CN105597176A - Intermittent CRRT (Continuous Renal Replacement Therapy) machine capacity balance device - Google Patents
Intermittent CRRT (Continuous Renal Replacement Therapy) machine capacity balance device Download PDFInfo
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- CN105597176A CN105597176A CN201610059234.2A CN201610059234A CN105597176A CN 105597176 A CN105597176 A CN 105597176A CN 201610059234 A CN201610059234 A CN 201610059234A CN 105597176 A CN105597176 A CN 105597176A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
- A61M1/1621—Constructional aspects thereof
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
- A61M1/1621—Constructional aspects thereof
- A61M1/1623—Disposition or location of membranes relative to fluids
- A61M1/1627—Dialyser of the inside perfusion type, i.e. blood flow inside hollow membrane fibres or tubes
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
- A61M1/1694—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes with recirculating dialysing liquid
- A61M1/1696—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes with recirculating dialysing liquid with dialysate regeneration
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Abstract
The invention discloses an intermittent CRRT (Continuous Renal Replacement Therapy) machine capacity balance device. The device comprises a blood circulation system, a first liquid circulation system, and a second liquid circulation system, wherein the blood circulation system consists of a hollow fiber dialyzer, a liquid outlet pipeline, a first circuit interrupting device, a liquid pump, a displacement liquid/dialysis liquid container and a liquid return pipeline; the second liquid circulation system consists of an exogenous displacement liquid/dialysis liquid container, an exogenous displacement liquid/dialysis liquid container liquid outlet pipeline, a second circuit interrupting device, a liquid pump, a displacement liquid/dialysis liquid container, and an exogenous displacement liquid/dialysis liquid container liquid return pipeline; the first liquid circulation system is in contact with the blood circulation system to perform substance exchange; since the volumes are fixed, volume change is not involved in the process of exchange; the first liquid circulation system is separated from the blood system, and is connected to the second liquid system to perform liquid exchange to be refilled with clean fresh displacement liquid, and then performs solute exchange with the blood system. The process is repeated to fulfill the aim of continuously removing solute.
Description
Technical field
The present invention relates to a kind of continuous blood purification device, specifically a kind of discontinuous CRRT machine capacity balancing device.
Background technology
The english abbreviation of CRRT (being continuousrenalreplacementtherapy) continuous renal replacement therapy. Have another name called CBP (continuousbloodpurification); Bedside hemo-filtration. Be to adopt 24 hours every days or approach the one of 24 hours long-time, continuous extracorporeal blood purifies therapy to substitute impaired renal function.
Nineteen ninety-five, in the international CRRT academic conference of the first of holding at San Diego, USA, CRRT is formally defined as: allly can continuity remove solute, and organ function is played to the blood purification technology of supporting function. During World War II, Canadian Murray and Delmore succeed in developing First artificial kidney machine, and are used for clinical treatment kidney failure in l946, and later blood purification technology is rapidly developed. Blood purification is blood samples of patients to be caused external and by a kind of purifier, removes wherein some morbid substance and purifies the blood and reach the object for the treatment of disease. It mainly comprises haemodialysis, blood filtering, hemodiafiltration, blood perfusion, plasma exchange, immunity absorption etc. Blood purification therapy has not been used for the treatment of merely acute and chronic patients with renal failure at present, in the rescue of anxious Cavity in Critical Patients, is widely applied yet.
CRRT clinical practice target is to remove excess moisture in body, removes internal metabolism refuse, poisonous substance, corrects Electrolyte imbalance, guarantees nutritional support, promotes graft function and removes various cell factors, inflammatory mediator. Can be used for: various cardiovascular functions unsettled, Metabolism or companion encephaledema acute and chronic renal failure, and Multiple Organ Dysfunction Syndrome, ARDS, crush syndrome, acute necrotic pancreatitis, chronic heart failure, hepatic encephalopathy, the treatment of medicine and toxic poisoning etc.
At present, the CRRT machine that mostly uses clinically German Bei Lang company to produce, or the CRRT machine produced of German Fresenius group, or the CRRT machine of some other brand carries out continuous kidney replacement therapy.
CRRT machine in the course of the work, needs accurately to control speed and the amount of turnover cardiopulmonary bypass in patients liquid, and the difference of the liquid in-out scale of construction is net ultrafiltration, i.e. the moisture content from removing in body. Conventionally CRRT machine controls by displacement liquid/dialysis liquid pump the liquid velocity that enters extracorporal circulatory system, control out the speed of extracorporal circulatory system liquid by waste drains pump, also carry out the amount of accurate kinetic measurement turnover liquid by the scale of CRRT machine intimate, and feedback regulates displacement liquid/dislysate, waste drains pump speed to reach the object of control turnover extracorporal circulatory system amount of liquid simultaneously.
Obviously, there is defect in the mode control turnover fluid balance by scale kinetic measurement liquid weight: the one, and scale needs often calibration, in use procedure, precision also can decline gradually, the 2nd, scale is measured and can only be carried out in inactive state, in therapeutic process, can cause scale to work to the collision of machine, therefore existing CRRT machine cannot be worked in mobile environment.
Use scale to weigh for overcoming, cannot in mobile environment, use the defect of CRRT machine, someone studies the volume controlled that adopts the method for flow monitoring to realize CRRT machine, and dynamic measurement flows into, flows out extracorporal circulatory system flow rate of liquid and calculate flow according to sectional area. The method of kinetic measurement flow velocity comprises magnetic current method and ultrasonic method. Although the defect that this method can avoid scale cannot work under mobile condition, still exists precision inadequate, the defect that error is large. Instant flow measurement needs the several seconds to measure a flow, in one minute, needs to measure tens times, then by the cumulative each measurement result amount of liquid obtaining in the unit interval. Even if therefore single measurement error is very little, but the additive effect of measuring result error must cause overall error very large many times. For instant flow measurement, therefore although the also kinetic measurement of scale system is all directly to measure total liquid turnover amount in certain time period at every turn, but not there is not additive effect in cumulative by measurement result repeatedly. In addition, the long-pending variation in use of the micro-bubble in liquid and pipe section all can affect flow measurement precision.
