CN1711114A - Blood purification device - Google Patents
Blood purification device Download PDFInfo
- Publication number
- CN1711114A CN1711114A CN 200380103159 CN200380103159A CN1711114A CN 1711114 A CN1711114 A CN 1711114A CN 200380103159 CN200380103159 CN 200380103159 CN 200380103159 A CN200380103159 A CN 200380103159A CN 1711114 A CN1711114 A CN 1711114A
- Authority
- CN
- China
- Prior art keywords
- blood
- value
- mentioned
- haemoconcentration
- blood circuit
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
Links
- 210000004369 blood Anatomy 0.000 title claims abstract description 321
- 239000008280 blood Substances 0.000 title claims abstract description 321
- 238000000746 purification Methods 0.000 title claims description 48
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 claims abstract description 78
- 230000007246 mechanism Effects 0.000 claims description 119
- 239000012530 fluid Substances 0.000 claims description 69
- 238000001802 infusion Methods 0.000 claims description 69
- 206010018873 Haemoconcentration Diseases 0.000 claims description 61
- 210000000056 organ Anatomy 0.000 claims description 25
- 238000001914 filtration Methods 0.000 claims description 19
- 230000017531 blood circulation Effects 0.000 claims description 17
- 230000008676 import Effects 0.000 claims description 10
- 230000004087 circulation Effects 0.000 claims description 9
- 230000008859 change Effects 0.000 claims description 7
- 238000005534 hematocrit Methods 0.000 abstract description 5
- 210000003462 vein Anatomy 0.000 abstract description 2
- 238000004140 cleaning Methods 0.000 abstract 4
- 210000001367 artery Anatomy 0.000 abstract 2
- 239000000470 constituent Substances 0.000 abstract 1
- 210000002381 plasma Anatomy 0.000 description 68
- 238000000502 dialysis Methods 0.000 description 36
- 239000000385 dialysis solution Substances 0.000 description 32
- 239000007788 liquid Substances 0.000 description 16
- 238000000034 method Methods 0.000 description 16
- 230000009471 action Effects 0.000 description 15
- 239000012510 hollow fiber Substances 0.000 description 11
- 238000012544 monitoring process Methods 0.000 description 10
- 230000015572 biosynthetic process Effects 0.000 description 8
- 238000005755 formation reaction Methods 0.000 description 8
- 239000000203 mixture Substances 0.000 description 8
- 238000001179 sorption measurement Methods 0.000 description 8
- 210000000601 blood cell Anatomy 0.000 description 7
- 238000001631 haemodialysis Methods 0.000 description 7
- 230000000322 hemodialysis Effects 0.000 description 7
- 108010054147 Hemoglobins Proteins 0.000 description 6
- 102000001554 Hemoglobins Human genes 0.000 description 6
- 230000004069 differentiation Effects 0.000 description 6
- 210000003743 erythrocyte Anatomy 0.000 description 6
- 239000000706 filtrate Substances 0.000 description 6
- 239000000463 material Substances 0.000 description 6
- 230000002093 peripheral effect Effects 0.000 description 6
- 238000007599 discharging Methods 0.000 description 5
- 230000009977 dual effect Effects 0.000 description 5
- 238000010521 absorption reaction Methods 0.000 description 4
- 239000003463 adsorbent Substances 0.000 description 3
- 201000010099 disease Diseases 0.000 description 3
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 3
- 239000012528 membrane Substances 0.000 description 3
- 230000003287 optical effect Effects 0.000 description 3
- 230000008439 repair process Effects 0.000 description 3
- 238000011144 upstream manufacturing Methods 0.000 description 3
- 208000032843 Hemorrhage Diseases 0.000 description 2
- 230000007812 deficiency Effects 0.000 description 2
- 230000000694 effects Effects 0.000 description 2
- 238000005259 measurement Methods 0.000 description 2
- 238000002616 plasmapheresis Methods 0.000 description 2
- 239000011148 porous material Substances 0.000 description 2
- 238000002360 preparation method Methods 0.000 description 2
- 230000008569 process Effects 0.000 description 2
- 238000012800 visualization Methods 0.000 description 2
- 239000002699 waste material Substances 0.000 description 2
- 230000002159 abnormal effect Effects 0.000 description 1
- 238000013459 approach Methods 0.000 description 1
- 230000008033 biological extinction Effects 0.000 description 1
- 238000010241 blood sampling Methods 0.000 description 1
- 230000000052 comparative effect Effects 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 238000011049 filling Methods 0.000 description 1
- 239000000383 hazardous chemical Substances 0.000 description 1
- 239000012535 impurity Substances 0.000 description 1
- 239000004973 liquid crystal related substance Substances 0.000 description 1
- 230000003204 osmotic effect Effects 0.000 description 1
- 238000012545 processing Methods 0.000 description 1
- 230000002035 prolonged effect Effects 0.000 description 1
- 230000001915 proofreading effect Effects 0.000 description 1
- MEYZYGMYMLNUHJ-UHFFFAOYSA-N tunicamycin Natural products CC(C)CCCCCCCCCC=CC(=O)NC1C(O)C(O)C(CC(O)C2OC(C(O)C2O)N3C=CC(=O)NC3=O)OC1OC4OC(CO)C(O)C(O)C4NC(=O)C MEYZYGMYMLNUHJ-UHFFFAOYSA-N 0.000 description 1
Images
Abstract
A blood cleaning apparatus capable of checking for a failure of each of constituent elements contained in the apparatus. The blood density of a patient does not need to be measured, the treatment time is shortened, and hence the load on the patient is lightened. The blood cleaning apparatus comprises a blood pump (3) provided in an artery blood circuit (1a), a blood cleaner (2) for cleaning blood, a blood cleaning apparatus body (6, 7) having a water-removing pump (8) for removing the water content from the blood, first and second measuring means (5a, 5b) for measuring the hematocrits provided in the artery blood circuit and a vein blood circuit, calculating means (11) for calculating the ratio between the measured hematocrits and the ratio between theoretical hematocrits obtained by a predetermined formula, and judging means (12) for judging whether or not the ratios calculated by the calculating means (11) are almost equal to each other.
Description
Technical field
The present invention relates to carry out the apparatus for purifying blood that extracorporeal circulation purifies it while the blood that makes the patient.
Background technology
Generally, in dialysis treatment, for the blood that makes the patient is using the blood circuit that mainly is made of the pliability pipe in extracorporeal circulation.This blood circuit mainly be included in the top be equipped with from the patient take blood the arterial side puncture needle the arterial side blood circuit and, on the top venous side blood circuit of blood being got back to patient's vein side puncture needle is installed, between these arterial side blood circuits and venous side blood circuit, dialyser is housed.
In addition, on the arterial side blood circuit, set and draw slim blood pump, take patient's blood from the arterial side puncture needle, make it in arterial side blood circuit, dialyser and venous side blood circuit, carry out extracorporeal circulation by driving this blood pump.Set a plurality of hollow fiber tubes in the inside of such dialyser, blood passes through the inside of each hollow fiber tube respectively.
On the other hand, outstanding dialysis solution introducing port and the dialysis solution export mouth of forming on the housing of dialyser, dialysis apparatus is to be connected with these mouthfuls.And when supplying with the dialysis solution of defined from dialysis apparatus by the dialysis solution introducing port, this dialysis solution is discharged by the dialysis solution export mouth by behind the outside (that is, between the outer peripheral face of hollow fiber tube and the inner peripheral surface of housing) of hollow fiber tube.
; wall at the hollow fiber tube forms small hole (lumen pore) formation membrane for purifying blood; when the garbage of the blood by hollow fiber tube inside etc. see through membrane for purifying blood and are discharged in the dialysis solution, discharge the blood that garbage etc. purified and get back in patient's the body., in dialysis apparatus, set and be used for when dialysis treatment, removing moisture from the dewatered water pump (utilizing the balance cylinder sometimes) that removes of patient's blood.
In the past, following scheme had once been proposed, the a pair of optical sensor that contains illuminating part and light accepting part promptly is set on the venous side blood circuit, when obtaining haemoconcentration (hematocrite value) by dialyser, relatively the haemoconcentration of this measured value with from the setting blood flow velocity of blood pump and set the theoretical value of removing the haemoconcentration that water speed calculates, monitor water removal (with reference to patent documentation 1).
Disclosed purifier in patent documentation 1, its formation is to obtain haemoconcentration by dialyser with the optical sensor that is arranged on the venous side blood circuit, with the measured value of haemoconcentration in this dialysis and, the setting flow of the haemoconcentration of prediction before the dialysis beginning and blood pump and the theoretical value of setting the haemoconcentration of calculating except that water speed compare and monitor water removal.By such formation, can prevent in advance that the error that dewaters from increasing, its result can prevent, and sb.'s illness took a turn for the worse because the error that dewaters causes the patient.
