JP5529711B2 - Air trap chamber of blood purification apparatus and priming method of blood purification apparatus - Google Patents

Description

  The present invention relates to a structure of an air trap chamber used in a blood purification apparatus, and a priming method of the blood purification apparatus using the chamber.

  The blood purification device used for dialysis treatment is a device that allows the patient's blood to flow inside the hollow fiber membrane, which is a semipermeable membrane, and the dialysate to flow to the outside, and dialyzes waste products in the blood through the hollow fiber membrane to the dialysate. The dialysate containing the waste is discharged from the dialyzer and the purified blood is returned to the patient. In addition, the blood purification apparatus is provided with an air trap chamber that removes air in the blood and discharges it outside so that the air is not returned to the patient when mixed with blood. The air trap chamber is provided with a blood inflow port at the upper part of a cylindrical main body, a blood outflow port through which blood flows out at the lower part, and a filter at the inner lower part. And the air isolate | separated from the blood is discharged | emitted from the liquid level adjustment line of an upper end (for example, refer patent document 1, 2).

  Before being used for dialysis treatment of a patient, the blood flow path, dialyzer, air trap chamber, etc. of such a blood purification device are filled with air or the like. Before using the blood purification apparatus, it is necessary to perform priming for removing air or the like filled in the apparatus by flowing physiological saline into the blood circuit.

  On the other hand, a technique for performing priming using a dialysis solution supplied to a dialyzer during dialysis treatment has been proposed. For example, after connecting the arterial blood circuit tip and the venous blood circuit tip, dialysate is supplied to the dialyzer, and the dialysate is reversed from the outer surface side of the hollow fiber membrane of the dialyzer toward the inside of the hollow fiber membrane. Priming is performed by allowing the dialysate to flow into each blood circuit and discharging the air filled in the blood purification apparatus from the overflow line connected to the air trap chamber provided in each blood circuit. A method of performing this has been proposed (see, for example, Patent Documents 3 and 4).

  In addition, when performing hemodiafiltration (HDF), it is necessary to supplement the patient's blood with dialysate as much as water is removed from the patient's blood. In this case, there is a type in which a replacement fluid circuit for replacing the dialysate from the line for supplying dialysate to the dialyzer is provided to the arterial blood circuit. When priming a blood purification apparatus provided with such a replacement fluid circuit, the replacement fluid circuit is connected to the upstream side of the blood pump and the blood pump is rotated forward to allow dialysate to flow from the artery side circuit to the blood pump and dialysis. The dialysis fluid flows out from the connection point of the replacement fluid circuit toward the arterial puncture needle side at the same time as it flows in the order of the blood vessel and the venous side circuit, and at the same time, priming of the dialyzer, the arterial circuit, and the venous circuit A method of performing this has been proposed (see, for example, Patent Document 5). In Patent Document 3, the arterial puncture needle end of the arterial circuit and the venous puncture needle end of the venous circuit are connected to form the arterial circuit and the venous circuit as a circulation circuit, and the venous circuit side of the connection point of the replacement fluid circuit is clamped. After the blood pump is rotated forward, the replacement fluid injected into the connection point is flowed in the order of the blood pump, dialyzer, and venous circuit, and air is supplied from the air discharge pipe of the venous air trap chamber provided in the venous circuit. After priming the dialyzer and the arterial circuit by letting it flow outside, the clamp is released, the blood pump is stopped, and the dialysate that has flowed in from the connection point flows to the venous circuit, and the venous air trap chamber A method of performing priming has been proposed.

JP 2004-329793 A Utility Model Registration No. 3105777 Specification JP 2002-325837 A Japanese Patent Laid-Open No. 2004-16619 JP 2004-313522 A

  The prior art air trap chambers described in Patent Documents 1 and 2 are provided with only three nozzles, that is, a blood inlet port, an outlet port, and a liquid level adjusting line for discharging a liquid. As described in Documents 3 and 4, dialyzer, saline, and venous blood are used to replace dialysate and physiological saline that replace the internal air from the injection point provided in the channel other than the air trap chamber. It is injected into a blood circuit configured to communicate with the flow path, and is discharged to the outside from the liquid discharge line of the air trap chamber. For this reason, when the amount of dialysate to be injected is small, it is necessary to prime the flow paths on both sides from the dialysate injection point to the air trap chamber one by one. For example, the dialyzer and the venous air trap chamber There is a problem in that it takes time for priming because it is necessary to perform priming a plurality of times for each portion, such as the venous side circuit, other venous side circuit, and arterial side circuit.