For CRRT treatment, every day fluid exchange amount generally more than 20L, more than reaching as high as 100L, if error is in 1%, the liquid margin of error is 200ml-1000ml, if the treatment absolute error amount of a few days is larger continuously. And flowmeter control capacitance balance error is difficult to reach below 1%.
Existing CRRT machine cannot be useful in the Moveable type vehicles such as aircraft, automobile, train, steamer and carry out CRRT treatment, this just gives and is badly in need of CRRT treatment, and due to the restriction on distance and the vehicles, cannot carry out CRRT treatment and bring challenge, such as the injured soldier in battlefield can only transport back, medical base is rescued and treatment, and patient with severe symptoms cannot rescue and treat enterprising the robbing of ambulance.
Therefore the more convenient use of CRRT machinery requirement, more accurate capacity control device and system.
Summary of the invention
In order to solve the problems of the technologies described above, the present invention proposes a kind of discontinuous CRRT machine capacity balancing device, comprise by entering blood vessel road, blood pump, hollow fiber dialyzer, the blood circulation system of blood back pipeline composition, by hollow fiber dialyzer, fluid pipeline, the first tripper, liquor pump, displacement liquid/dialysis fluid container, the first liquid circulatory system of liquid back pipe road composition, the first liquid circulatory system and blood circulation system are used common hollow fiber dialyzer, displacement liquid/dislysate in blood in blood circulation system and the first liquid circulatory system carries out solute exchange by common hollow fiber dialyzer, hollow fiber dialyzer comprises blood inlet, blood outlet, the outlet of displacement liquid/dislysate, displacement liquid/dislysate entrance.
Described enter the one end on blood vessel road introduce after patient vessel, connect the blood inlet of hollow fiber dialyzer through the other end by blood pump, one end of described blood back pipeline connects the blood outlet of hollow fiber dialyzer, the other end is by blood recovery patient body.
Displacement liquid/dislysate outlet that one end of described fluid pipeline connects hollow fiber dialyzer connects by after the first tripper, liquor pump, connect the entrance of displacement liquid/dialysis fluid container, the one end on described liquid back pipe road connects the outlet of displacement liquid/dialysis fluid container, by directly connecting blood back pipeline after the first tripper or entering blood vessel road, or connect the outlet of displacement liquid/dislysate or displacement liquid/dislysate arrival end.
Under forward and backward dilution filtration pattern, one end of described fluid pipeline connects displacement liquid/dislysate port of export of hollow fiber dialyzer, the one end on described liquid back pipe road connects blood back pipeline or enters blood vessel road, by displacement liquid/dislysate inlet seal corresponding hollow fiber dialyzer. One end of described fluid pipeline connects displacement liquid/dislysate arrival end of hollow fiber dialyzer, by displacement liquid/dislysate port of export sealing corresponding hollow fiber dialyzer.
Under dialysis mode, described fluid pipeline connects displacement liquid/dislysate port of export of hollow fiber dialyzer, and described liquid back pipe road connects displacement liquid/dislysate arrival end of hollow fiber dialyzer.
Also comprise by exogenous displacement liquid/dialysis fluid container, exogenous displacement liquid/dialysis fluid container fluid pipeline, the second tripper, liquor pump, displacement liquid/dialysis fluid container, the second liquid circulatory system of exogenous displacement liquid/dialysis fluid container liquid back pipe road composition, described exogenous displacement liquid/dialysis fluid container fluid pipeline is drawn from exogenous displacement liquid/dialysis fluid container, by connecting after the second tripper on the fluid pipeline occuping between the first tripper and liquor pump, after the liquid back pipe pass of one end, described exogenous displacement liquid/dialysis fluid container liquid back pipe road from displacement liquid/dialysis fluid container goes out, the other end feeds back exogenous displacement liquid/dialysis fluid container through the second tripper.
When the second tripper cuts out, when the first tripper is opened, the first liquid circulatory system of described displacement liquid/dialysis fluid container, hollow fiber dialyzer, fluid pipeline, liquid back pipe road composition becomes closed fluid circulation system, and volume is fixed.
When the first tripper cuts out, when the second tripper is opened, the described second liquid circulatory system being made up of exogenous displacement liquid/dialysis fluid container, exogenous displacement liquid/dialysis fluid container fluid pipeline, displacement liquid/dialysis fluid container, exogenous displacement liquid/dialysis fluid container liquid back pipe road becomes open fluid circulation system, and described exogenous displacement liquid/dialysis fluid container is replaceable.
Also be provided with the ultrafiltration system being formed by ultrafiltration pipeline, ultrafiltrate pump, ultrafiltration container at the front end of fluid pipeline.
Described ultrafiltration system also comprises flow-monitoring device, and described flow-monitoring device is arranged on ultrafiltration pipeline, and the flow rate of liquid in ultrafiltration pipeline and flow are monitored.
Described the first tripper and the second tripper are tubing clamp.
Described the first tripper and the interlock of the second tripper, control and open and close by the interlock of CRRT machine, in the time that CRRT machine is opened the first tripper, the second tripper interlock is closed, and the first liquid circulatory system and blood circulation system carry out mass exchange in hollow fiber dialyzer; In the time of CRRT machine switched off the first tripper, the second tripper interlock is open-minded, the second liquid circulatory system is carried out work, the waste liquid producing when the first liquid circulatory system is worked in displacement liquid/dialysis fluid container enters circulation in the second liquid circulatory system, dilution, feeds back in exogenous displacement liquid/dialysis fluid container.