The open 1997-149935 communique of Japan Patent
Summary of the invention
, in above-mentioned blood processor in the past, exist the haemoconcentration of the essential patient of mensuration before the dialysis beginning, correspondingly prolonged treatment time, increased the weight of the problem of patient's burden.This is because as the parameter of the theoretical value that is used to obtain haemoconcentration, except the setting blood flow rate of blood pump and set except that water speed, needs to use the cause of the haemoconcentration of mensuration before the dialysis beginning.
In addition, in above-mentioned device in the past, just carry out the supervision (error dewaters) of water removal, can not monitoring arrangement in intrinsic various elements, so wish mensuration consumingly, can monitor the device of all actions of the device that comprises blood circuit by haemoconcentration.
The present invention carries out in view of such situation, and its purpose is to provide a kind of apparatus for purifying blood, and it need not carry out haemoconcentration in advance for the patient and measure, treatment time can be shortened, alleviate patient's burden, simultaneously, can monitor the undesirable condition of the various elements in its device.
Inventing 1 described invention, is a kind of apparatus for purifying blood, it is characterized in that having: blood circuit, and the arterial side blood circuit and the venous side blood circuit that are carried out extracorporeal circulation by the blood that makes the patient who takes constitute; Blood pump is configured in the arterial side blood circuit of this blood circuit; Blood purification mechanism is connected between the arterial side blood circuit and venous side blood circuit of above-mentioned blood circuit, purifies mobile blood in this blood circuit; The 1st measures mechanism, is arranged in the arterial side blood circuit of above-mentioned blood circuit, is determined at mobile haemoconcentration in this arterial side blood circuit; The 2nd measures mechanism, is arranged in the venous side blood circuit of above-mentioned blood circuit, is determined at mobile haemoconcentration in the venous side blood circuit; Arithmetical organ, computing is measured the ratio that mechanism and the 2nd measures the haemoconcentration of mechanism's mensuration with the above-mentioned the 1st respectively, with with the setting purification speed of the setting blood flow velocity of above-mentioned blood pump and above-mentioned blood purification mechanism as parameter, the ratio of obtaining from the arithmetic expression of regulation as the haemoconcentration of theoretical value; Mechanism for identifying, differentiate by this arithmetical organ obtain as the ratio of the haemoconcentration of measured value and whether roughly the same as the ratio of the haemoconcentration of theoretical value.
Invent 3 described inventions, it is characterized in that in invention 2 described apparatus for purifying blood, configuration imports in the fluid infusion introducing mechanism of fluid infusion in above-mentioned blood circuit, above-mentioned arithmetical organ, remove on the water speed basis at above-mentioned setting blood flow velocity and setting, the rate of filtration of the setting fluid infusion velocity of this fluid infusion introducing mechanism and above-mentioned blood purification as parameter, is calculated ratio as the haemoconcentration of theoretical value from the regulation arithmetic expression.
Invent 4 described inventions, it is characterized in that in any 1 the described apparatus for purifying blood in invention 1～invention 3, have notifying operator, report above-mentioned mechanism for identifying as the ratio of the haemoconcentration of measured value and surpass the permissible range of regulation as the difference of the haemoconcentration ratio of theoretical value.
Invent 5 described inventions, it is characterized in that in invention 1～invention 4 in any 1 described blood processor, above-mentioned mechanism for identifying as the haemoconcentration of measured value than and when surpassing institute's permissible range as the difference of the haemoconcentration ratio of theoretical value, make blood flow rate, purification speed, fluid infusion velocity or the rate of filtration change specific bad position.
According to invention 1, because by being arranged on the 2nd mensuration mechanism that the 1st of arterial side blood circuit is measured mechanism and is arranged on the venous side blood circuit, mensuration import to the haemoconcentration before the blood purification mechanism and derive from blood purification after haemoconcentration, so need not carry out haemoconcentration in advance for the patient measures, treatment time can be shortened, alleviate patient's burden, simultaneously, can monitor the undesirable condition of the various elements in the apparatus for purifying blood.
According to invention 2, because the setting in employed blood purification of dialysis treatment and the apparatus for purifying blood main body is removed water speed as parameter, so also applicable to following the hemodialysis treatment apparatus and method for hemodialysis treatment that dewaters, need not carry out haemoconcentration in advance for the patient measures, treatment time can be shortened, alleviate patient's burden, simultaneously, can monitor the undesirable condition of the various elements in the apparatus for purifying blood.
According to invention 3,, in blood circuit, import in the device of fluid infusion as HDF, HF or AFBF, also need not carry out haemoconcentration in advance and measure, can shorten treatment time, alleviate patient's burden for the patient, simultaneously, can monitor the undesirable condition of the various elements in the apparatus for purifying blood.
According to invention 4, owing to surpass the defined permissible range as the ratio of the haemoconcentration of measured value with as the difference of the haemoconcentration ratio of theoretical value, any undesirable condition is arranged in the apparatus for purifying blood so medical worker etc. is identified in what notifying operator was reported mechanism for identifying.
According to invention 5, because can specific bad position, so can be slick and sly and place under repair or repair the specific bad position processing afterwards which element just can be so exactly.
Description of drawings
Fig. 1 represents the ideograph of the apparatus for purifying blood of the 1st embodiment of the present invention;
Fig. 2 represents to be applicable to that the dialysis of apparatus for purifying blood of the 1st embodiment of the present invention is with the ideograph of monitor apparatus;
Fig. 3 represents the block diagram of the apparatus for purifying blood of the 1st embodiment of the present invention (the 2nd embodiment and the 3rd embodiment are general);
Fig. 4 represents the ideograph of the apparatus for purifying blood of the 2nd embodiment of the present invention;
Fig. 5 represents the ideograph of the apparatus for purifying blood of the 3rd embodiment of the present invention;
Fig. 6 represents the ideograph of the apparatus for purifying blood of the 4th embodiment of the present invention.
The specific embodiment
Below, specifically describe embodiments of the present invention with reference to accompanying drawing.
The blood processor of the 1st embodiment is by patient's blood is constituted in extracorporeal circulation and the dialysis apparatus that carries out hemodialysis (HD).This dialysis apparatus, as shown in Figure 1, main composition comprises: blood circuit 1 is connecting the dialyser 2 as blood purification; Dialysis monitoring arrangement 6, to dialyser 2 supply dialysis solution on one side dewater on one side; Dialysate supply unit 7 (with reference to Fig. 2), the preparation dialysis solution.
In addition, when dialysis constituted apparatus for purifying blood main body of the present invention with monitoring arrangement 6 and dialysate supply unit 7, this apparatus for purifying blood main body and blood purification (dialyser 2) constituted blood purification of the present invention mechanism.That is, blood purification mechanism is connected between arterial side blood circuit 1a described later and the venous side blood circuit 1b, purifies the blood that flows through in blood circuit 1.
On the top of arterial side blood circuit 1a, be connected with in the arterial side puncture needle a, on the way set and draw slim blood pump 3 and arterial side drip chamber 4a.On the other hand, on the top of venous side blood circuit 1b, be connected with in the venous side puncture needle b, set venous side drip chamber 4b on the way.
And, when driving blood pump 3 under the state with arterial side puncture needle a and venous side puncture needle b puncture the patient, then patient's blood passes through arterial side blood circuit 1a after arterial side drip chamber 4a de-bubble, to dialyser 2, carry out blood purification by this dialyser 2, de-bubble and get back in patient's the body in venous side drip chamber 4b by venous side blood circuit 1b.That is, make patient's blood in blood circuit 1, carry out extracorporeal circulation and purification in dialyser 2.
In addition, in the way of arterial side blood circuit 1a or venous side blood circuit 1b, also can set a plurality of for rubber button of injecting medicinal liquid or blood sampling (not shown go out) etc., near the venous side puncture needle b of venous side blood circuit 1b, also can set bubble detector (not shown go out), detect whether mobile blood is mixed with air in this venous side blood circuit 1b.
Housing section at dialyser 2 forms blood introducing port 2a, blood export mouth 2b, dialysis solution introducing port 2c and dialysis solution export mouth 2d, and wherein, blood introducing port 2a connects arterial blood loop 1a, blood export mouth 2b and connects venous side blood circuit 1b.In addition, dialysis solution introducing port 2c and dialysis solution export mouth 2d are connected to from dialysis and prolong dialysis solution ingress pipe L1 and the dialysis solution discharge pipe L2 that is provided with monitoring arrangement 6.
In dialyser 2, take in a plurality of hollow fiber tubes, when this hollow fiber tube inside is made the stream of blood, make the stream of dialysis solution between inner peripheral surface hollow fiber tube outer peripheral face and housing section.The micro hole that is formed with its outer peripheral face of a plurality of perforations and inner peripheral surface in the hollow fiber tube forms hollow fiber membrane, the impurity in the blood etc. can be penetrated in the dialysis solution by this film.
In addition, when the end of dialysis solution discharge pipe L2 is connected in dialyser 2 (dialysis solution export mouth 2d), the other end is connected in not shown waste liquid mechanism, after the dialysis solution of supplying with from dialysate supply unit 7 arrives dialyser 2 by dialysis solution ingress pipe L1, be transported to waste liquid mechanism by dialysis solution discharge pipe L2 and bypass pipe L3.In addition, symbol 9 and 10 represents to be connected in heater and the deaerating mechanism of dialysis solution ingress pipe L1 respectively among this figure.
