CN109200371B - Body cavity liquid treatment device - Google Patents

Body cavity liquid treatment device Download PDF

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Publication number
CN109200371B
CN109200371B CN201810050301.3A CN201810050301A CN109200371B CN 109200371 B CN109200371 B CN 109200371B CN 201810050301 A CN201810050301 A CN 201810050301A CN 109200371 B CN109200371 B CN 109200371B
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body cavity
liquid
concentrated
ascites
line
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CN109200371A (en
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五反田裕也
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Asahi Kasei Medical Co Ltd
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Asahi Kasei Medical Co Ltd
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M1/00Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/34Filtering material out of the blood by passing it through a membrane, i.e. hemofiltration or diafiltration

Abstract

The invention provides a body cavity liquid treatment device. When the residual liquid in the body cavity such as ascites and the like in the concentrator, the recirculation line and the like is recovered to the concentration bag without being discarded, the amount of the recovered liquid is set to a predetermined amount while avoiding a difference from the predetermined amount of the recovered liquid. A body cavity fluid treatment device is provided with: a filter for removing a specific substance in the body cavity fluid; a concentrator for concentrating the body cavity fluid; a concentrated body cavity fluid bag for storing the concentrated body cavity fluid; the air and liquid feeding unit is communicated with the outlet of the filter; recirculation means for returning the concentrated body cavity fluid to the concentrator; a recycle line; a liquid amount measuring device for measuring the concentrated body cavity liquid stored in the concentrated body cavity liquid bag; and a control device which, after the filtration and/or concentration of the original body cavity liquid is completed, recycles a certain amount of the concentrated body cavity liquid in advance to remove water and then recovers the concentrated body cavity liquid by using the concentrated body cavity liquid bag, wherein the certain amount is an amount considering the total starting filling amount of the filter outer side, the filtration line, the concentrator inner side and the recycling line.

Description

Body cavity liquid treatment device
Technical Field
The invention relates to a body cavity liquid treatment device.
Background
As a method for treating refractory Ascites, there is an Ascites filtration-Concentrated intravenous infusion Therapy (Cell-free and Concentrated analytes infusion Therapy): removing ascites from a patient, removing causative substances such as bacteria and cancer cells from the ascites, removing water from the ascites while leaving useful components such as albumin, and returning the water-removed concentrate to the body.
In the above-mentioned treatment method, an ascites treatment device is generally used. The ascites treatment apparatus employs the following structure: the abdominal water bag, the filter, the concentrator and the concentrated ascites bag are connected in series in this order, and ascites is flowed by using a drop head or a pump and filtered and concentrated. The filter uses a filtration membrane such as a hollow fiber membrane.
As such an ascites treatment device, an ascites treatment device including a system for automatically transferring from filtration to recirculation is disclosed (for example, see patent document 1).
Patent document 1: japanese patent laid-open publication No. 2013-188427
Disclosure of Invention
Problems to be solved by the invention
However, the above-described system has the following problems: in the case of recovering the filtered ascites remaining in the circuit or concentrator after the treatment with ascites, the filtered ascites remaining in the concentrator and the recirculation line are discarded, thus causing waste, or in the case of recovery, the recovered portion is put into a concentration bag, thus causing a difference from a predetermined amount of the concentrated solution.
Accordingly, an object of the present invention is to provide a body cavity fluid treatment apparatus which can prevent a difference from a predetermined recovery amount and can reduce the amount of a recovered fluid to a predetermined amount when the body cavity fluid such as ascites fluid remaining in a concentrator, a recirculation line, or the like is recovered in a concentration bag without being discarded.
