CN1058193C - Portable artificial kidney - Google Patents

Portable artificial kidney Download PDF

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CN1058193C
CN1058193C CN 92101842 CN92101842A CN1058193C CN 1058193 C CN1058193 C CN 1058193C CN 92101842 CN92101842 CN 92101842 CN 92101842 A CN92101842 A CN 92101842A CN 1058193 C CN1058193 C CN 1058193C
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bag
dialysis solution
liquid
blood
artificial kidney
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CN1065799A (en
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彭罗民
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Abstract

A medical artificial kidney able to be moved by patient is composed of bidirectional dialysis liquid circulation system and extracorporeal blood circulation system, and is suitable for treating acute renal failure, chronic renal failure, uremia, multiple organ failure, poison, drug poisoning, etc. The present invention is similar to a venous transfusion frame, and is characterized by that the full dialysate bag is placed in high-position heat-insulating box and connected with dialysate conduit, and the empty dialysate bag is placed in low-position heat-insulating box and also connected with dialysate conduit, and connected with extracorporeal blood circulation system, and the two dialysate two-way circulation system is started, and two dialysate heat-insulating boxes can be alternatively up and down moved just like cable car, and the dialysate can be back-and-forth flowed in dialyzer or filter, and can be changed at regular time to implement treatment.

Description

Portable artificial kidney
The present invention relates to a kind of armarium, particularly a kind of portable artificial kidney; And can be used as Wearable hemodiafiltration (WHDF), Wearable blood dialysis ultrafiltration (WHDU), Wearable simple blood ultrafiltration (WSHU) and Wearable pure hemofiltration (WSHF)---two-way circulation of dialysis solution and extracorporeal circulation of blood device that Wearable artificial kidney (WAK) is supporting; Also can be used for membrane type blood plasma and separate, carry out replacement therapy of blood plasma.The present invention is suitable for medical institutions at different levels and is used for the treatment of acute renal failure, chronic renal failure with uremia, multiple organ failure, MOF, poisonous substance, drug intoxication, lupus erythematosus etc.
Present conventional hemodialysis (CHD) machine (conventional artificial kidney machine) has many shortcomings: 1. costing an arm and a leg, (with Sweden's Gambro AK-10 type and U.S. SPS-550 type is example, every ten thousand yuans of 15-18 of cover, as add that about 240,000 yuan in reverse osmosis water treatment system device is about totally 40 ten thousand yuan).2. volume heaviness can not promptly be moved patient's other rescue of bed according to patient's the state of an illness to temporarily.3. dependence water power source, and present conventional import artificial kidney machine all requires to keep certain hydraulic pressure, voltage to water, power supply, and low excessively hydraulic pressure, voltage all can not move, and cut off the water and can not do treatment at once.4. dialysis solution one-way flow, disposable fully the application by dialyser dumps, and causes energy waste.5. side reaction is big, and unbalanced syndrome usually takes place in the treatment, hypotension, very person's shock.External portable, Wearable artificial kidney, its ultimate principle is that the automatic monitor portion of conventional artificial kidney machine is dwindled, use the dialysate regeneration device and dwindle the dialysis solution feed system, as the REDY system, the mode that dialysis solution circulates in dialyser is the same with traditional conventional artificial kidney machine, is one-way flow.The the lighter of the gross weight of external Wearable artificial kidney is 4.5 kilograms, relies on the power supply of battery powered or external power supply.Because imperfection own is not popularized the domestic Wearable artificial kidney application report that does not still have import so far up till now yet in a large number.Continuous arterio venous hemofiltration (CAVH), though the other treatment of feasible bed the patient who rescues acute renal failure, chronic renal failure with uremia, multiple organ failure, MOF is offered convenience,, CAVH still has its shortcoming: 1. pair micromolecule is removed rate variance; 2. need in the treatment to replenish a large amount of displacement liquids and easily cause severe infections, and treat the cost height; 3. only can lie in bed treat slow continuous blood dialysis (SCHD) and/or continuously its shortcoming of arteriovenous hemodialysis (CAVHD) be: 1. dialysis solution still imitates traditional flow and method, is one-way flow, per minute 15ml, disposable application is still wasted.2, treatment time is long, and long-time anticoagulant easily causes hemorrhage.3. treatment only can be liied in bed and be carried out.United States Patent (USP), the patent No.: 4,631,050.Int.cl 4.A61M1/03。By " the automatic infusion system and method " of invention such as Charles C.Reed mainly by three impeller pumps, two filter unit and ultrafiltration unit and tubing and constitute, be used for wound, operation from the cleaning of body blood, concentrated, feedback, can not carry out hemodialysis.United States Patent (USP), the patent No.: 4,650,457.Int.cl 4.A61M1/03。" external lung auxiliary device " by inventions such as Tohrn Morilka is mainly used in the treatment acute respiratory failure.United States Patent (USP), the patent No.: 4,755,168.Int.cl 4.A61M1/03 be mainly used in the drainage wash of organ by " the medical drainage pump and the purging method " of inventions such as Pat Romanelli.United States Patent (USP), the patent No.: 4,838,865.Int.cl 4.A61M1/03。" liquid monitoring system " by inventions such as Hans P.Flank can be used for hemodialysis, hemofiltration, but design is too complicated, and volume is big.United States Patent (USP), the patent No.: 4,769,001 Int.cl 4.A61M1/03." standard combination pump liquid drainage system apparatus and method " by Paul R.Prince invention are the separating plasma when being used for plasmapheresis.This system applies two pumps, can not carry out hemodialysis, feasible separating plasma and filtration, its shortcoming is the volume and weight that two pumps have increased device.
Purpose of the present invention, a kind of portable artificial kidney that designs at above deficiency and can be used as Wearable hemodiafiltration (WHDF) and Wearable blood dialysis ultrafiltration (WHDU) Wearable simple blood ultrafiltration (WSHU) and Wearable pure hemofiltration (WSHF) exactly, Wearable hemodialysis and filtration, Wearable hemodialysis and ultrafiltration are carried out simultaneously---dress or supporting two-way circulation of dialysis solution and the extracorporeal circulation of blood device of artificial kidney (WAK); Also can be used for membrane type blood plasma and separate, displacement.Portable artificial kidney has been simplified conventional artificial kidney machine's dialysis solution feed system widely, does not rely on the water source, can freely move the patient and rescue at one's side, not limited by the place.Portable artificial kidney is simplified to complicated conventional artificial kidney machine just like an intravenous transfusion (IVT) pole, and it is the same to make hemodialysis become similar common venous transfusion, basic point of the present invention that Here it is, purpose of the present invention that Here it is.So, the patient that can make numerous needs obtain blood purification treatment can both obtain treatment, thereby changes the situation that present numerous unit plane is deeply aware of one's own helplessness when faced with a great task to the conventional artificial kidney machine of the import of costliness.Portable artificial kidney can make the basic automatization that realizes of the treatments of being carried out such as hemodialysis, improves individual medical worker's work efficiency.The present invention is suitable for hospitals at different levels, especially carries out the big-and-middle-sized hospital of specific treatment, county, city, district, township level hospital, and factories and miness hospital, Army ambulance corps, private clinics etc. have large-scale application prospect.
