JP2007117151A - Blood purifying column with pressure control means - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a method capable of suppressing the pressure rise of blood when performing treatment using a blood purifying column and damaging blood components. <P>SOLUTION: The blood purifying column 1 is composed of a cylindrical body 3, a first header 4 closing one end of the cylindrical body 3, a second header 5 closing the other end of the cylindrical body and an adsorbent 6 housed inside the cylindrical body. A pressure applied to the blood is controlled so as not to exceed a prescribed pressure by using a pressure measuring device connected through a tube 24. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

The present invention relates to a blood purification column used for extracorporeal circulation.

One of the blood purification treatments is treatment by extracorporeal circulation. The treatment by extracorporeal circulation has been actively implemented since the hemodialysis of acute renal failure treatment has been clinically performed, and various techniques have been developed for it. It is used. Treatment by extracorporeal circulation has been attracting attention because it enables treatment that could not be achieved by medicine. As a column used for this extracorporeal circulation, a cylinder, a first end plate provided at one end of the cylinder, a second end plate provided at the other end of the cylinder, and one end are opened. A blood flow tube having a number of openings through which blood flows on the side of the portion that is closed at the other end, extends through the central portion of the first end plate, extends into the tube, and is located in the tube, and the blood flow tube Between the outer peripheral surface of the cylindrical body and the inner peripheral surface of the cylindrical body, and a gap through which blood flows is formed between the inner peripheral surface of the cylindrical body and the outer peripheral surface of the second end plate. An extracorporeal circulation column is described in Patent Document 1. When blood purification was performed using this known extracorporeal circulation column, one end was engaged with a blood vessel of the living body and the other end was engaged with an opening of a blood flow tube of the column. It was observed that the pressure of flowing blood increased with time. An excessive increase in blood pressure can cause damage to other blood components, including platelets in blood during extracorporeal circulation. In the treatment by extracorporeal circulation, when blood pressure rises, treatment is performed to reduce blood pressure so that it does not become excessive, but this treatment may take a considerable amount of time, during which blood components The possibility of damage is increased. In addition, doctors and the like have to pay close attention so that blood pressure does not increase excessively.

  As a method for controlling the pressure applied to blood and blood components, in Patent Document 2, in a plasma separation apparatus that separates blood cell components and plasma components in blood by a plasma separation membrane, the transmembrane pressure difference exceeds a set pressure. Describes a method of controlling the pressure applied to blood components by reducing the rotation speed of the plasma pump, but in order to control the pressure applied to blood and blood components, the rotation speed is reduced in addition to the separation membrane. A special pump that could be used was needed.

Moreover, in the blood purification apparatus of Patent Document 3, a method for controlling the pressure in the venous blood flow path is described by providing blood flow rate adjusting means in the arterial blood flow path and venous blood flow path of the dialyzer. However, in order to control the pressure in the blood channel, a special blood channel (blood circuit) is required.
Japanese Patent Laid-Open No. 9-239022 JP 59-177058 A JP-A-6-218045

An object of the present invention is to provide a blood purification column capable of solving the above-described conventional problems and preventing an increase in blood pressure during blood processing due to extracorporeal circulation without using a special accessory device or the like.

The blood purification column of the present invention that achieves the above object has the following configuration. That is, a cylinder, a first header having a first blood channel that closes one end of the cylinder and communicates with the cylinder, and a second header that closes one end of the cylinder and communicates with the cylinder. When the blood to be purified is supplied from the first blood channel in the column composed of the second header having the blood channel and the adsorbent housed in the cylinder, the first header If the pressure is applied to the blood in the second blood flow path, the pressure control means is set so that the pressure applied to the blood does not exceed a predetermined pressure in the second blood flow path. The blood purification column is provided.

  In the column of the present invention, a first end plate having a blood flow path communicating with the first blood flow path is provided at an end of the cylindrical body on the first header side, and the second header A second end plate having a blood channel communicating with the second blood channel is provided at an end of the cylinder on the side, and the blood flow of the first end plate is provided at the center of the cylinder. A passage and a blood flow path of the second end plate communicate with each other and extend from the first end plate toward the second end plate. A blood flow tube is provided, the outer peripheral surface of the first end plate and the inner peripheral surface of the cylindrical body are closed, and between the outer peripheral surface of the second end plate and the inner peripheral surface of the cylindrical body Is provided with a gap through which blood flows, and the adsorbent is accommodated between an inner peripheral surface of the cylindrical body and an outer peripheral surface of the blood flow tube, and the second end plate Preferably includes a pressure control means.

  In the column of the present invention, one aspect of the pressure control means is a means for controlling the pressure by opening the valve when the pressure applied to the blood to be purified exceeds a predetermined pressure.