Described the first tripper has 2, lays respectively on fluid pipeline, liquid back pipe road, and interlock is carried out closure, Open control to fluid pipeline, liquid back pipe road; The second tripper has 2, lay respectively on exogenous displacement liquid/dialysis fluid container fluid pipeline, exogenous displacement liquid/dialysis fluid container liquid back pipe road, closure, Open control are carried out in interlock exogenous displacement liquid/dialysis fluid container fluid pipeline, exogenous displacement liquid/dialysis fluid container liquid back pipe road.
First liquid circulatory system exchange volume is 100-500ml.
Described tubing clamp is unidirectional folder, or two-way grip, or multidirectional folder.
Discontinuous CRRT machine capacity balancing device mentality of designing of the present invention and principle are as follows:
The actual two parts that comprise of CRRT fluid balance, a part is that the equivalent of turnover liquid is explained, a part is the removing of moisture in body, " dehydration " being commonly called as. Because Part I fluid exchange amount is large, required precision is high, realizes comparatively difficulty; And the every daily amount of Part II general < 4L, total amount is little, required precision is little, it is comparatively easy to realize. Existing CRRT machine puts these two parts to realize together. We design novel capacity control system by separately consideration of two parts, and the equivalent of first done with high accuracy turnover liquid exchanges, then realizes the dehydration of low precision.
Common CRRT system can be divided into two parts, and one is blood circulation system, and two is fluid circulation system. Thinking of the present invention is to increase by second fluid circulation system, and first fluid circulation system is designed to closed, and volume is fixed. First fluid circulation system contacts with blood circulation system and carries out mass exchange, because its volume is fixed, in exchange process, do not relate to the variation of capacity, but because its volume is limited, after exchanging to a certain degree with blood, both substantially reach balance and just do not have Solute removal effect, and now the liquid in this liquid system can be described as waste liquid. In this case, first fluid circulation system and hematological system are disconnected, be connected to second liquid system and carry out fluid exchange, second liquid system is open system, connect fresh clean displacement liquid, by fluid exchange, the waste liquid in first systematic is swapped out, make it to be full of again clean fresh displacement liquid. As after this again first liquid system and second liquid system disconnected, and become again the appearance systems such as closed, then connect with hematological system and carry out solute exchange. Above process constantly repeats, and reaches constant removing solute object.
The basic ideas of this design are to utilize enclosed positive displacement fixer system to carry out solute exchange, and guaranteed capacity is unchanged, then the liquid system having reached capacity is regenerated, to ensure to continue Solute removal ability.
Discontinuous CRRT machine capacity balancing device implementation: pass in and out two pipelines of hematological system in first liquid system side by side, second liquid system passes in and out two pipelines of exogenous displacement liquid side by side, carry out management and control by a two-way grip and realize pipeline, the open pipeline that passes in and out displacement liquid that folder closes turnover hematological system, or contrary, the pipeline of open turnover hematological system, the pipeline that folder closes turnover displacement liquid. First liquid system exchange volume can be designed to 100-500ml, and first liquid system recirculation pump speed and switching frequency require to set according to clinical treatment dosage. Extra alveolar fluid clearance, can, by increasing a ultrafiltrate pump, go out filter place at first systematic and carry out ultrafiltration, and dehydrating amount can be realized by traffic monitoring.
The advantage of this mode is succinct, and shortcoming is to have part-time to treat for the regeneration of first circulation.
Beneficial effect:
Discontinuous CRRT machine capacity balancing device of the present invention utilizes enclosed positive displacement fixer system to carry out solute exchange, guaranteed capacity is unchanged, when exchange liquid reaches capacity or approaches when saturated, regenerate by exogenous displacement liquid/dislysate, ensure to continue Solute removal ability, efficiently solve the problem that existing CRRT machine cannot use in mobile environment. Can be widely used in CAVH under mobile environment (CAVH), failure by CVVH (CVVH), slowly ultrafiltration (SCUF) continuously, arteriovenous haemodialysis (CAVHD) continuously, Continuous Veno-venous haemodialysis (CVVHD), continuous arteriovenous hemodiafiltration (CAVHDF), Continuous Veno-venous hemodiafiltration (CVVHDF).
Brief description of the drawings
After Fig. 1 discontinuous CRRT machine capacity balancing device, dilution filters mode configuration schematic diagram;
After Fig. 2 discontinuous CRRT machine capacity balancing device, dilute filtration pattern dual circuit clamping structure schematic diagram;
After Fig. 3 discontinuous CRRT machine capacity balancing device, dilution filters banding ultrafiltration structural representation;
After Fig. 4 discontinuous CRRT machine capacity balancing device, dilution filters banding ultrafiltration dual circuit clamping structure schematic diagram;
Before Fig. 5 discontinuous CRRT machine capacity balancing device, dilution filters mode configuration schematic diagram;
Dilution filtration pattern dual circuit clamping structure schematic diagram before Fig. 6 discontinuous CRRT machine capacity balancing device;
Before Fig. 7 discontinuous CRRT machine capacity balancing device, dilution filters banding ultrafiltration structural representation;
Before Fig. 8 discontinuous CRRT machine capacity balancing device, dilution filters banding ultrafiltration dual circuit clamping structure schematic diagram;
Fig. 9 discontinuous CRRT machine capacity balancing device dialysis mode structural representation;
Figure 10 discontinuous CRRT machine capacity balancing device dialysis mode dual circuit clamping structure schematic diagram;
Figure 11 discontinuous CRRT machine capacity balancing device dialysis mode band ultrafiltration structural representation;
Figure 12 discontinuous CRRT machine capacity balancing device dialysis mode band ultrafiltration dual circuit clamping structure schematic diagram;
Wherein:
Enter blood vessel road 1, blood pump 2, hollow fiber dialyzer 3, blood back pipeline 4, fluid pipeline 5, the first tripper 6, liquor pump 7, displacement liquid/dialysis fluid container 8, liquid back pipe road 9, blood inlet 10, blood outlet 11, displacement liquid/dislysate outlet 12, displacement liquid/dislysate entrance 13, exogenous displacement liquid/dialysis fluid container 14, exogenous displacement liquid/dialysis fluid container fluid pipeline 15, the second tripper 16, exogenous displacement liquid/dialysis fluid container liquid back pipe road 19, ultrafiltration pipeline 20, ultrafiltrate pump 21, ultrafiltration container 22.
