA PENGANTAR..3
I. PENDAHULUAN.4
II TINJAUAN PUSTAKA...5
A. DEFINISI..5
B. EPIDEMIOLOGI DAN ETIOLOGI.5
C. ANATOMI DAN FISIOLOGI NASOPHARING9
D. GEJALA DAN TANDA KNF.12
E. PATOFISIOLOGI KARSINOMA NASOFARING...13
F. DIAGNOSIS...15
G. DIAGNOSIS BANDING18
H. STADIUM..20
I. KOMPLIKASI21
J. PENATALKSANAAN...23
K. PENCEGAHAN..29
III. PENUTUP.30
A. KESIMPULAN...30
B. SARAN...30
DAFTAR PUSTAKA..312
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KATA PENGANTAR
S!"#" $%&' (") *+%,%- ,"' $")&"/,") ,"('-") T%") ")! M"" E*" +")! /#"
)#)! (") -,"/' ,"' )+#*"',") --"/ ')' ()!") "',. T")$" $-/#)!") D'"
%)!,') ,"' /'(", ",") *")!!%$ )+#*"',") ')' ()!") "',. R-"/ ')' ('*%*%) *"!"'
*+"-"/ %)/%, )!',%/ %&'") *#"') '/% "!"- $"" ("$"/ $-#%"* '#% /)/")!
KARSINOMA NASOFARING6 +")! ,"' *"&',") -("*"-,") $)!""/") ("-' -"!"'*%- +")! "(".
R-"/ ')' %"/ /)/")! KARSINOMA NASOFARING +")! *")!"/ -""+" "!'
,*"/") **-")!. K"' &%!" )!%"$,") /-'" ,"*' ,$"(" (*) $'')! THT
+"'/% (-. S%(&"-7"('6 S$. THT KL +")! /#" '')! ,"' "!"- ("$"/ )!-/' /)/")!
"!"'")" "-" ,"' )+%*%) --"/ (") )!-/' /)/")! '#% (' '(")! THT.
S!" --"/ ')' ("$"/ -',") 7"7"*") +")! #' #%"* ,$"(" $""."#"%$%) --"/ ')' '#',' ,#'") (") ,,%-")!"). K"' ) %)/%, *"-") (")
,-'/',)+". T-'" ,"*'.
J","-/"6 1: J%#' 2012
P)+%*%)
3
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8/14/2019 referat Karsinoma-Nasofaring(1)
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#'$%/' (')'*'6 ")"/' '*'#!' )"*"-')!6 $'('#!' (") /'#!'6 !&"#" (") /")("6
$"/'*'#!'6 ('"!)*'*6 ,$#',"*'6 /-"$' "%$%) $)!"")+". P)%#'* -%*"" %)/%,
)%#'*,") *%" "*$, /-*%/ ("#" /')&"%") $%*/"," -"-"/ ')' (") ('"-"$,") ("$"/
-")""/.
II TINJAUAN PUSTAKA
A. DEFINISI
C"-')" "("#" $-/%%") "-% +")! !")"* /-('-' ("-' *#*# $'/#'"# +")!
)(-%)! )!')'#/-"*' &"-')!") *,'/"-)+" (") )'%#,") /"*/"*'*.
;DORLAND.2002-/-" ->'"#'* I (") II
F"*'" *$" -)!!" +")! -'*' &"-')!") #)!!"
M%,*" #")&%/") ("-' %,*" "/"*
L"/-"# %,*" #")&%/") ("-' %,*" "/"* (") #",")!
M%"-" /%" %*/"''
F**" -*)%##-'
9
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Bangunan yang penting paa na!"p#a$ing
O*/'% /%" %*/"'' $"-* $"-+)!"#
T%" %*/"'' -%$",") ,")"# +")! )!%%)!,") ,">% )"*' ("))"*$"-+)! ()!") -)!!" /#')!" /)!". M%,*" */'% /%" /'(", ("/"- //"$'
)) *$-/' )"-"6 ('*%/ /-%* /%"-'%*.
