CN115427090A - Blood component measuring device and blood purifying device - Google Patents

Blood component measuring device and blood purifying device Download PDF

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Publication number
CN115427090A
CN115427090A CN202180029367.4A CN202180029367A CN115427090A CN 115427090 A CN115427090 A CN 115427090A CN 202180029367 A CN202180029367 A CN 202180029367A CN 115427090 A CN115427090 A CN 115427090A
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light
blood
output voltage
section
concentration
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星野步
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JMS Co Ltd
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JMS Co Ltd
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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
    • 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
    • A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N21/00—Investigating or analysing materials by the use of optical means, i.e. using sub-millimetre waves, infrared, visible or ultraviolet light
    • G01N21/17—Systems in which incident light is modified in accordance with the properties of the material investigated
    • G01N21/25—Colour; Spectral properties, i.e. comparison of effect of material on the light at two or more different wavelengths or wavelength bands
    • G01N21/27—Colour; Spectral properties, i.e. comparison of effect of material on the light at two or more different wavelengths or wavelength bands using photo-electric detection ; circuits for computing concentration

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  • Life Sciences & Earth Sciences (AREA)
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  • Investigating Or Analysing Materials By Optical Means (AREA)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)

Abstract

Provided is a blood component measurement device capable of measuring the concentration of a blood component in a short time and with high accuracy. A blood component measurement device (1) controls a light emission control unit (21) as follows: a light emitting unit (11) is caused to blink in a plurality of wavelength regions so that lighting sections do not overlap in a predetermined period T, the length of 1 lighting section Toff1 of a plurality of lighting sections Toff1, toff2 is longer than the fall time of the output voltage of a light receiving unit (12), and the length of the other lighting sections Toff2 is shorter than 1 lighting section Toff1, a concentration calculating unit (22) obtains the output voltage Vn of external light in 1 lighting section Toff1, and the concentration of the blood component is calculated based on values Vc1, vc2 obtained by subtracting the output voltage Vn of the external light from the output voltages V1, V2 of the light receiving unit (12) in the lighting sections Ton1, ton2.

Description

Blood component measuring device and blood purifying device
Technical Field
The present invention relates to a blood component measuring apparatus and a blood purification apparatus capable of continuously measuring a change in concentration of a blood component in extracorporeally circulating blood.
Background
In blood purification therapies such as dialysis treatment, the concentration of blood components contained in the blood of a patient is an important index for determining the effect and efficiency of the treatment. The concentration of blood components also changes during treatment, and therefore it is necessary to continuously measure the change in concentration of blood components in the extracorporeal circulation. As a method for continuously measuring the concentration of a blood component, the following methods are known: blood is irradiated with light of a predetermined wavelength from the light-emitting section via a tube or the like in a non-contact manner, the intensity of the transmitted light or the reflected light is converted into a voltage in the light-receiving section, and the concentration is measured based on the output voltage of the light-receiving section.
In the measurement using light in this manner, an error occurs in the output voltage of the light receiving unit due to the external light incident on the light receiving unit. In order to reduce this error, for example, patent document 1 describes the following method: the light-off and light-on of the light-emitting section are repeated, the output voltage at the time of light-off is used as the output voltage of the external light, the output voltage of the external light is subtracted from the output voltage at the time of light-on, and the concentration is calculated by correction. By correcting each flash of the light emitting section, the component concentration can be measured continuously and with high accuracy.
Patent document 2 describes a blood purification device that can measure the concentration of blood components such as hematocrit and oxygen saturation in blood using a plurality of light emitting units.
Generally, light in 2 wavelength regions of about 600nm and about 800nm is used for measuring oxygen saturation, and light in a wavelength region of about 800nm is used for measuring hematocrit. In order to measure the hematocrit with high accuracy, light having 2 wavelength regions of about 800nm and about 1300nm may be used.
Documents of the prior art
Patent literature
Patent document 1: japanese patent laid-open publication No. 2004-97782
Patent document 2: japanese patent laid-open publication No. 2016-125
Disclosure of Invention
Problems to be solved by the invention
As described in patent document 2, in the measurement using light of a plurality of wavelength regions, in order to perform measurement with high accuracy by the method described in patent document 1, the output voltage of external light may be measured by extending each lamp-off time to such an extent that the remaining light is lost. However, since light of a plurality of wavelength ranges is emitted, if the light-off time is long, the lighting cycle of light of each wavelength range becomes long. Therefore, the time required for measurement becomes long.
Accordingly, an object of the present invention is to provide a blood component measurement device capable of measuring the concentration of a blood component in a short time with high accuracy.
