JPH0340303Y2 - - Google Patents

Description

[Detailed description of the invention] "Field of industrial application" This invention relates to a peritoneal perfusion device that can be applied to continuous cyclic peritoneal dialysis (CCPD), intermittent peritoneal dialysis (IPD), etc.

``Prior art'' A conventional peritoneal perfusion device of this type is, for example, published in Japanese Patent Application Laid-Open No. 1989-1989.
This is shown in Publication No.-53155. This will be briefly explained with reference to FIG. In this example, irrigation fluid source 1
1, a bag 12 containing a first irrigation fluid;
and a bag 13 containing a second irrigation fluid are used, and the irrigation fluid in these bags 12 and 13 can be supplied to a common conduit 16 through valves 14 and 15, respectively. The irrigation fluid in the conduit 16 is supplied to the heating container 19 through the conduit 18 by a roller pump 17 for fluid supply.

The perfusate supplied into the heating container 19 is heated to approximately the human body temperature. Conduit 18 is branched;
It is connected to one end of a conduit 22 through a valve 21, and a connector 23 is attached to the other end of the conduit 22 for connection to a catheter (not shown) provided in the patient's abdominal cavity. The junction of valve 21 and conduit 22 is connected to trap 25 through valve 24. The liquid in the trap 25 is supplied to one end of a drainage conduit 27 by a drainage roller pump 26.

With the valves 21 and 24 closed, the valve 14 and, if necessary, the valve 15 are also opened to drive the fluid supply roller pump 17, so that the irrigation fluid is supplied from the irrigation fluid source 11 to the heating container 19.
A predetermined amount is sent to. Irrigation fluid from the heated container 19, which has been heated to a predetermined temperature, opens the valve 21 and is sent into the abdominal cavity of the patient through the conduit 22 by natural flow.

When the supply of the perfusate is finished, the valve 21 is closed and the perfusate remains in the reservoir state for a substantially fixed period of time, for example, 1 to 2 hours. During this time, waste products and fluids move through the peritoneum into the intraperitoneal irrigation fluid. When the storage mode is finished, the mode is set to drainage mode, the valve 24 is opened, and the drainage fluid in the abdominal cavity passes through the conduit 22 to the trap 25.
leaked inside. When the drained liquid in the trap 25 reaches a predetermined amount, the drained liquid roller pump 26 is driven, and the drained liquid in the trap 25 is discharged to the outside through the drained liquid conduit 27.

In this way, in the conventional peritoneal perfusion device, the roller pump 17 is used to supply the perfusion fluid to the heating container 19, and the roller pump 26 is used to drain the fluid, and two roller pumps and three valves are used. The configuration is complicated.

Furthermore, the amount of irrigation fluid injected into the abdominal cavity is measured using the fluid supply roller pump 17, and the amount of fluid drained is measured using the fluid drainage roller pump 26. In other words, the measurement is performed using two measuring means. Therefore, if there are differences between the two pumps and the tubes used for them,
The amount of water removed (the amount of liquid drained - the amount of liquid injected) cannot be determined correctly.

In addition, the conventional type has a large number of parts, the length of the conduit connecting these parts is long, and the piping is complicated, which makes it expensive and troublesome to attach and detach from the device.

Moreover, even if the injection volume is incorrectly set or a large amount of fluid remains in the patient's abdominal cavity, the set injection volume will be injected into the patient's abdominal cavity, causing abnormal pressure in the patient's abdominal cavity and putting the patient at risk. Sometimes it happens. Further, if the patient catheter and the first conduit become disconnected, or if the first conduit and catheter are bent and obstruct the flow of the liquid, detection may be delayed and may pose a danger.

``Means for solving the problem'' According to this invention, the supply of irrigation fluid into the patient's peritoneal cavity is achieved by pressure detection, which detects the patient's intra-abdominal pressure from an irrigation fluid source placed in a warmer. This is carried out using a pump that is controlled by both the means and the liquid injection amount setting means. That is, when the pressure detection means detects a pressure equal to or higher than a predetermined value, the pump is stopped to stop the liquid injection even if the amount of liquid injected has not reached the set value.

