Kehnscherper H, Rudolph S, Freitag B
Klinikum Südstadt Rostock, Abteilung Biomedizintechnik.
Anaesthesiol Reanim. 2004;29(3):74-8.
Among the many technical appliances for pain therapy which are currently available, the use of implantable drug pumps for prolonged pain treatment is of increasing importance. Since this kind of pain therapy can be used without any problems outside the hospital, it improves the quality of life of the patient. Furthermore, it is combined with a reduction of side-effects which frequently occur when analgesics are given orally or parenterally in big single doses. High initial costs are compensated by a good cost-benefit ratio of this kind of pain treatment, which enables the use of analgesics in low doses in out-patients. Based on the use of gas mixtures which can be compressed repeatedly, implantable mechanically-driven pumps are a nearly inexhaustible propulsion unit for drug infusions. The development of new gas mixtures and of innovative control mechanisms allows greater independence from surrounding influences and higher precision regarding infusion rates. Mechanically-driven pumps are characterized by prolonged functioning and low cost of purchase. Therefore, they will continue to be available on the medical market in future. Special progress in cardiac pacemaker therapy as well as further miniaturization of portable infusion pumps with peristaltic propulsion have led to the development of programmed implantable pumps with lithium batteries as energy sources. The advantages of these pumps, particularly those with "externally" programmable infusion rates (continuous, bolus, periodical bolus, etc.) point to the future. With these devices, evacuation and refilling of the pumps due to necessary changes of drug concentrations, as has to be done with mechanically working pumps with fixed infusion rates, are no longer necessary. Therefore, these programmable pumps can also be used for infusion of drug concentrates. At present, however, high costs and the battery-dependent limited duration of functioning of these devices are disadvantageous. As with cardiac pacemakers, battery exchange is necessary. Using implantable drug pumps, relevant changes of body temperature and atmospheric pressure lead to more or less considerable deviations of the infusion rates. These deviations differ from product to product and can be studied in the informative material published by the manufacturer.
在目前可用的众多疼痛治疗技术设备中，可植入式药物泵用于长期疼痛治疗的重要性日益增加。由于这种疼痛治疗可在医院外毫无问题地使用，它提高了患者的生活质量。此外，它还能减少口服或大剂量非肠道给药镇痛药时经常出现的副作用。这种疼痛治疗良好的成本效益比弥补了高昂的初始成本，使得门诊患者能够使用低剂量的镇痛药。基于可反复压缩的气体混合物的使用，可植入式机械驱动泵几乎是药物输注的无穷动力源。新型气体混合物和创新控制机制的发展使设备更少受到周围环境影响，输注速率更精确。机械驱动泵的特点是功能持久且购置成本低。因此，它们未来将继续在医疗市场上供应。心脏起搏器治疗的特殊进展以及蠕动推进式便携式输液泵的进一步小型化促使了以锂电池为能源的程控植入式泵的发展。这些泵的优点，尤其是那些具有“外部”可编程输注速率（连续、推注、周期性推注等）的泵，指明了未来的方向。有了这些设备，由于药物浓度的必要变化而像固定输注速率的机械工作泵那样对泵进行排空和重新填充已不再必要。因此，这些程控泵也可用于输注药物浓缩液。然而，目前这些设备成本高昂且功能持续时间受电池限制，这是不利因素。与心脏起搏器一样，需要更换电池。使用可植入式药物泵时，体温和大气压力的相关变化会导致输注速率或多或少出现明显偏差。这些偏差因产品而异，可在制造商发布的资料中进行研究。