Means for solving the problems
The present invention relates to a blood component measurement device that continuously measures a change in concentration of a blood component based on an intensity of transmitted light or reflected light of light irradiated to blood, the blood component measurement device including: a light emitting section that emits light in a plurality of wavelength regions including visible light; a light receiving unit that receives transmitted light or reflected light of the light emitted from the light emitting unit, converts the received light or reflected light into a voltage, and outputs the voltage; a light emission control unit that controls lighting on and off of the light emitting unit; and a concentration calculation unit that calculates a concentration of a blood component based on an output voltage of the light receiving unit, wherein the light emission control unit controls: the concentration calculation unit acquires an output voltage of the light receiving unit as an output voltage of external light in the 1 light-out section, and calculates a concentration of a blood component based on a value obtained by subtracting the output voltage of the external light from the output voltage of the light receiving unit in the light-up section.
Preferably, the light emission control unit controls the other light-off sections so that a fall time of the output voltage of the light-receiving unit becomes shorter.
Preferably, the light receiving unit includes a plurality of light receiving elements that receive light of different wavelength regions, and the concentration calculating unit obtains, as the output voltage of each external light, each output voltage of the plurality of light receiving elements in the 1 light-out period, and calculates the concentration of the blood component based on a value obtained by subtracting the output voltage of each external light from each output voltage of the plurality of light receiving elements in the light-out period of each wavelength region.
Further, the present invention relates to a blood purification apparatus including: the blood component measuring device; a blood purifier; a blood circuit; a blood pump provided in the blood circuit and configured to feed blood to the blood purifier; a measurement unit for measuring the concentration of a blood component flowing through the blood circuit; and a control device, wherein the light emitting section and the light receiving section are provided in the measuring section, and the light emission control section and the concentration calculating section are provided in the control device.
ADVANTAGEOUS EFFECTS OF INVENTION
According to the blood component measurement device of the present invention, the concentration of the blood component can be measured with high accuracy by increasing the output voltage of the external light by increasing 1 of the plurality of turned-off sections, and the concentration of the blood component can be measured in a short time by decreasing the other turned-off sections.
Drawings
FIG. 1 is a block diagram showing a blood component measurement device according to embodiment 1 of the present invention.
Fig. 2 is a schematic diagram for explaining the configuration of the measuring unit according to embodiment 1.
Fig. 3 is a graph showing the output voltage of the light receiving unit in embodiment 1.
FIG. 4 is a schematic diagram showing a configuration of a blood purification apparatus including a blood component measurement device according to embodiment 2 of the present invention.
FIG. 5 is a block diagram of a blood purification apparatus according to embodiment 2.
Fig. 6 is a schematic diagram for explaining the configuration of the measuring unit according to embodiment 2.
Fig. 7 is a graph showing the output voltage of the light receiving unit in embodiment 2.
Detailed Description
Preferred embodiments of the blood component measurement device according to the present invention will be described below with reference to the accompanying drawings.
The blood component measuring apparatus of the present invention can continuously measure the concentration of a blood component in blood in a non-contact manner in a treatment in which the blood of a patient is extracorporeally circulated by using a blood purification apparatus for performing a dialysis treatment or the like, an artificial heart-lung apparatus, or the like. In embodiment 1, a blood component measuring apparatus capable of measuring oxygen saturation as a blood component will be described, and in embodiment 2, a blood purifying apparatus including a blood component measuring apparatus capable of measuring oxygen saturation and hematocrit as blood components will be described.
< embodiment 1 >
Embodiment 1 will be described in detail with reference to fig. 1 to 3. Fig. 1 is a block diagram showing a blood component measurement device 1 according to embodiment 1 of the present invention.
As shown in fig. 1, the blood component measurement device 1 includes a measurement unit 10, a control unit 20, and a display unit 30.
The measurement unit 10 has a light-emitting portion 11 that emits light in 2 wavelength regions, and a light-receiving portion 12 that receives transmitted light or reflected light emitted from the light-emitting portion 11, converts the transmitted light or reflected light into a voltage, and outputs the voltage, and is attached to a channel through which blood flows, such as a tube or a blood chamber.
The light emitting unit 11 includes 2 light emitting elements L1 and L2 and a light emitting circuit LC. In the present embodiment, since the oxygen saturation is measured as an example of the blood component, a light emitting diode that emits light in a wavelength region of about 600nm, which is visible light, is used as the light emitting element L1, and a light emitting diode that emits light in a wavelength region of about 800nm is used as the light emitting element L2. The light-emitting circuit LC turns on or off the light-emitting elements L1 and L2 based on a signal transmitted from a light-emitting control circuit 21 described later. Light in the wavelength region of about 600nm is absorbed mainly by reduced hemoglobin, and light in the wavelength region of about 800nm is absorbed mainly by reduced hemoglobin and oxidized hemoglobin. When light in these 2 wavelength regions is irradiated to blood, a part is absorbed, a part is transmitted, and a part is reflected.