The blood that removes water pump 8 and be the patient from flow through dialyser 2 is removed moisture and is used.That is, if drive such water pump 8 that removes because dual pump P is a metered dose, thus the capacity of the liquid of discharging from dialysis solution discharge pipe L2 than many with the dialysis solution quantitative change that ingress pipe L1 imports from dialysis, its capacity how is the moisture that should remove from blood.In addition, also can from patient's blood, remove moisture with such mechanism except that water pump 8 (for example utilizing so-called balance cylinder etc.).
2 of the arterial side drip chamber 4a of arterial side blood circuit 1a and dialysers, be equipped with when being determined at the 1st of mobile haemoconcentration (hematocrite value specifically) among this arterial side blood circuit 1a and measuring the 5a of mechanism, be equipped with in the downstream (venous side puncture needle b side) of the venous side drip chamber 4b of venous side blood circuit 1b and be determined at the 2nd of mobile haemoconcentration among the venous side blood circuit 1b (hematocrite value specifically) and measure the 5b of mechanism.
The 1st mensuration 5a of mechanism and the 2nd like this measures the 5b of mechanism and is made of the hematocrite value pick off, such hematocrite value pick off, has photo detector as the light-emitting component of LED etc. and optical diode etc., from light-emitting component (for example with light, the near infrared ray of the wavelength of about 805 ± 15nm) when shining blood, the light measurement of accepting its light that sees through or reflection with photo detector represents to import the hematocrite value of concentration of the blood of patient after deriving before the dialyser 2 and from dialyser 2.
Specifically according to the hematocrite value of obtaining the expression haemoconcentration from the electric signal of photo detector output.That is, each composition of the erythrocyte of formation blood and blood plasma etc. has inherent extinction characteristic respectively, utilizes this character, and the erythrocyte of necessity during to the mensuration hematocrite value carries out electron optic quantitative Treatment, can obtain this hematocrite value thus.More specifically,, when reflexing to blood, be subjected to absorbing the influence with scattering, be subjected to light with photo detector from the near infrared ray of light-emitting component irradiation.Be subjected to the power of light to resolve the ABSORPTION AND SCATTERING rate of light from it, calculate hematocrite value.
And then, the above-mentioned the 1st measures the 5a of mechanism and the 2nd measures the 5b of mechanism, as shown in Figure 3, with the arithmetical organ 11 and the mechanism for identifying 12 that are provided in the dialysis usefulness monitoring arrangement 6, and then electrically be connected with notifying operator 13, measure the 5a of mechanism and the 2nd with the 1st and measure hematocrite value that the 5b of mechanism measures as the electric signal arithmetical organ 11 of delivering letters.In addition, arithmetical organ 11 and mechanism for identifying 12 can also can constitute with other computer with dialysis with the formations such as microcomputer in the monitoring arrangement 6.Notifying operator 13 can be luminous with the lighting means that is made of LED that monitoring arrangement 6 has with dialysis, is presented at liquid crystal display picture or exports any method the alarm from loudspeaker.
Just, from the relational expression of Hta (theoretical value) * Qb (setting value)=Htv (theoretical value) * (Qb (setting value)-Quf (setting value)), obtain the arithmetic expression of ratio Hta/Htv=1-Quf (the setting value)/Qb (setting value) of theoretical value.Therefore, the ratio of the theoretical value of obtaining by arithmetic expression and, the ratio of said determination value can obtain by arithmetical organ 11.In addition, in the present embodiment, the ratio of hematocrite value (measured value and ideal value both) is obtained with Hta/Htv, but also can obtain its Htv/Hta reciprocal.
Mechanism for identifying 12 be to arithmetical organ 11 obtain as the ratio of the hematocrite value of measured value and whether approximately equally differentiate as the ratio of the hematocrite value of theoretical value, for example, whether the ratio that can differentiate both is 1, perhaps deduct ratio (also can deduct measured value on the contrary) from theoretical value as the hematocrite value of theoretical value from ratio as the hematocrite value of measured value, whether by differentiating whether approach 0, it is approximately equal to differentiate these values.In addition, the evaluated error that the 5a of mechanism and the 2nd measures the 5b of mechanism is measured in pre-estimation the 1st, but the scope of the permissible value when setting subtraction is differentiated the scope that whether surpasses these permissible values with mechanism for identifying 12.
Normally drive blood pump 3 respectively and remove water pump 8, and do not have leakage etc. down Qb and Quf when setting, be consistent as the ratio of the hematocrite value of theoretical value with ratio as the hematocrite value of measured value then, the relational expression of Hta/Htv (measured value)=1-Quf (setting value)/Qb (setting value) should be set up.Therefore, when differentiating such relational expression establishment with mechanism for identifying 12, can judge that the dialysis apparatus that contains blood circuit 1 is not unusual, when differentiation above-mentioned relation formula is false, can judge blood pump 3 and remove water pump 8 and wait any one to have unusually, report with notifying operator 13 peripherad medical personnel located either.
In addition, when reporting, the action of two pumps is stopped, need carrying out the necessary repairing or the replacing of device with notifying operator 13.Like this, whether have unusually, so can make medical personnel located either recognize whether dialysis apparatus has unusually if can report blood pump 3 and removing water pump 8 by notifying operator 13.
Here, when the relational expression of Hta/Htv (measured value)=1-Quf (setting value)/Qb (setting value) is false, when the right (being theoretical value) is little value, can think that the actuating speed of removing water pump 8 is faster than what set, perhaps the actuating speed of blood pump 3 is slower than setting, but can't be specific any unusual.Therefore, in order to find out unusual position, when mechanism for identifying 12 differentiations are unusual, carry out following computing with arithmetical organ 11.
Just, when the relational expression of Hta/Htv (measured value)=1-Quf (setting value)/Qb (setting value) is false, because 1-Quf (setting value)/Qb (setting value) ≠ 1-Quf (actual value)/Qb (actual value), so the relational expression (hereinafter referred to as (1) formula) of (Quf (setting value)/Qb (setting value))/(Quf (actual value)/Qb (actual value))=p (still, p ≠ 1) is set up.
; the drive actions of removing water pump 8 maintains the original state down; change the actuating speed of blood pump 3; Qb (setting value) is made X, and doubly (setting value Qb is known; so X numerical value doubly also is given value); its result supposes when Qb (actual value) is y times, and then (Quf (setting value)/xQb (setting value))/(Quf (actual value)/yQb (actual value))=(y/x) relational expression of p (hereinafter referred to as (2) formula) is set up.At this moment, the action of blood pump 3 is if normal, because x=y, so the value that obtains with above-mentioned (1) formula should equal the value that obtains with above-mentioned (2) formula, still two are worth when not waiting mutually, can judge that blood pump 3 has unusually.
In addition, the drive actions of blood pump 3 maintains the original state down, change the actuating speed of removing water pump 8, Quf (setting value) is made a doubly, its result, suppose when Quf (actual value) is b times that then (aQuf (setting value)/Qb (setting value))/(bQuf (actual value)/Qb (actual value))=(a/b) relational expression of p (hereinafter referred to as (3) formula) is set up.At this moment, the action of blood pump 3 is if normal, because a=b, so the value that obtains with above-mentioned (1) formula should equal the value that obtains with above-mentioned (3) formula, but two be worth when not waiting mutually, and can judge except that water pump 8 has unusually.
In other words, Hta (theoretical value)/Htv (theoretical value)=1-Quf (setting value)/Qb (setting value) and Hta (measured value)/Htv (measured value)=1-Quf (actual value)/Qb (actual value) sets up, so blood pump 3 or remove water pump 8 and produce when unusual, the relational expression of { Quf (setting value)/Qb (setting value) }/{ Quf (actual value)/Qb (actual value) }=p (but p ≠ 1) is set up, and the formula that can obtain Quf (actual value)/Qb (actual value)=1-Hta (measured value)/Htv (measured value) from the above-mentioned relation formula is set up.
Therefore, because p={Quf (setting value)/Qb (setting value) }/{ 1-Hta (measured value)/Htv (measured value) } establishment, so can obtain p from known setting value and measured value.Then, (x is a constant just the actuating speed (setting value) of blood pump 3 to be changed to xQb, so xQb is known value), when supposing it Qb (actual value) being y times as a result, then become { Quf (setting value)/xQb (setting value) }/{ Quf (actual value)/yQb (actual value) }=(y/x) p.Here, relatively p and (y/x) p, p=(y/x) p, just y/x=1 can judge that blood pump 3 is not unusual, removing water pump 8 has unusually.Y/x ≠ 1 on the contrary just during y ≠ x, can judge that blood pump 3 is unusual.
More than be in the 1st embodiment with the method for discrimination (using) of mechanism for identifying 12 than comparing, differentiate unusually but also can followingly compare with difference.