T-%* /%"-'%*
F**" -*) %##-'
A("#" ("/"-") ,'# ('#",")! /-%* /%"-'%*. D"-" ')' -%$",") /$"/
$-('#,*' ,"-*')" )"*"-')!6 *%"/% /%- +")! "/',") )- 1 (' THT.
F-)' )"*"-')!
A("#" ("/"-") ('*#" "/"* /-%* /%"-'%*6 -%$",") /$"/ /%-
")!''-" )"*$"-')!
10
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A()'( /)*'# $"-+)!"##%*,"
S"-" /-'/'* "()'( ",") '#")! */#" $%-/"* ,"-)" "(")'( ",") )"$"' /'/',
$/'"# $"(" %%- 1214 /"%). L,"*' $"(" (')(')! *%$-'- (") (-*"# )"*$"-')!
*#" #"/-"# %-*" $"-+)!". F%)!*')+" *"!"' ,")'* $-/"")") /%%
/-"("$ ,%") ,%") +")! #7"/ &"#") )"$"* '(%)!.
N"*$"-')! ",") /-/%/%$ '#" $"#"/% ## #,"/ , (')(')! $*/-'- $"(" 7",/%
)#")6 %)/"6 )!%"$,") ,"/","/" /-/)/% *$-/' ",.
F%)!*' )"*$"-')!
S"!"' &"#") %("-" $"(" -*$'-"*'
J"#") %("-" , /%" %*/"''
R*)"/-
S"!"' (-"')"! *')%* $"-")"*"# ,">% /'$")' (") '(%)!
S-/ ("-' )"*$"-')! ("$"/ -!-", , "7" ,"-)"
11
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G"+" !-">'/"*'
G-",") )#")
G-",") *'#'" ;,')*'#'"'-%* *')!!" *# ,"#' )&"(' )-"# "/"% ("$"/ /-&"('
/-")*-"*' *# +"'/% ')/-",*' ")/"-" *# (") >'-%* *')!!" )!",'"/,") /-&"(')+"
14
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$-%"") *'"/ *# *')!!" /-&"(' /-")*-*' *# )&"(' !")"* *')!!" /-)/%, *#
,"),-.
G) EB +")! (',*$-*',") $"(" $)(-'/" KNF "("#" !) #"/)6 +"'/% EBER*6
EBNA16 LMP16 LMP2A (") LMP2B. P-/') EBNA1 -$-") ("#" $-/""),")
>'-%* $"(" '),*' #"/). P-/') /-")*-") LMP2A (") LMP2B )!""/ *')+"#
/+-*') ,')"* +")! ('$-"+" ("$"/ )!""/ *',#%* #'/', >'-%*. D'")/"-" !)!)
/-*%/6 !) +")! $"#')! -$-") ("#" /-")*-"*' *# "("#" !) LMP1. S/-%,/%-
$-/') LMP1 /-('-' "/"* 3:8 "*" "') +")! /-"!' )&"(' 20 "*" "') $"(" %&%)!
N6 : *!) $-/') /-")*-") ;1:: "*" "')< (") 200 "*" "') $"(" %&%)!
,"-,*' ;C )) (")
'#',' "!-!"*' "'#'"#. A)"#'*'* ,-#"*' )%)&%,,") !) HLA ;%") #%,+/
")/'!)< (") !) $)!( )' *'/,- $450 2E1 ;CP2E1< ,%)!,')") "("#" !)
,-)/")") /-"("$ ,"-*')" )"*"-')!. S'/,- $450 2E1 -/")!!%)! &"7" "/"*
",/'>"*' /"#', +")! /-,"'/ )'/-*"') (") ,"-*')!)
3< F",/- #')!,%)!")
S&%#" *"- */%(' ,"*%* +")! ('#",%,") $"(" $$%#"*' +")! -"(" (' -"!"'