The light receiving unit 12 includes 1 light receiving element F1 and a light receiving circuit RC. Since the 2 wavelength regions used in the present embodiment are approximately 600nm and approximately 800nm, the light receiving element F1 uses a photodiode that can receive light in both wavelength regions. Different photodiodes may also be used for the 2 wavelength regions, respectively. The light receiving circuit RC is a circuit that converts a weak current flowing therethrough into a voltage according to the intensity of light incident on the light receiving element F1, amplifies the voltage, and outputs the amplified voltage.
In the present embodiment, as shown in fig. 2, the light emitting section 11 and the light receiving section 12 are arranged in parallel, and light is irradiated from the light emitting section 11 to the blood B flowing through the tube, and the reflected light reflected on the surface portion of the blood is incident on the light receiving section 12 and converted into a voltage.
The control unit 20 includes a light emission control unit 21 and a density calculation unit 22.
The light emission control unit 21 controls lighting and lighting-off of the light emitting unit 11 by transmitting a signal for causing each of the light emitting elements L1 and L2 in the light emitting unit 11 to blink at a predetermined cycle to the light emitting circuit LC.
The concentration calculation section 22 calculates oxygen saturation as a blood component based on the voltage output from the light receiving circuit RC. The specific calculation method is described in detail below.
The display unit 30 is constituted by a liquid crystal panel or the like that displays the concentration of the blood component calculated by the concentration calculation unit 22, the change over time of the blood component, and the like.
Next, a specific method for measuring the concentration of a blood component will be described with reference to fig. 3.
The light emission control unit 21 controls the light emitting unit 11 so that the light emitting elements L1 and L2 blink with a predetermined cycle T. When the light emitting unit 11 is caused to blink at the predetermined cycle T in this manner, the output voltage of the light receiving unit 12 has a waveform as shown in fig. 3.
In fig. 3, a section from the start of lighting to the start of lighting of the light emitting element L1 is defined as a lighting section Ton1, and a section from the start of lighting to the start of lighting of the light emitting element L2 is defined as a lighting section Ton2. Further, a section from the light-off of the light-emitting element L2 to the light-on of the light-emitting element L1 is referred to as a light-off section Toff1, and a section from the light-off of the light-emitting element L1 to the light-on of the light-emitting element L2 is referred to as a light-off section Toff2.
In this case, the relationship of the predetermined period T = Toff1+ Ton1+ Toff2+ Ton2 holds. Here, the light emission control unit 21 controls the light-off interval Toff2 among the 2 light-off intervals Toff1 and Toff2 to be shorter than the light-off interval Toff 1. The light-out interval Toff1 is set to have a length that continues after the influence of the residual light generated by the lighting of the light-emitting element L2 disappears.
That is, in the lighting interval Ton2, the output voltage increased to the predetermined value is decreased for a predetermined decrease time in the lighting-out interval Toff1 and converged. That is, in the lamp-out period Toff1, after a predetermined fall time has elapsed, the output voltage of the light receiving unit 12 can be regarded as the output voltage Vn generated by the incidence of the external light.
In the present embodiment, ton1= Ton2= Toff1=8ms, and Toff2=4ms are given as an example. When the light-out period Toff2 is shortened as described above, the period T can be shortened, where the light-out period Toff2 is a light-out period other than the light-out period Toff1 for obtaining the output voltage Vn of the external light. Thus, the blood concentration can be measured in a short time. For example, in the case of the present embodiment, the cycle T =28ms, and the number of flickers of the light emitting element L1 which emits visible light within 1 second is 35.7 times. In general, since 35 or more blinks are not visible within 1 second, the flicker can be reduced by the above setting.
The concentration calculation unit 22 obtains the output voltage of the light receiving unit 12 as the output voltage Vn of the external light in the light-off interval Toff 1. Next, in the lighting interval Ton1 of the light emitting element L1, a value obtained by subtracting the output voltage Vn of the external light from the output voltage V1 is obtained as the correction voltage Vc1. Finally, in the lighting interval Ton2 of the light emitting element L2, a value obtained by subtracting the output voltage Vn of the external light from the output voltage V2 is obtained as the correction voltage Vc2. The concentration calculation unit 22 calculates the oxygen saturation by obtaining the ratio of the reduced hemoglobin and the oxidized hemoglobin from the correction voltage Vc1 depending on the concentration of the reduced hemoglobin and the correction voltage Vc2 depending on the concentration of the reduced hemoglobin and the concentration of the oxidized hemoglobin. Thereafter, this process is repeated, and the concentration calculation is continued.
According to the blood component measurement device 1 of embodiment 1 described above, the following effects can be exhibited.