Just, with use than method of discrimination in the same manner, from Hta/Htv (theoretical value)=1-Quf (setting value)/Qb (setting value), and two formulas of Hta/Htv (measured value)=1-Quf (actual value)/Qb (actual value) are when obtaining the poor Δ L1 of theoretical value and measured value, and then the arithmetic expression of Δ L1=(1-Quf (setting value)/Qb (setting value))-(1-Quf (actual value)/Qb (actual value))=Quf (actual value)/Qb (actual value)-Quf (setting value)/Qb (setting value) is set up.
Here, when removing water pump 8 and blood pump 3 and all being regular event, should Δ L1=0.Obtain the operation result of above-mentioned difference, when Δ L1 ≠ 0, can judge and remove water pump 8 or blood pump 3 has unusually.Therefore, when Δ L1 ≠ 0, the actuating speed of blood pump 3 is changed, Qb (setting value) is made a doubly (because setting value Qb is known, so also be known numerical value after a times), its result, suppose when Qb (actual value) is b times that the poor Δ L2 of this moment can calculate with following formula.
The arithmetic expression of Δ L2=Quf (actual value)/bQb (actual value)-Quf (setting value)/aQb (setting value) is set up, at this moment, the action of blood pump 3 just often because a=b, thus should Δ L1=a Δ L2 the relational expression of (and=b Δ L2) set up.When such relational expression is false, can judge except that water pump 8 unusual.In addition, also the actuating speed of removing water pump 8 can be made a doubly after, compare with above-mentioned arithmetic expression.
In other words, become Δ L1=1-{Quf (setting value)/Qb (setting value) }-{ 1-(Quf (actual value)/Qb (actual value)) }={ Quf (actual value)/Qb (actual value) }-{ Quf (setting value)/Qb (setting value) }={ 1-Hta (measured value)/Htv (measured value) }-{ Quf (setting value)/Qb (setting value) }, obtain Δ L1 by known setting value and measured value (measured value).Here, during Δ L1=0, can judge blood pump 3 and remove water pump 8 all not have unusually, but Δ L1 ≠ 0 o'clock can be judged blood pump 3 or remove water pump 8 generations unusually.
Δ L1 ≠ 0 o'clock is changed to aQb (because a is a constant, so aQb is known value) with the actuating speed (setting value) of blood pump 3, its result, suppose Qb (actual value) be b doubly, the poor Δ L2 of this moment can obtain with the following formula arithmetic expression.Just become Δ L2=1-{Quf (setting value)/aQb (setting value) }-{ 1-Quf (actual value)/bQb (actual value) }={ Quf (actual value)/bQb (actual value) }-{ Quf (setting value)/aQb (setting value), here, blood pump 3 is just often, then because a=b, so when calculating a Δ L2, a Δ L2=(a/b) { Quf (actual value)/Qb (actual value) }-{ Quf (setting value)/Qb (setting value) }=Δ L1, when perhaps calculating b Δ L2, b Δ L2={Quf (actual value)/Qb (actual value) then }-(b/a) { Quf (setting value)/Qb (setting value) }=Δ L1.By above-mentioned computing, in Δ L1 ≠ 0 o'clock, and, when a Δ L2=Δ L1 or b Δ L2=Δ L1, can judge that to remove water pump 8 unusual, can judge that blood pump 3 is unusual when a Δ L2 ≠ Δ L1 or b Δ L2 ≠ Δ L1.
According to above-mentioned the 1st embodiment, can not carry out mensuration in the past to patient's hematocrite value, shorten treatment time, in the time of relieve patient ' s burden, can monitor the blood pump 3 in the dialysis apparatus or remove various elements unusual of water pump 8, in addition because position that can specific exceptions, so can be sleekly and carry out next step the correspondence which element is what is called will repair or study for a second time courses one has flunked exactly.
Below, the 2nd embodiment of the present invention is described.
The related blood device of present embodiment is to be suitable for blood filtration dialysis (HDF), blood filtration method (HF), constitute by the structure that imports fluid infusion from the arterial side blood circuit, as shown in Figure 4, the blood circuit 1 that the blood purification 2 ' that is made of filter etc. connects, and be connected that the apparatus for purifying blood main body that can dewater 6 ' on the blood purification 2 ' constitutes.In addition,, give identical symbol, omit its detailed explanation simultaneously for the element identical with the 1st embodiment.
Extend the fluid infusion ingress pipe 15 that constitutes by flexable tube on the arterial side drip chamber 4a in the way that is provided in arterial side blood circuit 1a, when the connection of the top of this fluid infusion ingress pipe 15 can be accommodated the fluid infusion storage bag 14a of ormal weight fluid infusion, in the way of this fluid infusion ingress pipe 15, set and draw slim fluid infusion pump 14b.These fluid infusion storage bag 14a and fluid infusion pump 14b are configured for fluid infusion is imported to the fluid infusion introducing mechanism 14 of blood circuit 1.
In addition, be provided in the 1st of arterial side blood circuit 1a and venous side blood circuit 1b and measure 5a of mechanism and the 2nd mensuration 5b of mechanism, identical with the 1st embodiment, as shown in Figure 3, electrically be connected with arithmetical organ 11, mechanism for identifying 12 and notifying operator 13.At this, in the arithmetical organ 11 of present embodiment, except calculating as the 1st the measuring the ratio that the 5a of mechanism and the 2nd measures the hematocrite value that the 5b of mechanism measures of the 1st embodiment, the rate of filtration that the setting blood flow rate of blood pump 3, the setting that removes water pump 8 are removed the fluid infusion velocity of water speed, fluid infusion introducing mechanism 14 and blood purification 2 ' is as parameter, calculates hematocrite value as theoretical value from the regulation arithmetic expression.
For example, with the 1st measure the 5a of mechanism as the hematocrite value of measured value as Hta, with the 2nd measure the 5b of mechanism as the hematocrite value of measured value during as Htv, in the time of the ratio Hta/Htv of these measured values of computing, as Qb, the setting that removes water pump 8 removes water speed as Quf with the setting blood flow rate of blood pump 3, and the fluid infusion velocity of fluid infusion introducing mechanism 14 is as Qsin, the rate of filtration of blood purification 2 ' is during as Qsout, can calculate with following formula as the ratio Hta/Htv of theoretical value.
The hematocrite value of the blood of collapse due to massive hemorrhage is during as Htp, because Hta (theoretical value)=Htp * Qb/ (Qb+Qsin), Htv (theoretical value)=Htp * Qb/ (Qb+Qsin-Quf-Qsout), so the ratio of these theoretical values can calculate from following formula.Just become, Hta/Htv (theoretical value)=1-(Quf+Qsout)/(Qb+Qsin) in addition, in the situation of HF, in the time of with Qd=0, can control automatically in common apparatus for purifying blood and make Qsin=Qsout.
Therefore, the ratio of the theoretical value of obtaining with such arithmetic expression and, the ratio of said determination value, can derive with arithmetical organ 11.Whether these are slightly equal, can differentiate with the mechanism for identifying 12 identical with the 1st embodiment.In addition, in the present embodiment, be to obtain the ratio (measured value and ideal value both) of hematocrite value with Hta/Htv, but also can obtain Htv/Hta reciprocal.
When Qb, Quf, Qsin and Qsout are according to blood pump 3, remove water pump 8 and fluid infusion pump 1 4b difference driven, and when not having setting value that liquid leaks, consistent as the ratio of the hematocrite value of theoretical value with ratio as the hematocrite value of measured value, become that (Hta/Htv (measured value)=(Hta/Htv (theoretical value)), then the relation of Hta/Htv (measured value)=1-(Quf+Qsout)/(Qb+Qsin) should be set up.
Therefore, when differentiating such relation establishment with mechanism for identifying 12, it is unusual to differentiate the dialysis apparatus that contains blood circuit 1, when the differentiation above-mentioned relation is false, can differentiate blood pump 3, remove water pump 8 or fluid infusion pump 14b etc. and have some unusual, so can report by notifying operator 13 peripherad medical workers.
Here; the relation of Hta/Htv (measured value)=1-(Quf+Qsout)/(Qb+Qsin) is false; the right (being theoretical value) hour, can think the actuating speed of removing water pump 8 actuating speed faster than the speed of setting or blood pump 3 or fluid infusion pump 14b slower than the speed of setting unusual or liquid leakage etc. and produce the fluid infusion deficiency.But be that any unfavorable condition can not be specific.Thus, in order to carry out the specific of bad position, differentiating when mechanism for identifying 12 has when unusual, and available arithmetical organ 11 carries out following computing.
Just, when the relation of Hta/Htv (measured value)=1-(Quf+Qsout)/(Qb+Qsin) is false, because 1-(Quf (setting value)+Qsout (setting value))/(Qb (setting value)+Qsin (setting value)) ≠ 1-(Quf (actual value)+Qsout (actual value))/(Qb (actual value)+Qsin (actual value)), so the relational expression (but q ≠ 1) (hereinafter referred to as (4) formula) of { (Quf (setting value)+Qsout (setting value))/(Qb (setting value)+Qsin (setting value)) }/{ (Quf (actual value)+Qsout (actual value))/(Qb (actual value)+Qsin (actual value)) }=q is set up.