The present invention is achieved in that it is by hollow cylinder or hollow cubic column (1), hollow circle, spill, triangle or other shape groove posts (2), and power lead (3), driving-belt (4) slides control valve or control post (5-1; 5-2), dialysis solution slides couveuse (6-1; 6-2), dialyzate bag (7-1; 7-2), dialysis solution slides couveuse inner hanging hook (8-1; 8-2), ultrasonic detector probe or pressure transducer (9-1; 9-2), blood pump fixed station (10), power plug wire (11), pillar and foot dish engagement plate (12), foot dish (13), universal caster wheel (14), dialysis solution conduit (15-1; 15-2), monitor controller (16), reversible electric machine (17), brake valve (18), spragging gear (19), power transmission shaft (20), power transmission shaft support (21), ultrasonic monitor or pressure monitor (22), beeper (23), enumerator (24), computer single-chip microcomputer (25), display screen (26), "T"-shaped hook (27), panel enclosure (28) blood pump (29a; 29b), arterio-venous catheter (30), anticoagulant syringe (31), heparin pump (32a; 32b), dialyser, filter or plasma separator (33) are formed, as shown in Figure 1.The top of hollow cylinder or hollow cubic column (1) is connected monitor controller (16), (1) below is connected with foot dish (13) mutually by foot dish engagement plate (12), two sides in (1), be fixed with hollow circle, spill, triangle or its allotriomorphic groove post (2), two dialysis solution slide couveuse (6-1; 6-2) by sliding control valve or control post (5-1; When 5-2) in the groove of (2), moving up and down, rely on reversible electric machine (17) to drive power transmission shaft (20), by driving-belt (3) tractive (6-1; 6-2) realize operation, up and down just like the cable car sample, when full dialyzate bag (7-1 or 7-2) moves to a high position, cause that for preventing that reversible electric machine (17) from reversing voluntarily full dialyzate bag (7-1 or 7-2) moves down, the brake valve (18) of design can be after full dialyzate bag (7-1 or 7-2) runs to a high position, stretch out the braking arm in spragging gear (19) seam, prevent power transmission shaft (20) to reverse voluntarily, when full dialyzate bag stream sky, empty dialyzate bag stream is full, when two bags of high low levels of exchange started, the brake arm that stretches out was return simultaneously, again and again motion, shown in Fig. 2-3.Without dialysis solution, the ductus arteriosus of arterio-venous catheter (30), one end and dialyser, filter or plasma separator (33) are connected, by blood pump (29a or 29b) and heparin pump (32a or 32b), or there is not a plain pump of blood pump regulating liver-QI, the other end is connected with patient's tremulous pulse or vein, the venous duct of arterio-venous catheter, one end and dialyser, filter or plasma separator (33) are connected, the other end is connected with patient's vein, dialysis solution conduit (15-2) is connected on the dialysis solution or filtered solution hole of dialyser or filter (33) one ends, stop up another dialysis solution or the filtered solution hole of (33), adopt existing blood pump and heparin pump (29a, 32a) or improve blood pump and heparin pump (29b, 32b), or can carry out simple blood ultrafiltration or pure hemofiltration, shown in Fig. 4-6 without blood pump and heparin pump.Dialysis solution conduit (15-2) is changed into transfusion, blood transfusion sterile tube, and the plasma flow that is connected Membrane Plasma Separator (33) is stopped up another plasma flow and is portalled on portalling, and can carry out separating plasma, implements replacement therapy of blood plasma, as shown in Figure 7.The present invention realizes working procedure like this: beginning, fresh dialysis solution hung into high-order dialysis solution slide couveuse (6-1 or 6-2), pass through pressure transducer, pressure monitor is measured the fresh dialysis fluid amount, go up the milliliter number that shows fresh dialysis fluid at display screen (26), add up fresh fluid volume once, the dialysis solution of No. 1 liquid bag (high-order dialysis solution 7-1) flows into dialyser or filter (33) through dialysis solution conduit (15-1), flow out dialyser or filter (33) after dialysis solution conduit (15-2) flows into No. 2 liquid bags (low level dialyzate bag 7-2), survey through ultrasonic detector probe or pressure transducer (9-1), does and machine single-chip microcomputer (25) No. 1 liquid bag of analytical judgment (7-1) flow sky as calculated? be, flowed sky, reversible