Bruera E
J Pain Symptom Manage. 1990 Oct;5(5):287-96. doi: 10.1016/0885-3924(90)90045-l.
Until recently, patients who required hydration or parenteral administration of narcotics or antiemetics remained in hospitals until death. The period of admission, which varied between days and months, resulted in a decreased quality of life for the patient and family. With the development of portable infusion pumps, patients with these needs can now be safely discharged home for long periods of time, thereby significantly reducing the cost of medical care and improving quality of life for patients and families. The demonstration that the subcutaneous route is safe and effective for the administration of narcotics, antiemetics, and fluids has made home discharges particularly easy and simple. New devices even allow patients to self-administer extra doses of narcotics when needed. Each institution needs to carefully consider the different infusion devices available before starting a home parenteral administration program. The most important factors to consider are cost, health professional education, patient and family education, a system of monitoring in the home and safety. The high cost of portable pumps and supplies are a major obstacle for the establishment of large programs for home parenteral drug administration. More research is needed to better characterize the pharmacokinetics of different drugs when administered subcutaneously, and to develop simpler and more effective portable infusion devices. The results of this research will have a major impact on the quality of life of patients and their families.
直到最近，那些需要补液或通过胃肠外途径给予麻醉药或止吐药的患者一直留在医院直至死亡。住院时间从几天到几个月不等，这降低了患者及其家属的生活质量。随着便携式输液泵的发展，有这些需求的患者现在可以安全地长期出院回家，从而显著降低医疗成本，提高患者及其家属的生活质量。皮下途径用于给予麻醉药、止吐药和液体既安全又有效的这一证明，使得患者出院回家变得格外容易和简单。新设备甚至允许患者在需要时自行额外注射麻醉药。每个机构在启动家庭胃肠外给药项目之前，都需要仔细考虑现有的不同输液设备。需要考虑的最重要因素是成本、医护人员教育、患者及其家属教育、家庭监测系统和安全性。便携式泵和耗材的高昂成本是建立大型家庭胃肠外给药项目的主要障碍。需要进行更多研究，以更好地描述不同药物皮下给药时的药代动力学特征，并开发更简单、更有效的便携式输液设备。这项研究的结果将对患者及其家属的生活质量产生重大影响。