  In the prior art priming method described in FIG. 2 of Patent Document 5, it is necessary to switch between priming on the arterial circuit side from the dialysate injection point and priming on the venous circuit side from the dialysate injection point by clamping. For this reason, there is a case where the dialysate is wasted due to excessive priming of each circuit in order to sufficiently perform priming of each circuit while requiring time for switching.

  An object of this invention is to provide the air trap chamber which can perform priming of the blood purification apparatus efficiently by a simple method.

  An air trap chamber of the present invention is an air trap chamber that is used in a blood purification device and removes air in blood, and includes a cylindrical straight portion and a cylindrical upper end portion having a diameter larger than that of the straight portion. A main body including a taper part connecting the straight part and the upper end part, a cylindrical body part connected to the upper end of the taper part, and a bottom plate connected to the upper end of the body part, and the taper A blood inflow port provided on a side surface of the body portion, a replacement fluid inflow port provided on a side surface on the upper end side of the body portion, a drainage port provided on the bottom plate, and an inner surface of the bottom plate, A drainage inner tube that communicates with the working port and extends from the inner surface of the bottom plate along the longitudinal direction of the main body to the upper side of the longitudinal direction of the main body of the blood inflow port. And wherein the door.

  In the air trap chamber of the present invention, it is preferable that the drainage inner pipe extends between the replacement fluid inflow port and the blood inflow port.

  In the air trap chamber of the present invention, the replacement fluid inflow port is provided so as to extend in a tangential direction of the circumference of the body portion, and the blood inflow port extends in a tangential direction of the circumference of the tapered portion. It is also suitable as being provided.

  In the air trap chamber of the present invention, it is also preferable that the drainage port and the drainage inner pipe are provided at the center of a disc-shaped bottom plate.

  The priming method of the blood purification apparatus of the present invention comprises a dialyzer that purifies blood by bringing blood and dialysate into contact with each other through a semipermeable membrane, and an arterial blood flow path that allows patient blood to flow into the dialyzer. A venous blood flow path for returning blood purified by the dialyzer from the dialyzer to the patient, a cylindrical straight section, and a cylindrical shape having a diameter larger than that of the straight section. A main body including a tapered portion connecting the upper end portion, the straight portion and the upper end portion, a cylindrical body portion connected to the upper end of the taper portion, and a bottom plate connected to the upper end of the body portion; A blood inflow port provided on a side surface of the tapered portion; a replacement fluid inflow port provided on a side surface on an upper end side of the body portion; a drainage port provided on the bottom plate; and an inner surface of the bottom plate, Communication with drain port A drainage inner tube whose tip extends from the inner surface of the bottom plate along the longitudinal direction of the main body to the upper side of the longitudinal direction of the main body of the blood inflow port, and removes air in the blood. A blood purification apparatus priming method comprising: an air trap chamber, wherein the air staying in the arterial blood flow channel and the venous blood flow channel is extracted from the blood outflow port of the venous air trap chamber. Flowing the venous air trap chamber into the venous air trap chamber from the hydrating fluid inflow port of the venous air trap chamber; and Air from the drain port of the venous air trap chamber through the drain inner tube of the air trap chamber And a step of discharging the fluid from the blood inflow port of the venous air trap chamber to the arterial blood channel and the venous blood channel. .

  The present invention has an effect that it is possible to provide an air trap chamber capable of efficiently priming a blood purification apparatus by a simple method.