On the other hand, when discharging waste liquid, the pump is proportionally controlled by this pressure detection means so as not to discharge the liquid too quickly.
Also, by calculating the rotation speed of this pump,
Determine the amount of liquid injected and the amount of drained liquid, and calculate the amount of water removed from these values. Also, since the irrigation fluid source is heated, a heating container and a valve to control the flow of fluid from the irrigation fluid source to the heating container are not required. Furthermore, if the patient catheter and the first conduit are disconnected, or if the first conduit and catheter are bent and obstruct the flow of liquid, it is immediately detected, an alarm is issued, the operation is stopped, and safety can be ensured.

``Example'' Figures 1 to 4 show examples of this invention. Main body 3
1 is made easy to move by casters in this example.

A heating section 36 is provided within the case portion 32, and an irrigation fluid source 11 (see FIG. 2) is disposed within the heating section 36. A heater 38 is provided in the heating section 36, and the heater 38 can heat the irrigation fluid source 11 via air. A first conduit 41 from the irrigation fluid source 11 is connected to the case portion 3 through a first valve 39.
A connector 23 is connected to the end thereof for communicating with a catheter in the patient's abdominal cavity. The connection point between the first valve 39 and the first conduit 41 is connected to a second conduit 42 extending downward, a second valve 43 is provided in the middle of the second conduit 42, and the lower end of the second conduit 42 is connected to the outside. It is led out and inserted into the drainage container 44.

The first conduit 41 is provided with pressure detection means 49 . This pressure detection means 49 includes a soft container 50 that deforms according to intra-abdominal pressure as shown in FIGS. 3 and 4.
and a sensor 51 that measures the amount of deformation of the soft container 50.
and a holder 52 that accommodates a soft container 50, and the intraperitoneal pressure of the patient is measured without contacting the irrigation fluid.

Further, a pump 45 is provided between the pressure detection means 49 and the branch point of the second conduit 42 . The pump 45 is controlled via the control section 46 based on the patient's intra-abdominal pressure measured by the pressure detection means 49.

In other words, the normal intra-abdominal pressure is around 20 mmHg, so for example, the upper limit of intra-abdominal pressure should be set to 30 mm.
Hg, and when the pressure detection means 49 detects a pressure of 30 mmHg or more, the pump 45 is stopped and the injection of liquid is stopped even if the amount of liquid injected has not reached the set value. The injection rate may be gradually decreased while the intra-abdominal pressure is between 20 and 30 mmHg.

On the other hand, when discharging the waste liquid, the pump 45 is proportionally controlled by the pressure detection means 49 so as not to discharge the liquid rapidly. In addition, the amount of liquid injected and the amount of liquid drained are determined by calculating the number of rotations of the pump 45 in the forward and reverse directions, and the amount of water removed is calculated from these values.

The embodiment of the pressure detection means 49 shown in FIG. 3 is an example in which a differential transformer 53 is used as the sensor 51, and the displacement of the soft container 50 is
4. Detected by the differential transformer 53 via the core 53a. FIG. 4 shows a pressure detection means 4 that optically detects displacement using a reflection plate 55 and a light emitting/receiving device 56.
9 is illustrated.

As shown in FIG. 2, a control unit 46 is provided in the case 32, a key operation unit 47 and a display unit 48 are connected to the control unit 46, and the injection amount is set using a setting key 47a. It is possible,
The set injection amount is displayed on the display surface 48a of the display section 48. Further, by operating the other control key 47b of the key operation unit 47, the valves 39 and 43 are sequentially controlled, and each flow rate measurement value of liquid injection and drainage by the pump 45 is displayed on the liquid injection amount display screen 48b, and the amount of liquid drained. They are each displayed on the display surface 48c, and the amount of water removed is calculated and displayed on the water removal amount display surface 48d. Keys on the key operation section 47 and display surfaces 48a to 4 on the display section 48
8d is provided on the operation display panel 57 of the case portion 32.