(1) In the blood component measurement device 1, the light emission control unit 21 performs the following control: the light emitting unit 11 is caused to blink in a plurality of wavelength regions so that lighting sections do not overlap in a predetermined period T, and the length of 1 lighting section Toff1 of the plurality of lighting sections Toff1, toff2 is longer than the fall time of the output voltage of the light receiving unit 12, and the length of the other lighting section Toff2 is shorter than 1 lighting section Toff1, and the concentration calculating unit 22 is caused to acquire the output voltage Vn of the external light in 1 lighting section Toff1, and calculate the concentration of the blood component based on values Vc1, vc2 obtained by subtracting the output voltage Vn of the external light from the output voltages V1, V2 of the light receiving unit 12 in the lighting sections Ton1, ton2. This eliminates the need to make all the light-off sections long enough to eliminate the residual light, and thus the blood concentration can be measured in a short time and the concentration can be calculated with high accuracy. In addition, the period T can be shortened and flicker can be reduced.
< embodiment 2 >
Next, the blood component measurement device 1A according to embodiment 2 will be described with reference to fig. 4 to 7. In embodiment 2, a configuration in which the extracorporeal circulation device includes the blood component measurement apparatus 1A will be described. As an example of the extracorporeal circulation device, a blood purification device 100A that can perform dialysis therapy will be described. The blood purification apparatus 100A described in the present embodiment is an automatic blood purification apparatus that purifies blood of a patient with renal failure or a patient with drug poisoning, and continuously and automatically performs the following steps by controlling dialysate flowing through a blood circuit, the steps including: a pre-flushing step for cleaning the components of the apparatus; a blood removal step of removing blood from a patient; a dialysis step of removing excess water in blood; a blood returning step of returning blood to the patient.
Fig. 4 is a diagram showing a schematic configuration of a blood purification apparatus 100A including the blood component measurement device 1A according to embodiment 2 of the present invention, showing a state during a dialysis process, and fig. 5 is a block diagram of the blood purification apparatus 100A.
As shown in fig. 4, the blood purification apparatus 100A includes a blood circuit 110 for flowing blood, a blood purifier 120, a measurement unit 10A, a dialysate circuit 130, and a control device 140.
The blood circuit 110 has an arterial line 111, a venous line 112, a drug line 113, a drain line 114, and a blood chamber 115. The arterial line 111, the venous line 112, the drug line 113, and the drainage line 114 are each mainly composed of a flexible soft tube through which liquid can flow.
One end of the artery side tube 111 is connected to a blood inlet 122a of a blood purifier 120 described later. An artery-side connection portion 111, an artery-side air bubble probe 111b, a blood pump 111c, and an artery-side clamp 111d are disposed in the artery-side tube 111.
The artery-side connecting portion 111a is disposed on the other end side of the artery-side channel 111. A needle for puncturing a blood vessel of a patient is connected to the artery-side connecting portion 111 a.
The artery-side bubble detector 111b detects the presence or absence of bubbles in the tube.
The blood pump 111c is disposed downstream of the artery-side bubble detector 111b in the artery-side tube 111. The blood pump 111c strokes the tube constituting the artery side tube 111 with rollers, and sends out the blood, the priming solution, and other liquids inside the artery side tube 111.
The artery-side clamp 111d is disposed upstream of the artery-side bubble detector 111 b. For example, when returning blood through the artery-side tube 111, the artery-side clamp 111d is controlled to open and close the flow path of the artery-side tube 111 based on the detection result of bubbles by the artery-side bubble detector 111 b.
One end of the venous line 112 is connected to a blood outlet 122b of a blood purifier 120 described later. The vein-side tube 112 is provided with a vein-side connection portion 112a, a vein-side bubble detector 112b, a drip chamber 112c, and a vein-side holder 112d.
The vein-side connection portion 112a is disposed on the other end side of the vein-side tube. A needle for puncturing a blood vessel of a patient is connected to the vein-side connection portion 112 a.
The vein-side bubble detector 112b detects the presence or absence of bubbles in the tube.
The drip chamber 112c is disposed upstream of the vein-side bubble detector 112 b. The drip chamber 112c stores a certain amount of blood in order to remove air bubbles, coagulated blood, and the like mixed in the vein-side tube 112 and to measure the venous pressure.
The vein-side clamp 112d is disposed downstream of the vein-side bubble detector 112 b. The vein-side clamp 112d opens and closes the flow path of the vein-side tube 112 by controlling the flow path based on the bubble detection result of the vein-side bubble detector 112 b.
The drug line 113 supplies a drug required for hemodialysis to the artery side line 111. One end of the drug line 113 is connected to a drug solution pump 113a that sends out the drug, and the other end is connected to the artery line 111. Further, a clamp mechanism, not shown, is provided in the medicine line 113, and the flow path is held in a closed state by the clamp mechanism except when the medicine is injected. In embodiment 2, the other end side of the drug line 113 is connected to the downstream side of the blood pump 111c in the artery line 111.
