JP2003000705A - Peritoneal dialyzer - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a peritoneal dialyzer enabling a patient himself to do automate dialytic treatment, clear and comprehensible in the operability, enabling the treatment under the optimum condition and capable of easily corresponding to trouble even if occurred. SOLUTION: The peritoneal dialyzer has a dialysing liquid circuit including at least one dialysing liquid container filled with the dialysing liquid and at least one waste liquid container for recovering the dialysing liquid, a fluid feed means for feeding the dialysing liquid from the dialysing liquid container to the waste liquid container and a display part 23 for reporting a condition related to dialysis. The operation procedure becoming necessary for performing dialysis by supplying the dialysing liquid to a patient by the liquid feed means and recovering the waste liquid is displayed as a stationary or dynamic image including characters along with a sound guide in the display part 23.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a peritoneal dialysis device which a patient himself / herself can perform at home (home) or the like.

[0002]

2. Description of the Related Art Peritoneal dialysis (continuous ambulatory pe
ritoneal dialysis (hereinafter also referred to as "CAPD")
Since patients can change the dialysate container (bag) themselves at home or in the workplace, it is easy to get back into society and is receiving much attention.

In this CAPD, a catheter tube (peritoneal catheter) is placed in the abdominal cavity of a patient, a transfer tube is connected to the external end of the catheter tube, and a dialysate bag (injection bag) containing a dialysate therein.
After connecting the bag tube of the above, injecting the dialysate in the bag into each abdominal cavity through each tube and performing dialysis for a predetermined time, collect the dialysate drainage in the abdominal cavity through each tube into the drain bag. To do. The tubes are connected to each other aseptically by fitting male and female connectors mounted on the ends of both tubes.

In this CAPD, the dialysate is injected into the peritoneum by placing the dialysate bag at a position about 1 m higher than the patient's abdomen, and the drop causes the dialysate to flow from the dialysate bag into the abdomen. Transferred in. Also,
To collect the dialysate drainage fluid from the peritoneum, the drainage bag is placed at a position about 1 m lower than the abdomen of the patient, and the dialysate is transferred from the intraperitoneal membrane to the drainage bag due to the drop.

However, such dialysate injection,
In the drainage method, for example, when the patient performs peritoneal dialysis while sleeping, the bed is used to move the patient from the floor to 70 to 100c.
It is necessary to lie it in a high position of about m and to set the dialysate bag at a position of about 1 m higher than the patient. For this reason, the height of the entire device is as large as about 2 m, and it is not easy to handle and carry, and there is a possibility that a sleeping patient may overturn the device by hitting it over. Furthermore, in order to secure the required head for drainage,
There is also a drawback that the sleeping position (height) of the patient cannot be freely selected.

In order to make up for such drawbacks, there has been proposed a peritoneal dialysis device which automates injection and drainage and is not restricted by the height of the place where the dialysate and waste fluid bag is installed. For example, Japanese Patent No. 3113887 proposes a peritoneal dialysis device in which a valve actuator opens and closes a valve to switch the flow path of a disposable cassette at the time of selection. Further, Japanese Patent Application Laid-Open No. 11-347115 proposes a disposable cassette in which a pump part (diaphragm) for feeding a peritoneal dialysate and a heating part are integrally formed. This cassette is heated from both sides and is configured so that the heated peritoneal dialysate is delivered into the abdominal cavity of the patient by two pump portions (diaphragms).

[0007]

However, in order to perform peritoneal dialysis at home using such a peritoneal dialysis machine, the patient must be sufficiently trained to use the peritoneal dialysis machine before Since it is necessary to memorize all the procedures by oneself and operate them without fail, it is not a little burden to the patient.

Further, there is a problem that even if a slight trouble occurs in the operation procedure, it cannot be dealt with promptly.

Therefore, the present invention has been made in view of the above problems, and an object of the present invention is to enable automatization of dialysis treatment by the patient himself, and the operability is extremely clear and easy to understand. The object of the present invention is to provide a peritoneal dialysis device that can perform dialysis treatment under optimal conditions.

[0010]

[Means for Solving the Problems]
To achieve the object, according to the present invention, a dialysate circuit including at least one dialysate container filled with dialysate and at least one drainage container for collecting dialysate, and the dialysate container. Or the drainage container as an end point, and has a liquid sending means for sending a dialysate, and a display means for notifying a condition for displaying a condition related to dialysis, and the liquid sending means dialyzes the patient side. A peritoneal dialysis device that performs dialysis by supplying a liquid and collecting the drainage of the dialysis device. The operation procedure necessary for the dialysis is displayed on the display unit of the display means together with a voice guide and stationary. It is characterized by displaying images or moving images.

A dialysate circuit including at least one dialysate container filled with dialysate and at least one drainage container for collecting dialysate, and the dialysate container as a starting point, or With the liquid container as the end point, it has a liquid feeding means for feeding the dialysate, and a display means for notifying the conditions for displaying the conditions relating to dialysis. A peritoneal dialysis device for performing dialysis by collecting a liquid, in order to inform the abnormal state of the dialysis, a background color displayed in a still image or a moving image including characters together with a voice guide in the display unit of the display means. The background color of the normal state of the dialysis is different.

The still image or moving image is displayed in color.

A dialysate circuit including at least one dialysate container filled with dialysate and at least one drainage container for collecting the dialysate, and the dialysate container as a starting point, or With the liquid container as the end point, it has a liquid feeding means for feeding the dialysate, and a display means for notifying the conditions for displaying the conditions relating to dialysis. A peritoneal dialysis device for performing dialysis by collecting a liquid, wherein a setting procedure including a liquid supply necessary for the dialysis is included in the display unit of the display unit together with a voice guide and a background color does not change. The feature is that it is displayed as a still image.

Further, the display unit is composed of a liquid crystal touch panel whose screen is pressed, and the patient can appropriately press the operation procedure, the operation for eliminating the abnormal condition, and the setting procedure.

The dialysis start button and the dialysis start button are separately arranged at positions separated from the display unit, and are displayed by color, and Braille is provided under each button. .

