CN101203252B - 透析装置 - Google Patents

透析装置 Download PDF

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CN101203252B
CN101203252B CN200680022393XA CN200680022393A CN101203252B CN 101203252 B CN101203252 B CN 101203252B CN 200680022393X A CN200680022393X A CN 200680022393XA CN 200680022393 A CN200680022393 A CN 200680022393A CN 101203252 B CN101203252 B CN 101203252B
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张伟
艾尔克·舒尔特
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Abstract

本发明涉及一种透析装置，具有分配给该透析装置的测量单元，从所述测量单元到透析装置的数据传输以无线方式实现，其中至少一个可测得的变量可以所述测量单元确定并可以被发送给透析装置，所述可测得的变量也可由固定连接到所述透析装置的另一个测量装置确定，并且由所述测量单元和由所述测量装置所检测到的至少一个可测得的变量之间的比较可以得到关于该测量单元的分配和/或功能的结论。

Description

透析装置
本发明涉及一种如权利要求1的前序部分所述的透析装置。
这类透析装置是已知的，其中在透析处理期间通过透析机自动测量血压。在透析处理期间可能会突然、很快地、在任何时刻发生低张性症状(hypotonic episode)，并可能导致患者丧失意识，和/或必须终止治疗过程。因此对患者的身体状况和健康造成不利影响。
在透析处理期间，作为超滤作用的结果，血浆量下降。如果没有采取措施以从组织间隙恢复血浆量，心脏的注入压和血压将下降。过滤比率越高，则这种风险越大。
有许多不同的已知手段来对透析机进行配置，使得血压下降可以被较早地识别出来和/或得以避免。一种手段是，具有在透析处理期间测量血液量的监测装置，并在必要时对超滤作用进行调节。另一种手段是，具有通过确定脉搏波传导时间(PTT)连续监测病人血压变化并在必要时对超滤作用进行调节的监控装置。压力脉冲沿着患者的血管从一点传递到另一点所用的时间是血压的函数。这个时间可以相当容易地被确定。可以使用ECG信号作为起始信号，同时可使用位于远离心脏的一个点处的光脉搏计作为结束信号。这一过程已经在美国专利No.6736789中进行了描述。
通过箍袖带测量来监测血压的方法也是已知的。病人可能会发现必须以规则的间隔(例如每30分钟)向箍袖带中“打压(pumped up)”以执行测量是很不舒服的。更重要的是，箍袖带测量的另一个缺点是：由于测量是不连续的，很难检测出血压的急剧下降。
PTT测量单元通常连接到病人治疗所需的透析机。但这类线缆连接限制了病人的活动能力，并当病人活动时可能会导致信号错误。在测量探针情况下的另一种手段是通过无线电链路来代替线缆连接。
这例如可基于蓝牙标准。
本发明要解决的问题是提供一种手段，利用该手段透析机能够自动地检验经由无线链路向它发送测量数据的测量单元实际上就是分配给所考虑的这个透析机的测量单元。
特别是在多个这类透析机同时工作的医疗机构中这类监测是有益的，使得每个透析机能够检测出经由无线链路向它发送测量数据的测量单元没有正常工作或者可能断开连接的情况。
根据本发明，该问题通过权利要求1所述特征来解决，根据该特征，在分配有测量单元的透析机的情况下，所述测量单元经由无线链路向所述透析机发送数据，该测量单元能够确定至少一个可测得的变量，并把该值发送给透析机，所述可测得的变量还可以由物理连接到透析机的另一个测量装置测得，对由所述测量单元确定的和由所述测量装置确定的至少一个可测得的变量的比较表明所述测量单元是否正是分配给所考虑的透析机的测量单元和/或所述测量单元是否正常工作。
因此，其优点是所述透析机能够通过独立确定可测得的变量来监测和检查测量单元，该可测得的变量也已由无线链接到所述透析机上的测量单元确定。通过比较，可以检查是否将正确的测量单元与透析其相连接和/或该测量单元是否可能不正常工作。
所述测量装置可以通过将其集成到透析机本身中或者通过借助线缆链接将它连接到透析机，从而物理连接到所述透析机。
在根据权利要求2所述的实施例中，所述至少一个可测得的变量是患者的脉搏速率。
这里的优点在于，这个可测得的变量可以独立地由透析机再次确定。这个可测得的变量也可通过与透析机无线耦合的测量单元相当容易地被确定。
在根据权利要求3的透析机的实施例中，由测量装置进行的测量可以这样来执行，使得脉搏速率从体外血液循环回路中的动脉和/或静脉压力信号导出。
对于动脉和/或静脉压力的测量信号在透析机中总是可用的。具有优点的是进一步利用该测量信号，以便从中确定脉搏速率。为此，参照WO 97/10013。最好优先使用动脉压力信号，因此这里的脉搏更为显著。
有利的是，可以在一段确定的时间间隔内由压力信号确定脉搏速率，并将其与相同给定时间间隔内由测量单元测得的平均脉搏速率频率进行比较，并无线发送给透析机。如果这些平均值相互一致，则可以得出正确的测量单元与透析机相耦合并且测量单元正常工作的结论。
在根据权利要求4的透析机的实施例中，由测量装置进行的测量可以这样执行，使得通过箍袖带测量来确定脉搏速率。
物理连接到透析机的测量装置的结果在透析机中是可用的，例如通过常规的血压监测器。
如果在时刻t执行箍袖带测量，通过物理连接到透析机的测量装置进行的测量得到的脉搏速率值与通过连接到患者的无线测量单元所测得的值进行比较。由所述测量单元所得到的值在与箍袖带测量周期相同的时刻t被确定。由测量单元所得到的值是在这个周期内由测量单元所测得的数值的平均值。
如果由测量单元和测量装置所得到的值相互一致，则可以得出正确的测量单元被耦合到透析机并且测量单元正常工作的结论。
在根据权利要求5的透析机的实施例中，所述至少一个可测得的变量是脉搏时序。
在根据权利要求5的实施例中，由测量装置所确定的脉搏时序例如可以由体外压力信号导出。该脉搏时序还附带地由测量单元所确定。由测量装置在一个给定的时间窗内所确定的脉搏时序随后与由测量单元所确定的脉搏时序进行比较，看看这些值是否一致，也就是说，看看测量装置得到的每个脉搏是否以恒定的方式超前或落后于测量单元得到的脉搏。如果是这种情况的话，可以得出正确的测量单元被耦合到透析机并且测量单元正常工作的结论。
通常，可以在透析过程开始时执行检验。这可能等同于周期性地重复该检验过程，例如每30分钟重复一次。然后，也可以在透析期间很容易地执行检验，因为可以很容易地得到适当的可测得的变量。
根据本发明的透析机是如何工作的原理在附图中以举例的方式示出。
方框1表示透析过程开始。用于测量装置和测量单元的数据值被初始化，即置为“0”。
随后在步骤2中通过物理连接到透析机的测量装置来确定变量。
在步骤3中，通过向透析机无线发送数据的测量单元来确定相同的变量。
在步骤4中，检查由测量装置和测量单元所得到的可测得的变量值之间的差，看看这个差是否小于一个预定的阈值。
如果是这种情况的话，则确认耦合到透析机的测量单元是正确的测量单元。
如果不是的话，则确认可能将测量单元连接到了错误的患者身上。然后根据步骤5发出报警。
可以将步骤5变为提供一个识别器，用于对步骤4中检测出的差值超过阈值的情况进行计数。只有当这个识别器达到一个特征阈值时才生成故障信号。这种措施可以避免单个的错误测量导致不正确的报警信号。相反，如果由测量装置和测量单元所确定的后续数值相互一致，则该识别器可以被重置—其可以被立即重置也可以在满足特定条件的时候被重置(例如相互一致的测量值数目达到一个最小值)。