Preferably, the irrigation fluid bag 12 is normally sealed and has an exit port at the bottom that can be opened by piercing with a spike. All conduits, including these bags, connections to the peritoneal catheter, and conduits to drainage, are all connected in a closed manner to prevent infection, except for drainage. Conduit 34, 41,
42 is a synthetic resin tube, and valve 3
9,43 by crushing the tube,
The channel can be closed.

In the fluid injection mode, when the first valve 39 is opened, the pump 45 supplies the irrigation fluid from the irrigation fluid source 11, which has been preheated to 37° C. by the heating unit, into the patient's abdominal cavity through the first conduit 41.

At this time, the pressure detection means 49 detects the intra-abdominal pressure.
The liquid is injected while controlling the pump 45 so as not to exceed 30 mmHg. If the intra-abdominal pressure exceeds 30 mmHg, the first valve 39 is closed, the pump 45 is stopped, and an alarm is issued. If the intra-abdominal pressure is below 30mmHg,
Measuring the amount of liquid injected based on the rotation speed of the pump 45,
When the set injection amount is reached, the first valve 39 is closed and the pump 4
Stop 5.

Further, this injection amount is stored in the control unit 46 and displayed on the display surface 48b.

Reservoir mode Retains the perfusate within the patient's abdominal cavity for a predetermined period of time.

Drainage Mode The second valve 43 is opened, and the pump 45 drains fluid from the patient's abdominal cavity through the first conduit 41. At this time, the pressure detection means 49 detects intra-abdominal pressure of 10 mmHg.
The rotation of the pump 45 is controlled so as not to cause the following. At this time, the pump 45 is rotated in the opposite direction to that in the liquid injection mode.

The amount of drained liquid is measured based on the rotation speed of the pump 45, and the amount of drained liquid is stored in the control unit 46 and displayed on the display screen 4.
Displayed on 8c. The control unit 46 calculates "amount of drained fluid - amount of injected fluid = amount of water removed" and displays this amount of water removed on the display screen 48.
Display on d.

This liquid injection mode, storage mode, and liquid drainage mode are set to 1.
This is repeated for the set number of cycles. Note that the liquid draining mode is stopped when the liquid draining speed becomes equal to or less than a predetermined value.

"Effects of the Device" As described above, according to this device, the fluid is transferred while monitoring the patient's intra-abdominal pressure, resulting in high safety. Furthermore, since abnormalities in tube connections can be detected immediately, safety is increased in this aspect as well.

Furthermore, since multiple pumps are not used and the number of valves is reduced from three to two, it can be constructed at low cost and has fewer failures. Since the movement of the liquid in the first conduit 41 is measured by the pump 45, that is, the amount of liquid injected and the amount of liquid drained are also measured by the same pump, the amount of water removed can be determined more accurately. In addition, the number of parts is small, the length of the connecting conduit is short, it is easy to install and remove, and since there are no moving parts, it is difficult to break down and can be made at low cost.

[Brief explanation of the drawing]

FIG. 1 is a sketch showing an example of a peritoneal perfusion device according to this invention, FIG. 2 is a system diagram of the device shown in FIG. 1, and FIGS. 3 and 4 each show an example of pressure detection means using different sensors. The figure shown in FIG. 5 is a system diagram of a conventional device. 11... Irrigation fluid source, 39... First valve, 41...
First conduit, 42... Second conduit, 43... Second valve,
45...Pump, 49...Pressure detection means.

Claims (1)

[Scope of Claim for Utility Model Registration] An irrigation fluid source that supplies irrigation fluid, a warmer that warms the irrigation fluid source, a first conduit that connects the irrigation fluid source and a patient's peritoneal catheter; a second conduit that is branched and connected to the first conduit; and a second conduit provided between the irrigation fluid source of the first conduit and a branch point of the second conduit, for supplying irrigation fluid from the heating container to the patient's abdominal cavity. , a first valve that controls blocking, a second valve provided in the second conduit that controls draining and blocking of drainage from the patient's peritoneal cavity, and between a branch point of the second conduit and the catheter. a pressure detection means for detecting the intra-abdominal pressure of the patient; and a pressure detection means provided between the pressure detection means and the branch point of the second conduit, the flow rate of which is controlled based on the pressure detected by the pressure detection means. A peritoneal perfusion device comprising: