JPH06149B2 - Continuous measurement device for blood pressure and blood viscosity of arteriovenous shunt - Google Patents
Continuous measurement device for blood pressure and blood viscosity of arteriovenous shuntInfo
- Publication number
- JPH06149B2 JPH06149B2 JP1333436A JP33343689A JPH06149B2 JP H06149 B2 JPH06149 B2 JP H06149B2 JP 1333436 A JP1333436 A JP 1333436A JP 33343689 A JP33343689 A JP 33343689A JP H06149 B2 JPH06149 B2 JP H06149B2
- Authority
- JP
- Japan
- Prior art keywords
- blood
- pressure
- arteriovenous shunt
- viscosity
- blood pressure
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
Links
Landscapes
- External Artificial Organs (AREA)
Description
【発明の詳細な説明】 〔産業上の利用分野〕 この発明は動静脈シャント部の血圧及び、血液粘度を連
続測定装置に関し、さらに詳しくは、患者の動静脈シャ
ント部の血圧及び、血液粘度の両者または、一方を連続
的に測定するようにした動静脈シャント部の血圧及び、
血液粘度の連続測定装置に関する。The present invention relates to a device for continuously measuring blood pressure and blood viscosity of an arteriovenous shunt part, and more particularly, to a blood pressure and blood viscosity of a patient's arteriovenous shunt part. Both, or one of the blood pressure of the arteriovenous shunt that was measured continuously, and
The present invention relates to an apparatus for continuously measuring blood viscosity.
人工透析の実施に当たつては、透析患者の血圧や、血液
粘度を確実に把握しながら実施することが肝要であつ
て、そのために、血圧はカフ式血圧計を用いて測定し、
血液粘度は血液を採取して粘度計を用いて測定してお
り、何れの場合も間欠的な測定であつた。When carrying out artificial dialysis, it is essential to carry out while surely grasping the blood pressure of the dialysis patient and the blood viscosity, and therefore, the blood pressure is measured using a cuff type sphygmomanometer,
The blood viscosity was measured by collecting blood and using a viscometer, and in all cases, it was an intermittent measurement.
上述のような血圧や、血液粘度の測定では、透析患者に
とつて、人工透析中に見られる急激な血圧変化や、血液
粘度の上昇は甚だ危険であるにも拘らず、これを確実に
把握することができず、患者を危険にさらすことがあつ
た。In the measurement of blood pressure and blood viscosity as described above, the rapid change in blood pressure seen during artificial dialysis and the increase in blood viscosity are extremely dangerous for dialysis patients, but they can be grasped without fail. Could not do so, putting the patient at risk.
そこで、この発明は人工透析中の患者の状態、とくに血
圧ならびに、血液粘度の両方あるいは、何れか一方を連
続的に測定できる装置を提供することを目的とするもの
である。Therefore, an object of the present invention is to provide an apparatus capable of continuously measuring the state of a patient during artificial dialysis, particularly blood pressure and / or blood viscosity.
本発明の連続測定装置は、その目的を達成するため、動
静脈シャント部から血液ポンプ及びダイアライザを経て
前記動静脈シャント部に循環する人工透析用血液回路に
おいて、前記動静脈シャント部と前記血液ポンプとの間
及び前記ダイアライザと前記動静脈シャント部との間の
２点に圧力測定部を設け、該圧力測定部で検出された前
記２点における圧力の和及び差から、動静脈シャント部
の血圧及び／又は血液粘度を連続的に測定することを特
徴とする。In order to achieve the object, the continuous measuring device of the present invention provides an artificial dialysis blood circuit that circulates from an arteriovenous shunt part to the arteriovenous shunt part via a blood pump and a dialyzer, and the arteriovenous shunt part and the blood pump. Between the dialyzer and the arteriovenous shunt part, and a pressure measuring part is provided at two points, and the blood pressure of the arteriovenous shunt part is calculated from the sum and difference of the pressures at the two points detected by the pressure measuring part. And / or continuously measuring the blood viscosity.
この発明の連続測定装置によれば、人工透析中の血圧な
らびに、血液粘度を間欠的ではなく、連続的にモニタす
ることができるので、透析患者の容体の変化を瞬時に検
知することができ、患者の容体の変化に応じた処置を直
ちに施すことができる。According to the continuous measuring device of the present invention, the blood pressure during artificial dialysis and the blood viscosity can be continuously monitored, not intermittently, so that a change in the condition of the dialysis patient can be instantly detected. Immediate treatment can be given according to changes in the patient's condition.
