JP2003070907A - Hemocatharsis system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a hemocatharsis system in which the hemocatharsis operation can be efficiently and safely performed by a minimum operation burden. SOLUTION: A dialyzer 10 makes the blood of a patient contact with dialytic fluid made to flow in an flow out through dialytic fluid channels 18 and 20 through a semipermeable membrane to perform dialytic or/and filtration operation. The dialyzer is provided on blood circuits 12 and 14 where the blood of the patient is circulated. A dialytic fluid flowing device 22 is provided for making the dialytic fluid flow into the dialzyer 10 and flow out through the dialytic fluid channels 18 and 20. In addition, a blood flow rate measuring means 26 is provided for obtaining at least one of the blood flow rate of an artery without seeing the blood for feeding the blood to the head of the patient and blood flow rate of an artery for making the blood fed into the head of the patient during the dialytic and/or filtration operation of the blood in the dialyzer 10.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a blood purification system, and more particularly to an improved structure of a blood purification system that purifies blood of a patient by dialysis and / or filtration.

[0002]

BACKGROUND ART In recent years, various blood purification methods for purifying blood taken out from a patient's body and returning it to the body for the purpose of treating patients with renal failure and maintaining their lives have been studied and put to practical use. The so-called artificial kidney is widely used there. As a kind of such artificial kidney, a dialyzer provided on a blood circuit in which the blood of a patient is circulated, and a dialysate flow device for inflowing (supplying) dialysate into the dialyzer and flowing out (discharging) from the dialyzer. And a dialysate, which is made to flow into and out of the dialyzer through the blood circuit and the dialysate flow device, is brought into contact with the dialyser via a predetermined semipermeable membrane in the dialyzer, and dialysis and / or A blood purification system configured to purify blood by performing a filtration operation is known.

By the way, when a patient's blood is purified by a dialysis and / or filtration operation using such a blood purification system, a phenomenon occurs in which the blood pressure of the patient is suddenly lowered (decreased) for some reason. Occasionally, the patient's life is endangered.

Therefore, the above-described blood purification operation is
In many cases, it is carried out while frequently measuring the blood pressure of the patient, and as soon as the blood pressure of the patient falls below a predetermined value, appropriate measures for coping with the decrease in blood pressure are uniformly applied to the patient. The blood pressure is being increased.

However, during such purification of blood, the value of blood pressure when a patient falls into a critical condition due to a decrease in blood pressure greatly differs depending on the age and physical condition of the patient. Is not dangerous to life, and despite the fact that no treatment is necessary, there were cases where blood pressure was lowered, simply because the blood pressure fell below a prescribed level. is there.

[0006] Therefore, when the conventional blood purification system as described above is used to purify the blood of a patient by dialysis and / or filtration, an urgent work is required, resulting in a heavy work load. Since the extra treatment for the decrease was performed, it caused a big problem that the work load was excessively imposed on the operator (nurse, doctor, etc.) performing the blood purification operation. Of.

[0007]

Here, the present invention has been made in view of the circumstances as described above, and the problem to be solved is that when the blood pressure of a patient is lowered during blood purification, In order to protect the life of the patient, only those that need to be treated for such a decrease in blood pressure can be dealt with more appropriately, so that the blood purification operation of the patient can be performed as small as possible. An object of the present invention is to provide a blood purification system that can be implemented more efficiently and safely with a burden.

[0008]

Under such circumstances, the present inventors have focused on the blood flow rate in the brain, which has a close relationship with blood pressure fluctuations, in various examination courses carried out to solve the above technical problems. This blood flow in the brain has a blood pressure of, for example, 13.3 to 33.25 kPa in a healthy adult.
While it is in the range of (100 to 250 mmHg), the physiological compensation function of each person suppresses the increase / decrease accompanying blood pressure fluctuations as much as possible, and the blood pressure is applied although the value changes at a substantially constant value. When the value falls below the range, the value is drastically reduced.