Detailed description of the invention
Embodiment 1:As shown in Fig. 1-12, a kind of discontinuous CRRT machine capacity balancing device, comprise by entering blood vessel road 1, blood pump 2, hollow fiber dialyzer 3, the blood circulation system that blood back pipeline 4 forms, by hollow fiber dialyzer 3, fluid pipeline 5, the first tripper 6, liquor pump 7, displacement liquid/dialysis fluid container 8, the first liquid circulatory system that liquid back pipe road 9 forms, the first liquid circulatory system and blood circulation system use common hollow fiber dialyzer 3, displacement liquid/dislysate in blood in blood circulation system and the first liquid circulatory system carries out solute exchange by common hollow fiber dialyzer 3, hollow fiber dialyzer 3 comprises blood inlet 10, blood outlet 11, displacement liquid/dislysate outlet 12, displacement liquid/dislysate entrance 13.
Described enter the one end on blood vessel road 1 introduce after patient vessel, connect the blood inlet 10 of hollow fiber dialyzer 3 through the other end by blood pump 2, one end of described blood back pipeline 4 connects the blood outlet 11 of hollow fiber dialyzer 3, and the other end is by blood recovery patient body.
One end of described fluid pipeline 5 connects the outlet 12 of displacement liquid/dislysate or displacement liquid/dislysate entrance 13 ends of hollow fiber dialyzer 3, or connect into blood vessel road 1, after the first tripper 6, liquor pump 7, connect the entrance of displacement liquid/dialysis fluid container 8, the one end on described liquid back pipe road 9 connects the outlet of displacement liquid/dialysis fluid container 8, by the rear direct connection blood back pipeline 4 of the first tripper 6, or connect the outlet 13 of displacement liquid/dislysate or displacement liquid/dislysate entrance 12 ends.
Under rear diluting type filtration pattern, one end of described fluid pipeline 5 connects the outlet 12 of displacement liquid/dislysate or displacement liquid/dislysate entrance 13 ends of hollow fiber dialyzer 3, by displacement liquid/dislysate entrance 13 corresponding hollow fiber dialyzer 3, or displacement liquid/dislysate port of export 12 seals;
Under front diluting type filtration pattern, if connecting displacement liquid/dislysate entrance 12 ends or the displacement liquid/dislysate of hollow fiber dialyzer 3, the one end on described liquid back pipe road 9 exports 13 ends, displacement liquid corresponding hollow fiber dialyzer 3/dislysate is exported to 13, or change the 12 ends sealings of liquid/dislysate entrance;
Under dialysis mode, described fluid pipeline 5 connects displacement liquid/dislysate outlet 12 of hollow fiber dialyzer 3, and described liquid back pipe road 9 connects displacement liquid/dislysate entrance 13 of hollow fiber dialyzer 3;
Also comprise by exogenous displacement liquid/dialysis fluid container 14, exogenous displacement liquid/dialysis fluid container fluid pipeline 15, the second tripper 16, liquor pump 7, displacement liquid/dialysis fluid container 8, the second liquid circulatory system that exogenous displacement liquid/dialysis fluid container liquid back pipe road 19 forms, described exogenous displacement liquid/dialysis fluid container fluid pipeline 15 is drawn from exogenous displacement liquid/dialysis fluid container 14, occupy on the liquid back pipe road 5 between the first tripper 6 and liquor pump 7 by the rear connection of the second tripper 16, after draw on the liquid back pipe road 9 of 19 one end, described exogenous displacement liquid/dialysis fluid container liquid back pipe road from displacement liquid/dialysis fluid container 8, the other end feeds back exogenous displacement liquid/dialysis fluid container 14 through the second tripper 16.
When the second tripper 16 cuts out, when the first tripper 6 is opened, the first liquid circulatory system that described displacement liquid/dialysis fluid container 8, hollow fiber dialyzer 3, fluid pipeline 5, liquid back pipe road 9 form becomes closed fluid circulation system, and volume is fixed.
When the first tripper 6 cuts out, when the second tripper 16 is opened, the described second liquid circulatory system being made up of exogenous displacement liquid/dialysis fluid container 14, exogenous displacement liquid/dialysis fluid container fluid pipeline 15, displacement liquid/dialysis fluid container 8, exogenous displacement liquid/dialysis fluid container liquid back pipe road 19 becomes open fluid circulation system, and described exogenous displacement liquid/dialysis fluid container 14 is replaceable.
Also be provided with the ultrafiltration system being formed by ultrafiltration pipeline 20, ultrafiltrate pump 21, ultrafiltration container 22 at the front end of fluid pipeline 5.
Described ultrafiltration system also comprises flow-monitoring device, and described flow-monitoring device is arranged on ultrafiltration pipeline 20, and the flow rate of liquid in ultrafiltration pipeline 20 and flow are monitored.
Described the first tripper 6 and the second tripper 16 are tubing clamp.