[0016]

BEST MODE FOR CARRYING OUT THE INVENTION The peritoneal dialysis apparatus of the present invention will be described below in detail with reference to the preferred embodiments shown in the accompanying drawings.

First, FIG. 1 is an external perspective view showing the peritoneal dialysis device of the present invention together with a disposable cassette (peritoneal dialysis circuit) 8, and FIG. 2 is a schematic view showing the overall configuration.

In both figures, the peritoneal dialysis machine 1 comprises a dialysis machine body 2 and a cassette 8 for the peritoneal dialysis machine, which is detachably attached to the dialysis machine body 2.

Further, in FIG. 1, the dialysis machine main body 2 has a cassette mounting portion 21 having an opening 21a shown by a chain double-dashed line for mounting the cassette 8 from the front, and a state in which the cassette mounting portion 21 is closed and opened. 22 is rotated by holding the grip portion 22a at the positions shown by the solid line and the broken line in FIG.
The display unit 23, an operation unit 24a for performing a treatment start operation, and an operation unit 24b for performing a treatment stop operation.

The shapes and colors of the operating portion 24a and the operating portion 24b are different from each other so that they can be easily distinguished from each other, and one convex portion is provided on the starting operating portion (start button) 24a and one for stopping. Two convex portions are formed on the operation portion (stop button) 24b.

The display unit 23 is composed of, for example, a touch panel equipped with a liquid crystal (LCD) panel or the like, and displays various information necessary for dialysis by pressing the touch panel and operating instructions of the apparatus are shown by broken lines. Operability and convenience are ensured by performing the audio guide together with the speaker 400a.

A sensor 16a for detecting the closed state of the lid member 22 as shown by the solid line, a sensor 16b for detecting the loading of the cassette 8 and a bubble in the connection tube 85 connected to the cassette 8. A bubble sensor 14a for detecting the mixture is arranged at the position shown in the figure.

Further, a hook portion 2a is provided on the cover of the main body 2 so that the hook portion 2a can be stored therein.
The liquid transfer is ensured by hooking on a.

On the other hand, the dialysis machine main body 2 has a main base portion 200 and a sub-base portion 201, which are shown in broken lines, as a mounting base portion, and is provided with respective resin covers shown in the drawings.
The main base 200 and the sub-base 201 are made of an aluminum metal plate having a thickness of 1 to 2 mm, and large holes are bored everywhere to reduce the weight. A lightweight resin cover is fixed to these bases. Further, for example, a memory card 204 having a storage capacity of 100 megabytes or more is provided so that it can be loaded into the card reading device 203 shown by a broken line from the back of the device, and the display contents and sound of the display unit 23 can be changed and each country can be changed. It is configured so that the specifications of can be changed quickly. Further, the patient data is recorded in the memory card 204 so that each patient can be handled.

Further, a shield plate 202 is provided on the right side surface of the cassette mounting portion 21 shown by the two-dot chain line so as to be movable in the arrow direction shown by the broken line, and mechanically acts on the connecting tube 85 of the cassette 8. By preventing interference, the cassette 8 can be set at the loading position.

On the other hand, the cassette 8 has a cassette body 81 having a shape attachable to and detachable from the cassette mounting portion 21 of the dialysis machine body 2, a lower body frame 811 formed continuously from the cassette body 81, and the lower body frame 811. Upper body frame 812 provided to face each other with a gap 86 therebetween.
It consists of and.

Further, as shown in the figure, the cassette body 81 is integrally formed with a diaphragm 87 for feeding liquid, a heating section 83 and a flow path switching section, and the diaphragm 87 is surrounded by a flange member 815. Is configured.

Next, referring to FIG. 2, the peritoneal dialysis apparatus 1 is
The dialysate circuit unit 3 includes a dialysate circuit unit 3, and the dialysate circuit unit 3 stores a plurality of dialysate bags (dialysate) that contain (store) dialysate to be injected (injected) into the peritoneum (peritoneal cavity) of the patient K. (Container) 4, additional dialysate bag 5 containing dialysate with different concentrations, drainage tank (drainage container) 6 for collecting dialysate drained from the peritoneum of patient K, and peritoneum of patient K Dialysis catheter (catheter tube) 7 placed inside
Prepared to connect with.

Here, the dialysate circuit unit 3 has a liquid injection tube circuit 31, an additional liquid injection tube circuit 32, a liquid injection / drainage tube circuit 33, and a liquid drainage tube circuit 34. Furthermore, the dialysate circuit unit 3 has a switching cassette circuit 82 provided in the cassette body 81 of the cassette 8, a heating cassette circuit 83, and a bypass circuit (patient side tube circuit) 84. The circuit 82 includes a liquid injection circuit 821, an additional liquid injection circuit 822,
The liquid injection / drainage circuit 823 and the drainage circuit 824 are included.

Further, in the external perspective view showing the flow path switching unit and the clamper (clamp) 240 of the cassette 8 of FIG. 3, one end of the liquid injection circuit 821, one end of the additional liquid injection circuit 822, and the liquid injection / drainage circuit. The connection tubes 85a, 85b, 85c, and 85d are provided at the other end of the drainage circuit 824 and the other end of the drainage circuit 824.
Are connected.

In FIG. 2, a plurality of branch tube circuits 35 are branched and connected to one end side of the liquid injection tube circuit 31, and one end of each branch tube circuit 35 is connected to the dialysate bag 4. The other end of the liquid injection tube circuit 31 is connected to one end of the liquid injection circuit 821 via a connection tube 85a.

One end of the additional tube circuit 32 is connected to the additional dialysate bag 5, and the other end of the additional tube circuit 32 is connected to one end of the additional injection circuit 822 via the connection tube 85b. .

Further, one end of the liquid injection / drainage tube circuit 33 is connected to the other end of the liquid injection / drainage circuit 823 by a connecting tube 85c.
Is connected via the liquid injection / drainage tube circuit 33.
The other end of is connected to the dialysis catheter 7 via a transfer tube set 36. One end of the drainage tube circuit 34 is connected to the other end of the drainage circuit 824 by the connecting tube 8
5d, and the other end of the drainage tube circuit 34 is connected to the drainage tank 6.