The drain line 114 is connected to the drip chamber 112 c. A drain pipe clamp 114a is disposed on the drain pipe 114. The discharge line 114 is a line for discharging the priming solution in the priming step of cleaning and purifying the blood circuit 110 and the blood purifier 120.
The blood chamber 115 is provided at a position of the blood circuit 110 where the measurement unit 10A is installed. Blood chamber 115 is formed of a transparent and hard resin such as polycarbonate, and is configured in a flat shape so that the irradiation area from light emitting unit 11A becomes larger than that of the tube configuring blood circuit 110. In the present embodiment, the blood chamber 115 is provided in the artery-side channel 111 in order to measure the state of blood taken out from the patient. The blood chamber 115 may be attached to any position of the artery side tube 111, but in this embodiment, it is attached to one end of the artery side tube 111, that is, a connection portion with the blood introduction port 122a of the blood purifier 120.
The blood purifier 120 includes a container body 121 formed in a cylindrical shape and a dialysis membrane (not shown) housed inside the container body 121, and the inside of the container body 121 is divided into a blood-side channel and a dialysate-side channel (neither of which is shown) by the dialysis membrane. The container main body 121 is provided with a blood inlet port 122a and a blood outlet port 122b which communicate with the blood circuit 110, and a dialysate inlet port 123a and a dialysate outlet port 123b which communicate with the dialysate circuit 130.
According to the blood circuit 110 and the blood purifier 120, blood taken out from the artery of the subject (dialysis patient) is introduced into the blood-side channel of the blood purifier 120 while flowing through the artery-side line 111 by the blood pump 111 c. The blood introduced into the blood purifier 120 is purified by the dialysate flowing through the dialysate circuit 130 described later via a dialysis membrane. The blood purified by the blood purifier 120 flows through the vein-side line 112 and is returned to the vein of the subject.
As shown in fig. 5, the measurement unit 10A includes a light emitting portion 11A that emits light in 3 wavelength regions, and a light receiving portion 12A that converts transmitted light or reflected light emitted from the light emitting portion 11A into voltage and outputs the voltage, and is attached to the blood chamber 115.
The light emitting unit 11A includes 3 light emitting elements L1, L2, and L3 and a light emitting circuit LCA. In the present embodiment, the oxygen saturation and the hematocrit are measured as an example of the blood component. The light-emitting elements L1 and L2 for measuring oxygen saturation use the same light-emitting diodes as those described in embodiment 1, and therefore, description thereof is omitted. The light emitting element L3 is a light emitting diode that emits light in a wavelength region of about 1300 nm. The light-emitting circuit LCA turns on or off the light-emitting elements L1, L2, and L3 based on a signal transmitted from a light-emitting control circuit 21A described later. Light in the wavelength region of about 1300nm is absorbed mainly by water, and light in the wavelength region of about 800nm is absorbed mainly by hemoglobin. The hematocrit was measured using light in these 2 wavelength regions.
The light receiving unit 12A includes 2 light receiving elements F1 and F2 and a light receiving circuit RCA. Since about 600nm and about 800nm are close to each other among the 3 wavelength regions used in the present embodiment, the light receiving element F1 uses the same photodiode that can receive light in both wavelength regions as described in embodiment 1. The light receiving element F2 is a photodiode that can receive light in a wavelength region of about 1300 nm. The light receiving circuit RCA is a circuit that converts a weak current flowing therethrough into voltages according to the intensity of light incident on the light receiving elements F1 and F2, amplifies the voltages, and outputs the voltages.
In the present embodiment, as shown in fig. 6, the light emitting portion 11A and the light receiving portion 12A are disposed to face each other with the blood chamber 115 therebetween. Light is irradiated from the light emitting unit 11 to the blood B flowing through the blood chamber 115, and the light transmitted through the blood enters the light receiving unit 12A and is converted into a voltage.
In embodiment 2, the dialysate circuit 130 is configured by a so-called closed volume control type dialysate circuit 130. The dialysate circuit 130 includes a dialysate supply line 131a, a dialysate drain line 131b, a dialysate introduction line 132a, a dialysate discharge line 132b, and a dialysate delivery unit 133.
The dialysate feeding unit 133 includes a dialysate chamber 1331, a bypass line 1332, and a water removal/reverse filtration pump 1333.
The dialysate chamber 1331 is formed of a rigid container capable of storing a predetermined volume (for example, 300mL to 500 mL) of dialysate, and the interior of the container is divided by a soft diaphragm (diaphragm) into a liquid feeding container 1331a and a liquid discharging container 1331b.
The bypass line 1332 is connected to the dialysate extraction line 132b and the dialysate drain line 131 b.