Then, the present inventors investigated the relationship between the condition of the patient when blood pressure decreased during blood purification and the fluctuation in the blood flow in the brain of the patient during blood purification.
Even if the blood pressure decreases, there is no significant change in the patient's condition unless a rapid decrease in the blood flow in the brain is caused, and if the blood flow in the brain is rapidly decreased due to the decrease in blood pressure, the patient's condition changes. It was found that the patient was in a critical state, and it was found that the decrease in blood flow in the brain had a great effect on the life threat of the patient due to the decrease in blood pressure during blood purification.

The present invention has been completed based on the above findings, and the gist of the invention is to purify the blood of a patient by dialysis and / or filtration. In the system, (a) the blood is provided on a blood circuit in which the blood is circulated, and the blood is brought into contact with a dialysate flowing in and out through a dialysate flow path through a semipermeable membrane for dialysis and And / or a dialyzer for performing a filtering operation, and (b) a dialysate flow device for performing inflow of the dialysate into the dialyzer and outflow of the dialysate from the dialyzer through the dialysate flow path, and (c) ) At least one of the blood flow rate of an artery that sends blood to the head of the patient and the blood flow rate of an artery that allows blood sent to the head to flow into the brain is determined by the dialer. Dialysis of the blood in The and /
Alternatively, the blood purification system is characterized in that it has a blood flow rate measuring means which is non-invasively obtained during the filtration operation.

That is, in the blood purification system according to the present invention, a blood flow rate measuring means is additionally provided to the conventional system, and the head of the patient is obtained by the blood flow rate measuring means. In at least one of the blood flow rate of the artery that sends blood to the brain and the blood flow rate of the artery that allows the blood sent to the head to flow into the brain, the blood flow rate in the brain during purification of the patient's blood is It is designed to be measured.

Therefore, in such a blood purification system according to the present invention, the fluctuation of the blood flow in the brain during the purification of the blood of the patient can be grasped by the value obtained by the blood flow measuring means, As a result, a decrease in blood pressure occurs during purification of blood, and when the blood flow in the patient's brain falls below a predetermined limit value, in other words, when the blood pressure decrease puts the patient's life at risk. Immediately, the blood flow in the brain can be increased to a normal value by increasing the blood pressure of the patient by taking appropriate measures to cope with the decrease in blood pressure. On the other hand, if a decrease in blood pressure in the patient's brain is not observed even though a decrease in blood pressure has occurred, and there is no actual risk of life, the patient is left without treatment for any decrease in blood pressure. Therefore, it is possible to effectively eliminate the need for extra treatment for lowering blood pressure, which requires an urgent work load, and an operator (nurse who performs blood purification). The work load on the doctor, doctor, etc. can be significantly reduced.

Therefore, when the blood purification system according to the present invention as described above is used, when the blood pressure of the patient undergoing blood purification decreases, the blood pressure of the patient is treated in order to protect the life of the patient. Only the necessary items can be dealt with more appropriately, so that the patient's blood purification operation can be
It is possible to carry out the work more efficiently and safely with the work load as small as possible.

According to one of the preferred embodiments of the blood purification system according to the present invention, the blood flow rate measuring means detects the blood flow velocity of at least one of the arteries by the ultrasonic Doppler method. And a calculation unit that calculates the blood flow rate of at least one of the arteries based on the blood flow velocity detected by the detection unit. As a result, it is possible to more reliably and easily grasp the fluctuation of the blood flow in the brain of the patient during blood purification, and thus to carry out the blood purification operation of the patient even more smoothly and safely. You can do it.

According to another advantageous aspect of the blood purification system according to the present invention, the blood flow rate measuring means is provided for the patient during the dialysis and / or filtration operation of the blood in the dialyzer. A measurement unit that measures the change in energy of the pulsation of the artery that sends blood to the head, and an estimation unit that estimates the amount of change in the blood flow rate of the artery from the amount of change in the energy measured by the measurement unit. During the dialysis and / or filtration operation of blood in the dialyzer,
The blood flow rate of the artery is determined relative to the blood flow rate at the start of the operation based on the variation amount estimated by the estimation unit. This also
The fluctuation of the blood flow in the brain of the patient during the blood purification can be grasped with certainty, and thus the blood purification operation of the patient can be carried out more efficiently and safely.