Switching cassette circuit 8 forming a flow path switching portion
The infusion tube circuit 31, the additional infusion tube circuit 32, the infusion / drainage tube circuit 33, and the drainage tube circuit 34, which are connected to the No. 2 when the cassette 8 is attached to the dialyzer body 2, 2 is located on the front surface or the front side surface.

The branch tube circuit 35, the additional liquid injection tube circuit 32, the liquid injection / drainage tube circuit 33, and the liquid drainage tube circuit 34 each have a clamp 37 for opening and closing the flow path. Is provided.

Next, in the three-dimensional exploded view of the cassette 8 of FIG. 4, in this figure, the components already described are given the same reference numerals and the description thereof will be omitted. Two divided heating cassette circuits 831, A gap 86 is formed between 832, and when the cassette main body 81 is mounted on the cassette mounting portion 21 of the dialysis machine main body 2, it is applied to both sides (upper surface and lower surface) of each of the divided heating cassette circuits 831 and 832. The heater (heating unit) of the heating means 9 is located so that the divided heating cassette circuits 831 and 832 are heated by being sandwiched by the corresponding heaters.

The cassette body 81 is provided with the switching cassette circuit 82 shown in FIG. 1. The switching cassette circuit 82 includes the liquid injection circuit 821, the additional liquid injection circuit 822, and the liquid injection circuit 822 shown in FIG. / Drainage circuit 823 and drainage circuit 824. The other end of the additional liquid injection circuit 822 communicates with the middle of the liquid injection circuit 821, and one end of the drainage circuit 824 communicates with the vicinity of the other end of the liquid injection circuit 821.

Furthermore, when the cassette body 81 is mounted on the cassette mounting portion 21 of the dialysis machine body 2, the switching cassette circuit 82 is closed by the clamper 240 shown in FIG. It is configured to be switchable with.

Here, the liquid injection circuit state means the liquid injection circuit 82.
1 (or additional liquid injection circuit 822) and liquid injection / drainage circuit 82
The state in which the dialysis fluid bag 4 (or the additional dialysis fluid bag 5) and the dialysis catheter 7 are in communication with each other by the communication of 3
In other words, it refers to a state for injecting the dialysate into the peritoneum of the patient K (a state in which it can be infused).

The drainage circuit state is a state in which the dialysis catheter 7 and the drainage tank 6 are in communication with each other by the communication between the infusion / drainage circuit 823 and the drainage circuit 824, in other words, the peritoneum of the patient K. It means a state for draining the dialysate from the inside (a state in which the dialysate can be drained). Further, the cassette body 81 is provided with a heating cassette circuit 83 shown in FIG. The heating cassette circuit 83 includes two sheet-shaped divided heating cassette circuits 831 and 832 which are arranged to face each other.

One end of the lower divided heating cassette circuit 831 communicates with the other end of the liquid injection circuit 821, and the other end of the lower divided heating cassette circuit 831 is divided into the upper divided via the connecting pipe 833. It communicates with one end of the heating cassette circuit 832.
The other end of the upper divided heating cassette circuit 832 is
It communicates with one end of the liquid injection / drainage circuit 823.

Therefore, the dialysate sequentially flows through the lower divided heating cassette circuit 831 and the upper divided heating cassette circuit 832 in this order.

In the present invention, the dialysate may be divided into the divided heating cassette circuit 831 on the lower side and the divided heating cassette circuit 832 on the upper side, and then merged. .

The flow paths of the divided heating cassette circuits 831 and 832 are meandering as shown in the plan view of the cassette 8 of FIG. 5 and the rear view of the cassette 8 of FIG. It may be in a shape. As described above, by forming the meandering shape or the spiral shape, the flow paths of the divided cassette circuits 831 and 832 are lengthened, and the dialysate can be reliably heated.

Further, the cassette body 81 is provided with a diaphragm pump 87 which is kept airtight in a pump chamber described later for pumping operation by contraction and expansion to feed dialysate.
Are connected in the middle of the liquid injection circuit 821.

The flange member 815 accommodates the diaphragm pump 87 in a hermetically sealed state so that the diaphragm pump 87 contracts when pressurized and expands when depressurized.

The cassette body 81 is provided with the bypass circuit 84 as described above. One end of this bypass circuit 84 is connected to the upstream side of the heating cassette circuit 83, in the middle of the liquid injection circuit 821 in the present embodiment, and the other end of the bypass circuit 84 is connected to the downstream side of the heating cassette circuit 83.
In the present embodiment, it is connected in the middle of the liquid injection / drainage circuit 823. The bypass circuit 84 connects the upstream side and the downstream side of the heating cassette circuit 83, and forms a circulation circuit for cooling the dialysate.

Further, in order to forcibly cool the dialysate, the bypass circuit 84 may be provided with a forcible cooling means such as a Peltier element for quick and reliable cooling.

The switching cassette circuit 82, the heating cassette circuit 83, the bypass circuit 84 and the diaphragm pump 87 are arranged substantially in a plane. Thereby, the thickness of the cassette 8 can be made thinner.

When the cassette body 81 is mounted on the cassette mounting portion 21 of the dialysis machine body 2, the heating cassette circuit 8
The outlet side (downstream side) of 3 is switchable between a final liquid injection circuit state and a return circuit state. Here, the final liquid injection circuit state means a state in which the outlet side of the heating cassette circuit 83 is in communication with the liquid injection / drainage circuit 823 and is not in communication with the bypass circuit 84. The return circuit state means a state in which the outlet side of the heating cassette circuit 83 communicates with the bypass circuit 84 and does not communicate with the liquid injection / drainage circuit 823.

Further, as shown in a three-dimensional exploded view of the cassette 8 of FIG. 4, a first flow path switching section is formed in the lower main body frame 811 at a position corresponding to the switching cassette circuit 82.
~ Eighth support protrusions 881 to 888 are formed. First
The support protrusion 881 supports near one end of the liquid injection circuit 821, the second support protrusion 882 supports the additional liquid injection circuit 822, and the third support protrusion 883.
Is for supporting between the diaphragm pump 87 and one end of the bypass circuit 84 in the liquid injection circuit 821,
The fourth support protrusion 884 supports between the diaphragm pump 87 and one end of the heating cassette circuit 83 in the liquid injection circuit 821. Similarly, the fifth support protrusion 885
The sixth support protrusion 886 supports the drainage circuit 824, and supports the other end of the heating cassette circuit 83 and the other end of the bypass circuit 84 in the liquid injection / drainage circuit 823. The seventh support protrusion 887 supports the vicinity of the other end of the liquid injection / drainage circuit 823, and the eighth support protrusion 888 supports the bypass circuit 84.