Described the first tripper 6 and the second tripper 16 link, control and open and close by the interlock of CRRT machine, in the time that CRRT machine is opened the first tripper 6, the second tripper 16 interlocks are closed, and the first liquid circulatory system and blood circulation system carry out mass exchange in hollow fiber dialyzer 3; In the time of CRRT machine switched off the first tripper 6, the second tripper 16 links open-minded, the second liquid circulatory system is carried out work, the waste liquid producing when the interior first liquid circulatory system work of displacement liquid/dialysis fluid container 8 enters circulation in the second liquid circulatory system, dilution, feeds back in exogenous displacement liquid/dialysis fluid container 14.
Described the first tripper 6 has 2, lays respectively on fluid pipeline 5, liquid back pipe road 9, and interlock is carried out closure, Open control to fluid pipeline 5, liquid back pipe road 9; The second tripper 16 has 2, lay respectively on exogenous displacement liquid/dialysis fluid container fluid pipeline 15, exogenous displacement liquid/dialysis fluid container liquid back pipe road 19, closure, Open control are carried out in interlock exogenous displacement liquid/dialysis fluid container fluid pipeline 15, exogenous displacement liquid/dialysis fluid container liquid back pipe road 19.
First liquid circulatory system exchange volume is 100-500ml.
Described tubing clamp is unidirectional folder, or two-way grip, or multidirectional folder.
According to the difference of therapeutic modality, the continuous treatment of CRRT generally speaking can be divided into two kinds of filtration pattern and dialysis mode, and filtration pattern can be divided into again that rear diluting type filters and two kinds of patterns of front diluting type filtration pattern.
When for filtration pattern, displacement liquid/dialysis fluid container is commonly referred to displacement liquid container; Exogenous displacement liquid/dialysis fluid container is commonly referred to exogenous displacement liquid container, and displacement liquid and dislysate are identical liquid, and the container of this liquid of splendid attire is also identical container.
In the time being dialysis mode, displacement liquid/dialysis fluid container is commonly referred to dialysis fluid container; Exogenous displacement liquid/dialysis fluid container is commonly referred to exogenous dialysis fluid container, and displacement liquid and dislysate are identical liquid, and the container of this liquid of splendid attire is also identical container.
Embodiment 2:As Figure 1-4, for rear dilution filters pattern, when for filtration pattern, displacement liquid/dialysis fluid container is commonly referred to displacement liquid container; Exogenous displacement liquid/dialysis fluid container is commonly referred to exogenous displacement liquid container, displacement liquid and dislysate are identical liquid, just in the first liquid circulatory system liquid by hollow fiber dialyzer after blood back pipeline input in blood, but not input to hollow dialysis dialyzer displacement liquid/dislysate arrival end.
A kind of discontinuous CRRT machine capacity balancing device, comprise by entering blood vessel road 1, blood pump 2, hollow fiber dialyzer 3, the blood circulation system that blood back pipeline 4 forms, by hollow fiber dialyzer 3, fluid pipeline 5, the first tripper 6, liquor pump 7, displacement liquid container 8, the first liquid circulatory system that liquid back pipe road 9 forms, the first liquid circulatory system and blood circulation system use common hollow fiber dialyzer 3, displacement liquid in blood in blood circulation system and the first liquid circulatory system carries out solute exchange by common hollow fiber dialyzer 3, hollow fiber dialyzer 3 comprises blood inlet 10, blood outlet 11, displacement liquid outlet 12, displacement liquid entrance 13.
Described enter the one end on blood vessel road 1 introduce after patient vessel, connect the blood inlet 10 of hollow fiber dialyzer 3 through the other end by blood pump 2, one end of described blood back pipeline 4 connects the blood outlet 11 of hollow fiber dialyzer 3, and the other end is by blood recovery patient body.
One end of described fluid pipeline 5 connects the displacement liquid outlet 12 of hollow fiber dialyzer 3, also can connect displacement liquid entrance 13 ends, export 12 ends if connect displacement liquid, by the 13 end sealings of displacement liquid entrance, if connect displacement liquid entrance 13 ends, displacement liquid is exported to 12 end sealings, described fluid pipeline 5 passes through after the first tripper 6, liquor pump 7, connect the entrance of displacement liquid container 8, the one end on described liquid back pipe road 9 connects the outlet of displacement liquid container 8, by the rear direct connection blood back pipeline 4 of the first tripper 6;
Also comprise by exogenous displacement liquid container 14, exogenous displacement liquid container fluid pipeline 15, the second tripper 16, liquor pump 7, displacement liquid container 8, the second liquid circulatory system that exogenous displacement liquid container liquid back pipe road 19 forms, described exogenous displacement liquid container fluid pipeline 15 is drawn from exogenous displacement liquid container 14, occupy on the fluid pipeline 5 between the first tripper 6 and liquor pump 7 by the rear connection of the second tripper 16, after draw on the liquid back pipe road 9 of 19 one end, described exogenous displacement liquid container liquid back pipe road from displacement liquid container 8, the other end feeds back exogenous displacement liquid container 14 through the second tripper 16,
Close when the second tripper 16, the first tripper is opened 6 o'clock, and the first liquid circulatory system that described displacement liquid container 8, hollow fiber dialyzer 3, fluid pipeline 5, liquid back pipe road 9 form becomes closed fluid circulation system, and volume is fixed;
When the first tripper 6 cuts out, when the second tripper 16 is opened, the described second liquid circulatory system being made up of exogenous displacement liquid container 14, exogenous displacement liquid container fluid pipeline 15, displacement liquid container 8, exogenous displacement liquid container liquid back pipe road 19 becomes open fluid circulation system, and described exogenous displacement liquid container 14 is replaceable.
As shown in Figure 3,4, be also provided with at the front end of fluid pipeline 5 ultrafiltration system being formed by ultrafiltration pipeline 20, ultrafiltrate pump 21, ultrafiltration container 22.