; the drive actions of blood pump 3 and fluid infusion pump 14b is remaining unchanged down; change the actuating speed of removing water pump 8; Quf (setting value)+Qsout (setting value) is made z doubly; (Quf (actual value)+when Qsout (actual value) becomes s times (in the present embodiment in its result supposition; removing water pump 8 dewaters simultaneously and filters), the establishment of then { z (Quf (setting value)+Qsout (setting value))/(Qb (setting value)+Qsin (setting value)) }/{ s (Quf (actual value)+Qsout (actual value))/(Qb (actual value)+Qsin (actual value)) }=(z/s) relational expression of q (hereinafter referred to as (5) formula).At this moment, the action that removes water pump 8 just often because z=s, should equate according to the value of above-mentioned (4) formula with according to the value of above-mentioned (5) formula, but both can judge that to remove water pump 8 unusual when unequal.
On the other hand, think and (do not see that removing water pump 8 has unusually) when removing water pump 8 regular events that then Quf (setting value)+Qsout (setting value)=Quf (actual value)+Qsout (actual value) sets up, so (4) formula can be simplified according to following.Just, be simplified to (Qb (actual value)+Qsin (actual value))/arithmetic expression of (Qb (setting value)+Qsin (setting value))=q (wherein q ≠ 1).
Here, just stop fluid infusion and filtering state (promptly with as the identical state of HD of the 1st embodiment) in order to make, under the constant state of Quf (setting value), if Qsout (setting value) and Qsin (setting value) are made 0, then same with the 1st embodiment, the arithmetic expression of { Quf (setting value)/Qb (setting value) }/{ Quf (actual value)/(Qb (actual value) }=r (wherein r ≠ 1) is set up.
Below, with the HD of the 1st embodiment in the same manner, with the setting value of blood pump 3 make x doubly after; can confirm the unusual of blood pump 3 by comparing; on the other hand, do not have when unusual, can suspect that the unusual or fluid infusion ingress pipe 15 (fluid infusion loop) of fluid infusion pump 14b has leakage at blood pump 8.In addition, whether be the unusual of fluid infusion pump 14b or because that the leakage in fluid infusion loop causes is unusual, the operator can whether liquid leaks confirms with visualization.
More than be the method for discrimination with mechanism for identifying 12 (using) of the 2nd embodiment, below also can compare the differentiation unfavorable condition with difference than comparing.
Just, with use than method of discrimination in the same manner, from Hta/Htv (theoretical value)=1-(Quf (setting value)+Qsout (setting value))/(Qb (setting value)+Qsin (setting value)), and two formulas of Hta/Htv (measured value)=1-(Quf (actual value)+Qsout (actual value))/(Qb (actual value)+Qsin (actual value)) are when obtaining the poor Δ L3 of theoretical value and measured value, and then the arithmetic expression of Δ L3=(Quf (actual value)+Qsout (actual value))/(Qb (actual value)+Qsin (actual value))-(Quf (setting value)+Qsout (setting value))/(Qb (setting value)+Qsin (setting value)) (hereinafter referred to as (A) formula) is set up.
Here, when removing water pump 8 (perhaps dual-purpose does not remove the filtrate pump of water pump), blood pump 3 and fluid infusion pump 14b and being operate as normal respectively, should Δ L3=0.Obtain the operation result of above-mentioned difference, when Δ L3 ≠ 0, can judge that some pumps wherein have unusually.Therefore, when Δ L3 ≠ 0, Quf (setting value)+Qsout (setting value) is made c doubly, its result supposes that Quf (actual value)+when Qsout (actual value) became d times, the poor Δ L4 of this moment can calculate with following formula.
The arithmetic expression of Δ L4=d (Quf (actual value)+Qsout (actual value))/(Qb (actual value)+Qsin (actual value))-c (Quf (setting value)+Qsout (setting value))/(Qb (setting value)+Qsin (setting value)) is set up, at this moment, remove water pump 8 and not dual-purpose except that the action of the filtrate pump of water pump just often, because c=d, so the relational expression of Δ L4=C Δ L3 (and d Δ L3) should be set up.When such relational expression is false, can judge remove water pump 8 and not dual-purpose except that the remarkable action of the filtrate pump of water pump 8.
And then, when the relational expression of Δ L4=c Δ L3 (and d Δ L3) is set up, in (A) formula because the item of Quf+Qsout, set value identical with actual value, so can consider.Therefore, Δ L3 can simplify according to following formula Δ L3 '.Δ L3 '=1/Qb (actual value)+Qsin (actual value) just) arithmetic expression of-1/ (Qb (setting value)+Qsin (setting value)) is simplified.
Here, when the driving of fluid infusion pump 14b stops, in the above-mentioned arithmetic expression of having simplified, and then be simplified to Δ L3 '=1/Qb (actual value)-1/Qb (setting value).In this formula; Δ L3 '=0 o'clock can judge that blood pump 3 is regular events, and the fluid infusion introducing mechanism 14 that can judge the unusual of fluid infusion pump 14b on the other hand or contain this fluid infusion pump 14b has liquid leakage etc. to have some unusual; in contrast, when Δ L3 ' ≠ 0, can judge that blood pump 3 is unusual.
Then, describe for the 3rd embodiment of the present invention.
The apparatus for purifying blood of present embodiment is applicable to blood filtration dialysis (HDF), blood filtration method (HF) or AFBF (Aceyate-free biofilbration), constitute by the structure that imports fluid infusion from the venous side blood circuit, as shown in Figure 5, mainly from being connected with the blood circuit 1 of the blood purification 2 ' that constitutes by filter etc., and be connected that blood purification 2 ' is gone up and the apparatus for purifying blood main body 6 ' that can dewater constitutes.In addition, in the element identical, pay prosign, omit detailed explanation simultaneously with the 1st embodiment and the 2nd embodiment.
Be connected with the fluid infusion introducing mechanism 14 identical on the venous side drip chamber 4b in being provided in venous side blood circuit 1b way with the 2nd embodiment.In addition, be provided in the 1st of arterial side blood circuit 1a and venous side blood circuit 1b and measure 5a of mechanism and the 2nd mensuration 5b of mechanism, with the 1st embodiment and the 2nd embodiment in the same manner, as shown in Figure 3, electrically be connected on arithmetical organ 11, mechanism for identifying 12 and the notifying operator 13.
At this, in arithmetical organ 11, with the 2nd embodiment in the same manner, computing is measured the ratio that the 5a of mechanism and the 2nd measures the hematocrit that the 5b of mechanism determines with the 1st of the 1st embodiment, simultaneously the setting blood flow rate of blood pump 3, the setting that removes water pump 8 are removed the fluid infusion velocity of water speed, fluid infusion introducing mechanism 14, and with the rate of filtration of blood purification 2 ' as parameter, calculate ratio from the arithmetic expression of regulation as the hematocrite value of theoretical value.
With the computing of the arithmetical organ in the present embodiment 11, carry out according to following.Just with the hematocrite value of the blood of collapse due to massive hemorrhage during as Htp, at this moment, Htp=Hta, so become Htv (theoretical value)=Hta * Qb/ (Qb+Qsin-Quf-Qsout), can obtain Hta/Htv (theoretical value)=arithmetic expression of 1-(Quf+Qsout-Qsin)/Qb, the situation of HF in addition, with Qd=0, in common apparatus for purifying blood, can control automatically and make Qsin=Qsout.
Whether the ratio of the ratio of differentiating the above-mentioned theory values with mechanism for identifying 12 and, said determination value is approximately identical.When blood pump 3, remove water pump 8 and fluid infusion pump 14b is respectively a driven, and there is not a liquid leakage etc., Qb, Quf, Qsin and Qsout are during as the value of setting, because of as the ratio of the hematocrite value of theoretical value with consistent (Hta/Htv (measured value)=(Hta/Htv (theoretical value)) is so should set up the relation of Hta/Htv (measured value)=1-(Quf+Qsout-Qsin)/Qb as the ratio of the hematocrite value of measured value.
Therefore, when differentiating such relation establishment with mechanism for identifying 12, can judge that the dialysis apparatus that contains blood circuit 1 is not unusual, when differentiation above-mentioned relation formula is false, can judge blood pump 3, one of them is unusual to remove water pump 8 or fluid infusion pump 14b etc., by notifying operator 13 report to around the medical personnel.
Here; the relational expression of Hta/Htv (measured value)=1-(Quf+Qsout-Qsin)/Qb is false; when the right (being theoretical value) is little value; can think that the actuating speed of removing water pump 8 is faster than what set; perhaps the actuating speed of blood pump 3 is slower than setting; perhaps because the fluid infusion deficiency that the unusual or liquid leakage of fluid infusion pump 14b etc. cause still, is which still can not be specific.Therefore, in order to find out unusual position, mechanism for identifying 12 is differentiated to be had when unusual, carries out following computing with arithmetical organ 11.
