JP2000325470A - Automatic hemodialyzator - Google Patents

Abstract

PROBLEM TO BE SOLVED: To avoid secondary contamination caused by bacteria, endotoxin, or the like, from being generated in a blood dialysis therapy. SOLUTION: A dialysis liq. feeding system has a dialysis liq. feeding line L4 for feeding a dialysis liq. into a dialyzer D and a dialysis liq. discharging the L5 for discharging the dialysis lid. flowing out from the dialyzer, and a normally and reversely rotatable blood pump P1 is provided on one of blood circuits between both blood circuits of a blood circulation system and a chamber C connecting a liq. overflow line L3 with one of the blood circuits, and two switching means PV1 and PV2 on the upstream side and the downstream side of the chamber are provided and the dialysis liq. feeding line and the dialysis liq. discharging line respectively have a first liq. feeding means P2 and a second liq. feeding means P3, and one of bypass lines being the first bypass line L6 communication with the upstream side and the downstream side of the first liq. feeding means P2 or the second bypass line communicating with the upstream side 6 and the downstream side 7 of the second liq. feeding means P3 is provided and a third liq. feeding means P4 for removing water and feeding liq. is provided on the bypass line.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a hemodialysis apparatus in which a series of operations such as hemodialysis and related preparation and recovery which have been performed manually have been automated as much as possible, thereby saving labor.

[0002]

2. Description of the Related Art A hemodialysis apparatus is a medical device for purifying blood of a patient with renal failure or a drug addict. The mechanism of hemodialysis therapy is usually a hemodialyzer (dialyzer),
It consists of three parts: a blood circuit through which blood circulates, and a dialysate supply system. While maintaining extracorporeal circulation by a blood circuit directly connected to the blood vessel at two locations, blood flows into a hollow fiber lumen-side compartment of a hemodialyzer connected in the middle of the blood circuit.

On the other hand, an electrolyte solution called a dialysate flows into a compartment outside a hollow fiber of a hemodialyzer in a direction opposite to a blood flow. The two compartments of the hemodialyzer are separated by a separation membrane called a dialysis membrane.During the blood and dialysate flow in opposite directions, diffusion and migration of particles occur according to the concentration gradient on both sides of the separation membrane, and Removal of toxic substances and replacement of missing substances are performed. Generally, the above-mentioned hemodialysis apparatus is configured by a device for controlling maintenance of extracorporeal circulation, stable supply of dialysate, and removal of excess water from blood.

The conventional hemodialysis monitoring apparatus is excellent in monitoring equipment information and patient information during dialysis treatment and in terms of safety management. However, priming (treatment of a blood circuit and a flow path of a hemodialyzer before cleaning) is excellent. Preparatory step for cleaning), blood removal after puncture (operation to start extracorporeal circulation by drawing blood from the body into the blood circuit), fluid replacement during treatment, blood return at the end (blood in the blood circuit The operation for terminating extracorporeal circulation to return to the normal state), the smooth transition between the steps, and the like, are still insufficient in terms of labor saving in the overall work related to hemodialysis.

[0005] In particular, automation has been delayed in specific steps and transitions between steps, and in fact, it has been labor intensive and requires the skill of medical staff. In order to finish priming, blood removal and blood return of a large number of patients who come to the hospital at the same time in a short period of time, a large amount of staffing is required. On the other hand, such staffing is excessive during hemodialysis (blood circulation), which has caused temporal unevenness and labor inefficiency in the work content.

[0006] In the conventional hemodialysis, one liter of intravenous preparation physiological saline is used for washing and filling of a blood circuit and a hemodialyzer (dialyzer) in a priming process.
I was using it. It has been pointed out that washing with a volume of about 1 L does not sufficiently wash the flow path, and using a large amount of physiological saline for washing and filling increases the cost.

Further, when the blood pressure is reduced during the hemodialysis treatment, a physiological saline solution is required separately, which has been a factor of complicating the work and increasing the cost. In recent years, dialysate purification technology has remarkably advanced, and a system has been established in which a dialysate purified to ultra-purity is applied to back-filtration replacement fluid. In such a system, the purified dialysate can be back-filtered and used as a rinse or replacement fluid instead of saline, but without secondary contamination caused by stagnation of dialysate, during priming and treatment. A fluid replacement circuit system capable of simply and reliably supplying a reverse filtration dialysate for fluid replacement has not been disclosed.