Means for solving the problems
A body cavity fluid treatment device according to an aspect of the present invention filters a body cavity fluid stored in a body cavity of a patient or a body cavity fluid bag, and removes water from the filtered body cavity fluid to generate a concentrated body cavity fluid, the body cavity fluid treatment device including: a filter provided with a filter member for selectively removing a specific substance in the body cavity liquid; a filter line for fluid communication with the filter cavity during filtration; a concentrator that concentrates the filtrate from the filter; a concentrated body cavity liquid bag for recovering and storing the concentrated body cavity liquid concentrated by the concentrator; the air and liquid feeding unit is communicated with an outlet of the filtering cavity liquid of the filter; a recirculation means for returning the concentrated body cavity liquid stored in the concentrated body cavity liquid bag to the concentrator; a recirculation line in fluid communication with the concentrate chamber when recirculating; a liquid amount measuring device that measures a liquid amount of the concentrate chamber liquid stored in the concentrate chamber liquid bag; and a control device for recycling a predetermined amount of the concentrated body cavity liquid in advance to remove water after the filtration and/or concentration of the raw body cavity liquid are completed, and then recovering the liquid by using the concentrated body cavity liquid bag, wherein the predetermined amount is an amount considering the total starting filling amount of the filter outer side, the filtration line, the concentrator inner side and the recirculation line.
In the body cavity fluid treatment apparatus according to the above aspect, after the filtration and/or concentration of the body cavity fluid is completed, a predetermined amount of the concentrated body cavity fluid is recirculated in advance to remove water, and then the concentrated body cavity fluid is collected by the concentrated body cavity fluid bag, so that it is possible to avoid a difference between the initially predetermined collection amount and the actual collection amount, the predetermined amount being an amount in consideration of the total start-up filling amount of the filter outside, the filtration line, the concentrator inside, and the recirculation line. Further, by recovering the filtered ascites remaining in the concentrator and the recirculation line, waste can be suppressed.
In the body cavity fluid treatment apparatus according to the above aspect, the fluid amount measuring device may include a weight scale for measuring the weight of the concentrated body cavity fluid bag.
The body cavity fluid treatment apparatus according to the above aspect may further include a bubble detection unit disposed on the recirculation line.
ADVANTAGEOUS EFFECTS OF INVENTION
It is possible to provide a body cavity fluid treatment apparatus which can prevent the amount of a recovered fluid from becoming a predetermined amount by avoiding a difference from a predetermined amount of the recovered fluid when the body cavity fluid such as ascites fluid remaining in a concentrator, a recirculation line, or the like is recovered in a concentration bag without being discarded.
Drawings
Fig. 1 is an explanatory diagram showing an outline of the configuration of an ascites treatment device in the first embodiment.
FIG. 2 is an explanatory view showing a state of an ascites treating apparatus in the re-concentration step.
FIG. 3 is an explanatory view showing a state of the ascites treating apparatus in a step of collecting ascites remaining outside the filter, inside the filter line and inside the concentrator.
FIG. 4 is an explanatory view showing a state of the ascites treating apparatus in a step of collecting ascites remaining in the recirculation line.
Fig. 5 is an explanatory view showing another example of the step of collecting ascites remaining in the recirculation line.
FIG. 6 is a flowchart showing an example of a step of collecting residual ascites in the ascites treating apparatus.
FIG. 7 is a graph showing a transition example of the storage amount of concentrated ascites in the step of collecting residual ascites in the ascites treating apparatus.
Fig. 8 is an explanatory diagram showing an outline of the configuration of the ascites processing apparatus in the second embodiment.
Description of the reference numerals
1: ascites treatment devices (body cavity fluid treatment devices); 10: a primary abdominal water bag (primary body cavity liquid bag); 11: a filter; 11 c: a liquid through port (outlet of the filter); 18: a pump; 50: a control device; 62: a recirculation device; 70: a filtration membrane (filtration member); 110: a concentrator; 111: a condensed abdominal water bag (condensed body cavity liquid bag); 115: a concentration pump (pump); 150: a liquid amount measuring device; 160: an air feed pump (air and liquid feed unit); 170: a bubble detecting unit; FL: a filtration line; RL: a recycle line.
Detailed Description
Preferred embodiments of the present invention will be described below with reference to the accompanying drawings. Note that the same elements are denoted by the same reference numerals, and redundant description thereof is omitted. The positional relationship between the upper, lower, left, and right sides is not limited unless otherwise specified. The dimensional ratios in the drawings are not limited to the illustrated ratios. The following embodiments are illustrative of the present invention, and the present invention is not limited to these embodiments.