Just, when the relational expression of Hta/Htv (measured value)=1-(Quf (actual value)+Qsout (actual value)-Qsin (actual value))/Qb (actual value) is false, because 1-(Quf (setting value)+Qsout (setting value)-Qsin (setting value))/Qb (setting value) ≠ 1-(Quf (actual value)+Qsout (actual value)-Qsin (actual value))/Qb (actual value), so the relational expression (hereinafter referred to as (6) formula) of { (Quf (setting value)+Qsout (setting value)-Qsin (setting value))/Qb (setting value) }/{ (Quf (actual value)+Qsout (actual value)-Qsin (actual value))/Qb (actual value) }=t (still, t ≠ 1) is set up.
; the drive actions of removing water pump 8 and fluid infusion pump 14b is maintaining the original state down; change the actuating speed of blood pump 3; Qb (setting value) is made X doubly; its result; suppose when Qb (actual value) is y times that then { (Quf (setting value)+Qsout (setting value)-Qsin (setting value))/xQb (setting value) }/{ (Quf (actual value)+Qsout (actual value)-Qsin (actual value))/yQb (actual value) }=(y/x) relational expression of t (hereinafter referred to as (7) formula) is set up.At this moment, the action of blood pump 3 is if normal, because x=y, so the value of calculating with above-mentioned (6) formula should equal the value with the calculating of above-mentioned (7) formula, if both when not waiting mutually, can judge that blood pump 3 has unusually.
On the other hand, (do not find that blood pump 3 has unusually) when thinking blood pump 3 regular events, because Qb (setting value)=Qb (actual value), then (6) formula can be simplified according to following.Just, the arithmetic expression (hereinafter referred to as (8)) of (Quf (setting value)+Qsout (setting value)-Qsin (setting value))/(Quf (actual value)+Qsout (actual value)-Qsin (actual value))=t (but t ≠ 1) is set up.
Here, when the value of Quf (setting value)+Qsout (setting value) makes 0, when Qsin (setting value) is made c times, its result, suppose when Qsin (actual value) becomes d times that then the arithmetic expression of c Qsin (setting value)/d Qsin (actual value)=(c/d) t (below become formula (9)) is set up.And fluid infusion pump 14b is not unusual, and when fluid infusion ingress pipe 15 (fluid infusion loop) did not have liquid to leak, the value of calculating with above-mentioned (8) formula equaled the value with the calculating of above-mentioned (9) formula, can judge except that water pump 8 unusual.
On the other hand, when the value of calculating with above-mentioned (8) formula is not equal to the value of calculating with above-mentioned (9) formula, can suspect fluid infusion pump 14b unusually or fluid infusion ingress pipe 15 (fluid infusion loop) leakage is arranged.In addition, whether be the unusual of fluid infusion pump 14b or because that the leakage in fluid infusion loop causes is unusual, the operator can whether liquid leaks confirms with visualization.
It more than is the method for discrimination with mechanism for identifying 12 (using) in the 3rd embodiment than comparing.But, also can use poor relatively judgement unfavorable condition as shown below.
Just, with use than method of discrimination in the same manner, from Hta/Htv (theoretical value)=1-(Quf (setting value)+Qsout (setting value)-Qsin (setting value))/Qb (setting value), and two formulas of Hta/Htv (measured value)=1-(Quf (actual value)+Qsout (actual value)-Qsin (actual value))/Qb (actual value) are when obtaining the poor Δ L5 of theoretical value and measured value, and then the arithmetic expression of Δ L5=(Quf (actual value)+Qsout (actual value)-Qsin (actual value))/Qb (actual value)-(Quf (setting value)+Qsout (setting value)-Qsin (setting value))/Qb (setting value) (to call (B) formula in the following text) is set up.
Here, when removing water pump 8 (perhaps dual-purpose does not remove the filtrate pump of water pump 8), blood pump 3 and fluid infusion pump 14b and all being operate as normal, should Δ L5=0.Obtain the operation result of above-mentioned difference, when Δ L5 ≠ 0, can judge that some pumps wherein have unusually.Therefore, when Δ L5 ≠ 0, Qb (setting value) is made e doubly, its result supposes when Qb (actual value) is f times, and the poor Δ L6 of this moment can calculate with following formula.
The arithmetic expression of Δ L6=(Quf (actual value)+Qsout (actual value)-Qsin (actual value))/fQb (actual value)-(Quf (setting value)+Qsout (setting value)-Qsin (setting value))/eQb (setting value) is set up, at this moment, the action of blood pump 3 just often, because e=f, so the relational expression of Δ L5=e Δ L6 (and f Δ L6) should be set up.When such relational expression is false, can judge except that blood pump 3 unusual.
And then, when the relational expression of Δ L5=e Δ L6 (and f Δ L6) is set up, in (B) formula, because Qb (setting value) is identical with Qb (actual value), so there is not necessity of consideration.Therefore, Δ L5 can simplify according to following Δ L5 '.The arithmetic expression of Δ L5 '=(Quf (actual value)+Qsout (actual value)-Qsin (actual value))-(Quf (setting value)+Qsout (setting value)-Qsin (setting value)) just.
Here, when stopping the driving of fluid infusion pump 14b, the arithmetic expression of above-mentioned simplification can further be reduced to Δ L5 '=(Quf (actual value)+Qsout (actual value)-(Quf (setting value)+Qsout (setting value)).In the formula; if Δ L5 '=0; can judge remove water pump 8 or not the dual-purpose filtrate pump that removes water pump 8 be regular event; the fluid infusion introducing mechanism 14 that can judge simultaneously the unusual of fluid infusion pump 14b on the other hand or contain this fluid infusion pump 14b has some of liquid leakage etc. unusual; in contrast, when Δ L5 ' ≠ 0, can judge remove water pump 8 or dual-purpose to remove the filtrate pump of water pump 8 not unusual.
If according to the 2nd above-mentioned embodiment (to the fluid infusion of arterial side blood circuit 1a) and the 3rd embodiment (to the fluid infusion of venous side blood circuit 1b), even in the blood circuit of HDF or HF (comprising AFBF during the 3rd embodiment), import in the structure of fluid infusion, do not need to measure in advance patient's haemoconcentrations such as hematocrite value yet, can shorten the burden that treatment time alleviates the patient, can monitor that simultaneously (concrete is blood pump 3 for the various elements of pump in the blood device etc., remove water pump 8, leakage in the unfavorable condition of fluid infusion pump and the fluid infusion introducing mechanism) unfavorable condition.
The 4th embodiment of the present invention below is described.
The apparatus for purifying blood that present embodiment is related is made of the blood plasma adsorbent equipment, and this blood plasma adsorbent equipment comprises: the separating plasma operation, when making patient's blood carry out extracorporeal circulation from its blood separated plasma; Absorption process, selectively adsorb and remove the cause of disease hazardous substance that contains in separated plasma, as shown in Figure 6, its apparatus for purifying blood is mainly measured the 21b of mechanism, 21c and is constituted by blood circuit 1, plasma separator 16, blood plasma pump 17, adsorption column the 18, the 1st mensuration 21a of mechanism and the 2nd.Wherein, blood circuit is to be made of arterial side blood circuit 1a and venous side blood circuit 1b.In addition, give identical symbol, omit detailed explanation simultaneously with the element that the 1st embodiment～the 3rd embodiment is identical.
Plasma separator 16 is connected between arterial side blood circuit 1a and the venous side blood circuit 1b, is taking in a plurality of macaroni yarns (still, fenestra than common employed dialyser big) identical with the employed dialyser of dialysis apparatus in inside.Concrete is on plasma separator 16, be formed with blood plasma introducing port 16a, blood plasma outlet 16c, blood cell composition outlet 16b, this blood introducing port 16a is connected in the arterial side blood circuit, this blood plasma outlet 16c is used for discharging the blood plasma (liquid component) of the fenestra (hole) by macaroni yarn, this blood cell composition outlet 16b is connected among the venous side blood circuit 1b, and the blood plasma that is used for deriving the blood cell composition by the erythrocyte in the macaroni yarn etc. and can not discharges from blood plasma outlet 16c.
On above-mentioned blood plasma outlet 16c, be connected with an end of blood plasma ingress pipe 19, simultaneously, the other end of above-mentioned blood plasma ingress pipe 19 is being connected with the blood plasma introducing port 18a that forms on adsorption column 18.At disposing of blood plasma ingress pipe 19 the draw slim blood plasma pump 17 identical with blood pump 3 midway, it is according to attracting blood plasma to constitute to the mode of adsorption column 18 from plasma separator 16.
Adsorption column 18, its inner filling have can selectively adsorb the adsorbing material that is contained in the material related with the cause of disease in the blood plasma, and its top is formed with blood plasma introducing port 18a, and its below is formed with blood plasma outlet 18b.Such blood plasma outlet 18b is being connected with an end of blood plasma delivery line 20, and the other end of this blood plasma delivery line 20 is to be connected with the regulation position of venous side blood circuit 1b.In addition, plasma separator 16 and adsorption column 18 are equivalent to blood purification of the present invention mechanism.