Switching cassette circuit 82 and bypass circuit 8
4 and the diaphragm pump 87 are integrally formed by blow molding. As a result, it is possible to reduce the joining of separate parts, improve the quality of the cassette 8, and reduce the cost.

The divided heating cassette circuits 831 and 832 of the heating cassette circuit 83 are each formed by sheet molding. This simplifies the manufacturing of the divided heating cassette circuits 831 and 832 and reduces the cost.

Further, the switching cassette circuit 82, the bypass circuit 84 and the diaphragm pump 87 are subjected to high frequency fusion (high frequency welding) to the divided heating cassette circuits 831 and 832.
It is joined by adhesion.

Here, in order to form the divided heating cassette circuits 831 and 832 by sheet molding, for example, two resin sheets are superposed on each other and are fused in a predetermined pattern. The part that is not fused forms a flow path.

The constituent materials of the switching cassette circuit 82, the heating cassette circuit 83, the bypass circuit 84 and the diaphragm pump 87 are respectively soft resins such as polyethylene, polypropylene, ethylene-propylene copolymer and ethylene-acetic acid. Vinyl copolymer (EV
A) such as polyolefin, polyvinyl chloride, polyvinylidene chloride, polystyrene, polyamide, polyimide, poly- (4-methylpentene-1), ionomer, acrylic resin, polyethylene terephthalate (PET),
Polybutylene terephthalate (PBT) and other polyesters, styrene-based, polyolefin-based, polyvinyl chloride-based, polyurethane-based, polyester- and polyamide-based thermoplastic elastomers, silicone resins, polyurethanes, etc. Examples thereof include a coalesced product, a blended product, a polymer alloy, and the like, and these can be used alone or in combination of two or more (for example, as a laminate of two or more layers).

Further, positioning holes 8a, 8a are formed in the cassette body 81 so that the positioning by the positioning pins of the sub base 201 is performed. Further, openings 81b forming a part of the flow path switching portion are formed so as to face the first to eighth support protrusions, and the clamper can be closed by sneaking into these openings 81b. ing.

On the other hand, as shown in the heater block diagram of FIG.
A heating means 9 for heating the heating cassette circuit 83 of the cassette 8 is provided in the dialysis machine main body 2. The heating means 9 has a plate-shaped (layered) lower surface heater 91 and a plate-shaped heater. It has a (layered) upper surface heater 92 and a plate-shaped (layered) intermediate surface heater 93.

Here, the lower surface heater 91 heats the lower surface of the lower divided heating cassette circuit 831 from below through an aluminum plate 94a as a heat transfer member.
The upper surface heater 92 has an upper divided heating cassette circuit 83.
Aluminum plate 94d as a heat transfer member from above on the upper surface of 2
It is something that is heated through. Then, the intermediate surface heater 9
3 is located in the gap 86, and heats the upper surface of the lower divided heating cassette circuit 831 from above via the aluminum plate 94b as a heat transfer member, and also the upper divided heating cassette circuit 832. The lower surface is heated from below through an aluminum plate 94c as a heat transfer member.

As a result, the dialysate in the lower divided heating cassette circuit 831 is heated while being sandwiched between the lower surface heater 91 and the intermediate surface heater 93, and in the upper divided heating cassette circuit 832. The dialysate inside is the heater 9 on the upper surface.
It is heated in a state of being sandwiched between 2 and the intermediate surface heater 93.
Therefore, the heating efficiency of the dialysate inside the heating cassette circuit 83 by the heating means 9 is improved, which is advantageous for downsizing and weight saving of the dialyzer main body 2 and the cassette 8.

The clamp means 11 shown in FIG. 3 switches the switching cassette circuit 82 of the cassette 8 to one of the liquid injection circuit state and the liquid discharge circuit state, and the outlet side of the heating cassette circuit 83 is finally injected. It switches to one of the liquid circuit state and the drain circuit state, and assists the pumping operation of the diaphragm pump 87.

That is, first to eighth clamps 111 to 118 indicated by arrows are provided in the dialysis machine main body 2, and the first clamp 111 cooperates with the first support protrusion 881 to inject liquid. The vicinity of one end of the circuit 821 is clamped so that the flow path is closed. The second clamp 112 cooperates with the second support protrusion 882 to clamp the additional liquid injection circuit 822 so that the flow path is closed. The third clamp 113 has a third
In cooperation with the support protrusion 883, the diaphragm pump 87 in the liquid injection circuit 821 and one end of the bypass circuit 84 are clamped so that the flow path is closed. The fourth clamp (pumping control clamp) 114 has a fourth support protrusion 884.
In cooperation with, the diaphragm pump 87 in the liquid injection circuit 821 and the one end of the heating cassette circuit 83 are clamped so that the flow path is closed.

Similarly, the fifth clamp 115 cooperates with the fifth support protrusion 885 to clamp the drainage circuit 824 so that the flow path is closed. The sixth clamp 116 cooperates with the sixth support protrusion 886 to clamp the flow path between the other end of the heating cassette circuit 83 and the other end of the bypass circuit 84 in the liquid injection / drainage circuit 823. To do. The seventh clamp 117 cooperates with the seventh support protrusion 887 to clamp the vicinity of the other end of the liquid injection / drainage circuit 823 so that the flow path is closed. Then, the eighth clamp 118 is connected to the eighth support protrusion 88.
8 to clamp the bypass circuit 84 so that the flow path is closed. Therefore, when switching the switching cassette circuit 82 to the liquid injection circuit state, the first clamp 111
(Or second clamp 112), fourth clamp (pumping control clamp) 114, sixth clamp 116,
The seventh clamp 117 is switched to the unclamped state, and the second clamp 112 (or the first clamp 111), the fifth clamp 115, and the eighth clamp 118 are switched to the clamped state. Then, the chamber 814 is activated by the pumping operation means 10.
When pressurizing the inside, the fourth clamp 114 is switched to the unclamped state and the third clamp 113 is switched to the clamped state. Furthermore, when the pressure inside the chamber 814 is reduced by the pumping operation means 10,
The fourth clamp 114 is switched to the clamped state and the third clamp 113 is switched to the unclamped state. As a result, the dialysate can be sent from the dialysate bag 4 (or the additional dialysate bag 5) toward the dialysis catheter 7, that is, the dialysate can be injected.
It is possible to bring the dialysate into the abdominal cavity as shown in (a).