Fig. 1 is an explanatory diagram showing an outline of the configuration of an ascites treatment device 1 as a body cavity fluid treatment device according to the present embodiment. The ascites treatment apparatus 1 is an apparatus for filtering raw ascites extracted from a patient and stored in a raw ascites bag 10 and removing water from the filtered ascites to generate concentrated ascites.
The ascites treating apparatus 1 includes a filter 11, a first line 12, a second line 13, a third line 14, a fourth line 15, a first pressure measuring device 16, a second pressure measuring device 17, a pump 18, a first opening/closing device 19, an upstream opening/closing device 21, a control device 50, and the like. The ascites treatment apparatus 1 is divided into a filtration system (filtration section) 2 for performing filtration treatment and a concentration system (concentration section) 3 for performing concentration treatment (see fig. 2). The ascites treatment apparatus 1 according to the present embodiment further includes an air-supply pump 160, a bubble detection means 170, and a backflow prevention opening/closing device 22 (see fig. 1 and the like).
The filter 11 is, for example, cylindrical, and has liquid inlets 11a and 11b at both ends in the longitudinal direction and two liquid inlets 11c and 11d on the side surface. The filter 11 is provided with a filtration membrane 70 such as a hollow fiber membrane, and the filtration membrane 70 can selectively remove a specific substance in the abdominal water, for example, by removing a predetermined causative substance such as bacteria or cancer cells and passing a predetermined useful component such as albumin. The inner region of the filtration membrane 70 communicates with the liquid inlet ports 11a and 11b, and the outer region of the filtration membrane 70 communicates with the liquid inlet ports 11c and 11 d.
A first line 12 connects the raw ascites bag 10 with the filter 11. The downstream end of the first line 12 is connected to a liquid inlet 11a of the filter 11.
The second line 13 connects the filter 11 to a later-described concentrator 110 of the concentration system 3. The upstream end of the second line 13 is connected to a fluid inlet (outlet of ascites filtered by the filter 11) 11c of the filter 11.
One end of the third line 14 is connected to the liquid inlet 11b of the filter 11. The other end of the third line 14 is connected to, for example, a drain portion not shown.
One end of the fourth line 15 is connected to the liquid inlet 11d of the filter 11. The other end of the fourth line 15 is open to the atmosphere. In addition, soft tubes are used for the first to fourth lines 12 to 15.
Here, the connection of the first to fourth pipelines may be reversed. That is, the first line may be connected to the liquid passage port 11c, the second line may be connected to the liquid passage port 11a, the third line may be connected to the liquid passage port 11d, and the fourth line may be connected to the liquid passage port 11 b. In general, from the viewpoint of priming, the filter used for blood purification reduces the priming amount of blood by flowing blood to the inside of the filtration membrane and then filtering the blood to the outside, but in the case of a body cavity fluid treatment, a treatment method according to the amount and composition of the body cavity fluid may be appropriately selected. For example, in the case of filtration from the inside toward the outside of the filtration membrane 70 of the filter 11, a cleaning effect in the case of membrane cleaning (circulation of a cleaning liquid from the outside toward the inside of the filtration membrane 70) performed in the case of clogging of the membrane can be expected, and in the case of filtration from the outside toward the inside of the filtration membrane 70 of the filter 11, the surface area of the filtration membrane 70 is larger than in the case of flow from the inside toward the outside, and therefore, contribution to improvement of the membrane life of the filter 11 can be expected.
The first pressure measuring device 16 is provided to be able to measure the pressure in the first line 12 and measure the pressure on the primary side (inlet side) of the filtration membrane 70 of the filter 11. Here, in the case where the pressure value can be grasped without measuring the pressure value by utilizing the head pressure between the original ascites bag 10 and the filter 11, the first pressure measuring device 16 can be omitted. The second pressure measuring device 17 is provided to be able to measure the pressure in the fourth line 15 and measure the pressure on the secondary side (outlet side) of the filtration membrane 70 of the filter 11. The pressure measurement results of the first pressure measurement device 16 and the second pressure measurement device 17 are output to the control device 50. Here, the second pressure measuring device 17 may be disposed on the second line 13, and the disposition is not limited as long as the secondary side (outlet side) of the filtration membrane 70 of the filter 11 can be measured.