[0008]

DISCLOSURE OF THE INVENTION The present invention aims at rationalizing (automating, simplifying, labor-saving, and speeding up) hemodialysis treatment operations which have conventionally been considered to be labor-intensive, require skill, and are difficult to rationalize.・ Low cost) and to increase the safety of treatment. That is, the object of the present invention is different from the conventional apparatus in which a part of each step is automated, unlike the conventional apparatus. In the above-mentioned hemodialysis medical treatment, the hemodialysis which automates most steps from preparation for treatment to end of treatment. It is to provide a device. Thereby, the series of steps from the preparation of dialysis to the end of treatment are performed safely, reliably and promptly, and the labor and consumables costs are significantly reduced.

[0009]

According to the present invention, there is provided a hemodialysis apparatus for purifying a dialysate by contacting blood with the dialysate through a semipermeable membrane, wherein the dialysate is sent to a blood circulation system for circulating blood. Dialysate delivery system, the blood circulation system has an arterial blood circuit that draws blood from the patient and flows into the dialyzer and a venous blood circuit that returns blood flowing out of the dialyzer to the patient, The dialysate delivery system has a dialysate supply line for supplying dialysate to the dialyzer and a dialysate drain line for draining dialysate flowing out of the dialyzer. An overflow line connecting portion having at least one blood circuit having a blood pump capable of rotating forward and backward, and connecting an overflow line for overflowing a liquid to the other blood circuit (outside the circuit); Section upstream circuit and said The dialysis fluid supply line and the dialysis fluid drain line have a first fluid delivery unit (supply side) and a second fluid delivery unit (drainage side), respectively. A first bypass line connecting the upstream side and the downstream side of the first liquid sending unit, or a second bypass line connecting the upstream side and the downstream side of the second liquid sending unit. The above problem has been solved by an automatic hemodialysis apparatus having a third liquid sending means for removing water / replacement fluid in the bypass line. In the present specification, the upstream side or the downstream side of the blood circuit is distinguished by the direction in which blood flows during hemodialysis.

[0010] In the hemodialysis apparatus according to the present invention, (1) dialysate is injected into the blood circuit by back-filtration through a dialyzer to sufficiently perform automatic washing (priming) of the blood circuit.
(2) Synchronizing the blood pump and the third liquid sending means to simultaneously connect the arterial and venous puncture needles and the arterial and venous blood circuits, and then remove the water to remove the water in the blood circuit and the dialyzer. Replace the saline in the blood with (3)
During hemodialysis, by operating the third liquid feeding means, an arbitrary amount of dialysate is rapidly replenished (by the above-mentioned back filtration) at an arbitrary speed. (4) After the treatment, the third liquid feeding means An object of the present invention is to return the blood in the arterial and venous blood circuits to the patient (by the above-mentioned back filtration) without detaching the blood circuit by interlocking control of the blood pump.

The present invention also relates to the blood pump and the third pump.
The priming step before the start of hemodialysis, the blood removal step from the patient to the blood circulation system at the start of hemodialysis, and the blood removal step to the hemodialysis (blood circulation) step by linking the liquid sending means and the opening / closing means. Automatically starts each process and each mechanism of the blood return process that returns blood from the blood circulation system to the patient at the end of hemodialysis The said hemodialysis apparatus which performs.

In particular, a chamber connected to a blood pump and an overflow line provided in a blood circulation system, opening and closing means for a flow path provided on an upstream side and a downstream side of the chamber, and provided on the bypass line of a dialysate feeding system. Water removal /
The third fluid sending means for fluid replacement is linked, and the linked control is not limited to each step or mechanism, but the above-described priming step, blood removal step, (hemodialysis) start mechanism, replacement fluid mechanism, blood return step, etc. By applying the present invention to the entire series of work flows, the transition between the steps can be easily and smoothly performed, the human work involved in the transition can be reduced, and operation errors can be reduced.

For this reason, it is desirable that the blood pump, the third liquid sending means, and the two or more opening / closing means be a hemodialysis apparatus having a control means for interlockingly controlling them.

In the above-described hemodialysis apparatus, a first bypass line that bypasses the upstream and downstream sides of the first liquid feeding means provided in the dialysate supply line, or a first bypass line provided in the dialysate drain line. (2) By providing a third liquid sending means capable of sending liquid in both forward and reverse directions to one of the second bypass lines that bypasses the upstream side and the downstream side of the liquid sending means,
One liquid feeding means can be used for both the purpose of removing water to the blood circulatory system and the replacement of fluid.

That is, when a water flow pump is installed in the first bypass line provided on the dialysate supply side, and the liquid is sent in the same direction as the first liquid sending means (dialysate sending pump), the dialysate flowing into the dialyzer is sent. Is larger than the amount of fluid flowing out of the dialyzer, and as a result, fluid replacement to the blood circulation system is performed. When the liquid is sent in the opposite direction, the amount of inflow into the dialyzer is smaller than the amount of outflow, and as a result, water is removed from the blood circulation system.

The above mechanism is provided with a second dial provided on the dialysate drain side.
The same can be achieved by installing a water flow pump in the bypass line and switching the liquid sending direction. In this case, if the liquid is sent in the same direction as the second liquid sending means (dialysate drainage pump), the amount of drainage flowing out of the dialyzer becomes larger than the amount of liquid flowing into the dialyzer, and as a result, blood Water is removed from the circulation system. When the liquid is supplied in the opposite direction, the amount of the effluent to the dialyzer becomes smaller than the amount of the inflow, and consequently, the fluid is replenished to the blood circulation system. An embodiment in which a pump is installed in the second bypass line to perform replacement fluid or water removal is preferably applied to a personal dialysis device having a limited dialysate flow rate. When applied to a personal dialysis machine, a pump may be installed only in the second bypass line. However, by installing a pump in the first bypass line as well, it is possible to increase the capacity for supplying fluid replacement or dewatering. it can.

In this embodiment, a particularly complicated structure for water removal / rehydration is not required. The dialysis fluid delivery circuit and the bypass line are simple, and by providing the third fluid delivery means in one of the two bypass lines,
There is an advantage that the dialysate is less likely to stay. In other words, since the third liquid feeding means provided in the dialysate liquid feeding system in all the steps of hemodialysis operates almost continuously, substantially no stagnation occurs in the bypass line. By maintaining the flow in the circuit at all times, secondary bacterial growth of the dialysate can be suppressed and endotoxin contamination can be avoided.

Further, by providing the third liquid sending means in the first bypass line, the dialysate effluent does not circulate in the bypass line, and as a result, contamination of the bypass line and elimination of waste lines in the effluent can be prevented. There is no worry about clogging.

By installing the bubble detecting means in one or both of the arterial blood circuit and the venous blood circuit, the air bubbles mixed into the blood circuit can be quickly detected and notified to the practitioner. To encourage some action.

A blood pump is provided in the arterial blood circuit,
In the priming step, blood is provided in the venous blood circuit by providing a chamber to which an overflow line for overflowing a liquid outside the blood circuit is connected, and opening and closing means such as a pinch valve on the upstream side and the overflow line of the chamber. Cleaning of the circuit and removal of bubbles can be performed efficiently. Further, with the above configuration, in the blood return step, air mixing, erroneous puncture, blood contamination, and the like can be prevented, the burden on medical staff can be reduced, and blood can be returned quickly and safely.

By providing a flexible soft segment and a heparin injection segment in the arterial blood circuit and providing a pressure monitoring line in the venous blood circuit, poor blood removal, blood coagulation, stenosis or blockage of the blood circuit can be achieved. There is an advantage that abnormalities due to the above can be detected early.

The third liquid sending means is desirably a quantitative water pump. The liquid sending capacity should be defined in relation to the amount of liquid sent by a blood pump provided in the blood circulation system.
/ Min is preferable.

[0023]

DETAILED DESCRIPTION OF THE INVENTION In the present invention, the stable supply of ultrapure dialysate is a prerequisite for treatment. As shown in FIG. 1, the dialysate supplied from the dialysate manufacturing apparatus is dissolved by passing through the ultrafiltration filter (F) installed at the inlet of the automatic hemodialysis apparatus (H) according to the present invention. Removes impurities such as endotoxins and bacteria. In general, dialysate supplied from a dialysate manufacturing device has a predetermined water quality standard (Kyushu HDF Study Committee 1: 33-42, 1995)
It is desirable to purify according to.

The hemodialysis monitoring device → dialysis fluid flow control device (M) has the general performance of having a closed system as a dialysate fluid delivery mechanism, and further has a first fluid delivery means on the dialysate delivery line side. And a new bypass circuit (L6) of the first bypass line connecting the upstream side 6 and the downstream side 7 of the dialysate feed pump (P2), and the third feed means [ Hereinafter, also referred to as a water removal / replacement pump (P4)]. The water removal / replacement pump (P4) can switch the ejection direction in both forward and reverse directions, and the flow rate is 0 to 500 ml / min (preferably 0 to 500 ml / min).
This is a water flow pump that can be controlled to about 200 ml / min).

Here, even if a third liquid feeding means is provided in the dialysate drain line, water can be removed / replaced into the blood circulation system by back filtration of the hemodialyzer. That is, a second bypass line is provided between the upstream side and the downstream side of the dialysate drainage pump (P3), which is the second liquid sending means on the dialysate drainage line side, and the bypass is drained. / Replacement fluid pump (P4) may be installed. However, as described above, it is preferable to provide a bypass on the dialysate solution sending line side, because it is sanitary and protein adhesion to the pump and clogging can be prevented. Further, for the above reason, there is an advantage that the dialysate flow rate does not need to be increased. A blood pump for maintaining extracorporeal circulation (P1)
Can also control both forward and reverse rotation.

As shown in FIG. 2, the blood circuit of the automatic hemodialysis apparatus (H) includes the arterial blood circuit (L1) and the venous blood circuit (L2).
It consists of two parts, the arterial blood circuit (L1) is connected to the arterial puncture needle (1), the soft segment (S1),
Heparin infusion segment (S2), pump segment (S
3) and a connection part (2) to the hemodialyzer D. The venous blood circuit (L2) is connected to the hemodialyzer (3), venous chamber (C), overflow line (L3), venous pressure (blood pressure) monitoring line (S4), and connected to the venous needle. It consists of part (4).

This circuit is used in the recovery step at the end of treatment.
In consideration of the fact that the blood in the arterial blood circuit (L1) flows in the opposite direction to the normal direction and returns to the body, the structure is such that a thrombus is not easily formed in the circuit. In other words, the heparin infusion segment (S2) joins the arterial puncture needle to the connection (1) as close as possible to the arterial blood circuit (L1)
Does not have the arterial chamber that is conventionally standard equipment,
The feature is that a soft segment (S1) is inserted without a step instead of the pillow (pillow-shaped structure inserted into the circuit) that is standard equipment for confirming blood flow. The soft segment (S1) is made of a material that is softer than other parts, so that it collapses due to the extreme negative pressure that occurs when blood flow is poor, similar to the conventional pillow, so that poor blood flow can be screened visually. I have.

The hemodialyzer (H) has two bubble detectors (AD1, AD2). The air bubble detector 1 (AD1) is installed near the connection point 1 of the arterial blood circuit (L1). If air is detected at the time of blood return, the blood pump (P1) is immediately stopped immediately, and air is erroneously introduced into the body. Prevent infusion. The bubble detector 1 (AD1) can also detect an arterial puncture needle withdrawal accident during hemodialysis treatment. Bubble detector 2 (AD
2) is installed near the connection point 4 of the venous blood circuit (L2), immediately stops the blood pump (P1) and closes the pinch valve (PV1) when air is detected during treatment and when returning blood. This prevents erroneous injection of air into the body.

The hemodialysis monitor (H) has two pinch valves (PV1 and PV2) involved in the automatic priming process.
And the pinch valve 1 (PV1) is the venous blood circuit (L2)
Provided at a site between the connection point 3 and the venous chamber (C),
Pinch valve 2 (PV2) is provided on the overflow line (L3).

In the present hemodialysis apparatus (H), especially a blood pump
(P1), the water removal / rehydration pump (P4), and the pinch valve 1 (PV1) and the pinch valve 2 (PV2), which are the opening and closing means of the venous blood circuit, are interlocked and controlled. It is desirable to provide a control means G capable of controlling the components in accordance with changes in other components and a transmission system g for communicating the components with each other. Control means G
Is desirably provided on a hemodialysis console incorporating various monitors and safety devices of a general hemodialysis machine.

[0031]

[Example] (1) Automatic priming process The hemodialyzer (H) is set by connecting the hemodialyzer (D) and the blood circuit (L1, L2), and the blood circuit (L1, L
Short-circuit the tips 1 and 4 in 2). After replacing the filling water in this hemodialysis machine (H) with the dialysate using the dialysate sent from the dialysate manufacturing device, the dialysate circuit is routinely set at 8 and 9 points. Connect with (D). When the above preparation is completed, the automatic priming switch is turned on and the program is started. At the same time that the automatic priming switch is turned on, the dialysate circuit (L4 and L5) connected to the hemodialyzer (D) of the device (H) shall maintain a closed system. Automatic priming consists of the following five steps.

Pinch valve 1 (PV1) closed, pinch valve 2
With the (PV2) open, the water removal / rehydration pump (P4) is operated in the rehydration direction at an arbitrary speed, and dialysate is injected from the upstream 6 to the downstream 7 of the dialysate delivery line (L4), The arterial side of the hemodialyzer (D) is synchronized with the transfer of the dialysate into the blood circuit by back-filtration through the hemodialyzer and by operating the blood pump (P1) in reverse at the same flow rate. The portion, the entire arterial blood circuit (L1), and the terminal 4 of the venous blood circuit (L2) to the venous chamber (C) are washed at an arbitrary time setting. The washing liquid is drained from the overflow line (L3).

The blood pump (P1) is rotated forward at an arbitrary speed to open the pinch valve 1 (PV1) and close the pinch valve 2 (PV2), and the hemodialyzer (D) and the blood circuits (L1, L2) Is circulated for an arbitrary time. Pinch valve 1
(PV1) and pinch valve 2 (PV2) both open,
Operate the dehydration / rehydration pump (P4) at the desired flow rate in the rehydration direction and the blood pump (P1) at the desired flow rate in the forward rotation direction, and back-filtrate the dialysate through the hemodialyzer (D). Then, while circulating in the hemodialyzer (D) and the blood circuit (L1, L2), the same amount of circulating fluid as the reverse filtration rate, for example, 50 ml / min, is drained from the overflow line (L3). Here, the flow rate of the water removal / replacement pump (P4) is set to be smaller than the flow rate of the blood pump (P1).

Pinch valve 1 (PV1) open, pinch valve 2
With the (PV2) closed, the priming fluid in the hemodialyzer (D) and the blood circuit (L1, L2) is made to wait until the next blood removal step while circulating the blood pump (P1) at a forward rotation. At this time, the water removal / replacement pump (P4) is temporarily stopped. However, this priming step may be on standby only by recirculation as described above, or may be interlocked with the replacement fluid pump (P4) and circulated on standby while overflowing the liquid from L3.

(2) Automatic blood removal / dialysis program (step) This program automatically switches from blood removal to dialysis treatment after puncture, after connecting arterial / venous puncture needles and blood circuits (L1, L2) simultaneously. is there.

First, the set values of the target water removal amount (water removal rate), the treatment time, the blood flow during treatment, and the initial and continuous infusion amounts of heparin are set by manual operation. (Not shown). Perform arterial and venous puncture. The arterial and venous blood circuits (L1, L2) connected in the priming process are clamped and then separated. Connect the arterial / venous puncture needle and arterial / venous blood circuit (L1, L2) simultaneously and release their clamps. If liquid level adjustment is necessary, adjust the venous chamber in advance. The program is started by turning on a switch (automatic blood removal / dialysis switch) for instructing automatic transition from blood removal to hemodialysis.

The program is constituted by the following steps. First, at the same time as the automatic blood removal / dialysis switch is operated, the water removal / replacement fluid pump (P4) is operated in the water removal direction and the blood pump (P1) is operated in synchronization with the forward rotation direction. By closing the pinch valve 1 (PV1), the priming fluid filled in the hemodialyzer (D) and the arterial blood circuit (L1) is discharged from the hemodialyzer (D). The water removal rate by the water removal / rehydration pump (P4) and the blood removal rate by the blood pump (P1) are set to be the same. Blood circuit (L
The program is registered in advance so as to be the same as the filling priming liquid amount in 1). Further, after an arbitrary time (for example, 2 seconds) from the start of blood removal, the first infusion of heparin is performed. The standard blood removal rate is 100 ml / min, and the blood removal time is 1 minute and 30 seconds.

Next, after the predetermined blood removal time has expired, the pinch valve 1 (PV1) is opened, and the dialysis treatment is automatically switched to the previously input water removal amount (water removal speed), treatment time, and blood flow. Move to In synchronization with the transition to the dialysis treatment, the switches of the bubble detectors 1 and 2 (AD1, AD2) and the syringe pump are automatically activated.

(3) Quick rehydration operation Program executed when blood pressure decreases during hemodialysis. When activated, a series of fluid replacement operations using a back-filtration dialysate proceeds.

A rehydration switch for manually instructing automatic rehydration is turned on. Alternatively, it can be programmed to operate the rehydration switch at an arbitrary blood pressure level in conjunction with an automatic blood pressure monitor. With the operation of the rehydration switch, the water removal / rehydration pump (P4) reverses from the water removal direction to the rehydration direction, and upstream of the dialysate delivery line at a predetermined speed and for an arbitrary time (ie, an arbitrary amount). Inject dialysate from downstream side 6 to downstream side 7 and use hemodialyzer (D)
The dialysate is replenished to the inside of the blood circuit by back-filtration through. The water removal / replacement pump (P4) stops when an arbitrary predetermined time (ie, a predetermined amount) is reached.

Usually, the setting is made such that 100 to 200 ml of replacement fluid is performed in one operation. During this time, the blood pump (P1) is stopped in order to avoid a rise in venous pressure by back-filtration replacement fluid. Also, the monitoring range of the venous pressure gauge / dialysis fluid pressure gauge alarm is canceled. If additional fluid replacement is required, the operation of manually turning on the fluid replacement switch is repeated. When the rehydration switch is turned on again during rehydration, the rehydration operation stops. After the rehydration operation,
An observation period is set for an arbitrary time (for example, 4 minutes), and the blood pump (P1) is kept at a low flow rate (for example, 50 ml / min) to prevent the blood pressure from lowering again. After the end of the observation period, the blood flow automatically returns to the previous one. Whether or not the water removal speed is automatically returned to the previous value is optional when registering the program.

(4) Automatic collection (blood return) program (step) This is a program that automatically shifts to the blood return step of extracorporeal circulation at the end of treatment (the arrival of both the treatment time and the target water removal amount). Automatic collection can be started at any time by a manual command.

When the treatment is completed or the automatic blood return switch is manually turned on, the program starts.
With the start of the program, the dialysate supply system (P2, P3, etc.) and the syringe pump of the hemodialysis monitoring device (M) are automatically stopped. Also, the venous pressure / dialysis fluid pressure gauge alarm is released. The dehydration / rehydration pump (P4) operates at a preset speed in the rehydration direction, and causes the hemodialyzer (D) to back-filter the dialysate. At this time, synchronize the blood pump (P1)
Reverse rotation at an arbitrary preset speed.