("-" (' "*'" (") "-'" %/"-"6 /#" (',)'-"*',") "7" ',") "*') (") ",")") #"')
+")! "7/,") )!")(%)! *&%#" *"- )'/-*('/+"') ;NDMA
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F. DIAGNOSIS
J'," ('/%,") "(")+" ,%-'!"") +")! )!"-" $"(" *%"/% ,"-*')" )"*"-')!6 $-/,#
('"7" ')' ("$"/ ")/% %)/%, )!",,") ('"!)*'* $"*/' *-/" */"('% /%-
1. A)")*'* $-',*"") '*',
A)")*'* -("*"-,") ,#%") +")! ('-"*",) $"*') ;/")(" (") !&"#" KNF*',%#-6 -)/%, >"# "/"%
%#"/ ()!") )%,##' +")! "*. P"(" %%)+" "/"* *# /'(", /-#'"/ ()!")
"*.
T'$ /")$" ('-)*'"*' (") /")$" ,-"/')'*"*' $%)+"' *'"/ +")! *""6 +"'/% -*'"/
-"('*)*'/'. S(")!,") &)'* ()!") ,-"/')'*"*' /'(", !'/% -"('*)*'/'. K#"*'',"*'
!""-") '*/$"/#!' /-"-% +")! ('-,)("*',") # HO $"(" /"%) 19916
")+" ('"!' "/"* 2 /'$6 +"'/%
K"-*')" *# *,%"*" -,-"/')'*"*' ;Keratinizing Squamous Cell
Carcinoma
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P*'*' L"/-"# ()!") /,)', / %)/%, &"-')!") #%)", ;soft tissue
tec"nique-/,*
T!-" L"/-"# ("-" )"*"-')!
T!-") A)/-$*/-'- ("-" )"*"-')!
'% C.T.S(an
P"(" %%)+" KNF +")! ("$"/ ('(/,*' *"-" "* ()!") -"('!-"' $#*
"("#" &'," /%- /-*%/ %,%$ *"- (") ,*'/',6 *(")!,") %#" ,'#
%)!,') /'(", ",") /-(/,*'. T-#'#' &'," $-#%"*") /%- "("#"
*%%,*"6 "," "# ')' ",") *%,"- ('#'"/ ()!") $-',*"") -"('!-"' $#*.
D','") $%#" &'," $)+"-") , &"-')!") *,'/"-)+" #% /-#"#% #%"* ",")
/-("$"/ ,*%,"-"),*%,"-") ("#" )(/,*' "# /-*%/. K%)!!%#") C.T.
S") ('")(')!,") ()!") / $#* '"#" ,"$%")+" %)/%, (",")
-"""" ()*'/"* $"(" ("-" )"*"-')!6 "', '/% $"(" &"-')!") #%)",
"%$%) $-%"")$-%"") $"(" /%#")!6 !)!") -'/-'" /-/)/% ("$"/ (')'#"'
*%"/% /%- )"*"-')! +")! "*' ,'#. S#"') '/% ()!") #' ",%-"/ ("$"/
(')'#"' $"," *%(" "(" $-#%"*") /%- , &"-')!)" *,'/"-)+"6 )'#"' "("
/'(",)+" (*/-%,*' /%#")! *-/" "(" /'(",)+" $)+"-") ')/-"-")'"#.
A(" -"$" $*'*' ()!") / $#* +")! $-#% ('%"/ ("#" )"-'
,%)!,')" "(")+" /%- $"(" ("-" )"*"-')! +"'/%
P*'*' L"/-"# ()!") /,)', / %)/%, &"-')!") #%)", ;soft tissue
tec"nique-/,*
T!-" L"/-"# ("-" )"*"-')!
18
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T!-") A)/-$*/-'- ("-" )"*"-')!
:. P-',*"") )%-/"##!'
K"-)" )"*"-')! -%%)!") (,"/ ()!") -)!!" /)!,-", #"#%' -"$" #")!6
"," !")!!%") -"$" *"-" /", ("$"/ /-&"(' *"!"' !&"#" #")&%/ KNF ')'.