A pump 18 is arranged in the second line 13. The pump 18 is, for example, a tube pump capable of forward rotation and reverse rotation for pressurizing ascites in a delivery tube by treating the tube. The pump 18 is also used to close the second line 13 when stopped, and functions also as an opening/closing device (flow rate adjustment device).
The first opening/closing device 19 is, for example, an opening/closing valve, and is provided in the third line 14.
The upstream opening/closing device 21 is, for example, an opening/closing valve, and is provided in the first line 12.
The open/close device for preventing backflow 22 is a device for preventing backflow of ascites toward the filter 11 during the recirculation treatment of ascites or the recovery treatment of ascites. The opening/closing device 22 for preventing backflow according to the present embodiment is disposed on the filter 11 side of the second line 13 with respect to the junction with the circulation line 114.
The other end of the fourth line 15 is connected to the air feed pump 160. The air-supply pump 160 can be used when filtered ascites (ascites after filtration) remaining on the outlet side of the filtration membrane 70 of the filter 11 or the like is collected through the second line 13. The air feed pump 160 supplies gas (atmospheric air) to the outlet side of the filtration membrane 70 to push out the filtered ascites on the outlet side of the filtration membrane 70 to the second line 13.
The bubble detecting unit 170 is configured to include a gas detecting device (see fig. 1 and the like) that detects bubbles in the ascites flowing through the concentrate line 112 or the circulation line 114. A single gas detection device may be provided across concentrate line 112 and recycle line 114.
The control device 50 is, for example, a microcomputer having a CPU, a memory, and the like. The control device 50 can control the operations of the respective devices such as the pump 18, the first opening/closing device 19, the upstream opening/closing device 21, the first pressure measurement device 16, the second pressure measurement device 17, the pump of the recovery device, and the concentration system 3, and the operations of the devices such as the concentration pump 115 described later, and execute ascites treatment. The control device 50 receives measurement results and the like of the liquid amount measuring device 150 described later. The control device 50 executes a liquid recovery process described later. The control device 50 can execute a program stored in advance in a memory, for example, to perform ascites treatment.
The concentration system 3 includes a concentrator 110, a concentrated ascites bag 111 as a concentrated ascites reservoir, a concentration line 112, a drain line 113, a circulation line 114, a concentration pump 115, a third pressure measuring device 117, a fourth pressure measuring device 118, and the like, and further includes a liquid amount measuring device 150. Although not particularly shown, for example, an air intake port for sending air from the outside into the second line 13 and a valve for opening and closing the air intake port may be provided in the third pressure measurement device 117.
The concentrator 110 has, for example, a cylindrical shape. The concentrator 110 has liquid inlets 110a and 110b at both ends in the longitudinal direction, and two liquid inlets 110c and 110d on the side surface. For example, the liquid passage 110a of the concentrator 110 is connected to the second line 13.
The concentrator 110 includes a concentration membrane 120 such as a hollow fiber membrane, and the concentration membrane 120 removes water from the filtered ascites supplied from the second line 13, for example, to concentrate the filtered ascites. The inner region of the concentrating membrane 120 communicates with the liquid inlets 110a and 110b, and the outer region of the concentrating membrane 120 communicates with the liquid inlets 110c and 110 d. In the present embodiment, the liquid passage port 110d is closed, but may communicate with the drain line 113.
The concentrated ascites bag 111 is a container capable of collecting and storing concentrated ascites concentrated by the concentrator 110. The concentration line 112 connects the liquid passing port 110b of the concentrator 110 with the concentrated ascites bag 111. One end of the drain line 113 is connected to the liquid inlet 110c of the concentrator 110, and the other end is connected to a drain unit, not shown.
The circulation line 114 connects, for example, the concentrate bag 111 with the second line 13. The circulation line 114 is connected to the second line 13 at a position upstream of the pump 18 (on the filter 11 side). An opening/closing device 119 including, for example, an opening/closing valve is provided in the circulation line 114. For example, soft tubes are used for the concentrate line 112, the drain line 113, and the circulation line 114.
The concentration pump 115 is disposed, for example, on the downstream side of the concentrator 110 of the concentration line 112, and delivers the concentrated ascites to the concentrated ascites bag 111. The concentration pump 115 uses, for example, a tube pump.