以下、この発明の実施例を添付した図面に沿つて説明す
る。Embodiments of the present invention will be described below with reference to the accompanying drawings.
先ず、第１図において、患者の腕における動静脈シャン
ト部１の圧力をＰｏ、体外循環血液回路２内のポンプ５
の上流３における圧力をＰ１、ダイアライザ６の下流４
における圧力をＰ２、血液回路内の流量をＱ、シャント
部と圧力測定部の間の流体抵抗をＲとすると、 Ｐ１＝Ｐｏ−Ｒ・Ｑ Ｐ２＝Ｐｏ＋Ｒ・Ｑ この２つの式の和と差を用いて Ｐｏ＝（Ｐ１＋Ｐ２）／２ Ｒ＝（Ｐ２−Ｐ１）／２Ｑ と求めることができる。First, in FIG. 1, the pressure of the arteriovenous shunt part 1 in the arm of the patient is Po, and the pump 5 in the extracorporeal circulation blood circuit 2 is used.
P 1 the pressure in the upstream third, downstream 4 of the dialyzer 6
P 2 the pressure at the flow rate of the blood circuit Q, the fluid resistance between the shunt portion and the pressure measuring unit and R, P 1 = Po-R · Q P 2 = Po + R · Q sum of the two expressions And Po = (P 1 + P 2 ) / 2 R = (P 2 −P 1 ) / 2Q.
この流体抵抗Ｒは、管路が細いものほど流体抵抗が大き
いことから、主としてシャント部に穿刺された留置針の
流体抵抗によるものである。This fluid resistance R is mainly due to the fluid resistance of the indwelling needle punctured in the shunt portion, because the fluid resistance increases as the conduit becomes thinner.
流体力学においては、細管の流体抵抗、管の直径をＤ、
長さをＬ、流体の粘度をμとする時、 Ｒ＝１２８μ／πＤ４ で与えられる。従つて、流体抵抗は血液粘度に比例する
ことが分かる。In fluid mechanics, the fluid resistance of the thin tube, the diameter of the tube is D,
When the length is L and the viscosity of the fluid is μ, it is given by R = 128 μ / πD 4 . Therefore, it can be seen that the fluid resistance is proportional to the blood viscosity.
上述の測定方式を採用した装置について説明を加える。A description will be given of the device that employs the above-described measurement method.
先ず、第１図に示すように、この測定装置は圧力変換器
７，８、さらには演算部９ないし演算部14、そして、表
示部15から構成されている。圧力変換器７，８の信号は
回路９、10により増幅され、回路11，12により動静脈シ
ャント部の圧力Ｐ０と、シャント部と圧力測定部の間の
流体抵抗Ｒが計算され、回路13，14によりアラーム状態
が検出される。First, as shown in FIG. 1, this measuring device is composed of pressure transducers 7 and 8, further operating units 9 to 14, and a display unit 15. The signals of the pressure transducers 7 and 8 are amplified by the circuits 9 and 10, and the pressure P0 of the arteriovenous shunt portion and the fluid resistance R between the shunt portion and the pressure measurement portion are calculated by the circuits 11 and 12, and the circuits 13 and 12 are calculated. An alarm condition is detected by 14.
表示部15には動静脈シャント部の圧力Ｐ０と、シャント
部と圧力測定部の間の流体抵抗Ｒの時間的経過及び、設
定されたアラームレベル、検知されたアラームの内容が
表示される。The display unit 15 displays the pressure P0 of the arteriovenous shunt unit, the time course of the fluid resistance R between the shunt unit and the pressure measuring unit, the set alarm level, and the content of the detected alarm.
上述のようにこの発明の連続測定装置によれば、実時間
で連続的に、透析患者の血圧と、血液粘度とを測定する
ことができ、人工透析中の患者の状態を常に監視し、第
２図および、第３図における「処置」点において適切な
処理を施すことができる。As described above, according to the continuous measuring device of the present invention, it is possible to continuously measure the blood pressure and blood viscosity of a dialysis patient in real time, constantly monitor the condition of the patient during artificial dialysis, and Appropriate processing can be performed at the "treatment" points in FIG. 2 and FIG.