. P-',*"") *-#!'.
P-',*"") *-#!' I!A ")/' EA ;"-#+ ")/'!)< (") '!A ")/' CA ;"$*'( ")/'!)'-%* EB /#" )%)&%,") ,"&%") ("#" )(/,*' ,"-*')"
)"*"-')!. T&,- S/'+ ("-' FK UI J","-/" )("$"/,") ("-' 41 $"*') ,"-*')"
)"*"-')! */"('% #")&%/ ;*/"('% III (") I< *)*/'>'/"* I!A CA "("#" 965= (")
*$*''/"* 9168= ()!") /'/- -,'*"- ")/"-" 10 *"$"' 1280 ()!") /-")+", /'/- 1:0.
I!A ")/' EA *)*'/'>'/"*)+" 100= //"$' *$*''/"*)+" ")+" 3060=6 *')!!"
$-',*"") ')' ")+" ('!%)",") %)/%, )/%,") $-!)*'* $)!"/")6 /'/- +")!
('($"/ -,'*"- ")/"-" 80 *"$"' 1280 (") /-")+", 1:0.
G. DIAGNOSIS BANDING
1. H'$-$#"*'" "()'(
B'"*")+" /-("$"/ $"(" ")",")",6 &"-)"! $"(" -")! (7"*"6 $"(" ")",")",
+$-$#"*'" ')' /-&"(' K"-)" '),*' -%#")!. P"(" / $#* ",") /-#'"/ *%"/% "**"
&"-')!)" #%)", $"(" ""/"$ )"*"-')! %%)+" -"/"* /!"* (") %%)+" *'/-'* *-/"
*/-%,/%-*/-%,/%- *,'/"-)+" /", /"$", /")(" /")(" ')'#/-"*' *$-/' /"$", $"("
,"-*')".
2. A)!''-" &%)'#'*
B"'*")+" ('/%' $"(" %*'" -#"/'> %(" ()!") !&"#"!&"#" )+-%$"' KNF.
T%- ')' ,"+" ",") $%#% ("-" (") '"*)+" /'(", ')'#/-"/'>. P"(" / $#* ",")
19
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('("$"/ *%"/% "**" $"(" "/"$ )"*"'-)! +")! -"/"* /!"*. P-** ("$"/ #%"*
*$--/' $"(" $)+"-") ,"-*')"6 7"#"%$%) &"-")! )'%#,") (*/-%,*' /%#")!
")"+ -*' *"&" ,"-)" $),")") /%-. B'"*")+" "(" $#)!,%)!") , "-" ($") ("-'
(')(')! #",")! *')%* ",*'#"-'*+")! (',)"#* !"' antral sign. K"-)" /%- ')' ,"+"
",") >"*%#"- "," "-/-'!-"' "-/'* ,*/-)" *")!"/ ('$-#%,") *" !""-")+"
*")!"/ ,"-",/-'*/',. K"(")!,"(")! *%#'/ $%#" (",") ")!''-" &%>)'#*
()!") $#'$ '(%)! $"(" / $#*.
3. T%- *')%* *$)'("#'*
T%- !")"* $-'- *')%* *$)'("#'* "("#" *")!"/ &"-")! (") '"*")+" /%-
*%(" *"$"' */"('% "!", #")&%/ 7",/% $"*') ("/')! %)/%, $-',*"") $-/"".
4. N%-'-"
K#$, /%- ')' *-')! /'%# $"(" -%")! "-')! #"/-"# *')!!" )+-%$"'
,!")"*") ('()(')! #"/-"# )"*"-')!. *"-" C.T. S")6 $)(*",") -%")! $"-" "-')!
," -" ('"# ("$"/ ")/% (",") ,#$, /%- ')' ()!") KNF.