Described ultrafiltration system also comprises flow-monitoring device, and described flow-monitoring device is arranged on ultrafiltration pipeline 20, and the flow rate of liquid in ultrafiltration pipeline 20 and flow are monitored.
Described the first tripper 6 and the second tripper 16 are tubing clamp.
Described the first tripper 6 and the second tripper 16 link, control and open and close by the interlock of CRRT machine, in the time that CRRT machine is opened the first tripper 6, the second tripper 16 interlocks are closed, and the first liquid circulatory system and blood circulation system carry out mass exchange in hollow fiber dialyzer 3; In the time of CRRT machine switched off the first tripper 6, the second tripper 16 links open-minded, the second liquid circulatory system is carried out work, the waste liquid producing when the interior first liquid circulatory system work of displacement liquid/dialysis fluid container 8 enters circulation in the second liquid circulatory system, dilution, feeds back in exogenous displacement liquid/dialysis fluid container 14.
As shown in Figure 3,4, described the first tripper 6 has 2, lays respectively on fluid pipeline 5, liquid back pipe road 9, and interlock is carried out closure, Open control to fluid pipeline 5, liquid back pipe road 9; The second tripper 16 has 2, lay respectively on exogenous displacement liquid container fluid pipeline 15, exogenous displacement liquid container liquid back pipe road 19, closure, Open control are carried out in interlock exogenous displacement liquid/dialysis fluid container fluid pipeline 15, exogenous displacement liquid container liquid back pipe road 19.
First liquid circulatory system exchange volume is 100-500ml.
Described tubing clamp is unidirectional folder, or two-way grip, or multidirectional folder.
Embodiment 3:As shown in Fig. 5-8, for front dilution filters pattern, when for filtration pattern, displacement liquid/dialysis fluid container is commonly referred to displacement liquid container; Exogenous displacement liquid/dialysis fluid container is commonly referred to exogenous displacement liquid container, displacement liquid and dislysate are identical liquid, just in the first liquid circulatory system, liquid inputs in blood by the hollow fiber dialyzer blood vessel road of advancing, but not inputs to hollow dialysis dialyzer displacement liquid/dislysate arrival end.
A kind of discontinuous CRRT machine capacity balancing device, comprise by entering blood vessel road 1, blood pump 2, hollow fiber dialyzer 3, the blood circulation system that blood back pipeline 4 forms, by hollow fiber dialyzer 3, fluid pipeline 5, the first tripper 6, liquor pump 7, displacement liquid container 8, the first liquid circulatory system that liquid back pipe road 9 forms, the first liquid circulatory system and blood circulation system are used common hollow fiber dialyzer 3, displacement liquid in blood in blood circulation system and the first liquid circulatory system carries out solute exchange by common hollow fiber dialyzer 3, hollow fiber dialyzer 3 comprises blood inlet 10, blood outlet 11, displacement liquid outlet 12, displacement liquid entrance 13,
Described enter the one end on blood vessel road 1 introduce after patient vessel, connect the blood inlet 10 of hollow fiber dialyzer 3 through the other end by blood pump 2, one end of described blood back pipeline 4 connects the blood outlet 11 of hollow fiber dialyzer 3, and the other end is by blood recovery patient body;
One end of described fluid pipeline 5 connects hollow fiber dialyzer 3 displacement liquid entrances 12 or displacement liquid outlet 13, if connect displacement liquid entrance 13,, by displacement liquid outlet 13 sealings, if connect displacement liquid outlet 13, displacement liquid entrance 12 is sealed. , after the first tripper 6, liquor pump 7, connecting the entrance of displacement liquid container 8, the one end on described liquid back pipe road 9 connects the outlet of displacement liquid container 8, by connecting into blood vessel road 1 after the first tripper 6.
Also comprise by exogenous displacement liquid container 14, exogenous displacement liquid container fluid pipeline 15, the second tripper 16, liquor pump 7, displacement liquid container 8, the second liquid circulatory system that exogenous displacement liquid container liquid back pipe road 19 forms, described exogenous displacement liquid container fluid pipeline 15 is drawn from exogenous displacement liquid container 14, occupy on the fluid pipeline 5 between the first tripper 6 and liquor pump 7 by the rear connection of the second tripper 16, after draw on the liquid back pipe road 9 of 19 one end, described exogenous displacement liquid container liquid back pipe road from displacement liquid container 8, the other end is in the second tripper 16 feeds back exogenous displacement liquid container 14,
Open-minded when the first tripper 6, when the second tripper 16 cuts out, the first liquid circulatory system that described displacement liquid container 8, hollow fiber dialyzer 3, fluid pipeline 5, liquid back pipe road 9 form becomes closed fluid circulation system, and volume is fixed;
When the first tripper 6 cuts out, when the second tripper 16 is opened, the described second liquid circulatory system being made up of exogenous displacement liquid container 14, exogenous displacement liquid container fluid pipeline 15, displacement liquid container 8, exogenous displacement liquid container liquid back pipe road 19 becomes open fluid circulation system, and described exogenous displacement liquid container 14 is replaceable.
As shown in Figure 7,8, be also provided with at the front end of fluid pipeline 5 ultrafiltration system being formed by ultrafiltration pipeline 20, ultrafiltrate pump 21, ultrafiltration container 22.
Described ultrafiltration system also comprises flow-monitoring device, and described flow-monitoring device is arranged on ultrafiltration pipeline 20, and the flow rate of liquid in ultrafiltration pipeline 20 and flow are monitored.
Described the first tripper 6 and the second tripper 16 are tubing clamp.