electric machine (17) is at once along planting to rotation, exchange 1, No. 2 (height, low level) position of dialyzate bag, count simultaneously 1 time, and at display screen (26) demonstration per minute flow, No. 2 liquid bags this moment (high-order dialyzate bag 7-2) are last, No. 1 liquid bag (7-1) infra, dialysis solution flows into dialysis solution conduit (15-2) through No. 2 liquid bags (high-order dialyzate bag 7-2), flow into dialyser or filter (33), flow out dialyser or filter (33) again, flow into No. 1 liquid bag (low level dialyzate bag 7-1) through dialysis solution conduit (15-1), survey through ultrasonic monitor probe or pressure transducer (9-2), do and machine single-chip microcomputer (25) No. 2 liquid bags of analytical judgment (7-2) flow sky as calculated? be, No. 2 liquid bags (7-2) have flowed sky, rotate in reversible electric machine (17) contra solem, exchange 2, No. 1 (7-2; Count 1 time the 7-1) position of liquid bag, shows flow on screen (26), has machine single-chip microcomputer (25) judged whether pre-timing number as calculated? not, do not arrive pre-regularly number, go round and begin again, continue aforementioned process; Be, arrived pre-regularly number, suspend upset, beeper (23) is notified from a phone call: " * * bed, * * people should change liquid ".Notifying from a phone call content can be fixed by the operator before fixed point is used, and also can be imported before use by the special messenger.When notifying from a phone call, measure low level liquid bag liquid measure (exhausted dialysis solution 7-2 or 7-1), numeration adds up, calculate to show ultrafiltration volume (ultrafiltration volume=fresh liquid measure/bag-used liquid measure/bag, positive number is negative ultrafiltration, and negative is positive ultrafiltration, as 3,000ml-3300ml=-300ml is positive ultrafiltration 300ml, expression exceeds 300ml liquid in patient's body, on the contrary, showing has 300ml liquid to be stayed in patient's body).Ultrafiltration total amount (the ultrafiltration volume addition, positive number is negative ultrafiltration, and negative is positive ultrafiltration).After changing fresh dialysis solution, capable aforementioned process continues, treatment time arrives, the order fulfillment seance, have a power failure during the treatment suddenly, beeper (23) is notified from a phone call and is manually changed liquid, stop to notify from a phone call after changing liquid, can hang over a dialyzate bag on the "T"-shaped hook, another dialyzate bag places low level, exchange two bags position repeatedly, regularly change fresh dialysis solution, manual operations continues to go and treats, and rotates blood pump (29a), inject heparin or rotation blood pump (29b) and heparin pump (32b) and keep the blood extracorporeal circulation to incoming call or stopped treatment, as shown in Figure 8.The measuring method of dialysis solution per minute flow of the present invention is different from traditional employing spinner flowmeter continuous mode method, but adopt dialysis liquid measure (ml)/bag, take advantage of exchange number of times (t), remove the method for unit interval (min) and calculate acquisition, appliance computer calculates continuously and shows, with formulate, that is:
Figure C9210184200091
As the liquid measure of dialysing (ml)/bag=3, the 000ml/ bag; Exchange number of times 5 times; 30 minutes unit interval, that is: 3,000 ml × 5 30 = 500 ml / min
The per minute flow equals 500 milliliters, and is identical with conventional artificial kidney machine's dialysis solution per minute flow, but practical application dialysis liquid measure reduces widely than conventional artificial kidney machine, and it is still big to be actually used in the dialysis solution exchange capacity of treatment, and key is fully to have used dialysis solution.
Dialyzate bag (the 7-1 that the present invention is used; Be special 7-2), its structure and capacity and prior art to continue the used dialyzate bag of bed property peritoneal dialysis (CAPD) different, the prior art dialyzate bag is a rectangle, liquid in-out pipe diameter is 4.5-5mm, capacity is 1,000ml/ bag, 1,500ml/ bag, 2,000ml/ bag, material are plastics; The used dialyzate bag employing of the present invention diameter is that the junction block of 7-9mm is done the liquid in-out pipe, and capacity is 3, and 000ml/ bag, the material of dialyzate bag are plastics, flexible packing materials such as silication plastics, silicone rubber, polyurethane silicone rubber.