その結果、急激な血圧降下に対しても（第２図）、直ち
に治療手段を施すことができ、例えば、生理食塩水を注
入するとか、除水速度を減少させるとか、さらには昇圧
剤を投与するなどの処置が行われる。As a result, even for a sudden drop in blood pressure (Fig. 2), a therapeutic means can be immediately applied, for example, by injecting physiological saline, decreasing the water removal rate, or administering a pressor agent. And the like is performed.
次に、流体抵抗をモニタすることによつて、血液の粘度
の変化を知ることができ、一般には人工透析治療の進行
に従い、粘度は上昇するので第３図のようにシャント部
と圧力測定部の間の流体抵抗Ｒも増加するが、過度の増
加は体内の血液循環を阻害するので前記流体抵抗Ｒをモ
ニタすることで、これを適切に下げることができる（第
３図Ａ点）。Next, by monitoring the fluid resistance, it is possible to know the change in the viscosity of the blood, and generally the viscosity rises as the artificial dialysis treatment progresses, so as shown in FIG. 3, the shunt portion and the pressure measuring portion are measured. Although the fluid resistance R during the period also increases, an excessive increase hinders the blood circulation in the body, so by monitoring the fluid resistance R, this can be appropriately reduced (point A in FIG. 3).
また、シャント部と圧力測定部の間の流体抵抗Ｒの急峻
な上昇は、留置針の入口が血管壁で塞がれる場合にみら
れるものであり、この場合も適切な処置を直ちに採るこ
とができる（第３図Ｂ点）。Further, the sharp increase in the fluid resistance R between the shunt portion and the pressure measuring portion is observed when the inlet of the indwelling needle is blocked by the blood vessel wall, and in this case also, appropriate measures can be taken immediately. Yes (point B in Figure 3).
以上の説明から明らかなように、この発明の動静脈シャ
ント部の血圧及び、血液粘度の連続測定装置によれば、
一般に人工透析中には除水により総循環血液量が減少し
て、血圧は低下し、血液粘度は上昇するので、このよう
な変化が過度に発生すると、ショック状態を呈し、危険
な状態に陥るので、患者によつては２、３分の間に血圧
が大きく低下してしまい、カフ式上腕血圧計による測定
では間欠的に血圧を知るだけであるが、それを連続的に
知ることができ、また、血液の粘度の変化をも連続的に
知ることができ、これにより人工透析患者の体内の変化
の状態に合わせて適切な処置を迅速に施し得るなどの効
果がある。As is clear from the above description, according to the blood pressure of the arteriovenous shunt portion of the present invention, and the continuous measuring device of blood viscosity,
Generally, during artificial dialysis, water removal reduces the total circulating blood volume, lowers blood pressure, and raises blood viscosity, so if such changes occur excessively, a shock state will occur, causing a dangerous state. Therefore, depending on the patient, the blood pressure will drop significantly within a few minutes, and the cuff-type brachial sphygmomanometer only allows intermittent knowledge of the blood pressure. In addition, it is possible to continuously know the change in the viscosity of the blood, which has an effect that an appropriate treatment can be rapidly performed according to the state of change in the body of the artificial dialysis patient.