Described the first tripper 6 and the second tripper 16 link, control and open and close by the interlock of CRRT machine, in the time that CRRT machine is opened the first tripper 6, the second tripper 16 interlocks are closed, and the first liquid circulatory system and blood circulation system carry out mass exchange in hollow fiber dialyzer 3; In the time of CRRT machine switched off the first tripper 6, the second tripper 16 links open-minded, the second liquid circulatory system is carried out work, the waste liquid producing when the interior first liquid circulatory system work of displacement liquid/dialysis fluid container 8 enters circulation in the second liquid circulatory system, dilution, feeds back in exogenous displacement liquid/dialysis fluid container 14.
As shown in Fig. 6,8, described the first tripper 6 has 2, lays respectively on fluid pipeline 5, liquid back pipe road 9, and interlock is carried out closure, Open control to fluid pipeline 5, liquid back pipe road 9; The second tripper 16 has 2, lay respectively on exogenous displacement liquid container fluid pipeline 15, exogenous displacement liquid container liquid back pipe road 19, closure, Open control are carried out in interlock exogenous displacement liquid container fluid pipeline 15, exogenous displacement liquid container liquid back pipe road 19.
First liquid circulatory system exchange volume is 100-500ml.
Described tubing clamp is unidirectional folder, or two-way grip, or multidirectional folder.
Embodiment 4:As shown in Fig. 9-12, be dialysis mode, in the time being dialysis mode, displacement liquid/dialysis fluid container is commonly referred to dialysis fluid container; Exogenous displacement liquid/dialysis fluid container is commonly referred to exogenous dialysis fluid container, and displacement liquid and dislysate are identical liquid, and the container of this liquid of splendid attire is also identical container.
A kind of discontinuous CRRT machine capacity balancing device, comprise by entering blood vessel road 1, blood pump 2, hollow fiber dialyzer 3, the blood circulation system that blood back pipeline 4 forms, by hollow fiber dialyzer 3, fluid pipeline 5, the first tripper 6, liquor pump 7, dialysis fluid container 8, the first liquid circulatory system that liquid back pipe road 9 forms, the first liquid circulatory system and blood circulation system are used common hollow fiber dialyzer 3, displacement liquid in blood in blood circulation system and the first liquid circulatory system carries out solute exchange by common hollow fiber dialyzer 3, hollow fiber dialyzer 3 comprises blood inlet 10, blood outlet 11, dislysate outlet 12, dislysate entrance 13,
Described enter the one end on blood vessel road 1 introduce after patient vessel, connect the blood inlet 10 of hollow fiber dialyzer 3 through the other end by blood pump 2, one end of described blood back pipeline 4 connects the blood outlet 11 of hollow fiber dialyzer 3, and the other end is by blood recovery patient body;
One end of described fluid pipeline 5 connects the dislysate outlet 12 of hollow fiber dialyzer 3, after the first tripper 6, liquor pump 7, connect the entrance of dialysis fluid container 8, the one end on described liquid back pipe road 9 connects the outlet of dialysis fluid container 8, by the rear connection dislysate of the first tripper 6 entrance 13 ends;
Also comprise by exogenous dialysis fluid container 14, exogenous dialysis fluid container fluid pipeline 15, the second tripper 16, liquor pump 7, dialysis fluid container 8, the second liquid circulatory system that exogenous dialysis fluid container liquid back pipe road 19 forms, described exogenous dialysis fluid container fluid pipeline 15 is drawn from exogenous dialysis fluid container 14, occupy on the fluid pipeline 5 between the first tripper 6 and liquor pump 7 by the rear connection of the second tripper 16, after draw on the liquid back pipe road 9 of 19 one end, described exogenous dialysis fluid container liquid back pipe road from dialysis fluid container 14, the other end is in the second tripper 16 feeds back exogenous dialysis fluid container 14,
Open-minded when the first tripper 6, when the second tripper 16 cuts out, the first liquid circulatory system that described dialysis fluid container 8, hollow fiber dialyzer 3, fluid pipeline 5, liquid back pipe road 9 form becomes closed fluid circulation system, and volume is fixed;
When the first tripper 6 cuts out, when the second tripper 16 is opened, the described second liquid circulatory system being made up of exogenous dialysis fluid container 14, exogenous dialysis fluid container fluid pipeline 15, dialysis fluid container 8, exogenous dialysis fluid container liquid back pipe road 19 becomes open fluid circulation system, and described exogenous dialysis fluid container 14 is replaceable.
As shown in Figure 11,12, be also provided with at the front end of fluid pipeline 5 ultrafiltration system being formed by ultrafiltration pipeline 20, ultrafiltrate pump 21, ultrafiltration container 22.
Described ultrafiltration system also comprises flow-monitoring device, and described flow-monitoring device is arranged on ultrafiltration pipeline 20, and the flow rate of liquid in ultrafiltration pipeline and flow are monitored.
Described the first tripper 6 and the second tripper 16 are tubing clamp.
Described the first tripper 6 and the second tripper 16 link, control and open and close by the interlock of CRRT machine, in the time that CRRT machine is opened the first tripper 6, the second tripper 16 interlocks are closed, and the first liquid circulatory system and blood circulation system carry out mass exchange in hollow fiber dialyzer 3; In the time of CRRT machine switched off the first tripper 6, the second tripper 16 links open-minded, the second liquid circulatory system is carried out work, the waste liquid producing when the interior first liquid circulatory system work of dialysis fluid container 8 enters circulation in the second liquid circulatory system, dilution, feeds back in exogenous displacement liquid container 14.
As shown in Fig. 9,12, described the first tripper 6 has 2, lays respectively on fluid pipeline 5, liquid back pipe road 9, and interlock is carried out closure, Open control to fluid pipeline 5, liquid back pipe road 9; The second tripper 16 has 2, lay respectively on exogenous dialysis fluid container fluid pipeline 15, exogenous dialysis fluid container liquid back pipe road 19, closure, Open control are carried out in interlock exogenous dialysis fluid container fluid pipeline 15, exogenous dialysis fluid container liquid back pipe road 19.