It is a systematic diagram of the blood purification apparatus provided with the air trap chamber in embodiment of this invention. It is a longitudinal cross-sectional view which shows the structure of the air trap chamber in embodiment of this invention. It is a cross-sectional view which shows the structure of the air trap chamber in embodiment of this invention. It is explanatory drawing which shows the flow of the fluid in the case of priming operation | movement of a blood purification apparatus provided with the air trap chamber in embodiment of this invention. It is explanatory drawing which shows the flow of the fluid in the case of the priming operation | movement of the air trap chamber in embodiment of this invention. It is explanatory drawing which shows the flow of the fluid in the case of the priming operation | movement of the air trap chamber in embodiment of this invention. It is explanatory drawing which shows the flow of the fluid in the case of the priming operation | movement of the air trap chamber in embodiment of this invention. It is explanatory drawing which shows the flow of the fluid in the case of the priming operation | movement of the air trap chamber in embodiment of this invention.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings. As shown in FIG. 1, a blood purification apparatus 100 of the present invention includes a dialyzer 10 that purifies blood by bringing blood and dialysate into contact with each other through a semipermeable membrane, and allows the patient's blood to flow into the dialyzer 10. An arterial blood flow channel 20, an arterial air trap chamber 23 provided in the arterial blood flow channel 20 for removing air in the blood, and a blood pump 21 provided in the arterial blood flow channel 20 and capable of rotating in the forward and reverse directions. A venous blood flow path 30 for returning blood purified by the dialyzer 10 from the dialyzer 10 to the patient, a venous air trap chamber 33 provided in the venous blood flow path 30 for removing air in the blood, Connected to the venous air trap chamber 33 and connected to the venous air trap chamber 33 for draining the air removed by the venous air trap chamber 33 to the outside and the dialysis fluid to the venous blood The replacement fluid channel 40 supplied to the channel 30, the replacement fluid pump 41 provided in the replacement fluid channel 40, the connection plug 27 provided at the patient side end of the arterial blood channel 20, and the patient side of the venous blood channel 30 A connection plug 37 provided at the end, and a controller 60 that changes the flow rates of the blood pump 21 and the replacement fluid pump 41 are provided. The dialyzer 10 is connected to a dialysate supply channel 51 for supplying dialysate and a dialysate discharge channel 52 for discharging dialysate from the dialyzer 10. A dialysate pump 53 is provided in the dialysate supply channel 51.

  The dialyzer 10 has a large number of hollow fiber membranes, which are semipermeable membranes, inside. The blood flowing into the dialyzer 10 from the upper blood inlet 11 flows through the hollow fiber membrane and flows out from the lower blood outlet. I will do it. On the other hand, a dialysate inlet 10a for allowing dialysate to flow into the outer surface of the hollow fiber membrane is provided at the lower portion of the side surface of the dialyzer 10, and waste products in blood are passed through the hollow fiber membrane at the upper portion of the side surface of the dialyzer 10. A dialysate outlet 10b is provided for allowing the dialyzed solution after dialysis to flow out. The dialysate supplied from the dialysate supply channel 51 to the dialysate inlet 10a by the dialysate pump 53 is discharged from the dialysate outlet 10b to the dialysate discharge channel 52 after dialysis with blood.

  An arterial blood channel 20 is connected to the blood inlet 11 of the dialyzer 10. The arterial blood channel 20 includes a connection plug 27 connected to a puncture needle inserted into a patient's artery, a blood pump inlet channel 24 connecting the connection plug 27 and the blood pump 21, and a blood pump 21. And an arterial air trap chamber inlet flow path 25 connecting the arterial air trap chamber 23, and a dialyzer inlet flow path 26 connecting the arterial air trap chamber 23 and the blood inlet 11 of the dialyzer 10. It is out. The blood pump 21 is an ironing type pump driven by a motor 22, and the blood is flowed by squeezing the outside of a flexible tube provided inside the blood pump 21 in a predetermined direction. The flexible tube may be provided inside the blood pump 21, or the blood pump inlet channel 24 or the arterial air trap chamber inlet channel 25 is formed of a flexible tube, and a part thereof is formed. You may comprise like a squeeze. The arterial air trap chamber 23 is a cylindrical container and is provided with a blood inlet 23b as a blood inflow port on the upper side surface, a blood outlet 23c as a blood outflow port at the lower side, and a mesh under the inside. 23a is provided.

  A venous blood flow path 30 is connected to the blood outlet 12 of the dialyzer 10. The venous blood channel 30 is configured to connect the blood outlet 12 of the dialyzer 10 and the venous air trap chamber 33 to the venous air trap chamber inlet channel 35 and blood flowing from the venous air trap chamber 33 to the patient. A blood return channel 36 for returning to the vein and a connection plug 37 provided at the distal end of the blood return channel 36 and connected to a puncture needle inserted into the artery of the patient are included.