The third pressure measuring device 117 is provided to be able to measure the pressure in the second line 13, for example, and measure the pressure on the primary side (inlet side) of the concentration membrane 120 of the concentrator 110. The fourth pressure measuring device 118 is provided in the drain line 113, and measures the pressure on the secondary side (outlet side) of the concentration membrane 120 of the concentrator 110. The pressure measurement results of the third pressure measurement device 117 and the fourth pressure measurement device 118 are output to the control device 50. The control device 50 can control the operations of the respective devices of the concentration system 3, such as the concentration pump 115, the pump 18, the third pressure measurement device 117, and the fourth pressure measurement device 118, and execute ascites treatment. In addition, when the pressure value can be grasped without measuring the pressure value by the head pressure between the concentrator 110 and the end of the drain line 113, the fourth pressure measuring device 118 can be omitted.
In the concentration system 3, a means (recirculation means) for recirculating the concentrated ascites stored in the concentrated ascites bag 111 to the concentrator 110 is constituted. For example, in the ascites treatment apparatus 1 of the present embodiment, the recirculation apparatus 62 is constituted by the aforementioned circulation line 114, the concentration pump 115, the pump 18, and the like. The concentration pump 115 may be disposed in the drain line 113.
The fluid amount measuring device 150 measures the fluid amount of the concentrated ascites stored in the concentrated ascites bag 111. The specific configuration of the liquid amount measuring device 150 is not particularly limited, and for example, it may be configured to include a weight scale capable of measuring the weight of the concentrated ascites bag 111 storing the concentrated ascites, and calculate the pump flow rate by multiplying the time based on the flow rate of the concentration pump 115 controlled based on the measured value of the weight scale.
When the liquid amount measuring device 150 is a device having a weight as described above, the liquid amount in the concentrate bag 111 can be controlled based on the measured value of the weight.
Alternatively, the amount of the concentrated ascites stored in the concentrated ascites bag 111 can be calculated from the known weight of the concentrated ascites bag 111 and the weight per unit volume of the concentrated ascites by using a weight in the same manner as described above. For example, the volume may be measured by measuring the capacity of the concentrated abdominal water bag 111 (for example, using an ultrasonic sensor, an electrostatic capacitance sensor, or the like, not shown), and the volume may be converted into the weight. In addition to calculating the amount of the concentrated ascites based on the weight as described above, the volume may be calculated from the result of the volume measurement, and the control may be performed based on the calculated volume. In this case, the amount of liquid in the concentrated ascites bag 111 is controlled based on the increase/decrease amount of the volume.
Next, an outline of ascites treatment using the ascites treatment device 1 described above will be described (see fig. 6, fig. 7, and the like).
< filtration and concentration step >
First, the raw abdominal water bag 10 containing ascites extracted from the patient is connected to the first line 12. Then, the ascites filtration and concentration step is started. In a state where the first opening/closing device 19 is closed and the upstream opening/closing device 21 and the backflow prevention opening/closing device 22 are opened, the pump 18 is rotated in the forward direction to operate the concentration pump 115 (see fig. 1).
Thereby, the ascites in the original abdominal water bag 10 is transferred to the filter 11 through the first line 12. The ascites flows into the inlet side (inner region) of the filter membrane 70 from the fluid inlet 11a of the filter 11, passes through the filter membrane 70, and flows out to the outlet side (outer region) of the filter membrane 70. At this time, a predetermined causative substance is removed from the ascites. The filtered ascites flowing out to the outlet side of the filtering membrane 70 flows out from the filter 11 to the second line 13, is transferred to the concentrator 110 through the second line 13 and flows into the inlet side of the concentrating membrane 120 of the concentrator 110. Here, a part of the moisture, for example, the filtered ascites flows out to the outlet side of the concentration membrane 120 through the concentration membrane 120 by a pressure difference (flow rate difference) between the pump 18 and the concentration pump 115. Thereby, water is removed from the filtrated ascites, and the filtrated ascites is concentrated. The concentrated ascites concentrated by the concentrator 110 is received in the concentrated ascites bag 111 through the concentration line 112.