5. T%- ,#)&"-- $"-/'*
T%- ,#)&"- $"-/'* /-%/"" +")! -"*"# ("-' #%* +")! /-#/", "!", ("#"
)!)"' -%")! $"-" "-')! (") )) ,"-" #%) )"*"-')!. $"(" *"!'") *"-
,"*%* /-#'"/ $)(*",") -%")! $"-""-')! ," -" ('"# +")! /"$", $"("
$-',*"") C.T.S").
:. C-("
"#"%$%) /")(" %/"" -(" "("#" (*/-%,*' /%#")!6 //"$' )!')!"/ KNF
$%) *-')! )'%#,") (*/-%,*' /%#")!6 "," *-')! /'%# ,*%#'/") %)/%,
(",")+". D)!") / $#*6 ("$"/ ('#'"/ ,"#*'',"*' "/"% (*/-%,*' /-%/"" ('
20
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8/14/2019 referat Karsinoma-Nasofaring(1)
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M1 T-("$"/ /"*/"* &"%.2636913
B-("*"-,") TNM /-*%/ (' "/"*6 */"('% $)+",'/ ("$"/ ('/)/%,")
S/"('% I T1 N0 M0
S/"('% II T2 N0 M0
S/"('% III T3 N0 M0
T16T26T3 N1 M0
S/"('% I T4 N06N1 M0
T'"$ T N26N3 M0
T'"$ T T'"$ N M12
M)%-%/ A-'") J')/ C'// C")- /"%) 19886 /%- */"!')! ("-'
)"*"-')! (',#"*'',"*',") *"!"' -',%/
T'* C"-')" ') *'/%
T1 T%- +")! /-("$"/ $"(" *"/% *'*' ("-' )"*"-')! "/"% /%- +")! /", ("$"/ ('#'"/6 //"$'
")+" ("$"/ (',/"%' ("-' "*'# '$*'.
T2 T%- +")! )+-")! (%" /$"/6 +"'/% (')(')! $*/-*%$-'- (") (')(')!#"/-"#.
T3 P-#%"*") /%- *"$"' , ("#" -)!!" '(%)! "/"% -"-')!.
T4 T%- +")! )&"#"- , /)!,-", ,$"#" "/"% )+-")! *"-" -")'"# ;"/"% ,(%")+"
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A(")+" ,#%$%") *"-" /", "(")+" ,-%*",") /%#")! /)!,-",
A(")+" /"*/"*'* &"%
J. KOMPLIKASI
1. P/-*$)'( *')(-
T%- /%% , "/"* , ("*"- /)!,-", #7"/ -") #"*-% *"$"' *')%*
,">-)*%* ),") *"-" N. III6 N. I6 N.I &%!" ),") N.II. +")! -',")
,#"')")
N%-"#!'" /-'!')%* ; N. < T-'!')"# )%-"#!'" -%$",") *%"/% )+-' $"("
7"&" **'*' +")! ('/")("' ()!") -"*" *$-/' /-,)" "#'-") #'*/-', +")! /-"/"*
$"(" ("-" ('*/-'%*' ("-' )->%* /-'!')%*.
P/*'* $"#$-" ; N. III ",%#">",%#" +")! ,"'-)+" -",'"/ *# ",") "/' (") )!'#")!. P"(" *%"/% ,!")"*")
('/")("' # '/*'* *# +")! -#'") */"('% $-"* '/*'* -%$",") */"('% +")!
$"#')! -)/") /-"("$ -"('"*'. D"-" )"*"-')! (") *,'/"-)+" +")! #'$%/' *" *--'('"6 ,") (") ("-" $"-""-')! *$-/'!" #- "!'") "/"*. D"-"("-" #"'))+" +")!
('#')(%)!' ()!") #, /'". A-" $)+')"-") ("-' #"/-"# ,")") (") ,'-'6 ,%"#' '#" "("
$)+-")!") ,-)!!" '(%)! (") *')%* $"-")"*"# "," $-#% $)""") #"$")!") -"('"*' ("-'
($"). P"(" $)(-'/" ()!") */"('% +")! "*' /-"/""* ;T16T2
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D*'* -"('"*' %%)+" -,'*"- ")/"-" :000 000 -"(6 ("#" 7",/% : ')!!% ()!")