  The venous air trap chamber 33 is a cylindrical container that includes a blood inlet 33b that is a blood inflow port, a blood outlet 33c that is a blood outflow port, a replacement fluid inlet 33e that is a replacement fluid inlet port, and a drainage port that is a drainage port. A liquid port 33d is provided, and a mesh 33a is provided below the inside thereof. More specifically, as shown in FIG. 2, the vein-side air trap chamber 33 includes a main body 700, and the main body 700 includes a first main body 70 and a second main body 80. The first main body 70 includes a cylindrical straight portion 71, a cylindrical upper end portion 72 having a diameter larger than that of the straight portion 71, and a tapered portion 73 that connects the straight portion 71 and the upper end portion 72. On the straight portion 71 side (lower side) of the taper portion 73, a projection 74 protruding toward the inner surface is provided. A blood inlet 33 b that is a blood inflow port is provided on a side surface of the tapered portion 73 of the first main body 70. The blood inlet 33b is a cylindrical nozzle, and is provided horizontally along the circumferential tangential direction of the outer surface of the tapered portion 73, as shown in FIG. 3 (b), and a hole 75 provided in the tapered portion 73. It is comprised so that it may communicate with the inside of the 1st main body 70 via.

  The second main body 80 is configured by a cylindrical body portion 81 whose lower end is fitted to the outer surface of the upper end portion 72 of the first main body 70, and a disc-shaped bottom plate 84 connected to the upper end of the body portion 81. The body portion 81 of the second body 80 includes a lower body portion 83 that fits outside the upper end portion 72 of the first body 70 and an upper body portion 82 that has a slightly smaller diameter than the lower body portion 83. ing. The upper body part 82 of the second main body 80 is the body part described in the claims. The bottom plate 84 is attached to the upper end of the upper body part 82. A replacement fluid inlet 33 e that is a replacement fluid inflow port is provided on a side surface of the upper body portion 82 of the second main body 80. As shown in FIG. 3A, the replacement fluid inlet 33 e is provided horizontally along the circumferential tangential direction of the outer surface of the upper body portion 82, and the second through the hole 85 provided in the upper body portion 82. The main body 80 is configured to communicate with the inside. A drainage port 33d, which is a drainage port, is provided on the outer surface of the center of the bottom plate 84 of the second main body 80. The drainage port 33d communicates with the inner surface of the center of the bottom plate 84 from the inner surface of the bottom plate 84. A drainage inner tube 86 having a distal end 87 extending between the replacement fluid inlet 33e and the blood inlet 33b along the longitudinal direction of the first main body 70 is provided. In addition, a pressure detection pipe 88 that guides the pressure to the pressure sensor 89 is provided on the upper surface of the bottom plate 84.

  In the present embodiment, the lower body portion 83 of the second main body 80 is configured to be fitted to the outside of the upper end portion 72 of the first main body 70, but the second main body 80 is connected to the first main body 70. You may make it shape | mold as integral.

  3 (a) and 3 (b) show examples of the arrangement of the replacement fluid inlet 33e and the blood inlet 33b, respectively, and the inlets 33e and 33b may be arranged so as to extend in the same direction. However, they may be arranged to extend in different directions. Further, as shown in FIGS. 3A and 3B, the inlets 33e and 33b may be arranged at positions shifted by 180 degrees in the circumferential direction and may be arranged to extend in the same direction. . Further, the inlets 33e and 33b do not have to be provided horizontally along the tangential direction of the circumferences of the outer surfaces of the upper body part 82 and the taper part 73, for example, the upper body part 82 and the taper part 73, respectively. It may be provided toward the center in the longitudinal direction, or may be disposed in other directions.

  As shown in FIG. 1, a replacement fluid channel 40 is connected to the replacement fluid inlet 33e. The replacement fluid channel 40 includes a replacement fluid pump 41, a replacement fluid pump inlet channel 43 that connects the branch point 54 of the dialysate supply channel 51 and the inlet of the replacement fluid pump 41, and the replacement fluid pump 41 and the venous air trap chamber 33. And a replacement fluid supply channel 44 for connecting the replacement fluid inlet 33e. The replacement fluid pump 41 is an ironing-type pump driven by a motor 42, and flows blood by squeezing the outside of a flexible tube provided inside the replacement fluid pump 41 in a predetermined direction. The flexible tube may be provided inside the replacement fluid pump 41, or the replacement fluid pump inlet channel 43 or the replacement fluid supply channel 44 is formed of a flexible tube, and a part thereof is configured to be squeezed. May be. A drainage flow path 38 is connected to the drainage port 33 d at the top of the vein-side air trap chamber 33. The discharge side end of the drainage flow path 38 extends to a trap (not shown).

  The control unit 60 is a computer that performs signal processing including a CPU and a memory therein. The motor 22 of the blood pump 21, the motor 42 of the replacement fluid pump 41, and the dialysate pump 53 are connected to the control unit 60 and are configured to operate according to commands from the control unit 60.