The back-filtration dialysate is supplied at a rate defined by the rehydration rate of the dehydration / rehydration pump (P4) and the reverse rotation rate of the blood pump, and the arterial blood circuit (L1) and the venous blood circuit (L2).
The blood in the hemodialyzer (D) and in each circuit is sequentially returned to the body via an arterial / venous needle. The blood return time is set arbitrarily. For example, if the speed of the water removal / rehydration pump (P4) is 250 ml / min, the reverse rotation speed of the blood pump (P1) is 150 ml / min, and the blood return time is 1 minute, the arterial blood circuit (L1) and the venous blood The volume of the rinsing liquid passing through the circuit (L2) is 150 ml and 100 ml, respectively. After the predetermined blood return time, the blood pump (P1) and the water removal / replacement pump (P4) are stopped, the pinch valve 1 (PV1) is closed, and the end of the collection process is notified by a notification light or sound. . The puncture needle is routinely removed by manual operation to stop bleeding and end the treatment.

[0045]

According to the hemodialysis monitoring apparatus and the dedicated blood circuit according to the present invention, the priming process is automated, the operation is simplified in the blood removal process, and the priming solution can be prevented from flowing into the patient. And even blood removal
-The series of treatment steps from start of hemodialysis-collection-end is automated by the program. As a result, the time during which the medical staff is restrained at the bedside is significantly reduced, contributing to remarkable efficiency and labor saving of medical work related to hemodialysis treatment.

At the end, the operation of removing the arterial / venous puncture needle becomes easy, and the frequency of blood contamination can be reduced. Since the series of operations is extremely simplified, the skill of a dialysis worker is not required as in the related art. Further, in priming, since a sufficient amount of the back-filtration dialysate is used for washing, washing is performed more sufficiently than washing using 1 L of normal saline, and the extracorporeal circulation circuit is more clean. further,
Fluid replacement can be performed quickly and easily even when a decrease in blood pressure occurs during treatment. It is also economical to not use saline for priming and rehydration. As described above, the present invention is expected to bring great effects on the efficiency, labor saving, safety improvement, and cost reduction of hemodialysis treatment.

In the hemodialysis apparatus according to one embodiment of the present invention, since the pump for water removal and the reverse filtration and replacement of dialysate is also used, the water is removed in any of priming, blood removal, hemodialysis treatment, and blood collection. Since the rehydration / rehydration pump (P4) operates in either the forward or reverse direction, there is substantially no stagnation in the flow path of the dewatering / rehydration bypass line, and thus there is no danger of bacteria growing in the circuit.

[Brief description of the drawings]

FIG. 1 is a schematic view of an embodiment of a fully automatic hemodialysis apparatus according to the present invention.

FIG. 2 is a diagram showing an example of a blood circuit diagram in the hemodialysis apparatus of the present invention.

[Explanation of symbols]

H. Automatic hemodialysis machine G. Control means g. Transmission system AD1. Bubble detector 1 AD2. Bubble detector 2 C. Venous chamber D. Hemodialyzer (dialyzer) F. Ultrafiltration filter (endotoxin removal filter) L1. Arterial blood circuit L2. Venous blood circuit L3. Overflow line L4. Dialysate sending line L5. Dialysate drain line L6. Dewatering / replacement fluid bypass line (first bypass line) Dialysate flow control device P1. Blood pump P2. Dialysate feed pump (first feed means) P3. Dialysate drainage pump (second liquid feeding means) P4. Water removal / replacement fluid pump (third fluid sending means) PV1. Pinch valve 1 (opening / closing means) PV2. Pinch valve 2 (opening / closing means) S1. Soft segment S2. Heparin injection segment S3. Pump segment S4. Venous pressure monitoring line 1. Connection point between arterial puncture needle and arterial blood circuit (L1) 2. Connection point between arterial blood circuit (L1) and hemodialyzer 3. Connection point between hemodialyzer and venous blood circuit (L2) 4. Connection point between venous blood circuit (L2) and venous puncture needle 5. Dialysate supply unit to dialysate monitoring device 6. Upstream side of the first bypass line 7. Downstream side of the first bypass line 8. Connection point between dialysate delivery line (L4) and hemodialyzer Connection point between hemodialyzer and dialysate drain line (L5) a. Connection point between heparin injection segment (S2) and heparin syringe b. Connection point between venous pressure monitoring line (S4) and venous pressure monitor