$-'( '*/'-""/ 2 3 ')!!% ;?*$#'/ (*@#/"!@-/>#/"!@
R*$) -"('"*'
S/#" ('-',") -"('"*'6 "," ('#",%,") >"#%"*' -%$" -*$) /-"("$ -"('"*'. R*$)
(')'#"' ("-' $)!'#") ,#)&"- !/" )')! #- (") $)!'#") /%- $-'- (' )"*"-')!.
P)'#"'") -*$) -"('"*' -("*"-,") ,-'/-'" HO
C$#/ R*$)* )!'#")!,") *#%-% ,#)&"- !/" )')! +")! *"-.
P"-/'"# R*$)* $)!'#") ,#)&"- !/" )')! *"$"' 50= "/"% #'.
N C")! %,%-") ,#)&"- !/" )')! +")! )/"$. P-!-**'> D'*"* %,%-") ,#)&"- !/" )')! *"- 25= "/"% #'.
K$#',"*' -"('/-"$' ("$"/ -%$"
"< K$#',"*' (')'
B'"*")+" /-&"(' *#"" "/"% -"$" ')!!% */#" -"('/-"$'6 *$-/'
-*/'" M%"#%)/"
M%,*'/'* ;)+-' /#")6 %#%/ ,-')!6 (") '#")!)+" '/" -"*"< ,"(")!
('$-$"-" ()!") '),*' &"%- $"(" %,*" #'(" (") $"#"/%
A)-,*'
-*/"'" ;,,-')!") %,*" %#%/ ",'"/ ('*%)!*' ,#)&"- $"-/'*
+")! /-,)" -"('"*'") /'(", ("$"/ ('-',") !'/% *"&" //"$' '#',' ')(',"*' +"'/% '#"
*/#" )("$"/ /-"$' %/"")+" +")! ",*'"# /-)+"/"
,"),-)+" "*' "("6 ('")" '$*' "*' $*'/'
,%)!,')") *"- ,"),-)+" "*' "("6 *,'$%) /'(", "(" %,/' *"-" ",-*,$'*.
$"(" /%- ()!") (-"&"/ ,!")"*") /')!!' ; # ,"-)" /')!!')+" -*', ,,"%")
(") /"*/"*'* &"%
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3. post definiti$e c"emot"erapy ;*"!"' /-"$' /""") $"*," $("") (") "/"%
radiasi )
E, S"$')! K/-"$'
A!) ,/-"$' /'(", ")+" )+-")! *# /%- /"$' &%!" *# )-"# +")! #"
*"-" $"/ *$-/' *# -"%/6 *%*% /%#")! (") S# $"(" /-",/%* !"*/- ')/*/')"#. A,'"/
+")! /'%# '*" -%$" $-("-"")6 ($-*' *%*% /%#")! +")! %(",") /-&"(')+"
'),*'. P"(" /-",/%* !"*/- ')/*/')"# '*" /-&"(' %"#6 %)/" ")-,*'" (") %#*-"*' *"#%-")
-)". S(")!,") $"(" *# -"%/ )!",'"/,") ,-)/,") -"%/. J"-')!") /%% )-"#
+")! $"/ $-#'-"*' '*"#)+" *%*% /%#")!6 #',# -"%/6 %,*" *"#%-") $)-)"")
%(" /-,)" , "/ *'/*/"/',". U)/%)!)+" *# ,"),- )&"#")' *',#%* #' #"" ("-' *#
)-"#6 *')!!" ("$"/ #' #"" ('$)!"-%' # *'/*/"/'," (") *# )-"# #' $"/ $%#'
("-' $"(" *# ,"),-
E, *"$')! +")! %)%# $"(" &")!," $")&")! "("#" /,*'*'/"* /-"("$ &")/%)!6 +")!