  The flow of blood and dialysate during dialysis of the blood purification apparatus 100 of the present embodiment configured as described above will be described. The blood of the patient's artery enters the blood pump inlet channel 24 through the connection plug 27 and is sent to the artery-side air trap chamber 23 by the blood pump 21 rotating in the forward direction. The blood that has flowed into the artery-side air trap chamber 23 is freed of air mixed in the blood in the artery-side air trap chamber 23, and the dialyzer inlet channel 26 passes from the blood outlet 23 c below the artery-side air trap chamber 23. From the end of the hollow fiber membrane disposed in the dialyzer 10 through the blood inlet 11 of the dialyzer 10 and into the inside thereof. On the other hand, the dialysate is supplied from the dialysate supply channel 51 to the dialysate inlet 10 a by the dialysate pump 53. The dialysate flowing into the dialyzer 10 from the dialysate inlet 10a flows while filling the outer surface of the hollow fiber membrane. The blood and dialysate come into contact with each other through a semipermeable membrane hollow fiber membrane, and the waste products in the blood are dialyzed into the dialysate.

  The blood from which the waste product has been removed by dialysis flows from the other end of the hollow fiber membrane to the blood outlet 12 of the dialyzer 10 and flows out of the dialyzer 10. In addition, the dialysate containing waste products is discharged from the dialysate outlet 10 b of the dialyzer 10 to the dialysate discharge channel 52. The blood that has flowed out of the dialyzer 10 flows into the venous air trap chamber 33 from the venous air trap chamber inlet channel 35. As shown in FIG. 2, a blood surface 90 is formed inside the venous air trap chamber 33. The blood surface 90 is positioned so that the tip 87 of the drainage inner tube 86 is slightly immersed. Further, a space is formed above the blood surface 90, and the pressure in this space is detected by the pressure sensor 89. The blood that has flowed into the venous air trap chamber 33 is freed of air mixed in the blood in the venous air trap chamber 33, flows out from the blood outlet 33c below the venous air trap chamber 33, and returns to the blood. It is returned to the patient's vein through the passage 36, connection plug 37. Further, the air removed in the vein-side air trap chamber 33 is discharged from the drainage flow path 38 to the outside. In this way, the blood purification apparatus 100 of the present embodiment performs blood dialysis.

  Next, the priming operation of the blood purification apparatus 100 of the present embodiment will be described with reference to FIGS. In the following description, the dialyzer 10, the arterial blood channel 20, and the venous blood channel 30 of the blood purification apparatus 100 are filled with air, and the priming operation is an operation for discharging the filled air. explain. First, the connection plug 27 of the artery-side blood channel 20 and the connection plug 37 of the vein-side blood channel 30 are connected, and the artery-side blood channel 20, the vein-side blood channel 30, and the dialyzer 10 are circulated channels. To configure. Then, for example, the controller 60 starts the priming operation by pressing a priming start button on the operation panel or clicking a priming start button on the screen.

  When the priming start signal is input, the control unit 60 outputs a reverse rotation command to the motor 22 that drives the blood pump 21. By this command, the motor 22 starts to rotate in the reverse direction, and the blood pump 21 starts to send out air in the direction opposite to the blood flow during the dialysis operation described above. Further, the control unit 60 outputs a command for starting the replacement fluid pump 41. By this command, the replacement fluid pump 41 is started and starts to send dialysate from the dialysate supply channel 51 to the venous air trap chamber 33. The controller 60 outputs a command to set the delivery flow rate Q1 of the blood pump 21 to the flow rate Q1 necessary for priming of the dialyzer 10 and the blood flow paths 20 and 30. By this command, the motor 22 that drives the blood pump 21 has a rotation speed at which the delivery flow rate of the blood pump becomes Q1. Further, the control unit 60 outputs a command for setting the flow rate of the replacement fluid pump 41, that is, the flow rate of the dialysate supplied to the venous air trap chamber 33 to a flow rate Q 2 larger than the flow rate Q 1 of the blood pump 21. . For example, the flow rate Q2 is preferably 10% to 100% higher than the flow rate Q1, and more preferably 20% to 40% higher than the flow rate Q1. In response to this command, the motor 42 that drives the replacement fluid pump 41 rotates at a rotation speed at which the delivery flow rate of the replacement fluid pump 41 becomes Q2.