< reconcentration step >
The pump 18 and the concentration pump 115 are operated in a state where the opening/closing device 119 is opened and the opening/closing device for backflow prevention 22 is closed (see fig. 2). Thereby, the concentrated ascites in the concentrated ascites bag 111 is transferred to the concentrator 110 through the circulation line 114 and the second line 13, and returned from the concentrator 110 to the concentrated ascites bag 111 through the concentration line 112 to be circulated. By this, the concentrated ascites is re-concentrated. In the case of a configuration in which the opening/closing device 19 and the upstream opening/closing device 21 can be closed, the opening/closing device 22 for preventing backflow can be omitted.
In the step of filtering and concentrating ascites, the first pressure measuring device 16 and the second pressure measuring device 17 are operated to monitor the pressure on the inlet side and the pressure on the outlet side of the filtration membrane 70 of the filter 11. For example, when the pressure difference (P1 to P2) between the pressure P1 on the inlet side and the pressure P2 on the outlet side of the filtration membrane 70 (the pressure difference between the membranes) in the filter 11 exceeds a predetermined threshold value D, the upstream opening/closing device 21 may be closed to stop the process of filtering and concentrating ascites, assuming that the filtration membrane 70 is clogged. The threshold value D is obtained and set in advance by experiments and calculations.
< recovery step >
In the ascites treatment device 1 of the present embodiment, after the filtration treatment and/or concentration treatment of ascites is completed, ascites remaining in the outside of the filter 11, the inside of the filter line, the concentrator 110, and the recirculation line are recovered as follows (see fig. 3, fig. 4, and the like).
Herein, the term "filtration line" as used herein refers to a line through which ascites flows when the filtration treatment of ascites is performed. Specifically, the line is connected to the outlet (liquid inlet 11c) of the strainer 11, and more specifically, the line is connected from the strainer 11 to the concentrate bag 111 through the concentrator 110. In fig. 3, the filtration line is indicated by a bold line and reference FL.
The term "recirculation line" as used herein refers to a line through which ascites flows when the ascites is subjected to a recirculation treatment. Specifically, it refers to the surrounding lines including the recycle line 114, a portion of the second line 13, and the concentrate line 112. In fig. 4, the recirculation line is indicated by a bold line and reference RL.
(stage 0 (concentration stage))
First, in the present embodiment, as the re-concentration step in the stage prior to the recovery step, a predetermined amount of concentrated ascites is recycled in advance to remove water, the predetermined amount being an amount that takes into account the total start-up filling amount of the ascites treatment apparatus 1. As a result, the amount of the concentrated ascites stored in the concentrated ascites bag 111 is reduced by an amount that takes into account the total priming volume (see fig. 2).
In addition, the priming amount is generally an index indicating how much amount of the patient's blood enters the blood circuit for hemodialysis, and in the present embodiment, corresponds to the amount of ascites stored in the concentrated ascites bag 111 after the recovery treatment performed after the passage of the residual ascites in the circuit. The amount of the total priming amount may be a known amount input to the control device 50 in advance, or may be a value set by the user.
(stage 1 (recovery stage of filtration line, etc.))
Next, in stage 1 of the ascites collection treatment, ascites remaining outside the filter 11, the filtration line FL, and inside the concentrator 110 are collected (step SP 1). Specifically, the air-supply pump 160 is driven to supply air to the filter 11 through the liquid passage port 11d in a state where the first opening/closing device 19, the upstream opening/closing device 21, and the opening/closing device 119 are closed and the opening/closing device 22 for preventing backflow is opened (see fig. 3). This allows ascites remaining outside the filter 11, inside the filter line FL and the concentrator 110 to be collected in the concentrate abdominal water bag 111.
In the middle of the recovery process of the residual ascites, when the bubble detecting means 170 detects the bubble flowing through the concentration line 112 (step SP 2: "YES"), the pump 18 and the concentration pump 115 are stopped, and the recovery stage of the filtration line FL and the like is ended (step SP 3). Alternatively, step SP2 may be stopped after the pump 18, the concentration pump 115, and the like are driven to cause a predetermined amount of residual ascites to flow or a predetermined amount of residual ascites to be collected.