Further, according to another preferred aspect of the blood purification system according to the present invention, when the value obtained by the blood flow rate measuring means falls below a preset limit value, it is automatically adjusted. Informing means for informing is further provided. In the blood purification system having such a configuration, an operator (nurse or doctor) who performs a blood purification operation when the blood flow in the brain is decreased enough to endanger the life of the patient, The patient can be informed that the treatment for lowering blood pressure needs to be urgently performed, and as a result, the blood purification operation can be performed more safely. Further, according to such a configuration,
Until the automatic notification is performed by the notification means, it is possible to advantageously eliminate the need for the operator to confirm the measurement value of the blood flow rate measurement means or to measure the blood pressure of the patient. The work load of the above can be reduced more effectively.

Further, according to still another preferred embodiment of the blood purification system according to the present invention, when the value obtained by the blood flow rate measuring means falls below a preset limit value, the value is reduced. The amount of dialysate flowing into the dialyzer or the amount of flow out of the dialyzer by the dialysate flow device is controlled so as to return to the limit value or more, and / or the circulation amount of the blood in the blood circuit. At least one of a control device for controlling the fluid, a fluid replacement device for automatically starting fluid replacement for a patient, or a supply means for automatically supplying a dialysate having a high Na concentration to the dialysate flow path is provided, Composed.

In the blood purification system having such a configuration, when blood pressure is lowered during blood purification and the blood flow in the brain of the patient falls below a predetermined limit value,
Appropriate measures to protect the patient's life, which can respond to the decrease in blood pressure, can be immediately performed to rapidly increase the blood pressure of the patient and thereby increase the blood flow in the brain to the normal value. And as a result, the blood purification operation
Further, it can be carried out even more safely, and the work burden on the operator of the blood purification operation can be reduced more effectively.

Further, according to another advantageous aspect of the blood purification system according to the present invention, when the value obtained by the blood flow rate measuring means falls below a preset limit value, the blood pressure of the patient is reduced. Blood pressure measuring means for automatically measuring is further provided. As a result, the blood pressure of the patient can be surely grasped before the treatment for the decrease in blood pressure, and as a result, it is possible to smoothly carry out the appropriate treatment that accurately corresponds to the decrease in blood pressure. It will be possible.

[0020]

BEST MODE FOR CARRYING OUT THE INVENTION In order to more specifically clarify the present invention, the configuration of a blood purification system according to the present invention will be described in detail below with reference to the drawings.

First, FIG. 1 is a system diagram showing a hemodialysis system, which is an embodiment of a blood purification system having a structure according to the present invention, in which the blood of a patient is purified by a dialysis action. In FIG. 1, 10 is
A dialyzer as a dialyzer (purifier) having a known structure, which is used for dialysis (purification) of blood,
For example, a hollow fiber semipermeable membrane is housed inside a cylindrical box.

A blood supply channel 12 for guiding blood from the patient's body is connected to one end side of the dialyzer 10 in the axial direction, and the dialyzer 1 is connected to the other end side.
At 0, the blood return flow path 14 for returning the purified blood into the patient's body is connected. That is, here
A blood circuit is constituted by the blood supply flow path 12, the blood circulation part in the dialyzer 10, and the blood return flow path 14. In addition, on the blood supply channel 12,
A blood pump 16 is provided, and the operation of the blood pump 16 allows blood to flow through the blood circuits 12, 14 and the dialyzer 10.

The dialyzer 10 is connected to a dialysate supply channel 18 for guiding the dialysate into the dialyzer 10 from its storage tank (not shown), and further, the dialyzer 10 is supplied through the blood supply channel 12. A dialysate discharge flow path 20 for guiding the dialysate brought into contact with the blood, which has been brought into contact through the semipermeable membrane, to the outside of the system and discharging the dialysate is connected to the blood. That is, here, the dialysate supply flow path 18, the dialysate flow path in the dialyzer 10, and the dialysate discharge flow path 20 constitute a dialysate flow path.

On the dialysate supply passage 18 and the dialysate discharge passage 20, the known dialysate flow device 2 is provided.
2 is provided, and the dialysate flow device 22 allows fresh dialysate introduced from the storage tank to flow (supply) into the dialyzer 10 through the dialysate supply passage 18, while the dialysate half of the dialyzer 10 is provided. The dialysate drainage containing waste products and excess water diffused and filtered from the blood side through the permeable membrane can be discharged (discharged) from the dialyzer 10 through the dialysate drainage channel 20. ing.