  The predetermined pressure is preferably 21.3 kPa. The adsorbent is preferably formed of a fiber aggregate or a granular aggregate. Among these, a fiber assembly is more preferable.

  Furthermore, it is preferable that a physiologically active substance is supported on the adsorbent.

  According to the present invention, when treating using a blood purification column, it is possible to prevent blood pressure from rising excessively and prevent damage to blood components without using a special accessory device or the like. Also, it is not necessary to always pay attention during treatment so that the blood pressure does not rise excessively.

  The blood purification column according to the present invention closes one end of the cylinder, a first header having a first blood flow path communicating with the cylinder, one end of the cylinder, and the cylinder. A column comprising a second header having a second blood flow path communicating with the body and an adsorbent accommodated in the cylinder, and supplying blood to be purified from the first blood flow path When applied, the pressure applied to the blood in the first blood channel, or the pressure applied to the blood in the second blood channel when the blood to be purified is supplied from the second blood channel, The pressure control means is provided so as not to exceed a predetermined pressure.

  FIG. 1 shows a blood purification column 1 (shown in a longitudinal section, and the blood flow inside is indicated by an arrow 2), which is an example of a blood purification column according to the present invention. The blood purification column is accommodated in the cylindrical body 3, the first header 4 that closes one end of the cylindrical body 3, the second header 5 that closes the other end of the cylindrical body 3, and the cylindrical body 3. The first header 4 and the second header 5 are respectively provided with a first blood channel 7 and a second blood channel 8 communicating with the inside of the cylindrical body 3. . In the column 1, a first end plate 9 and a second end plate 10 are further provided on both end surfaces of the adsorbent body 6 in the cylinder axial direction, and the first end plate 9 to the second end plate are provided. A blood flow tube 11 reaching 10 is installed at the central portion in the cross-sectional direction of the cylindrical body 3. The blood flow tube 11 has a large number of openings 12 through which blood flows on the outer peripheral surface thereof. Further, both ends of the blood flow tube 11 are connected to the end plates 9 and 10, respectively, and one end is opened to the outside of the first end plate 9 and communicated with the first blood channel 7. The other end is not opened outside the second end plate 10. As will be described later, the second end plate is provided with a means for controlling the pressure applied to the blood. The first end plate 9 is mounted in the cylindrical body 3 with its outer peripheral surface fitted on the inner peripheral surface of the cylindrical body 3. A filter 13 is attached to the outer (first header 4 side) surface of the first end plate 9. The blood that has flowed into the cylinder 3 from the first blood channel 7 passes through the filter 13 and flows into the blood flow tube 11. On the other hand, the second end plate 10 is mounted in the cylindrical body 3 with a gap 14 for blood flowing between the outer peripheral surface and the inner peripheral surface of the cylindrical body 3. The gap 14 communicates with the second blood channel 8. A filter 15 is attached to the outer (second header 5 side) surface of the second end plate 10. The blood that has passed through the numerous openings 12 of the blood flow tube 11 and has flowed into the space in the adsorbent body 6 flows in the adsorbent body 6 in the outer circumferential direction, while the adsorbent body 6 adsorbs the substance to be removed. After being removed, it flows through the gap between the outer peripheral surface of the adsorbent 6 and the inner peripheral surface of the cylinder 3, passes through the filter 15 from the gap 14, and reaches the second blood flow path 8. As a method of circulating the blood in the column 1, the method of supplying blood from the first blood channel 7 described above into the cylinder 3 is opposite to the method of circulating the second blood channel 8. There is a method in which blood is supplied into the cylindrical body 3.

  In the extracorporeal circulation of blood using the column 1, a blood outlet conduit 19 led out from the femoral vein 17 of the patient 16 is coupled to the first blood channel 7, while from the femoral vein 20 of the patient 16. The derived blood return line 21 is coupled to the second blood flow path 8, and blood purification is performed by operating the blood pump 18 installed in the blood discharge line 19. At this time, an anticoagulant is introduced into the blood outlet line 19 at a position indicated by an arrow 22 upstream of the blood pump 18. The pressure of blood in the first blood channel 7 is measured by a pressure measuring device connected to the air trap 23 through the tube 24.