Claims (8)
1. a discontinuous CRRT machine capacity balancing device, comprise by entering blood vessel road, blood pump, hollow fiber dialyzer, the blood circulation system of blood back pipeline composition, by hollow fiber dialyzer, fluid pipeline, the first tripper, liquor pump, displacement liquid/dialysis fluid container, the first liquid circulatory system of liquid back pipe road composition, the first liquid circulatory system and blood circulation system use common hollow fiber dialyzer, displacement liquid/dislysate in blood in blood circulation system and the first liquid circulatory system carries out solute exchange by common hollow fiber dialyzer, hollow fiber dialyzer comprises blood inlet, blood outlet, the outlet of displacement liquid/dislysate, displacement liquid/dislysate entrance,
Described enter the one end on blood vessel road connect after patient vessel, connect the blood inlet of hollow fiber dialyzer through the other end by blood pump, one end of described blood back pipeline connects the blood outlet of hollow fiber dialyzer, the other end is by blood recovery patient body;
It is characterized in that: one end of described fluid pipeline connects displacement liquid/dislysate port of export of hollow fiber dialyzer, connect by after the first tripper, liquor pump, connect the entrance of displacement liquid/dialysis fluid container, the one end on described liquid back pipe road connects the outlet of displacement liquid/dialysis fluid container, by directly connecting blood back pipeline after the first tripper or entering blood vessel road, or connect displacement liquid/dislysate arrival end;
Under forward and backward dilution filtration pattern, one end of described fluid pipeline connects displacement liquid/dislysate port of export of hollow fiber dialyzer, by displacement liquid/dislysate arrival end sealing corresponding hollow fiber dialyzer; One end of described fluid pipeline connects displacement liquid/dislysate arrival end of hollow fiber dialyzer, by displacement liquid/dislysate port of export sealing corresponding hollow fiber dialyzer;
Under dialysis mode, described fluid pipeline connects displacement liquid/dislysate port of export of hollow fiber dialyzer, and described liquid back pipe road connects displacement liquid/dislysate arrival end of hollow fiber dialyzer;
Also comprise by exogenous displacement liquid/dialysis fluid container, exogenous displacement liquid/dialysis fluid container fluid pipeline, the second tripper, liquor pump, displacement liquid/dialysis fluid container, the second liquid circulatory system of exogenous displacement liquid/dialysis fluid container liquid back pipe road composition, described exogenous displacement liquid/dialysis fluid container fluid pipeline is drawn from exogenous displacement liquid/dialysis fluid container, by connecting after the second tripper on the fluid pipeline occuping between the first tripper and liquor pump, after the liquid back pipe pass of one end, described exogenous displacement liquid/dialysis fluid container liquid back pipe road from displacement liquid/dialysis fluid container goes out, the other end feeds back exogenous displacement liquid/dialysis fluid container through the second tripper,
When the second tripper cuts out, when the first tripper is opened, the first liquid circulatory system of described displacement liquid/dialysis fluid container, hollow fiber dialyzer, fluid pipeline, liquid back pipe road composition becomes closed fluid circulation system, and volume is fixed;
When the first tripper cuts out, when the second tripper is opened, the described second liquid circulatory system being made up of exogenous displacement liquid/dialysis fluid container, exogenous displacement liquid/dialysis fluid container fluid pipeline, displacement liquid/dialysis fluid container, exogenous displacement liquid/dialysis fluid container liquid back pipe road becomes open fluid circulation system, and described exogenous displacement liquid/dialysis fluid container is replaceable.
2. discontinuous CRRT machine capacity balancing device according to claim 1, is characterized in that: be also provided with the ultrafiltration system being made up of ultrafiltration pipeline, ultrafiltrate pump, ultrafiltration container at the front end on liquid back pipe road.
3. discontinuous CRRT machine capacity balancing device according to claim 1, it is characterized in that: described ultrafiltration system also comprises flow-monitoring device, described flow-monitoring device is arranged on ultrafiltration pipeline, and the flow rate of liquid in ultrafiltration pipeline and flow are monitored.
4. discontinuous CRRT machine capacity balancing device according to claim 1, is characterized in that: described the first tripper and the second tripper are tubing clamp.
5. discontinuous CRRT machine capacity balancing device according to claim 1, it is characterized in that: described the first tripper and the interlock of the second tripper, control and open and close by the interlock of CRRT machine, in the time that CRRT machine is opened the first tripper, the second tripper interlock is closed, and the first liquid circulatory system and blood circulation system carry out mass exchange in hollow fiber dialyzer; In the time of CRRT machine switched off the first tripper, the second tripper interlock is open-minded, the second liquid circulatory system is carried out work, the waste liquid producing when the first liquid circulatory system is worked in displacement liquid/dialysis fluid container enters circulation in the second liquid circulatory system, dilution, feeds back in exogenous displacement liquid/dialysis fluid container.
6. discontinuous CRRT machine capacity balancing device according to claim 1, is characterized in that: described the first tripper has 2, lays respectively on fluid pipeline, liquid back pipe road, and interlock is carried out closure, Open control to fluid pipeline, liquid back pipe road; The second tripper has 2, lay respectively on exogenous displacement liquid/dialysis fluid container fluid pipeline, exogenous displacement liquid/dialysis fluid container liquid back pipe road, closure, Open control are carried out in interlock exogenous displacement liquid/dialysis fluid container fluid pipeline, exogenous displacement liquid/dialysis fluid container liquid back pipe road.
7. discontinuous CRRT machine capacity balancing device according to claim 1, is characterized in that: first liquid circulatory system exchange volume is 100-500ml.
8. discontinuous CRRT machine capacity balancing device according to claim 4, is characterized in that: described tubing clamp is unidirectional folder, or two-way grip, or multidirectional folder.
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