Further, such a dialysate circulating device 22 is
The operating state is controlled by the control device 24, whereby the flow rate of the fresh dialysate into the dialyzer 10 by the dialysate flow device 22 and the dialysate drainage from the dialyzer 10 are controlled. The outflow rate can be adjusted arbitrarily.

That is, in the dialysate circulation device 22, the amount of dialysate drainage flowing out of the dialyzer 10 is determined based on the water removal start signal output from the control device 24 and instructing the start of the water removal action. A dialyzer for fresh dialysate 1
It is possible to remove water in the dialyzer 10 by increasing the flow rate into the dialyzer 10 and adjust the water removal rate by the difference between the outflow rate of the dialysate effluent and the inflow rate of the fresh dialysate. And again,
The water removal action is stopped by making the outflow amount of the dialysate drainage liquid and the inflow amount of the fresh dialysate liquid equal based on the water removal stop signal output from the control device 24 to stop the water removal action. At the very least, the amount of water removed can be reduced to zero. Furthermore, in such a dialysate flow device 22,
Based on the start signal of the replacement fluid by the dialysate that instructs the start of the dialysate pushing action output from the control device 24, the inflow amount of the fresh dialysate into the dialyzer 10 is changed from the dialysate drainage dialyzer 10 to The dialysate can be pushed to the blood side in the dialyzer 10 by increasing the outflow amount.

Further, the control device 24 is constructed so as to be able to control the operation of the blood pump 16 provided on the blood supply flow path 12, and the operation control of the blood pump 16 by the control device 24 allows the blood pump 16 to operate. The circulation amount of blood in the circuits 12 and 14, that is, the inflow amount of blood into the dialyzer 10 can be increased or decreased.

By the way, in such a hemodialysis system of the present embodiment, it is not found in the conventional system.
A blood flow measuring device 26 as a blood flow measuring means is provided. This blood flow rate measuring device 26 detects a blood flow velocity of a blood vessel to be inspected by an ultrasonic Doppler method, and a probe 28 as a detection unit, and the probe 2
8 and a main body 30 as a calculation unit for electrically calculating the blood flow rate of the blood vessel based on the value detected by the probe 28.

That is, in the blood flow rate measuring device 26, the probe 28 vibrates so that a transducer (not shown) for transmitting an ultrasonic wave and a reflected signal of the ultrasonic wave transmitted from the transducer are received. It has a child (not shown) and
With this probe 28, the blood flow velocity of the blood vessel to be inspected can be detected at any time by utilizing the Doppler effect of ultrasonic waves continuously transmitted from the transducer. Further, here, since the probe 28 is fixed to the lower portion of the headband 32 with the detection site of the tip facing inward, the headband 32 is simply attached to the head of the patient. And probe 2
The detection site at the tip of 8 is positioned in the temporal region of the patient, and the blood flow velocity of the middle cerebral artery in the brain, that is, the artery that allows blood sent to the head to flow into the brain is It can be detected at any time during dialysis (purification).

Further, the main body 30 of the blood flow measuring device 26
Is the blood flow rate of the middle cerebral artery calculated by multiplying the blood flow velocity of the middle cerebral artery detected by the probe 28 by the average value of the cross-sectional area of the middle cerebral artery stored in advance. Therefore, it is being continuously requested. The blood flow rate of the middle cerebral artery thus obtained is displayed through a built-in printer, a monitor or the like (both not shown), and can be sequentially output to the control device 24. is there.

Here, in particular, as described above,
When the blood flow rate of the middle cerebral artery measured (determined) by the blood flow rate measurement device 26 is input to the control device 24,
A determination unit (not shown) incorporated in the control device 24 compares the blood flow rate with a preset limit value to determine whether or not the blood flow rate is less than the limit value. There is. Then, only when it is determined that the blood flow rate of the middle cerebral artery is less than the limit value, the operation of the alarm device 34 electrically connected to the control device 24 and serving as a notification unit is started. Controlled and dialysate flow device 2
2 and the operation control of the blood pump 16 can be performed.