Blood pump (29a) heparin pump (32a) that the present invention adopts is characterized in that the conventional artificial kidney machine's of volume ratio blood pump, heparin pump is little.Blood pump (29b) and heparin pump (32b) are characterised in that two pumps and on a pump head, utilize blood pump roller idle running space on one side, make its roll extrusion injecting heparin conduit, reach the purpose of injecting heparin, reduce frame for movement, improved blood pump unit effect, shown in Fig. 1,2,4,7.The heparin liquid catheter clip can be realized that both the roll extrusion ductus arteriosus drove blood circulation in the card pipe support, but roll extrusion heparin liquid conduit orders about heparin liquid and enters ductus arteriosus again, with the internal diameter of heparin liquid conduit and the concentration control injection rate of preparation, reach the purpose of injecting heparin automatization.

Claims (6)

1. medical portable artificial kidney, it is characterized in that: portable artificial kidney is by hollow cylinder or cubic column (1), hollow circle, spill, triangle or other shape groove post (2), power lead (3), driving-belt (4) slides control valve or control post (5-1; 5-2), dialysis solution slides couveuse (6-1; 6-2), dialyzate bag (7-1; 7-2), dialysis solution slides couveuse inner hanging hook (8-1; 8-2), ultrasonic detector probe or pressure transducer (9-1; 9-2), blood pump fixed station (10), power plug wire (11), pillar and foot dish engagement plate (12), foot dish (13), universal wheel (14), dialysis solution conduit (15-1; 15-2), monitor controller (16), reversible electric machine (17), brake valve (18), spragging gear (19), power transmission shaft (20), power transmission shaft support (21), ultrasonic monitor or pressure monitor (22), beeper (23), enumerator (24), computer single-chip microcomputer (25), display screen (26), "T"-shaped hook (27), panel enclosure (28), blood pump (29a; 29b), arterio-venous catheter (30), anticoagulant syringe (31), heparin pump (32a; 32b), dialyser or filter or plasma separator (33) are formed.
2. the method for work of portable artificial kidney according to claim 1 is characterized in that:
A. working procedure is, beginning, fresh dialysis fluid is hung into high-order couveuse (6-1 or 6-2), measure the fresh dialysis fluid amount, the milliliter number that shows fresh dialysis fluid at display screen (26), add up fresh fluid volume once, the dialysis solution of No. 1 liquid bag (high-order dialyzate bag 7-1) is through dialysis solution conduit (15-1), flow into dialyser or filter (33), flow out dialyser or filter (33) after dialysis solution conduit (15-2) flows into No. 2 liquid bags (low level dialyzate bag 7-2), survey through ultrasonic detector probe or pressure transducer (9-1), does and machine single-chip microcomputer (25) No. 1 liquid bag of analytical judgment (7-1) flow sky as calculated? be, flowed sky, reversible electric machine (17) rotates along clockwise at once, exchange No. 1.2 (height, low level) position of dialyzate bag, count simultaneously 1 time, and at display screen (26) demonstration per minute flow, No. 2 liquid bags this moment (7-2) are last, No. 1 liquid bag (7-1) infra, dialysis solution flows into dialysis solution conduit (15-2) through No. 2 liquid bags (high-order dialyzate bag 7-2), flow into dialyser or filter (33), flow out dialyser or filter (33) again, flow into No. 1 liquid bag (low level dialyzate bag 7-1) through dialysis solution conduit (15-1), survey through ultrasonic monitor probe or pressure transducer (9-2), do and machine single-chip microcomputer (25) No. 2 liquid bags of analytical judgment (7-2) flow sky as calculated? be, No. 2 liquid bags (7-2) have flowed sky, rotate in reversible electric machine (17) contra solem, exchanges No. 2.1 (7-2; Count 1 time the 7-1) position of liquid bag, shows flow on screen (26), has machine single-chip microcomputer (25) judged whether pre-timing number as calculated? not, do not arrive pre-regularly number, go round and begin again, continue aforementioned process; Be, arrived pre-regularly number, suspend upset, beeper (23) is notified from a phone call: " * * bed, * * people, should change liquid ".Measure low level liquid bag liquid measure simultaneously, add