(stage 2 (recovery stage of recycle line))
Next, as the stage 2 of the ascites collection treatment, ascites remaining in the recirculation line RL is collected (step SP 4). Specifically, since concentrated ascites remains in the circulation line 114, the concentrated ascites is mainly recovered (see fig. 4).
In the present embodiment, as the stage 2 of the ascites collecting treatment, the pump 18 is rotated in the reverse direction with at least the open/close device 22 for preventing backflow closed. In this case, for example, air is taken in from an air intake port (not shown) provided in the third pressure measuring device 117. Thus, the concentrated ascites remaining in the circulation line 114 can be returned to the concentrated ascites bag 111.
In the middle of the recovery process in stage 2, when the bubble detecting means 170 detects the bubble flowing through the circulation line 114 (step SP 5: YES), the pump 18 is stopped, and the recovery stage of the recirculation line RL is ended (step SP 6). Alternatively, step SP6 may be terminated after a predetermined amount of ascites is made to flow or a predetermined amount of ascites is collected.
As a result, the ascites collection process (see fig. 6) remaining outside the filter 11, inside the filtration line, the concentrator 110, and the recirculation line is completed.
(other examples of stage 2 (recovery stage of recycle line))
The above-mentioned stage 2 of the ascites collection treatment is merely a preferable example, and the stage 2 of the ascites collection treatment can be performed as follows (see fig. 5), for example.
In a state where the first opening/closing device 19 and the upstream opening/closing device 21 are closed and the opening/closing device 119 is opened, the air-supply pump 160 is driven to supply air to the filter 11 through the liquid passage port 11 d. Thus, the concentrated ascites remaining in the circulation line 114 can be returned to the concentrated ascites bag 111.
In the middle of the recovery process in stage 2, if the bubble detection means 170 detects bubbles flowing through the circulation line 114, the air feed pump 160 is stopped, and the recovery stage of the recirculation line RL is terminated. Alternatively, step SP6 may be terminated after a predetermined amount of ascites is made to flow or a predetermined amount of ascites is collected.
In the above embodiment, the ascites treatment apparatus 1 filters and concentrates the ascites contained in the raw ascites bag 10 and then stores the filtered and concentrated ascites bag 111, but the ascites may be directly taken out from the patient to the first line 12 and filtered and concentrated.
The above embodiment is a preferred example in which the present invention is applied to an ascites treatment device 1 for treating ascites, but the present invention can also be applied to a body cavity fluid treatment device for treating other body cavity fluids such as pleural effusion.
In the above-described embodiment, the ascites after filtration and concentration is collected in the concentrated ascites bag 111, but this is merely a preferred example. The abdominal water concentration bag 111 is a kind of container for collecting and storing the concentrated ascites concentrated by the concentrator 110, and a container other than such a bag may be used for collection.
The air-supply pump 160 is merely a preferable example of an air-supply/liquid-supply unit (fluid-supply unit) that supplies gas or liquid. Instead of the air supply pump 160 for supplying air, a pump for supplying a liquid such as physiological saline may be used. In short, any fluid may be used as long as it can be used for recovery of ascites (body fluid) remaining in the circuit.
In the above-described embodiment, the case where the air supply pump 160 is connected to the liquid inlet 11d of the filter 11 by using the fourth line 15 to supply air has been exemplified and described (see fig. 1 and the like), but this is merely a preferable example. In addition, for example, if a pump for feeding a liquid such as physiological saline as described above is used as the air/liquid feeding means (fluid supply means), the liquid can pass through the filter membrane 70, and therefore the liquid feeding pump can be connected to the liquid inlet 11a of the filter 11. Alternatively, the original ascites 10 may be replaced with a liquid such as a physiological saline solution.
In the above-described embodiment, the ascites is prevented from flowing back toward the filter 11 by closing the open/close device for backflow prevention 22 provided in the second line 13 at the time of the re-concentration step (see fig. 2) and at the recovery stage of the recirculation line (see fig. 4), but this is merely a preferred example. The backflow prevention valve may be disposed at any position, or a structure in which a certain pump is stopped to prevent backflow may be employed instead of providing the backflow prevention valve.