More specifically, in the hemodialysis system of this embodiment, the blood flow in the brain is sharply reduced due to a decrease in blood pressure during dialyzing blood in the dialyzer 10, and the patient's life is endangered. A blood flow rate value that is larger than the blood flow rate of the middle cerebral artery by a predetermined amount in such a state is stored in the determination unit of the control device 24 as the limit value.

In this hemodialysis system, if the blood flow rate of the middle cerebral artery input from the blood flow rate measuring device 26 is below the above-mentioned limit value in the judging section of the control device 24. When the determination is made, an operation signal is output from the control device 24 to the alarm device 34, and an alarm is issued by the alarm device 34. At the same time, the dialysate drainage liquid by the dialysate flow device 22 is discharged. The decrease of the outflow amount from the dialyzer 10 and the increase of the inflow amount of the fresh dialysate into the dialyzer 10 are performed at the same time or one of them is performed,
The difference between the outflow of dialysate effluent and the inflow of fresh dialysate is reduced or equalized, or the difference between the outflow of dialysate effluent and the inflow of fresh dialysate is By making it negative, the dewatering action is reduced or stopped, or the dialysate is moved to the blood side, and the dewatering amount is reduced or becomes zero, or replacement fluid with the dialysate is performed, and That is, the operation amount of the blood pump 16 is reduced, and the inflow amount of blood into the dialyzer 10 can be reduced.

Thus, the alarm device 34 by the control device 24
Operation lowers the patient's blood pressure and reduces the patient's middle cerebral arterial blood flow, or blood flow in the brain, to such an extent that the patient's life is threatened. A dialysate flow device 22 for reducing the amount of water removed or forcing the dialysate to the blood side, which is implemented by the control device 24, can be notified to a person or the like. Blood pump 1 for controlling the operation of the pump and reducing the inflow of blood into the dialyzer 10.
By the operation control for 6, the blood pressure of the patient is increased, and the blood flow in the brain can be increased to a normal value.

Here, in the dialyzer 10, operation control is performed by the control device 24 for the dialysate flow device 22 for reducing or eliminating the amount of water removal or for pushing the dialysate into the blood side. The operation control of the blood pump 16 that reduces the inflow of blood into the blood pump 16 is performed by both or both of them depending on the operating condition of the hemodialysis system, the condition of the patient, the decrease in the blood flow rate of the middle cerebral artery, and the like. One of the two is selected and performed, and the reduction amount of the water removal amount due to their operation control, the movement amount of the dialysate to the blood side, and the inflow amount of the blood into the dialyzer 10 are controlled. The reduction amount is appropriately determined according to the operating condition of the hemodialysis system, the condition of the patient, the reduction amount of the blood flow rate in the middle cerebral artery, and the like.

As described above, in the hemodialysis system according to this embodiment, the blood flow rate in the middle cerebral artery during dialysis of the blood in the dialyzer 10, that is, the fluctuation of the blood flow in the brain, is detected by the blood flow rate measuring device 26. The controller 24 constantly monitors the blood flow in the brain to such an extent that the decrease in blood pressure of the patient may endanger the life of the patient. Notifying a nurse, a doctor, or the patient himself, the blood pressure of the patient is raised, and a procedure for increasing the blood flow in the brain to a normal value can be automatically performed. Therefore, the dialysis of the blood of the patient can be carried out more safely, and during the dialysis of the blood, the nurse and the doctor can confirm the measurement value by the blood flow measuring device 26 one by one. That need is obtained advantageously be eliminated, work burden of their nurses and doctors is as it can be effectively reduced.

In particular, the hemodialysis system of this embodiment is different from the conventional system in which the blood pressure of the patient is directly monitored, and when the blood pressure is lowered, the blood pressure is increased. As described above, the blood flow in the brain of the patient is monitored, and when the blood flow falls below a predetermined limit value, a treatment for increasing the blood pressure of the patient is performed. If a decrease in blood flow in the patient's brain is not observed, although there is a decrease in blood pressure, and if there is no actual risk of life, the patient can be left alone without any treatment for lowering blood pressure. ,
As a result, the work load becomes enormous due to the urgent need, and it is possible to effectively eliminate the need for extra treatment for blood pressure drop, and the work load on the nurses, doctors, etc. who are the operators of the system is further reduced. It can be advantageously reduced.