up, calculate the demonstration ultrafiltration volume, the ultrafiltration total amount.After changing fresh dialysis solution, continue aforementioned process, treatment time arrives, the order fulfillment seance, have a power failure during the treatment suddenly, beeper (23) is notified from a phone call and is manually changed liquid, can hang over a dialyzate bag " on the T shape hook; another dialyzate bag places low level; exchange two bags position repeatedly, regularly change fresh dialysis solution, treatment is proceeded in manual operations; rotate blood pump (29a), injects heparin or rotation blood pump (29b) and heparin pump (32b) and keeps the blood extracorporeal circulation to incoming call or stopped treatment;
B. without dialysis solution, the ductus arteriosus of arterio-venous catheter (30), one end and dialyser, filter or plasma separator (33) are connected, be connected with patient's tremulous pulse or vein with the heparin pump other end by blood pump, the venous duct of arterio-venous catheter (30), one end and dialyser, filter or plasma separator (33) are connected, the other end is connected with patient's vein, dialysis solution conduit (15-2) is connected on dialyser or filter (33) dialysis solution or filtered solution hole on one side, stop up another hole of (33), can carry out simple blood ultrafiltration or filtration, dialysis solution conduit (15-2) change into the transfusion or blood line be connected on the stomidium of plasma separator (33), stop up another stomidium, can carry out separating plasma;
C. dialysate flow calculating method is, dialysis liquid measure (ml/ bag) is taken advantage of exchange number of times (t), removes the unit interval (min), represents with following formula:
Figure C9210184200031
3. portable artificial kidney according to claim 1 is characterized in that: dialysis solution slides couveuse (6-1; Inwall 6-2) is made by insulation material, slides control valve or control post (5-1; 5-2) with corresponding knot form in hollow circle, spill drives driving-belt (4) by reversible electric machine (17) in triangle or other shape groove post (2), driving-belt (4) tractive dialysis solution and is slided couveuse (6-1; Move just like the cable car sample 6-2) up and down.
4. the method for work of portable artificial kidney according to claim 2, it is characterized in that: reversible electric machine (17) reverses automatically and causes full dialyzate bag to move down, the control valve (18) of design can be after full dialyzate bag (7-1 or 7-2) rises to a high position, stretch out brake arm in spragging gear (19) seam, stop power transmission shaft (20) to reverse, when full dialyzate bag flows empty, empty dialyzate bag stream is full, when two bags of high and low positions of exchange started, the brake arm that stretches out was return simultaneously, again and again motion.
5. portable artificial kidney according to claim 1 is characterized in that: dialyzate bag (7-1; Material 7-2) is plastics, the silication plastics, and silicone rubber, packaging material such as polyurethane silicone rubber, the junction block diameter of dialyzate bag is 7-9mm, capacity is the 3000ml/ bag.
6. portable artificial kidney as claimed in claim 1, it is characterized in that: blood pump (29b) and heparin pump (32b) are the purposes that is realized its pump blood notes heparin liquid by one group of roller pump continuous roll extrusion blood ductus arteriosus and heparin liquid pipe, i.e. offside design at the ductus arteriosus of " U " shape bending has the card pipe support, and the heparin liquid pipe clamp can be finished in the card pipe support.
CN 92101842 1992-03-15 1992-03-15 Portable artificial kidney Expired - Fee Related CN1058193C (en)

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8202241B2 (en) * 2007-02-15 2012-06-19 Asahi Kasei Medical Co., Ltd. Blood purification system
US20140263062A1 (en) 2013-03-14 2014-09-18 Fresenius Medical Care Holdings, Inc. Universal portable machine for online hemodiafiltration using regenerated dialysate
CN105079902A (en) * 2014-05-16 2015-11-25 彭罗民 Standard peritoneal dialysis house
CN109331241B (en) * 2018-09-28 2021-04-20 中南大学湘雅三医院 Ascites drainage control device

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