A water removal/reverse filtration pump 1333 is disposed in the bypass line 1332. The dewatering/reverse filtration pump 1333 is constituted by a pump that can be driven to send liquid in the following directions: a direction (water removal direction) in which the dialysate in the bypass line 1332 flows toward the dialysate drain line 131b, and a direction (reverse filtration direction) in which the dialysate in the bypass line 1332 flows toward the dialysate extraction line 132 b.
The dialysate supply line 131a is connected to a dialysate supply device (not shown) at its proximal end and to the dialysate chamber 1331 at its distal end. The dialysate supply line 131a supplies dialysate to the liquid supply container 1331a of the dialysate chamber 1331.
The dialysate introduction line 132a connects the dialysate chamber 1331 and the dialysate introduction port 123a of the blood purifier 120, and introduces the dialysate contained in the liquid supply container 1331a of the dialysate chamber 1331 into the dialysate side flow path of the blood purifier 120.
The dialysate extraction line 132b connects the dialysate extraction port 123b of the blood purifier 120 to the dialysate chamber 1331, and extracts the dialysate discharged from the blood purifier 120 to the drainage storage portion 1331b of the dialysate chamber 1331.
The proximal end side of the dialysate discharge line 131b is connected to the dialysate chamber 1331, and discharges the dialysate contained in the discharge containing section 1331b.
According to the dialysate circuit 130 described above, the amount of dialysate drawn from the dialysate chamber 1331 (the amount of dialysate supplied to the liquid feed container section 1331 a) and the amount of the dialysate collected in the dialysate chamber 1331 (the liquid discharge container section 1331 b) can be made the same by partitioning the inside of the hard container constituting the dialysate chamber 1331 by the soft diaphragm (diaphragm).
Thus, the flow rate of the dialysate introduced into the blood purifier 120 can be made the same as the amount of the dialysate (drain) led out from the blood purifier 120 in a state where the water removal/reverse filtration pump 1333 is stopped. In addition, when the water removal/reverse filtration pump 1333 is driven to feed the liquid in the water removal direction, a predetermined amount of water is removed from the blood at a predetermined speed in the blood purifier 120. In addition, when the water removal/reverse filtration pump 1333 is driven to send the liquid in the reverse filtration direction, a predetermined amount of dialysate is injected (reverse filtered) into the blood circuit 110 in the blood purifier 120.
The control device 140 is constituted by an information processing device (computer), and controls the operation of the blood purification device 100A by executing a control program. Specifically, as shown in fig. 5, the control device 140 controls the operations of various pumps, clamps, and the like disposed in the blood circuit 110 and the dialysate circuit 130, and executes various steps performed by the blood purification apparatus 100, such as a priming step, a apheresis step, a dialysis step, a fluid replacement step, and a blood return step.
Further, the control device 140 includes a control unit 20A constituting the blood component measurement device 1A. The control unit 20A includes a light emission control unit 21A and a density calculation unit 22A.
The light emission control unit 21A transmits a signal for causing the light emitting elements L1, L2, and L3 in the light emitting unit 11A to blink at a predetermined cycle to the light emitting circuit LCA, thereby controlling lighting and lighting-off of the light emitting unit 11A.
The concentration calculating unit 22A calculates oxygen saturation and hematocrit as blood components based on the voltage output from the light receiving circuit RCA. The specific calculation method is described in detail below.
Among the various steps performed by the blood purification apparatus 100A, the dialysis step shown in fig. 4 will be briefly described.
In the dialysis step, water excess to the patient and metabolic waste are removed.
In the dialysis step, the blood of the patient introduced from the artery-side connection portion 111a is purified by the blood purifier 120 through the artery-side line 111, and returned to the patient from the vein-side connection portion 112a through the vein-side line 112.
As shown in fig. 4, in the dialysis step, the artery-side connection portion 111a and the vein-side connection portion 112a are connected to needles that puncture blood vessels of the patient, the drainage line holder 114a is closed, and the vein-side holder 112d is opened.
A dialysate supply device, not shown, supplies and discharges dialysate to and from the dialysate chamber 1331 at a liquid feed rate of 500mL/min on average, and as an example of the direction of water removal, the water removal/reverse filtration pump 1333 is operated so as to feed 10mL, and water removal is performed at 10mL/min in the blood purifier 120.
The blood pump 111c sends blood from the artery side connecting portion 111a side to the blood purifier 120 side at a flow rate of, for example, 200 mL/min.
In the blood purifier 120, blood flows in from the blood inlet 122a at a flow rate of 200mL/min, is removed from the blood by a flow rate of 10mL/min, and is discharged from the blood outlet 122b at a flow rate of 190 mL/min. The dialysate is discharged from the dialysate outlet port 123b.
In this manner, water removal was performed at a flow rate of 10mL/min in the dialysis step.