When the switching cassette circuit 82 is switched to the drainage circuit state and replaced, the seventh clamp 117 and the eighth clamp 117 are used.
The clamp 118 is switched to the unclamped state, and the first clamp 111 and the second clamp 1
The waste liquid recovery state shown in FIG. 6B can be obtained by switching the 12, fourth clamp 114, and sixth clamp 116 to the clamp state, respectively.

When the pressure inside the pump chamber is reduced by the pumping operating means, the third clamp 113 is switched to the unclamped state and the fifth clamp 115 is switched to the clamped state. Further, when the inside of the chamber 814 is pressurized by the pumping operation means, the third clamp 113 is switched to the clamped state and the fifth clamp 113 is pressed.
By switching the clamp 115 to the unclamped state, the dialysate can be drained from the dialysis catheter 7 toward the drain tank 6.

The diaphragm pump 87, the third clamp 113, the fourth clamp 114, and the fifth clamp 11
5, the pumping actuating means constitutes a liquid sending means for sending the dialysate.

Further, when the switching cassette circuit 82 is in the liquid injection circuit state and the outlet side of the heating cassette circuit 83 is in the final liquid injection circuit state, the seventh clamp 117 is in the unclamped state and the eighth clamp 118 is in the unclamped state. It is in a clamped state.

When the outlet side of the heating cassette circuit 83 is switched to the return circuit state, the first clamp 111, the second clamp 111
The clamp 112 and the seventh clamp 117 are switched to the clamp state, and the eighth clamp 118 is switched to the unclamp state. As a result, the dialysate does not flow from the outlet side of the heating cassette circuit 83 toward the dialysis catheter 7 but flows through the bypass circuit 84 toward the diaphragm pump 87. That is, the dialysate circulates between the bypass circuit 87 and the heating cassette circuit 83.

Seventh clamp 117 and eighth clamp 118
And constitute a liquid injection return circuit switching means for switching the outlet side of the heating cassette circuit 83 between the final liquid injection circuit state and the return circuit state.

Here, when the dialysate is drained, the drainage is collected in the drain tank 6 via the bypass circuit 84. This can simplify the structure of the flow path.

As described above, by providing the cassette body 81 with the switching cassette circuit 82, the heating cassette circuit 83, the bypass circuit 84, and the diaphragm pump 87, the size and weight of the peritoneal dialysis apparatus 1 can be reduced. Therefore, the peritoneal dialysis device 1 can be easily handled, such as being transported, and a smooth medical procedure can be performed.

In particular, each of the divided heating cassette circuits 831, 8
Since the dialysate flowing through 32 is heated while being sandwiched by the corresponding heaters, the heating efficiency of the dialysate is improved, and the peritoneal dialysis device 1 can be made smaller and lighter. it can.

On the other hand, as shown in FIG.
Is equipped with various sensors for controlling the temperature of the dialysate.

That is, on the downstream side of the heating cassette circuit 83 of the dialysis machine main body 2, the temperature (outlet liquid temperature) of the dialysate flowing through the outlet side (downstream side) of the heating cassette circuit 83 is measured (detected). The temperature sensor 12A for the outlet liquid temperature is installed,
At the upstream side of the heating cassette circuit 83, an inlet fluid temperature sensor 12B for measuring (detecting) the temperature (inlet fluid temperature) of the dialysate flowing through the inlet side (upstream side) of the heating cassette circuit 83 is installed. Has been done.

Here, as the outlet liquid temperature temperature sensor 12A and the inlet liquid temperature temperature sensor 12B, it is preferable to use a thermopile type infrared sensor (non-contact type temperature sensor) having an extremely fast response speed. Thereby, the temperature of each surface heater 91, 92, 93 can be controlled with high precision.

Further, as shown in FIG. 5, each surface heater 91,
Each of 92 and 93 is provided with a heater temperature sensor 13 such as a thermistor for measuring (detecting) the temperature. Further, the dialysis machine main body 2 is provided with a bubble sensor 14 for detecting bubbles on the inlet side and the outlet side of the switching cassette circuit 82, respectively. In addition, the peritoneal permeation device 1 includes various sensors (various sensors 16) other than an occlusion sensor that detects occlusion of a circuit.

Further, as shown in the block diagram of FIG.
The peritoneal dialysis device 1 is equipped with a control system (control means) 15 that controls each of injection and drainage of dialysate.

That is, the control system 15 includes the CPU 1
51 and a storage unit 152, and the CPU 151 includes a clamp control unit 153 for controlling the plurality of clamps 111 to 118, a heater control unit 154 for controlling the temperatures of the plurality of surface heaters 91, 92, 93, and pumping. Actuating means 1
Pumping operation control units 155 that control 0 are electrically connected to each other. Further, the CPU 151 includes an outlet liquid temperature temperature sensor 12A, an inlet liquid temperature temperature sensor 12B, heater temperature sensors 13, bubble sensors 14, a display unit 23, and operation units 24a and 24b, respectively.
Each is electrically connected. The CPU 15
1, a power supply circuit 156, a battery circuit 157, a sound generation circuit 400, and a cassette loading control unit 301 that controls the cassette loading means 300 are electrically connected.
The display unit 23 is electrically connected to a card reading device 203 into which the above memory card can be loaded.