  When the blood pump 21 is operated at the delivery flow rate Q1, as shown in FIG. 2, the air filled in the arterial blood flow path 20, the venous blood flow path 30 and the dialyzer 10 is transferred to the dialyzer 10. Then, the blood is sucked into the blood pump 21 and flows into the venous blood flow path 30, and enters the venous air trap chamber 33 from the blood outlet 33 c below the venous air trap chamber 33. Then, it passes through the mesh 33 a provided at the lower part of the venous air trap chamber 33 and enters the venous air trap chamber 33 from below the venous air trap chamber 33. On the other hand, the dialysate that has flowed into the venous air trap chamber 33 by the replacement fluid pump 41 flows into the venous air trap chamber 33 from a replacement fluid inlet 33 e provided on the upper side surface of the venous air trap chamber 33.

  As shown in FIG. 5, initially, the inside of the venous air trap chamber 33 is filled with air, and the air that has entered the venous air trap chamber 33 from below the venous air trap chamber 33 is shown in FIG. As indicated by the dotted arrow in the figure, the blood pump 21 rotating in the reverse direction is sucked from the blood inlet 33b and recirculated toward the venous air trap chamber inlet channel 35 and the dialyzer 10. Further, the dialysate that has flowed into the venous air trap chamber 33 from the replacement fluid inlet 33e flows from the upper part to the lower part of the venous air trap chamber 33 as shown by the solid line arrow in the figure. A mesh 33a shown in FIG. 4 is provided at the lower part of the venous air trap chamber 33, and the air sent out by the blood pump 21 flows through the gap between the meshes 33a, so that the dialysate flows from the lower blood outlet 33c. It does not flow out and accumulates in the vein side air trap chamber 33.

  As shown in FIG. 6, when the dialysate accumulates inside the venous air trap chamber 33 and the liquid level 91 is formed, the air flowing into the venous air trap chamber 33 from the blood outlet 33c shown in FIG. It rises in the dialysate accumulated inside the venous air trap chamber 33 as bubbles 95, flows out as air from the liquid level 91, and flows from the blood inlet 33b to the venous air trap chamber inlet channel 35, dialysis. The blood is pumped into the blood pump 21 through the vessel 10 and recirculated through the dialyzer 10, the arterial blood channel 20, and the venous blood channel 30. For this reason, until the water level of the dialysate formed inside the venous air trap chamber 33 reaches the blood inlet 33b, the air flowing from the lower part of the venous air trap chamber 33 is hardly discharged to the outside.

  As shown in FIG. 7, when the water level of the dialysate formed inside the vein-side air trap chamber 33 reaches above the blood inlet 33b, the blood inlet 33b is submerged in the dialysate, and the dialysate becomes vein-side air. The blood begins to flow from the blood inlet 33b of the trap chamber 33 to the vein-side air trap chamber inlet channel 35. The air flowing in from the lower blood outlet 33 c shown in FIG. 4 becomes bubbles 95 and rises in the dialysate collected in the venous air trap chamber 33. Since the replacement fluid inlet 33e is provided toward the tangential direction of the upper body portion 82, the dialysate flowing into the upper body portion 82 of the second main body 80 from the replacement fluid inlet 33e swirls along the inner surface of the upper body portion 82. The liquid level 91 is reached. For this reason, a swirling flow is generated in the dialysate staying at the upper end portion 72 and the taper portion 73 of the first main body 70, and the pressure on the outer peripheral side of the upper end portion 72 of the first main body 70 and the taper portion 73 of the dialysate. Becomes higher than the pressure on the center side, and the bubbles 95 rising in the dialysate gradually gather to the vicinity of the center in the longitudinal direction of the first main body 70 as the dial 95 rises up to the taper portion 73. Gather on the outer periphery. Then, the liquid level 91 on the outer peripheral side rises slightly from the center. Further, since the projection 74 protrudes toward the center at the boundary between the straight portion 71 and the taper portion 73 and the flow path becomes narrow, the bubble 95 is brought closer to the center when passing through the portion of the projection 74.

  In this way, since the bubbles 95 gather on the center side and the dialysate gathers on the outer peripheral side, the bubbles 95 gathered on the center side flow out as air from the liquid surface 91 near the center, and remain at the center position of the bottom plate 84 as they are. Flows from the drainage inner pipe 86 to the drainage port 33d and is discharged to the outside from the drainage flow path 38 shown in FIG. Further, the diameter of the upper end portion 72 and the tapered portion 73 is larger than that of the straight portion 71 of the first main body 70, and the hole 75 provided in the tapered portion 73 communicating with the blood inlet 33 b is provided with the blood inlet 33 b in the straight portion 71. In some cases, the position is far from the longitudinal center of the first main body 70, and the bubbles 95 are unlikely to flow out of the blood inlet 33b with the dialysate. As described above, the blood inlet 33b is disposed at a position away from the center in the longitudinal direction of the first main body 70 toward the outer peripheral side, and the replacement fluid inlet 33e is disposed along the circumferential tangential direction of the upper body portion 82. By making the inflowing dialysate into a swirl flow, the air inflow from the lower blood outlet 33c does not flow out from the blood inlet 33b along with the dialysate, and is provided in the center of the bottom plate 84 for drainage 86. From the drainage flow path 38 shown in FIG. 4 to the outside.