  FIG. 2 shows a longitudinal sectional view of a blood purification column 31 which is an embodiment of the blood purification column according to the present invention. The blood purification column 31 is accommodated in the cylindrical body 32, a first header 33 that closes one end of the cylindrical body 32, a second header 34 that closes the other end of the cylindrical body 32, and the cylindrical body 32. The first header 33 and the second header 34 are respectively provided with a first blood channel 36 and a second blood channel 37 communicating with the inside of the cylindrical body 32. . A first end plate 38 and a second end plate 39 are provided on both end faces of the adsorbent body 35 in the cylindrical axis direction, respectively, and blood flow tubes extending from the first end plate 38 to the second end plate 39 are provided. 40 is installed in the center part in the cross-sectional direction of the cylindrical body 32. The blood flow tube 40 has a large number of openings 41 through which blood flows on the outer peripheral surface thereof. Further, both ends of the blood flow tube 40 are connected to the end plates 38 and 39, respectively, but one end is opened to the outside of the first end plate 38 and communicated with the first blood channel 36. The other end is not opened outside the second end plate 39. The second end plate 39 is provided with a means for controlling the pressure applied to the blood as will be described later. The first end plate 38 is mounted in the cylindrical body 32 with the outer peripheral surface thereof being fitted to the inner peripheral surface of the cylindrical body 32. A filter 42 is mounted on the outer (first header 33 side) surface of the first end plate 38. The blood that has flowed into the cylindrical body 32 from the first blood flow path 36 passes through the filter 42 and flows into the blood flow tube 40. On the other hand, the second end plate 39 is mounted in the cylindrical body 32 in a state in which a gap 43 through which blood flows is formed between the outer peripheral surface and the inner peripheral surface of the cylindrical body 32. The gap 43 is in communication with the second blood channel 37. A filter 44 is mounted on the outer (second header 34 side) surface of the second end plate 39. The blood that has passed through a large number of openings 41 of the blood flow tube 40 and has flowed into the space in the adsorbent 35 flows in the adsorbent 35 toward the outer periphery, while the adsorbent 35 adsorbs the substance to be removed. After being removed, it flows through the gap between the outer peripheral surface of the adsorbent 35 and the inner peripheral surface of the cylinder 32, passes through the filter 44 from the gap 43, and reaches the second blood flow path 37. In addition, as a method of circulating blood in the column 31, the method of supplying blood into the cylindrical body 32 from the first blood channel 36 described above is opposite to the method of circulating the second blood channel. There is a method in which blood is supplied into the cylinder 32 from 37.

The adsorbent 35 is preferably formed as an aggregate of granular materials or an aggregate of fibers. The aggregate of fibers is preferably formed of a knitted fabric, a woven fabric, a non-woven fabric, or a cotton-like product. The granular materials and fibers each preferably have a surface area per unit weight of 0.1 to 100 m ² / g. As the fibrous material, polystyrene fibers, crosslinked polystyrene fibers, acrylic acid / acrylonitrile copolymer fibers, or polyvinyl alcohol fibers having a carboxyl group are preferable because functional groups can be easily introduced. Moreover, since processability and durability are good, a composite fiber reinforced with an island component, so-called sea-island composite fiber, is preferably used. In this case, a sea-island composite fiber in which the sea component is polystyrene and the island component is polypropylene is preferably used.

  The adsorbent 35 can also carry a physiologically active substance. As the physiologically active substance, a polypeptide typified by polymyxin B, vancomycin, actinomycin, and viomycin are used. The fiber to which the physiologically active substance is immobilized is prepared by mixing a fiber having a functional group and a physiologically active substance, or by adding a peptide condensing agent thereto. As such a peptide condensing agent, {cyclohexyl carbopositimide, 1-ethyl-3- (3-dimethylaminopropyl) -carbodiimide} is used.

  A method for assembling the column 31 will be described in the case where the adsorbent 35 is formed of a knitted fabric or a woven fabric. The knitted fabric or woven fabric as the adsorbent is wound around the outer peripheral surface of the blood flow tube 40 in a layered manner to a desired thickness. A first end plate 38 with a filter 42 attached is attached to one end of the formed adsorbent 35, and a second end plate 39 with a filter 44 attached is attached to the other end to attach an end plate. The adsorbent 35 is assembled. The adsorbent 35 with the end plate is inserted into the cylinder 32 and fixed. After that, the first header 33 and the second header 34 are attached to both ends of the cylindrical body 32 and fixed to assemble the column 31.

  One embodiment of the pressure control means according to the present invention will be described below with reference to an enlarged view 51 of the blood purification column shown in FIG. The increase in blood pressure in the blood flow path is considered to be caused by blood components such as platelets being activated and coagulated, and adhering to the adsorbent. In the blood purification column, the activity and coagulation of blood components are likely to occur mainly when the blood contacts the adsorbent. When blood clotting occurs, the blood flow in the blood purification column decreases and the extracorporeal circulation cannot be continued, and the blood supply to the blood purification column is continued by the blood pump. The pressure on the blood increases in the meantime. In order to solve this problem, as a feature common to the blood purification column of the present invention, when blood pressure rises, the pressure provided in the portion corresponding to the second end plate 54 connected to the blood flow tube The control means functions. More specifically, in the example shown in FIG. 3, in the second end plate 54, the pressure applied to the blood is between the blood flow tube 53 and the blood channel 55 provided in the second end plate 54. A valve is provided that opens when a predetermined pressure is exceeded. This valve includes a sealing plate 56 and an elastic body 57 such as a spring or rubber (a spring is used in FIG. 3). Since the sealing plate 56 is pushed up with a predetermined force in the initial state, the blood flow tube 53 and the blood flow channel 55 are not in communication. However, when the pressure applied to the blood exceeds a predetermined pressure, the force for pushing down the sealing plate 56 by the blood becomes larger than the force by which the sealing plate 56 is pushed up by the elastic body 57 such as a spring or rubber. When the sealing plate 56 is pushed down, the blood flow tube 53 and the blood channel 55 communicate with each other, and the blood passes through the newly communicated blood channel 55, whereby the pressure applied to the blood is controlled. The blood that has passed through the newly connected blood channel 55 passes through the filter 58 and the blood channel 60 provided in the second header 59. The filter 58 used here does not allow the adsorbent component to pass through, and does not change as long as it comes into contact with blood or does not cause blood coagulation, and may be a chemical product such as polyester. The blood that has passed through the filter 58 reaches the blood channel 60 without passing through the adsorbent 52. Thereafter, when the pressure applied to the blood returns within a predetermined pressure range, the force that the sealing plate 56 is pushed up by the elastic body 57 such as a spring or rubber becomes larger than the force that is pushed down by the blood, and the sealing plate 56 is initially The communication between the blood flow tube 53 and the blood channel 55 provided in the end plate 54 is sealed. When the sealing plate 56 returns to the initial position, blood flows from the blood flow tube 53 through the adsorbent 52 to the blood channel 60. Thus, according to the present invention, it is possible to prevent the pressure applied to blood from exceeding a predetermined pressure. The predetermined pressure is preferably 21.3 kPa.

The conceptual diagram explaining the state in which the blood purification column which concerns on this invention is used, and the blood purification treatment is performed. The longitudinal section of one embodiment of the blood purification column concerning the present invention. The figure of one embodiment of the pressure control means with which the blood purification column which concerns on this invention is provided.

Explanation of symbols

1 Blood purification column 1
2 direction of blood flow 3 cylinder 4 first header 5 second header 6 adsorbent 7 first blood channel 8 second blood channel 9 first end plate 10 second end plate 11 blood Flow tube 12 opening 13 filter 14 gap 15 filter 16 patient 17 femoral vein 18 blood pump 19 blood outlet conduit 20 femoral vein 21 blood return circuit 22 arrow 23 air trap 24 tube 31 blood purification column 32 cylinder 33 first header 34 Second header 35 Adsorbent 36 First blood flow path 37 Second blood flow path 38 First end plate 39 Second end plate 40 Blood flow tube 41 Opening 42 Filter 43 Gap 44 Filter 51 Blood purification column Enlarged view 52 Adsorber 53 Blood flow tube 54 Second end plate 55 Blood flow path 56 Sealing plate 57 Elastic body 58 Filter 59 Second header 60 Blood flow path

Claims (6)

  A cylinder, a first header having a first blood flow path that closes one end of the cylinder and communicates with the cylinder, and a second blood that closes one end of the cylinder and communicates with the cylinder When blood to be purified is supplied from the first blood flow path in a column composed of a second header having a flow path and an adsorbent housed in the cylinder, the first blood Pressure control means is provided so that the pressure applied to the blood does not exceed a predetermined pressure in the second blood flow channel in the flow channel or when supplied from the second blood flow channel. A blood purification column characterized by that.   A first end plate having a blood channel communicating with the first blood channel is provided at an end of the cylinder on the first header side, and an end of the cylinder on the second header side A second end plate having a blood channel communicating with the second blood channel is provided at a portion, and the blood channel and the second end of the first end plate are provided at a central portion of the cylindrical body. A blood flow tube is provided which communicates with the blood flow path of the plate and extends from the first end plate toward the second end plate and has a large number of openings through which blood flows. The outer peripheral surface of the first end plate and the inner peripheral surface of the cylindrical body are closed, and a gap through which blood flows between the outer peripheral surface of the second end plate and the inner peripheral surface of the cylindrical body. The adsorbent is housed between the inner peripheral surface of the cylindrical body and the outer peripheral surface of the blood flow tube, and the second end plate is provided with pressure control means. Blood purification column according to claim 1, symptoms.   The blood purification column according to claim 1 or 2, wherein the pressure control means comprises means for controlling the pressure by opening a valve when the pressure applied to the blood to be purified exceeds a predetermined pressure.   The blood purification column according to any one of claims 1 to 3, wherein the predetermined pressure is 21.3 kPa.   The blood purification column according to any one of claims 1 to 4, wherein the adsorbent is formed as a fiber aggregate or a granular aggregate. The blood purification column according to claim 5, wherein a physiologically active substance is supported on the adsorbent.

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