第１図はこの発明の測定装置を使用する状態をしめす説
明図、第２図および第３図は測定結果を示す線図であ
る。 １…動静脈シャント部、２…人工透析用血液回路、 ３，４…エアートラツプ、５…血液ポンプ、 ６…ダイアライザ、７，８…圧力変換器、 ９，10…信号増幅器、 11，12…加減回路、13，14…アラーム検知回路、15…表
示回路FIG. 1 is an explanatory view showing a state in which the measuring device of the present invention is used, and FIGS. 2 and 3 are diagrams showing the measurement results. 1 ... Arteriovenous shunt part, 2 ... Artificial dialysis blood circuit, 3, 4 ... Air trap, 5 ... Blood pump, 6 ... Dialyzer, 7, 8 ... Pressure converter, 9, 10 ... Signal amplifier, 11, 12 ... Adjustable Circuit, 13, 14 ... Alarm detection circuit, 15 ... Display circuit
フロントページの続き (72)発明者 森 多加応 神奈川県川崎市川崎区並木73 (72)発明者 小野寺 三千代 東京都大田区東糀谷６―87―710 (56)参考文献 特開 昭63−63469（ＪＰ，Ａ) 実開 昭56−163447（ＪＰ，Ｕ)Front page continuation (72) Inventor Morita Kao 73 Namiki, Kawasaki-ku, Kawasaki-shi, Kanagawa Prefecture (72) Inventor Michiyo Onodera 6-87-710 (56) Higashi-Kojiya, Ota-ku, Tokyo (56) Reference JP-A-63-63469 (JP) , A) Actual development Sho 56-163447 (JP, U)
Claims (1)
アライザを経て前記動静脈シャント部に循環する人工透
析用血液回路において、前記動静脈シャント部と前記血
液ポンプとの間及び前記ダイアライザと前記動静脈シャ
ント部との間の２点に圧力測定部を設け、該圧力測定部
で検出された前記２点における圧力の和及び差から、動
静脈シャント部の血圧及び／又は血液粘度を連続的に測
定することを特徴とする動静脈シャント部の血圧及び血
液粘度の連続測定装置。1. A blood circuit for artificial dialysis, which circulates from an arteriovenous shunt part to a blood pump and a dialyzer to the arteriovenous shunt part, wherein between the arteriovenous shunt part and the blood pump and between the dialyzer and the arteriovenous. A pressure measuring section is provided at two points between the shunt section and the blood pressure and / or blood viscosity of the arteriovenous shunt section is continuously measured from the sum and difference of pressures at the two points detected by the pressure measuring section. An apparatus for continuously measuring blood pressure and blood viscosity of an arteriovenous shunt part, which is characterized by:
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP1333436A JPH06149B2 (en) | 1989-12-22 | 1989-12-22 | Continuous measurement device for blood pressure and blood viscosity of arteriovenous shunt |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP1333436A JPH06149B2 (en) | 1989-12-22 | 1989-12-22 | Continuous measurement device for blood pressure and blood viscosity of arteriovenous shunt |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| JPH03193059A JPH03193059A (en) | 1991-08-22 |
| JPH06149B2 true JPH06149B2 (en) | 1994-01-05 |
Family
ID=18266085
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP1333436A Expired - Lifetime JPH06149B2 (en) | 1989-12-22 | 1989-12-22 | Continuous measurement device for blood pressure and blood viscosity of arteriovenous shunt |
Country Status (1)
| Country | Link |
|---|---|
| JP (1) | JPH06149B2 (en) |
Families Citing this family (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| DE19541783C1 (en) * | 1995-11-09 | 1997-03-27 | Fresenius Ag | Method for operating a blood treatment device for determining hemodynamic parameters during an extracorporeal blood treatment and device for determining hemodynamic parameters during an extracorporeal blood treatment |
| IT1288767B1 (en) * | 1996-10-18 | 1998-09-24 | Hospal Dasco Spa | METHOD OF DETERMINING THE VALUE OF THE RECIRCULATION OF A SUSPENSION SUBJECT TO TREATMENT. |
| JP4374660B2 (en) * | 1999-06-23 | 2009-12-02 | 株式会社ジェイ・エム・エス | Hemodialysis apparatus, blood processing method using the hemodialysis apparatus, and recording medium for controlling the hemodialysis apparatus |
| DE102006032815A1 (en) * | 2006-07-14 | 2008-01-17 | Fresenius Medical Care Deutschland Gmbh | Method and device for monitoring extracorporeal blood circulation |
| JP5574147B2 (en) * | 2009-08-25 | 2014-08-20 | 国立大学法人広島大学 | Blood viscosity estimation method, blood viscosity ratio estimation method, blood viscosity monitoring device, and blood viscosity ratio monitoring device |
| ES2442875T3 (en) * | 2010-04-28 | 2014-02-14 | Gambro Lundia Ab | Method and device for monitoring a state of a blood duct in a machine for extracorporeal blood treatment |
| DE102014018072A1 (en) * | 2014-12-08 | 2016-06-09 | Fresenius Medical Care Deutschland Gmbh | dialysis machine |
-
1989
- 1989-12-22 JP JP1333436A patent/JPH06149B2/en not_active Expired - Lifetime
Also Published As
| Publication number | Publication date |
|---|---|
| JPH03193059A (en) | 1991-08-22 |
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