  The delivery flow rate Q2 of the replacement fluid pump 41, that is, the flow rate of the dialysate flowing into the venous air trap chamber 33 from the replacement fluid inlet 33e flows into the venous air trap chamber 33 from the delivery flow rate Q1 of the blood pump 21, that is, the blood outlet 33c. Greater than air flow. For this reason, even if all the air that has flowed into the venous air trap chamber 33 flows out from the upper drainage flow path 38, the water level of the dialysate inside the venous air trap chamber 33 gradually increases. Then, as shown in FIG. 8, the dialysate liquid level 91 is above the tip 87 of the drainage inner tube 86, and the tip 87 of the drainage inner tube 86 is immersed in the dialysate. As described above, even when the distal end 87 of the drainage inner pipe 86 is immersed in the dialysate, the bubbles 95 gather on the center side in the longitudinal direction of the first main body 70 as described above with reference to FIG. Therefore, the air is directly supplied to the drainage inner pipe 86 provided at the center position of the bottom plate 84, and is discharged to the outside through the drainage port 33d. Further, since the flow rate Q2 of the dialysate flowing into the venous air trap chamber 33 is larger than the air flow rate Q1, the dialysis fluid corresponding to the flow rate difference ΔQ = (Q2−Q1) flows from the blood inlet 33b to the venous air. The trap chamber inlet channel 35 does not flow toward the dialyzer 10, and the drain port 33d is connected with the air shown by the dotted line arrow in FIG. It flows out from the drainage flow path 38 through the outside. Further, since air remains in the space between the distal end 87 of the drainage inner pipe 86 and the bottom plate 84, the dialysate does not enter the pressure detection pipe 88, and the venous air trap chamber can be reliably used during dialysis. 33 pressures can be detected.

  In addition, the flow rate Q2 of the dialysate flowing into the venous air trap chamber 33 from the replacement fluid inlet 33e is larger than the air flow rate Q1 flowing into the venous air trap chamber 33 from the blood outlet 33c. Even if all the air that has flowed into the chamber 33 flows out of the upper drainage flow path 38, the water level of the dialysate inside the venous air trap chamber 33 does not drop, and the dialysate always flows from the blood inlet 33b. The dialysate flows toward the dialyzer 10 from the blood inlet 33b. The flow rate of the dialysate flowing from the blood inlet 33b toward the dialyzer 10, that is, the washing flow rate of the dialyzer 10 is Q1.

  As described above, the air filled in the dialyzer 10, the arterial blood flow path 20, and the venous blood flow path 30 sent out by the blood pump 21 is discharged into the drainage inner pipe 86 of the venous air trap chamber 33. The dialysate discharged from the drainage flow path 38 through the liquid port 33d and supplied by the replacement fluid pump 41 flows into the dialyzer 10, the arterial blood flow path 20, and the venous blood flow path 30, and is dialyzed. 10. The arterial blood channel 20 and the venous blood channel 30 are replaced with dialysate, and the blood purification apparatus 100 is primed.

  As described above, the venous air trap chamber 33 provided in the blood purification apparatus 100 of the present embodiment arranges the blood inlet 33b at a position away from the center in the longitudinal direction of the first main body 70 toward the outer peripheral side. At the same time, the replacement fluid inlet 33e is arranged along the circumferential tangential direction of the upper body portion 82, and the inflowing dialysate is used as a swirl flow, so that the air flowing in from the lower blood outlet 33c is dialyzed from the blood inlet 33b. The blood purifier 100 flows from the drainage inner pipe 86 provided at the center of the bottom plate 84 to the drainage port 33d and is smoothly discharged from the drainage flow path 38 to the outside. Priming can be performed.

  In the present embodiment, the structure of the venous air trap chamber 33 has been described in detail. However, the arterial air trap chamber 23 has the same structure as the venous air trap chamber 33, and a replacement fluid is used when hemodiafiltration (HDF) is performed. You may make it inject | pour into the artery side air trap chamber 23. FIG.

  10 Dialyser, 10a Dialysate inlet, 10b Dialysate outlet, 11, 23b, 33b Blood inlet, 12, 23c, 33c Blood outlet, 20 Arterial blood flow path, 21 Blood pump, 22, 42 Motor, 23 Arterial air Trap chamber, 23a, 33a mesh, 24 blood pump inlet channel, 25 arterial air trap chamber inlet channel, 26 dialyzer inlet channel, 27, 37 connection plug, 30 venous side blood channel, 33 venous side air trap Chamber, 33d Drainage port, 33e Replacement fluid inlet, 35 Venous air trap chamber inlet channel, 36 Blood return channel, 38 Drainage channel, 40 Replacement fluid channel, 41 Replacement fluid pump, 43 Replacement fluid pump inlet channel, 44 Replacement fluid supply channel, 51 Dialysate supply channel, 52 Dialysate discharge channel, 53 Dialysate pump, 54 Branch point, 60 Control part, 70 1st main body, 71 Straight part, 72 Upper end part, 73 Tapered part, 74 Protrusion, 75, 85 hole, 80 2nd main body, 81 Body part, 82 Upper body part, 83 Lower body part, 84 Bottom plate 86, drainage inner tube, 87 tip, 88 pressure detection tube, 89 pressure sensor, 90 blood surface, 91 liquid surface, 95 bubbles, 100 blood purification device, 700 main body.

Claims (5)

An air trap chamber used in a blood purification device to remove air in blood,
A cylindrical straight portion, a cylindrical upper end portion having a diameter larger than that of the straight portion, a tapered portion connecting the straight portion and the upper end portion, and a cylindrical body connected to the upper end of the tapered portion And a main body including a bottom plate connected to an upper end of the body part,
A blood inflow port provided on a side surface of the tapered portion;
A replacement fluid inflow port provided on a side surface on the upper end side of the body portion;
A drainage port provided on the bottom plate;
Drainage provided on the inner surface of the bottom plate, communicating with the drainage port, and extending from the inner surface of the bottom plate along the longitudinal direction of the main body to the upper side of the longitudinal direction of the main body of the blood inflow port. Inner pipe,
An air trap chamber comprising: The air trap chamber according to claim 1,
The air trap chamber, wherein the drainage inner pipe extends between the replacement fluid inflow port and the blood inflow port. The air trap chamber according to claim 1 or 2,
The replacement fluid inflow port is provided so as to extend in the tangential direction of the circumference of the body part,
The blood inflow port is provided to extend in a tangential direction of the circumference of the tapered portion;
An air trap chamber. The air trap chamber according to claim 3,
The drainage port and the drainage inner pipe are provided at the center of a disc-shaped bottom plate;
An air trap chamber. A dialyzer that purifies blood by contacting blood and dialysate through a semipermeable membrane;
An arterial blood flow path for flowing the patient's blood into the dialyzer;
A venous blood flow path for returning blood purified by the dialyzer from the dialyzer to the patient;
Provided in the venous blood flow path, a cylindrical straight portion, a cylindrical upper end portion having a diameter larger than the straight portion, a taper portion connecting the straight portion and the upper end portion, and an upper end of the taper portion A main body including a cylindrical body portion to be connected, a bottom plate connected to an upper end of the body portion, a blood inflow port provided on a side surface of the taper portion, and a side surface on an upper end side of the body portion. A replacement fluid inflow port, a drainage port provided on the bottom plate, provided on the inner surface of the bottom plate, communicated with the drainage port, and the tip of the main body extends from the inner surface of the bottom plate along the longitudinal direction of the main body. A priming method for a blood purification apparatus comprising: a drainage inner tube extending to an upper side of a longitudinal position of the main body of the blood inflow port; and a vein-side air trap chamber that removes air in the blood. I,
Inflowing air staying in the arterial blood flow channel and the venous blood flow channel from the blood outflow port of the venous air trap chamber into the venous air trap chamber;
Flowing a replacement fluid having a flow rate larger than the flow rate of the air from the replacement fluid inflow port of the vein-side air trap chamber into the vein-side air trap chamber;
Exhausting the air from the drainage port of the vein-side air trap chamber through the drainage inner tube of the vein-side air trap chamber;
Draining a replacement fluid from the blood inflow port of the venous air trap chamber to the arterial blood channel and the venous blood channel;
A method for priming a blood purification device.

Images