When the temperature measured by the outlet liquid temperature sensor 12A exceeds a preset temperature (39 ° C. in this embodiment), the control system 15 causes the clamp controller 153 to control 7 clamp 117
Control to switch to the clamped state, and the eighth clamp 11
While controlling 8 to switch to the unclamped state,
The heater control unit 154 controls the plurality of surface heaters 91, 9
Switch to the OFF state to stop the driving of Nos. 2 and 93.

The output (output value) of each surface heater 91, 92, 93 is selected based on the dialysate temperature control flow and the dialysate temperature. That is, the control system 15
The temperature of the dialysate to be injected falls within a predetermined temperature range based on the temperature laterally measured by the outlet fluid temperature sensor 12A and the temperature measured by the inlet fluid temperature sensor 12B. The output (drive) of the plurality of surface heaters 91, 92, 93 is controlled so that Then, the clamp controller 153
The first clamp 111 (or the second clamp 1
12), the fourth clamp 114, the sixth clamp 116, and the seventh clamp 117 are controlled to switch to the unclamped state, and the second clamp 112 (or the first clamp 111), the fifth clamp 115, and the eighth clamp 11 are controlled.
Control 8 to switch to the clamped state. This allows
The switching cassette circuit 82 can be switched to the liquid injection circuit state. Further, the heater control unit 154 controls to supply electric power (output) to the plurality of surface heaters 91, 92, 93. As a result, the heating step of heating the dialysate flowing through the heating cassette circuit 83, in other words, the temperature control flow of the dialysate enters the preheating step.

The preheating step ends when T1 time has elapsed after the supply of electric power to the plurality of surface heaters 91, 92, 93 was started. When this preheating step is completed, the pumping operation controller 155 controls the pumping operation means 10 to alternately repeat pressurization and depressurization in the pump chamber. Further, the clamp control unit 153 controls the fourth clamp 114 to alternately switch between the clamped state and the unclamped state in accordance with pressurization and depressurization in the chamber 814, and also controls the third clamp 113 to perform the clamping. Status,
The switching of the unclamping state is alternately repeated according to the pressurization and the pressure reduction in the chamber 814. As a result, the diaphragm pump 87 is pumped (contracted and expanded) to send the dialysate from the dialysate bag 4 toward the dialysis catheter 7 and inject it.

When the preheating step is completed, the dialysate temperature control flow enters the initial heating step. When the initial heating process is completed, the dialysate temperature control flow normally enters the heating process. In the normal heating process, a plurality of surface heaters 9
Output control of 1, 92 and 93 is performed by the outlet liquid temperature temperature sensor 1
If the temperature measured by 2A is less than 33 ° C, P
The output value of the heater under control is set to a plurality of surface heaters 91, 9
2 and 93.

On the other hand, when the temperature measured by the outlet liquid temperature sensor 12A is 33 ° C. or higher and lower than 39 ° C., P
The output value of the heater by the I control is set to a plurality of surface heaters 91, 9
2 and 93.

As a result, the plurality of surface heaters 91, 92,
The output control of 93 can be performed with high precision. In the initial heating step or the normal heating step, when the temperature measured by the outlet liquid temperature temperature sensor 12A becomes 39 ° C. or higher,
The clamp control unit 153 controls the seventh clamp 117 to switch to the clamp state and controls the eighth clamp 118 to switch to the unclamp state. Further, the heater control unit 154 controls the plurality of surface heaters 91,
The power supply to 92, 93 is stopped, in other words, the plurality of surface heaters 91, 92, 93 are switched off. As a result, the outlet side of the heating cassette circuit 83 can be switched to the return circuit state, and the dialysate is heated by the heating cassette circuit 83.
From the bypass circuit 84 to the bypass circuit 84 without flowing toward the dialysis catheter 7.
Returns to the upstream side of the heating cassette circuit 83 via the, and circulates between the bypass circuit 84 and the heating cassette circuit 83,
In the meantime, the temperature drops (cools). That is, the dialysate heating control flow moves to the cooling step (step 1
2). Therefore, it is considerably higher than the body temperature of patient K (3
A dialysis solution having a temperature of 9 ° C. or higher is not injected into the patient K, and safe dialysis treatment can be performed.

When the temperature measured by the outlet liquid temperature sensor 12A becomes less than 39 ° C., the clamp controller 153 controls the seventh clamp 117 to switch it to the unclamped state, and the eighth clamp 118.
To switch to the clamped state. Further, the plurality of surface heaters 91, 92, 93 are switched on. Thus, the outlet side of the heating cassette circuit 83 can be returned to the final liquid injection circuit state, and the initial heating process or the normal heating process is performed again. When a predetermined amount of dialysate is injected (injected) into the peritoneum of the patient K, the injection of dialysate ends.

After the injection of the dialysate is completed, the clamp controller 154 controls the seventh clamp 117 and the eighth clamp 118 to switch them to the unclamped state, and also controls the fourth clamp 114 and the sixth clamp 116. Then switch to the clamped state. As a result, the switching cassette circuit 82 can be switched to the drainage circuit state.

Then, the pumping operation control unit 155 controls the pumping operation means 10 to control the chamber 81.
The depressurization and pressurization of 4 are alternately repeated. Further, the clamp controller controls the third clamp 113 to alternately switch the unclamped state and the clamped state in accordance with the depressurization and pressurization of the chamber-814, and also controls the fifth clamp 115 to perform the clamping. Switching between the state and the unclamped state is alternately repeated according to the pressure reduction and the pressure increase in the chamber 814. As a result, the diaphragm pump 87 can be pumped to send the dialysate in the peritoneum from the dialysis catheter 7 to the drainage tank 6 for drainage.

Subsequently, FIGS. 8 to 13 are views showing display screens which are sequentially changed in the display section 23 shown in FIG.

In the block diagrams of FIGS. 7 and 8, the device 2
When the power of the device is turned on and the operation unit 24a is pressed, an initial screen 500 of the name of the device manufacturer is displayed and a screen 50 in which a nurse and a sheep (character image) as guides are displayed in color.
1, and the storage unit 152 is displayed by moving the arrow on the screen 502.
Is initialized, and at the same time, a message “A treatment should be performed in a bright and clean place. Be sure to wash your hands” is generated from the speaker 400a by an electronic voice. Following this, the screen 503 is automatically switched. On this screen, the treatment pattern, initial drainage volume, infusion volume, retention time in the abdominal cavity, number of cycles, final infusion volume, final concentration change, dialysis time, scheduled dialysis end time, total dialysate volume, etc. The parameters required for peritoneal dialysis are displayed as previous data. If this is acceptable, the “Next” touch key 506 is pressed to proceed to the screen of FIG.

The screen 507 of FIG. 9 is displayed together with a voice guide so that the cassette 8 can be set in the mounting portion of the apparatus. Further, on the screen 507, the touch key 508 for “confirm setting” appears at the same time. When the touch key 508 is pressed, the screen 523 of FIG. 11 is displayed. On the screen 509 after the screen 507, a voice guide is generated saying "It is a procedure to insert my home pico" which is composed of the cassette 8 and the piping shown in FIG. They are displayed interchangeably. Then, when the patient touches the “Next” touch key 510, the screen changes to the screen 511, and the text “Please close all clamps” and the operation procedure together with a voice guide show a still image in color. When the “Next” touch key 512 on this screen 511 is pressed,
On the screen 513, a screen is displayed so that the lid member 22 is opened to the front, voice guidance is performed, and the screen is automatically switched to the screen 514. On this screen 514, a color moving image is displayed showing that the cassette 8 is inserted from above the lid member of the apparatus. Following this, a screen for closing the lid member after loading the cassette is displayed on the screen 515 together with the voice guide, and the screen changes to the screen 516 in FIG. Following this,
On the screen 517, a video is displayed with a voice guide to set the connection tube on the hook 2a of the main body,
Move to screen 518.

On this screen 518, "Connect a dialysis bag to Pico Set (trademark of Terumo Corporation) 8" is displayed together with the voice guide, and when "Next" is touched, screen 5 is displayed.
Instead of 19, voice guidance is generated together with an image showing the state of connection. This transition, screens 520, 521, 5
By automatically switching to 22, the operation for the necessary connection is instructed. The screen of FIG. 11 corresponds to the screens 507 and 50 of FIG.
8 is a screen that is sequentially displayed when the “setting confirmation” touch key 508 in FIG. 8 is touched. On the screen 523, a message for confirming the connection is displayed together with the voice guide, and after the connection is completed, the message “Next” is displayed. By touching the touch key 524, after the standby screen display of the screen 525 is performed,
After the display of the unclamping after connection and the voice guide are displayed on the screen 526, the touch key of “setting” is touched on the screen 528 to prepare for dialysis, and the operation unit 24a is pressed to start dialysis. Further, on the screen 528, when the touch key 530 of "up and down arrows" is touched, items 1 to 5 on the screen are highlighted and the touch key of return is touched to enable confirmation. Further, on the screen 526, the item which the patient needs explanation can be selected by the touch key 530.

On the other hand, when the "change" touch key 504 on the screen 503 of FIG. 8 is touched, the screen is changed to the screen 531 of FIG. 12, and the touch key 533 of "up / down arrow" is touched to move the screen 53.
Settings are made by dialogue with the screens 4 to 541. Since the display color of the screens of these screens 534 to 541 is a single color and the background color does not change, it is understood that the patient is changing the setting.

Drainage line blockage, column liquid line blockage, poor liquid injection, poor liquid drainage, insufficient amount of liquid drainage, additional liquid fill line blockage, battery voltage drop, outside temperature drop, peritoneal line blockage, bubble detection, power failure, etc. The contents of the abnormal states and the operating procedures corresponding to them are stored in the storage unit 152 in advance. When an abnormality is detected by the bubble sensor 14 or the various sensors 16, the screen automatically shifts to a screen for displaying the abnormal state, and what kind of abnormality is occurring is sequentially displayed on the screen, and the user is asked in a sequential question format. Correspondence can be confirmed for (patient).

FIG. 13 shows a case where the drainage line is blocked as an example of an abnormal state of dialysis. In order to notify an abnormal state, a still image or a moving image including characters is displayed along with a voice guide on the screens 550 to 554, and a background color is displayed as a prominent predetermined color such as yellow or orange shown by hatching in the figure. By doing so, the patient is notified of the abnormal condition.

On the screen 550, the text "Please press the stop switch to stop the alarm sound" is displayed on the alarm / instruction screen, and at the same time, the message "Please press the stop switch to stop the alarm sound" is displayed.・ Instructions are given.

In accordance with this instruction, the operation section (stop button)
When 24b is pressed, a question type screen is displayed as shown in screen 551, and one of the occlusion sites (patterns) stored in the storage unit 152 in advance is displayed along with a schematic diagram of the peritoneal dialysis line along with an arrow 551a and a predetermined color. This is indicated by a circular dot mark 551b of (red), and a question as to whether or not "the pink clamp is closed" is displayed by voice along with a character display.

If you click "No" on the screen 551, the screen moves to the screen 552, but if you click "Yes", the screen 555 is displayed, and the procedure to be handled is to instruct by the text and voice "Please open the pink clamp". To be done. When the procedure according to this instruction is executed and "Next" is clicked, a screen 552 is displayed.

If you click "No" on the screen 552, the screen moves to the screen 554, but if you click "Yes", the screen 555 is displayed, and the procedure to be followed is "Please crush the tube, fix the twist". Instructed by letters and voice. The procedure according to this instruction is executed, and when "Next" is clicked, a screen 554 is displayed.

On the screen 554, a message "Please press the start switch. Please receive the doctor's instruction when canceling" is indicated by the characters and voice.

In this way, the contents and location of the abnormality are assumed in advance and stored in the storage unit 152 so that they can be sequentially confirmed.

Further, in each screen, by pressing the operation portion 24a, the original operation can be returned.

In addition to the blockage of the drainage line shown in FIG. 13, this abnormal state includes blocking of the liquid fill line during treatment and during priming, poor liquid filling, poor drainage and lack of liquid, air bubble mixing, during treatment and during priming. There are additional liquid injection line blockage, battery backup due to power failure, and outside air temperature drop, and when these abnormalities occur, all become background colors in prominent colors such as yellow and orange, and at the same time notify the abnormality by voice guide, Even if a trouble should occur, you can easily handle it, so you can use it with confidence.