The 1st mensuration 21a of mechanism, the 2nd mensuration 21b of mechanism and 21c and the 1st～the 3rd embodiment are the hematocrit sensor formation by the concentration that is used for measuring blood (concrete is hematocrite value) in the same manner, the 1st measures the 21a of mechanism is configured on the arterial side blood circuit 1a (being the upstream side of plasma separator 1b), and the 2nd mensuration 21b of mechanism and 21c are configured on the venous side blood circuit 1b (being the downstream of plasma separator 16).In addition, the 2nd mensuration 21b of mechanism is the upstream side that is configured in the contact of venous side blood circuit 1b and blood plasma delivery line 20, and the 2nd measures the downstream that the 21c of mechanism is configured in this contact.
Above-mentioned the 1st mensuration 21a of mechanism, the 2nd measures the 21b of mechanism and 21c electrically is being connected (with reference to Fig. 3) with arithmetical organ, mechanism for identifying and notifying operator in the same manner with the 1st embodiment.Arithmetical organ is that respectively computing is measured the 21a of mechanism and the 2nd with the 1st and measured the 21b of mechanism, perhaps the 1st measure the 21a of mechanism and the 2nd measure the blood that the 21c of mechanism measures concentration ratio and, with the setting blood flow rate of blood pump, and the haemoconcentration ratio obtained as the regulation arithmetic expression of parameter with the rate of filtration (setting purification speed) of plasma separator 16 as theoretical value.
On the other hand, with the 1st embodiment in the same manner, mechanism for identifying is to be used for differentiating with whether approximately equating as the ratio of the haemoconcentration of measured value with as the ratio of the haemoconcentration of theoretical value that arithmetical organ is obtained, notifying operator be with mechanism for identifying as the haemoconcentration of measured value than and use as the scope that the difference of the haemoconcentration ratio of theoretical value has surpassed the regulation permission.
Below, the effect of the blood plasma adsorbent equipment in the above-mentioned formation is described.
To be formed on the arterial side puncture needle a at blood circuit 1 two ends and venous side puncture needle b puncture after on the patient, when driving blood pump 3 (settings flow is Qb), driving blood plasma pump 17 (the setting flow is Quf).Thus, patient's blood reaches the 1st from arterial side puncture needle a by arterial side blood circuit 1a and measures the 21a of mechanism, measure this haemoconcentration (hematocrite value) with the 1st mensuration 21a of mechanism after, import in the plasma separator 16.
In passing through plasma separator 16 processes, the blood cell composition of the erythrocyte in the blood etc. (also comprise above-mentioned from blood plasma outlet 16c can not emptying blood plasma, below identical), discharge from blood cell composition outlet 16b, on the other hand, blood plasma in the blood is discharged from blood plasma outlet 16c by the captivation of pump 17, delivers in the adsorption column 18 by blood plasma ingress pipe 19.In addition, the rate of filtration (setting purification speed) of the blood plasma that will discharge from blood plasma outlet 16c is as Quf.
Deliver to the blood plasma in the adsorption column 18, selectively adsorb with adsorbing material and remove the material that contains cause of disease association, after purifying thus, discharge, deliver to venous side blood circuit 1b by blood plasma delivery line 20 from blood plasma outlet 18b.Then, the blood cell composition of discharging from plasma separator 16b and the purification of discharging from blood plasma post 18 blood plasma turn back in patient's the body by venipuncture needle b together.
Here, blood after just having discharged from plasma separator 16 (promptly, with the state before the blood plasma interflow of discharging from adsorption column 18), when measuring the 21b of mechanism mensuration haemoconcentration (hematocrite value), measure the 21c of mechanism with the haemoconcentration at this blood plasma interflow with the 2nd and measure by the 2nd.Then, in arithmetical organ, computing the 1st measure the 21a of mechanism and the 2nd measure the 21b of mechanism ratio (ratio of theoretical value and the ratio of measured value) and, the 1st measure the ratio (ratio of theoretical value and the ratio of measured value) that the 21a of mechanism and the 2nd measures the 21c of mechanism, whether these ratios of differentiation approximately equal in mechanism for identifying.In addition, for each than operation method and method of discrimination and the 1st embodiment carry out in the same manner.
And ought normally drive blood pump 3 and blood plasma pump 17 respectively, and, there not being leak down Qb and Quf of liquid is during as the value set, at mechanism for identifying, the ratio of judging each is about equates, on the other hand, and during if any the bad or leakage of any one pump, then in mechanism for identifying, determine at least one than being approximately not wait, by notifying operator with abnormal conditions report to around the medical personnel.
In addition, as the 1st embodiment, differentiating has when unusual, changes preferably that the blood flow rate Qb of blood pump 3 or blood pump 17 or rate of filtration Quf are specific to go out bad position.In addition, in this form of implementation, be to connect 2 the 2nd to measure 21b of mechanism and 21c, but also can connect one of them.And, the 2nd mensuration 21c of mechanism is because be connected the downstream of the contact of venous side loop 1b and blood plasma delivery line 20, so the haemoconcentration of measuring the 21a of mechanism with the 1st of plasma separator 16 upstream sides relatively can detect the leakage of blood circuit 1 self etc.
More than, the apparatus for purifying blood related for present embodiment is illustrated, but the present invention is not limited by these, for example employed dialysis apparatus is that dialysate supply unit and dialysis constitute with the monitoring arrangement split in the 1st～the 3rd embodiment, be so-called centring system, they be integral (so-called personal dialysis apparatus) but also be suitable for.
Particularly in the 1st embodiment, supply with dialysis solution with the dual pump P in the monitoring arrangement to dialyser 2 with dialysis, but also can adopt the so-called balance cylinder mode of this dual pump P not etc.In addition, though and then in blood circuit, used crosspointer type with arterial side puncture needle a and venous side puncture needle b, also can use single needle type with 1 root puncture pin.
In the 4th embodiment,, also be applicable to and these blood plasma absorption method diverse ways (for example, in plasmapheresis, can sieve the material of the pore by film and two tunic Filtrations of intransitable material etc.) though be suitable for the blood plasma absorption method.Certainly also be useful in the plasmapheresis, will replace additional liquid and turn back to the intravital method of patient while discard blood plasma after separating.
And then, be applicable to that it is the hematocrite value of measuring as haemoconcentration that the 1st mensuration mechanism of the present invention and the 2nd measures mechanism, but also can measure the demonstration haemoconcentration parameter that shows other.Replace above-mentioned haemoconcentration, for example consider the so-called hemoglobin concentration (g/dL) of the hemoglobin in the erythrocyte and when using, the mass conservationization that also can regard hemoglobin in hemodialyzer or plasma separator even dewater or when filtering as (just, erythrocyte all is filtered in plasma separator), so dewater or filter before and after hemoglobin concentration as Hba, Hbv (g/dL), to enter the blood flow of blood purification or plasma separator as Qb (dL/min), to dewater or the rate of filtration during as Quf (dL/min)
Can obtain the theoretical value ratio of Hba/Hbv=1-Qb/Quf from the relational expression of Hba (g/dL) * Qb (dL/min) * t (min)=Hbv (g/dL) * (Qba-Quf) (dL/min) * t (min).According to the ratio of such theoretical value and the ratio of measured value, differentiate at mechanism for identifying, also can monitor the unfavorable condition of the various elements in the apparatus for purifying blood (comprising dialysis apparatus or plasma separating unit).
And then, in the quality of the hemoglobin of considering the per unit blood quality during as concentration index (g/kg), with above-mentioned same, with dewater or filter before and after haemoconcentration as Xa, Xv (g/kg), will enter blood purification or plasma separator blood flow (mass flow) as Qbm (kg/min), will dewater or the rate of filtration (mass velocity) during as Qufm (kg/min)
Can obtain the ratio of the theoretical value of Xa/Xv=1-Qbm/Qufm from Xa (g/kg) * Qbm (kg/min) * t (min)=Xv (g/kg) * (Qbm-Qufm) (kg/min) * relational expression of t (min).Differentiate according to the ratio of such theoretical value and the ratio of measured value, same as described abovely, also can monitor the unfavorable condition of the various elements in the apparatus for purifying blood (comprising dialysis apparatus and plasma separating unit).
As previously discussed, can show the haemoconcentration ratio with mass/volume concentration ratio and mass/mass concentration ratio.These are not limited to hematocrite value and hemoglobin concentration, are suitable for too for the concentration based on other indexs.In addition, in the 2nd embodiment and the 3rd embodiment, also be applicable to online HDF and online HF.
And then the action of the ratio of the haemoconcentration of comparative measurements value and the haemoconcentration of theoretical value can automatically be implemented, and also can implement (implementing repeatedly in certain blanking time) continuously.In addition, when making the osmotic pressure variable effect to blood cell big or small owing to the influence of blood plasma and dialysate concentration (situation of HD, HDF, HF), compare (method etc. that for example, can consider to utilize the value of the dialysate concentration that dialysis apparatus measures) after also can proofreading and correct to it.