In such a dialysis step, since the blood of the patient is gradually concentrated by gradually performing water removal, the water removal rate, the measurement of the recirculation, and the like can be adjusted by measuring the hematocrit as a blood component. In addition, the change in the amount of circulating blood of the patient can also be calculated based on the hematocrit. In addition, in the dialysis step, by measuring the oxygen saturation level, there is a possibility that sleep apnea syndrome and the like can be detected.
Next, a specific method for measuring the concentration of a blood component in the present embodiment will be described with reference to fig. 7.
The light emission control section 21A controls the light emitting elements L1, L2, L3 to emit light at a predetermined period T A The light emitting unit 11A is controlled to blink. Thus, the light emitting part 11A is made to emit light at a predetermined period T A In the case of flicker, the output voltage 1 from the light-receiving element F1 and the output voltage 2 from the light-receiving element F2 can be obtained as the output voltage of the light-receiving section 12A. Each of the output voltages 1 and 2 has a waveform as shown in fig. 7.
In fig. 7, a lighting interval T is defined as an interval from lighting-up to lighting-off of the light emitting element L1 A on1, the section of the light emitting element L2 from the start of lighting to the start of lighting is set as a lighting section T A on2, the section of the light emitting element L3 from the start of lighting to the start of lighting is set as a lighting section T A on3. Further, a section from the light-off of the light-emitting element L3 to the light-on of the light-emitting element L1 is defined as a light-off section T A off1, and a period from the light-off of the light-emitting element L1 to the light-on of the light-emitting element L2 is set as a light-off period T A off2, and a period from the light-off of the light-emitting element L2 to the light-on of the light-emitting element L3 is defined as a light-off period T A off3. A predetermined period T A ＝T A off1+T A on1+T A off2+T A on2+T A off3+T A The relationship on3 holds. The light emission control part 21A is used for 3 light-out intervals T A off1、T A off2, and T A 1 light-off interval T in off3 A off3 is more than other light-off interval T A off1、T A off2 is short. In addition, a light-off interval T A off3 is set to a length that continues after the influence of the excessive light generated by lighting of light emitting element L2 disappears. That is, in the lighting interval T A In on2, the output voltage increased to a predetermined value is in the light-off interval T A off3 is decreased by a predetermined decrease time and converged. That is, in the light-off interval T A off3, if the predetermined fall time is exceeded, the output voltages of the light receiving elements F1 and F2 of the light receiving unit 12A can be regarded as the output voltages V generated by the incident external light A n1、V A n2. In addition, in the light-out interval T A off1、T A In off2, the lighting of the next light-emitting element L1 and the next light-emitting element L2 is started as it is in a state where the residual light of the light-emitting element L3 and the residual light of the light-emitting element L1 do not converge, respectively. That is, the light-off section T is set by lighting the light-emitting element that emits light immediately before A off1、T A off2 is set to be shorter than the fall time of the output voltage rising to a predetermined value.
In the present embodiment, T is given as an example A on1＝T A on2＝T A on3＝5ms、T A off3＝7ms、T A off1＝T A off2=3ms. By using the output voltage V for obtaining the external light in this way A n light-out interval T A off interval T other than off3 A off1、T A off2 is set to a short time at which the residual light is not converged, and the period T can be further shortened A . Thus, the blood concentration can be measured in a shorter time. For example, in the case of the present embodiment, the cycle T =28ms, and the number of flickers of the light emitting element L1 which emits visible light within 1 second is 35.7 times. In general, since flickers that blink 35 times or more in 1 second are not visible, the flickers can be reduced by the above setting.
Concentration calculating part 22A in the light-off interval T A off3 obtains the output voltages from the light receiving elements F1 and F2 in the light receiving unit 12A asOutput voltage V of external light A n1、V A n2. Next, in the lighting interval T of the light emitting element L3 A on3 deriving the slave output voltage V A 3 subtracting the output voltage V of the external light A n2 as a correction voltage V A c3. Next, in the lighting interval T of the light emitting element L1 A on1 taking the slave output voltage V A 1 minus the output voltage V of the external light A n1 as a correction voltage V A c1. Finally, in the lighting interval T of the light emitting element L2 A on2 deriving the slave output voltage V A 2 subtracting the output voltage V of the external light A n1 as a correction voltage V A c2. The concentration calculating section 22A calculates the correction voltage V from the correction voltage V depending on the concentration of the reduced hemoglobin A c1 and a correction voltage V dependent on the concentration of reduced hemoglobin and the concentration of oxidized hemoglobin A And c2, calculating the ratio of the reduced hemoglobin to the oxidized hemoglobin to calculate the oxygen saturation. The concentration calculating section 22A corrects the voltage V from the correction voltage V depending on the concentration of hemoglobin A c2, and a correction voltage V dependent on the proportion of water A And c3, calculating the hematocrit. Thereafter, this process is repeated, continuing to calculate oxygen saturation and hematocrit.