In the above embodiment, the order of the stage 1 and the stage 2 may be reversed, or the stages may be performed simultaneously.
Next, a second embodiment will be described with reference to fig. 8. The ascites treatment apparatus 1 according to the second embodiment is configured as follows: a pump 180 is provided on the primary side (inlet side) of the filtration membrane 70 of the filter 11, and ascites is pressurized by the pump 180 and then pushed out toward the filter 11. In this embodiment, when the concentrated ascites stored in the concentrated ascites bag 111 is recirculated to the concentrator 110, the concentrated ascites is recirculated by pressurizing with the pump 23 disposed in the circulation line 114.
It should be noted that the description of the second embodiment is merely another preferred example different from the first embodiment. In short, the specific configuration of the ascites treatment device 1 is not particularly limited as long as the residual filtered ascites is recovered and the amount of recovered fluid is a predetermined amount regardless of the connection of the respective lines or the position of the pump.
Industrial applicability
The present invention is suitably applied to a body cavity fluid treatment apparatus for filtering a body cavity fluid such as ascites fluid stored in a body cavity of a patient or a body cavity fluid bag and removing water from the filtered body cavity fluid to produce a concentrated body cavity fluid.

Claims (3)

1. A body cavity fluid treatment device for filtering a body cavity fluid stored in a body cavity of a patient or a body cavity fluid bag and removing water from the filtered body cavity fluid to generate a concentrated body cavity fluid, the body cavity fluid treatment device comprising:
a filter provided with a filter member that selectively removes a specific substance in the body cavity liquid;
a filter line for fluid communication with the filter cavity during filtration;
a concentrator that concentrates the filtered body fluid filtered by the filter;
a concentrated body cavity liquid bag recovering and storing the concentrated body cavity liquid concentrated by the concentrator;
an air and liquid feeding unit which is communicated with an outlet of the filtering coelomic liquid of the filter;
a recirculation device that returns the concentrate chamber fluid stored in the concentrate chamber fluid bag to the concentrator;
a recirculation line in fluid communication with the concentration chamber when recirculating;
a liquid amount measuring device that measures a liquid amount of the concentrate chamber liquid stored in the concentrate chamber liquid bag; and
and a control device that, after the filtration and/or concentration of the body cavity liquid is completed, recirculates a predetermined amount of the concentrated body cavity liquid to remove water before the concentrated body cavity liquid is recovered by the concentrated body cavity liquid bag, and then recovers the concentrated body cavity liquid bag by the concentrated body cavity liquid bag, the predetermined amount being an amount that takes into account a total start-up filling amount of the filter outside, the filtration line, the concentrator inside, and the recirculation line.
2. The body cavity fluid treatment apparatus according to claim 1,
the liquid amount measuring device includes a weight scale that measures the weight of the concentrated body cavity liquid bag.
3. A body cavity fluid treatment apparatus according to claim 1 or 2,
further comprises a bubble detection means disposed on the recirculation line.
CN201810050301.3A 2017-07-07 2018-01-18 Body cavity liquid treatment device Active CN109200371B (en)

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Publication number Priority date Publication date Assignee Title
JPS5516674A (en) * 1978-07-24 1980-02-05 Kuraray Co Abdominal dropsy treatment device
JPS5529358A (en) * 1978-08-25 1980-03-01 Asahi Medical Co Device that treat abdominal dropsy
JP5062631B2 (en) * 2008-06-12 2012-10-31 圭祐 松崎 Ascites treatment system and operating method thereof
JP5856821B2 (en) * 2010-11-26 2016-02-10 旭化成メディカル株式会社 Ascites filtration concentrator
JP5952601B2 (en) * 2012-03-15 2016-07-13 旭化成メディカル株式会社 Ascites treatment apparatus and ascites treatment method
WO2013176140A1 (en) * 2012-05-25 2013-11-28 旭化成メディカル株式会社 Method and apparatus for producing high-concentration protein solution
JP5800099B2 (en) * 2013-01-15 2015-10-28 国立大学法人徳島大学 Stock solution concentrator, stock solution processing device, and circulation type processing device
CN106999640B (en) * 2014-12-26 2019-10-29 旭化成医疗株式会社 Body cavity liquid treating system

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