The various apparatus for purifying blood that the present invention purifies when going for making patient's blood to carry out extracorporeal circulation.
Claims (5)
1. apparatus for purifying blood is characterized in that having: blood circuit, and the arterial side blood circuit and the venous side blood circuit that are carried out extracorporeal circulation by the blood that makes the patient who takes constitute;
Blood pump is configured in the arterial side blood circuit of this blood circuit;
Blood purification mechanism is connected between the arterial side blood circuit and venous side blood circuit of above-mentioned blood circuit, purifies mobile blood in this blood circuit;
The 1st measures mechanism, is arranged in the arterial side blood circuit of above-mentioned blood circuit, is determined at mobile haemoconcentration in this arterial side blood circuit;
The 2nd measures mechanism, is arranged in the venous side blood circuit of above-mentioned blood circuit, is determined at mobile haemoconcentration in the venous side blood circuit;
Arithmetical organ, computing is measured the ratio that mechanism and the 2nd measures the haemoconcentration of mechanism's mensuration with the above-mentioned the 1st respectively, with with the setting purification speed of the setting blood flow velocity of above-mentioned blood pump and above-mentioned blood purification mechanism as parameter, the ratio of obtaining from the arithmetic expression of regulation as the haemoconcentration of theoretical value;
Mechanism for identifying, differentiate by this arithmetical organ obtain as the ratio of the haemoconcentration of measured value and whether roughly the same as the ratio of the haemoconcentration of theoretical value.
2. apparatus for purifying blood according to claim 1, it is characterized in that above-mentioned blood purification mechanism has blood purification and apparatus for purifying blood main body, above-mentioned blood purification is connected between above-mentioned arterial side blood circuit and the venous side blood circuit, above-mentioned apparatus for purifying blood main body has water removal body, this water removal body is connected in the above-mentioned blood purification, remove the moisture in the blood that flows through this blood purification, the setting that above-mentioned setting purification speed is above-mentioned water removal body removes water speed.
3. apparatus for purifying blood according to claim 2, it is characterized in that configuration imports in the fluid infusion introducing mechanism of fluid infusion in above-mentioned blood circuit, above-mentioned arithmetical organ, remove on the water speed basis in above-mentioned setting blood flow rate and setting, the rate of filtration of the setting fluid infusion velocity of this fluid infusion introducing mechanism and above-mentioned blood purification as parameter, is calculated ratio as the haemoconcentration of theoretical value from the regulation arithmetic expression.
4. according to any 1 the described apparatus for purifying blood in the claim 1～3, it is characterized in that having notifying operator, report above-mentioned mechanism for identifying as the ratio of the haemoconcentration of measured value and surpass the permissible range of regulation as the difference of the haemoconcentration ratio of theoretical value.
5. according to any 1 the described blood processor in the claim 1～4, it is characterized in that above-mentioned mechanism for identifying as the haemoconcentration of measured value than and when surpassing institute's permissible range as the difference of the haemoconcentration ratio of theoretical value, make blood flow rate, purification speed, fluid infusion velocity or the rate of filtration change specific bad position.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP330984/2002 | 2002-11-14 | ||
| JP2002330984 | 2002-11-14 | ||
| JP358200/2003 | 2003-10-17 |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN1711114A true CN1711114A (en) | 2005-12-21 |
| CN100441243C CN100441243C (en) | 2008-12-10 |
Family
ID=35707180
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CNB2003801031596A Expired - Lifetime CN100441243C (en) | 2002-11-14 | 2003-11-13 | Blood purification device |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN100441243C (en) |
Cited By (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN101778646B (en) * | 2007-05-29 | 2013-01-30 | 弗雷塞尼斯医疗保健控股公司 | Solutions, dialysates, and related methods |
| CN103249439A (en) * | 2010-03-25 | 2013-08-14 | 日机装株式会社 | Blood purification device |
| CN105473170A (en) * | 2013-09-02 | 2016-04-06 | 日机装株式会社 | Blood purifier |
| CN106687156A (en) * | 2014-09-12 | 2017-05-17 | 日机装株式会社 | Blood purification device |
| CN112312941A (en) * | 2018-06-27 | 2021-02-02 | 株式会社Jms | Dialysis device and fluid infusion control method |
| CN113164667A (en) * | 2018-12-03 | 2021-07-23 | 费森尤斯医疗保健控股公司 | Determination of the blood volume of a patient at the start of a dialysis treatment |
Family Cites Families (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPH0271754A (en) * | 1988-09-07 | 1990-03-12 | Nikkiso Co Ltd | Monitoring system for water removal control mechanism in artificial dialyzer |
| JPH0363065A (en) * | 1989-07-31 | 1991-03-19 | Shimadzu Corp | Artificial dialyser |
| JPH09149935A (en) * | 1995-11-30 | 1997-06-10 | Nissho Corp | Dehydration quantity monitoring device for dialyzer |
| AU3273101A (en) * | 1997-02-14 | 2001-06-04 | Nxstage Medical, Inc. | Extracorporeal circuits for performing hemofiltration employing pressure sensingwithout an air interface |
-
2003
- 2003-11-13 CN CNB2003801031596A patent/CN100441243C/en not_active Expired - Lifetime
Cited By (10)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN101778646B (en) * | 2007-05-29 | 2013-01-30 | 弗雷塞尼斯医疗保健控股公司 | Solutions, dialysates, and related methods |
| CN103249439A (en) * | 2010-03-25 | 2013-08-14 | 日机装株式会社 | Blood purification device |
| CN103249439B (en) * | 2010-03-25 | 2015-07-22 | 日机装株式会社 | Blood purification device |
| CN105473170A (en) * | 2013-09-02 | 2016-04-06 | 日机装株式会社 | Blood purifier |
| CN105473170B (en) * | 2013-09-02 | 2017-05-17 | 日机装株式会社 | Blood purifier |
| CN106687156A (en) * | 2014-09-12 | 2017-05-17 | 日机装株式会社 | Blood purification device |
| CN106687156B (en) * | 2014-09-12 | 2019-02-15 | 日机装株式会社 | Apparatus for purifying blood |
| CN112312941A (en) * | 2018-06-27 | 2021-02-02 | 株式会社Jms | Dialysis device and fluid infusion control method |
| CN112312941B (en) * | 2018-06-27 | 2023-09-08 | 株式会社Jms | Dialysis device and fluid replacement control method |
| CN113164667A (en) * | 2018-12-03 | 2021-07-23 | 费森尤斯医疗保健控股公司 | Determination of the blood volume of a patient at the start of a dialysis treatment |
Also Published As
| Publication number | Publication date |
|---|---|
| CN100441243C (en) | 2008-12-10 |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| TWI309169B (en) | The blood purifier | |
| US7618531B2 (en) | Hemodialysis treatment apparatus and method for hemodialysis treatment | |
| CN100346869C (en) | Method and apparatus for hemodiafiltration delivery module | |
| CN1604798A (en) | Automatic apparatus for blood dialyis and priming method using the apparatus | |
| US9878083B2 (en) | Blood purification apparatus with recognition and control means | |
| AU2010281016B2 (en) | Device and method for detecting blood or blood constituents in the liquid system of a device for extracorporeal blood treatment | |
| CN1968723A (en) | Blood dialyzing apparatus | |
| CN1968722A (en) | Blood purification device | |
| CN101060869A (en) | Automatic blood returning device | |
| CN105473170A (en) | Blood purifier | |
| JP2004000488A (en) | Medical apparatus | |
| CN1190902A (en) | System and treating extracorporeally circulating blood for curing inflamatory diseases | |
| CN1578683A (en) | Hematocrit sensor | |
| CN1711114A (en) | Blood purification device | |
| TW550094B (en) | Blood processing system | |
| CN1968721A (en) | Blood purification apparatus | |
| JP2016165402A (en) | Blood purification device | |
| JP6437349B2 (en) | Blood purification equipment | |
| CN1314463C (en) | Blood purification apparatus for elevating purification efficiency | |
| CN208097046U (en) | A kind of medicinal blood dialysis effluent purifying equipment | |
| CN113350593B (en) | Control method of blood purification apparatus, and storage medium | |
| JP5276906B2 (en) | Blood purification equipment | |
| CN1956744A (en) | Hemodialyzer capable of intermittent repetition of infusion and water removal operation | |
| EP3897770A1 (en) | System for continuous renal replacement therapy | |
| JP2017006539A (en) | Blood purification device and blood purification system |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| C06 | Publication | ||
| PB01 | Publication | ||
| C10 | Entry into substantive examination | ||
| SE01 | Entry into force of request for substantive examination | ||
| C14 | Grant of patent or utility model | ||
| GR01 | Patent grant | ||
| CX01 | Expiry of patent term |
Granted publication date: 20081210 |
|
| CX01 | Expiry of patent term |