("$"/ ('>"#%"*' ()!") EKG (") /,*'*'/"* $"(" $"-% -%$" ,-)', '-*'* $"(" $"-%.
T,*'*'/"* $"(" $"- (") !')&"# #' *-')! /-&"(' (") *"',)+" ('>"#%*' %)!*' ""# $"-
(") ""# !')&"#)+". K#"')") )%-#!' &%!" -%$",") *"#" *"/% , *"$')! $-'")
,/-"$'.
K-"('/-"$' ,')"*' "("#" $-'") ,/-"$' -*""") ()!") -"('/-"$' ("#"
-")!," )!)/-# /%- *"-" #,-!')"# (") )')!,"/,") sur$i$al $"*') ()!") "-"
)!"/"*' *# ,"),- *"-" *'*/', #7"/ ',-*'-,%#"*'.
M")""/ K-"('/-"$' "("#"
1. M)!'#,") "**" /%-6 ,"-)" ()!") )!'#,") /%- ",") -',") "*'#
/-"$' -"('"*' #' ,/'. T#" (',/"%' "7" $%*"/ /%- /-'*' *# '$,*', (")
-"('/-"$' ,)>)*')"# /'(", ,/' &'," /'(", /-("$"/ ,*'!). P)!%-")!") "**"
/%- ",") )+",") $%#" -,%-")!)+" &%#" *# '$,*'".
2. M)!)/-# /"*/"*'* &"% (") )!)/-# ',-/"*/"*.
28
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3. M('',"*' #,%# DNA # ,/-"$' )+",") *# #' *)*'/' /-"("$
-"('"*' +")! ('-',") ;-"('*)*'/'*-
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B-"$" #'/-"/%- )+"/",") "7" $-'") ,/-"$' *"-" -*""") ()!")
-"('"*' ()!") *+"-"/ (*'* -"('"*' /'(", /-#"#% -"/ (") &"(7"# $-'") /'(", ('$-$")&")!6
"," *"',)+" !%)",") -!') ,/-"$' +")! *(-")" **%"' &"(7"# $-'").
U)/%, )!%-")!' , *"$')! ("-' ,-"('/-"$' ('-',") ,/-"$' /%)!!"# ;single
agent c"emot"erapy< (*'* -)(" ()!") /%&%") ,%*%* %)/%, )')!,"/,") *)*'/'>'/"* *#
,"),- /-"("$ -"('/-"$' ;-"('*)*'/'-",*') *$*'', -") !#',$-/') >'-%* E$*/') B"--
+")! ('%-)',") $"(" $)(%(%, +")! -/$"/ /')!!"# (' ("-" ()!") -*', /')!!'.
M')(",") ;'!-"*'< $)(%(%, ("-' ("-" -*', /')!!' , /$"/ #"'))+".
P)-")!") ",") ,'"*"") '(%$ +")! *"#"6 )!%" "-" "*", ",")") %)/%,
)!" ",'"/ +")! /'%# ("-' "")"") +")! -""+".
P)+%#%") )!)"' #')!,%)!") '(%$ +")! /'(", *"/6 )')!,"/,") ,"("") **'"#
,)' (") -"!"' "# +")! -,"'/") ()!") ,%)!,')"),%)!,')") ",/-
$)+".
30
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M#",%,") /* *-#!', I!A ")/' CA (") I!A ")/' EA *"-" "**"# (' "*" +")! ",")
("/")! -")""/ ("#" )%,") ,"-*')" )"*"-')! *"-" #' (')'.
PENUTUP
I. KESIMPULAN
K"-*')" )"*"-')! -%$",") /%- !")"* )- *"/% +")! "/',") (")
)$"/' %-%/") , 10 ("-' *#%-% /%- !")"* (' /%%.
B")+", ",/- +")! ('(%!" -%%)!") ()!") KNF6 +"'/%
;1
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