According to the blood component measurement device 1A of embodiment 2 described above, the following effects can be obtained in addition to the above effect (1).
(2) Light emission control unit 21A of blood component measurement device 1A is set to light-off interval T A off1、T A off2 is controlled to be shorter than the fall time of the output voltage from the light receiving elements F3 and F1 of the light receiving unit 12A. This can further shorten the cycle time, and thus can shorten the time for measuring the blood concentration. In addition, it is possible to further reduce flicker.
(3) The light receiving unit 12A of the blood component measuring apparatus 1A has a plurality of light receiving elements F1, F2, the plurality of light receiving elements F1, F2 receive light of different wavelength regions, respectively, and the concentration calculating unit 22A is in 1 light-off interval T A off3 obtains the output voltages from the light receiving elements F1 and F2 as the output voltage V of the external light A n1、V A n2, based on the lighting interval T from each wavelength region A on1、T A on2、T A on3, the output voltage V of each of the plurality of light receiving elements F1 and F2 A 1、V A 2、V A 3 subtracting the output voltage V of each external light A n1、V A n2 resulting in a value V A c1、V A c2、V A And c3, calculating the concentration of the blood component. Therefore, even if the number of light receiving elements included in the light receiving unit is increased, the cycle time can be shortened because only 1 long lamp-out section is required.
The blood component measuring device of the present invention is not limited to the above embodiments, and can be modified as appropriate.
For example, although the light emitting section is configured using a plurality of light emitting elements that emit light in different wavelength regions in the above embodiments, the light emitting section may be configured to emit light in a plurality of wavelength regions by mounting a filter on1 light emitting element.
In the above embodiments, the measurement unit is attached to the tube or the blood chamber of the blood circuit, but for example, the measurement unit may be provided in a housing of the apparatus main body of the extracorporeal circulation apparatus, and the tube constituting the blood circuit may be attached to the measurement unit.
Description of the reference numerals
1. 1A blood component measuring device
10. 10A measuring part
11. 11A light emitting part
12. 12A light receiving part
20. 20A control part
21. 21A light emission control unit
22. 22A concentration calculating part
30. Display unit
100A dialysis device
110. Blood circuit
111. Artery side pipeline
111c blood pump
112. Vein side pipeline
120. Blood purifier
130. Dialysate circuit
133. Dialysate feeding unit
140. A control unit.

Claims (4)

1. A blood component measurement device that continuously measures a change in concentration of a blood component based on the intensity of transmitted light or reflected light of light that is irradiated to blood, the blood component measurement device comprising:
a light emitting section that emits light in a plurality of wavelength regions including visible light;
a light receiving unit that receives transmitted light or reflected light of the light emitted from the light emitting unit, converts the received light or reflected light into a voltage, and outputs the voltage;
a light emission control unit that controls lighting on and off of the light emission unit; and
a concentration calculation section that calculates a concentration of a blood component based on an output voltage of the light receiving section,
the light emission control section controls: the light emitting section is caused to blink in a plurality of wavelength regions so that lighting sections do not overlap each other in a predetermined period, and the length of 1 lighting section out of the plurality of lighting sections is longer than the fall time of the output voltage of the light receiving section and the lengths of the other lighting sections are shorter than the 1 lighting section,
the concentration calculation unit obtains an output voltage of the light receiving unit as an output voltage of the external light in the 1 light-out section, and calculates a concentration of the blood component based on a value obtained by subtracting the output voltage of the external light from the output voltage of the light receiving unit in the light-up section.
2. The blood component measurement device according to claim 1, wherein the light emission control unit controls the other light-off section so that a fall time of the output voltage of the light receiving unit becomes shorter than a fall time of the output voltage of the light receiving unit.
3. The blood component measurement device according to claim 1 or 2, wherein the light receiving unit has a plurality of light receiving elements,
the plurality of light receiving elements receive light of different wavelength regions,
the concentration calculation unit obtains each output voltage of the plurality of light receiving elements as an output voltage of each external light in the 1 light-out section, and calculates the concentration of the blood component based on a value obtained by subtracting the output voltage of each external light from each output voltage of the plurality of light receiving elements in the light-up section of each wavelength region.
4. A blood purification device provided with:
a blood component measurement device according to any one of claims 1 to 3;
a blood purifier;
a blood circuit;
a blood pump provided in the blood circuit and configured to feed blood to the blood purifier;
a measurement unit for measuring the concentration of a blood component flowing through the blood circuit; and
a control device for controlling the operation of the motor,
the light emitting section and the light receiving section are provided in the measuring section,
the light emission control unit and the concentration calculation unit are provided in the control device.
CN202180029367.4A 2020-05-28 2021-05-26 Blood component measuring device and blood purifying device Pending CN115427090A (en)

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