[0103]

As described above, according to the present invention,
It is possible to automate dialysis treatment by the patient himself.
It is possible to provide a peritoneal dialysis device that has extremely clear operability and is easy to understand, can perform treatment under optimal conditions, and can perform dialysis treatment under optimal conditions that can be easily dealt with even if a trouble occurs.

[Brief description of drawings]

FIG. 1 is an external perspective view showing a peritoneal dialysis device of the present invention together with a cassette 8.

FIG. 2 is a diagram schematically showing an embodiment of a peritoneal dialysis device of the present invention.

3 is an external perspective view showing a flow path switching unit of the cassette 8 and a clamper 240. FIG.

FIG. 4 is a three-dimensional exploded view of the cassette 8.

FIG. 5 is a relationship diagram between a heating circuit of the cassette 8 and a heater.

FIG. 6 (a) is a schematic diagram showing a state in which a dialysate is delivered into the abdominal cavity, and FIG. 6 (b) is a schematic diagram showing a state in which drainage solution is delivered.

FIG. 7 is a block diagram of a dialysis machine main body.

FIG. 8

FIG. 9

FIG. 10:

FIG. 11:

FIG. 12

FIG. 13 is a diagram showing a display screen that sequentially changes on the display unit 23.

[Explanation of symbols]

1 Peritoneal dialysis device 2 Dialysis machine body 21 cassette mount 22 Lid member 23 Display 24a, 24b operation unit 3 dialysate unit 31 Injection tube circuit 32 Additional injection tube circuit 33 Injection / drainage tube circuit 34 Drainage tube circuit 35 branch tube circuit 36 transfer tube set 37 Clemme 4 dialysate bag 5 Additional dialysate bag 6 drainage tank 7 dialysis catheter 8 cassettes 81 cassette body 811 Lower body frame 812 Upper body frame 82 Switching cassette circuit 821 Injection circuit 822 Additional liquid injection circuit 823 Injection / drainage circuit 824 drainage circuit 83 Heating cassette circuit 831 split heating cassette circuit 832 split heating cassette circuit 833 Connection tube 84 Bypass circuit 85a-85d Connection tube 86 gap 87 diaphragm pump 881 first support protrusion 882 Second support protrusion 883 Third support protrusion 884 Fourth support protrusion 885 Fifth support protrusion 886 Sixth support protrusion 887 7th support protrusion 888 Eighth support protrusion 9 Heating means 91 Lower surface heater 92 Upper surface heater 93 Intermediate heater 94a-94d Aluminum plate 10 Pumping actuation means 101 Air circuit 102 Branch air circuit 103 Branch air circuit 104 Air pressure generator 105 Vacuum pressure generator 106 switching valve 11 Clamping means 111 first clamp 112 Second clamp 113 3rd clamp 114 Fourth Clamp 115 Fifth Clamp 116 sixth clamp 117 7th clamp 118 8th clamp 12A outlet temperature sensor for liquid temperature 12B Temperature sensor for inlet liquid temperature 13 Heater temperature sensor 14 Bubble sensor 15 Control system 151 CPU 152 storage 153 Clamp controller 154 Heater control unit 155 Pumping operation control unit 156 power supply circuit 157 battery circuit 16 Various sensors 200 Main base 201 Sub-base 202 Shield 203 Card reader 204 memory card 500-554 screen

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[Procedure amendment]

[Submission date] June 21, 2001 (2001.6.2)
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   ─────────────────────────────────────────────────── ─── Continued front page    (72) Inventor Hironobu Suzuki             2656-1 Obuchi, Fuji-shi, Shizuoka Terumo Stock Association             In-house F term (reference) 4C077 AA06 BB01 DD30 EE03 HH21

Claims (6)

[Claims] 1. A dialysate circuit including at least one dialysate container filled with dialysate and at least one drainage container for collecting dialysate; and the dialysate container as a starting point.
Alternatively, it has a liquid feeding means for feeding a dialysate with the drainage container as an end point, and a display means for notifying a condition for displaying a condition relating to dialysis, and supplies the dialysate to the patient side by the liquid feeding means. Along with, a peritoneal dialysis device for performing dialysis by collecting the drainage, the operation procedure necessary for the dialysis, a still image or a moving image including characters with a voice guide in the display unit of the display means. The peritoneal dialysis device characterized by being displayed by. 2. A dialysate circuit including at least one dialysate container filled with dialysate and at least one drainage container for collecting dialysate; and the dialysate container as a starting point.
Alternatively, it has a liquid feeding means for feeding a dialysate with the drainage container as an end point, and a display means for notifying a condition for displaying a condition relating to dialysis, and supplies the dialysate to the patient side by the liquid feeding means. Along with, a peritoneal dialysis device for performing dialysis by collecting the drainage, in order to inform the abnormal state of the dialysis, a still image or a moving image including characters is displayed together with a voice guide on the display unit of the display means. The peritoneal dialysis device is characterized in that the background color to be changed is different from the background color in the normal state of the dialysis. 3. The peritoneal dialysis device according to claim 1, wherein the still image or the moving image is displayed in color. 4. A dialysate circuit including at least one dialysate container filled with dialysate and at least one drainage container for collecting dialysate, and the dialysate container as a starting point,
Alternatively, it has a liquid feeding means for feeding a dialysate with the drainage container as an end point, and a display means for notifying a condition for displaying a condition relating to dialysis, and supplies the dialysate to the patient side by the liquid feeding means. In addition, a peritoneal dialysis device that performs dialysis by collecting the drainage, and a setting procedure that includes liquid transfer necessary for the dialysis, a background including characters with a voice guide in the display unit of the display unit. A peritoneal dialysis device, which displays a still image whose color does not change. 5. The display unit is composed of a liquid crystal touch panel whose screen is pressed, and a patient can appropriately press the operation procedure, the abnormal state elimination operation, and the setting procedure. Item 5. The peritoneal dialysis device according to any one of Items 1 to 4. 6. The dialysis start button and the dialysis start button are separately arranged at positions separated from the display unit, and are displayed by color, and Braille is provided under each button. The peritoneal dialysis device according to any one of claims 1 to 5.