Claims (6)

1.一种透析机，具有分配给它的测量单元，从所述测量单元到透析机的数据传输以无线方式实现，其特征在于，所述测量单元能够确定并向透析机发送至少一个可测得的变量(3)，所述可测得的变量还由物理连接到所述透析机的另一个测量装置确定(2)，由所述测量单元和由所述测量装置所确定的至少一个可测得的变量之间的比较表明了该测量单元实际上是否是分配给所考虑的透析机的测量单元。
2.根据权利要求1所述的透析机，其特征在于，由所述测量单元和由所述测量装置所确定的至少一个可测得的变量之间的比较表明了该测量单元是否正常工作(4)。
3.根据权利要求1所述的透析机，其特征在于，所述至少一个可测得的变量是患者的脉搏速率。
4.根据权利要求3所述的透析机，其特征在于，由测量装置进行的测量这样执行，使得所述脉搏速率由透析机的体外血液循环回路中的动脉和/或静脉压力信号导出。
5.根据权利要求3或4所述的透析机，其特征在于，由测量装置进行的测量这样执行，使得所述脉搏速率通过箍袖带测量来确定。
6.根据权利要求1至4中任一项所述的透析机，其特征在于，所述至少一个可测得的变量是脉搏时序。
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JP4729616B2 (ja) 2011-07-20
EP1904122A1 (de) 2008-04-02
US20120172736A1 (en) 2012-07-05
WO2006136134A1 (de) 2006-12-28
DE102005029709B3 (de) 2007-01-11
CN101203252A (zh) 2008-06-18
US20090223880A2 (en) 2009-09-10
ES2382346T3 (es) 2012-06-07
PL1904122T3 (pl) 2012-07-31
ATE544480T1 (de) 2012-02-15
EP1904122B1 (de) 2012-02-08
US20090078622A1 (en) 2009-03-26

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