Continued on the front page (72) Inventor Kim Seiyasu 2-8-21 Norimatsu, Yahatanishi-ku, Kitakyushu-shi, Fukuoka Prefecture (72) Inventor Kunihiko Yamanaka 3-1-1, Jitsutsu, 3-1-1, Kokurakita-ku, Kitakyushu-shi, Fukuoka 301 (72) Invention Person Katsunori Masaoka 10th Shinjijin, Chiyoda-cho, Yamagata-gun, Hiroshima Prefecture Inside the JMS Chiyoda Plant (72) Inventor Atsushi Ikeda 10th Shinjin-chijin, Chiyoda-cho, Yamagata, Hiroshima Pref.JMS Chiyoda, Inc. Inside the factory (72) Inventor Yasuji Ishimaru 12-17 Kakomachi, Naka-ku, Hiroshima-shi, Hiroshima F-term in JMS Co., Ltd. 4C077 AA05 BB01 DD07 DD16 DD25 DD26 EE02 GG02 HH03 HH07 HH13 JJ13 JJ16 KK19 KK25

Claims (9)

[Claims] 1. A hemodialysis apparatus for purifying a blood by contacting blood and a dialysate through a semipermeable membrane, comprising a blood circulation system for circulating blood and a dialysate solution sending system for feeding the dialysate. The blood circulation system has an arterial blood circuit that draws blood from a patient and flows into the dialyzer and a venous blood circuit that returns blood flowing out of the dialyzer to the patient. A dialysate supply line for supplying dialysate to the device and a dialysate drain line for draining dialysate flowing out of the dialyzer, and at least one of the two blood circuits of the blood circulation system, An overflow line connecting portion having a blood pump rotatable in forward and reverse directions and connecting an overflow line for overflowing a liquid to (outside of the circuit) with the other blood circuit, an upstream circuit of the connecting portion, and the overflow On the line Has a closing means, has the dialysate supply line and the dialysate discharge each line the first fluid feeding means (supply side) and the second fluid feeding means (drainage side),
At least one of a first bypass line connecting the upstream side and the downstream side of the first liquid sending unit or a second bypass line connecting the upstream side and the downstream side of the second liquid sending unit is provided. An automatic hemodialysis apparatus, wherein the bypass line is provided with a third liquid sending means for water removal / replacement. 2. A priming step before the start of hemodialysis, a blood removal step from a patient to the blood circulatory system at the start of hemodialysis, by interlocking the blood pump, the third liquid sending means, and the opening / closing means. Initiation mechanism for shifting from the blood removal process to the hemodialysis (blood circulation) process, rehydration mechanism for supplying fluid to the dialyzed blood circuit during the hemodialysis process, blood return for returning blood from the blood circulation system to the patient at the end of hemodialysis The hemodialysis apparatus according to claim 1, wherein each of the steps and each of the mechanisms are automatically performed. 3. The hemodialysis apparatus according to claim 2, further comprising control means for interlocking control of at least the blood pump, the third liquid feeding means, and the two or more opening / closing means. 4. The apparatus according to claim 1, wherein the third liquid sending means is provided in one of the first bypass line and the second bypass line, and the third liquid sending means is capable of sending liquid in both forward and reverse directions. The hemodialysis apparatus according to any one of Items 1 to 3. 5. The hemodialysis apparatus according to claim 4, wherein said third liquid sending means is provided in a first bypass line. 6. The hemodialysis apparatus according to claim 1, wherein at least one of the arterial blood circuit and the venous blood circuit is provided with a bubble detecting means. 7. The hemodialysis apparatus according to claim 1, wherein a blood pump is mounted on the arterial blood circuit. 8. The arterial blood circuit has a soft segment of a flexible chamber and a heparin injection segment, and the venous blood circuit has a pressure monitoring line.
The hemodialysis apparatus according to any one of the above items. 9. The liquid supply amount of the third liquid supply means is 0 to 500 m.
The hemodialysis apparatus according to any one of claims 1 to 8, wherein the flow rate is 1 / min.