Therefore, in the hemodialysis system of this embodiment as described above, in order to protect the life of the patient, it is necessary to increase the blood pressure only for those which need to be treated to reduce the blood pressure. Appropriate measures can be taken, and as a result, the dialysis operation of the patient's blood can be carried out more efficiently with a work load as small as possible.

Further, in this embodiment, when the blood flow rate in the middle cerebral artery (blood flow rate in the brain) during dialysis of blood in the dialyzer 10 falls below the limit value, the alarm device 34 gives an alarm. When it is emitted, it can be notified to the operator of the hemodialysis system.For example, when the blood flow rate of the middle cerebral artery is below the limit value for some reason, Even when the control device 24 does not control the operation of the dialysate flow device 22 or the blood pump 16, the operator of the hemodialysis system can manually perform the procedure for increasing the blood pressure of the patient. Therefore, the dialysis operation of blood can be performed even more safely.

Further, in the hemodialysis system of this embodiment, when the blood flow rate in the middle cerebral artery becomes less than the limit value during the dialysis of blood in the dialyzer 10, the dialysate circulation device 22 and the blood pump 16 are provided. Is controlled to reduce or eliminate the amount of water removed, or the dialysate is pushed to the blood side, or the dialyzer 10 is operated.
Since the inflow of blood into the inside is reduced, the blood pressure of the patient can be raised quickly and efficiently, and the blood flow in the brain can be smoothly returned to a normal value. In addition, it is possible to eliminate the need for the operator of the system to take special steps to raise the blood pressure, and the work load in the hemodialysis operation can be more effectively reduced. .

Furthermore, in this embodiment,
The blood flow measuring device 26 uses the ultrasonic Doppler method,
A probe 28 for detecting the blood flow velocity of the middle cerebral artery and a main body 30 for obtaining the blood flow rate of the middle cerebral artery based on the blood flow velocity detected by the probe 28. The fluctuation of the blood flow in the brain of the patient during the dialysis of blood can be more reliably and easily grasped, so that the dialysis operation of the blood of the patient can be carried out even more smoothly and safely. Of.

The specific construction of the present invention has been described in detail above, but this is merely an example, and the present invention is not restricted by the above description.

For example, in the above-described embodiment, the dialyzer 10 is constructed by accommodating the hollow fiber-shaped semipermeable membrane inside the cylindrical box, but the structure of the dialyzer is not limited to this. However, any of various known structures of a dialyzer incorporated in a blood purification system can be adopted.

In the above embodiment, in the blood flow measuring device 26, based on the blood flow velocity of the middle cerebral artery of the patient detected by the probe 28, the blood flow of the middle cerebral artery, that is, the blood is sent to the head. The blood flow in the arteries that allow blood to flow into the brain was determined, and when this blood flow fell below the limit value, measures were taken to raise the blood pressure in the patient. In addition to or in addition to this, for example, the blood flow velocity of the internal carotid artery of the patient is detected by the probe 28 of the blood flow measuring device 26, and based on this, the blood flow rate of the internal carotid artery, in other words, the head of the patient. Even if the blood flow rate of the artery for sending blood to the area is non-invasively determined, and when the blood flow rate thus determined falls below the limit value, a procedure for increasing the blood pressure of the patient may be performed. , It is prayer.

Further, the artery whose blood flow rate is measured by the blood flow rate measuring device 26 is not limited to the internal carotid artery as described above or the middle cerebral artery shown in the above-described embodiment, but blood is not limited to the head of the patient. Among the arteries that feed blood into the brain and the arteries that flow blood into the head to the brain, arteries whose blood flow rate can be measured noninvasively can be appropriately selected. In particular, the common carotid artery is suitable for measuring the blood flow rate by the blood flow rate measuring device 26 because it sends a part of the blood to the face and the scalp while sending a large part of the blood into the brain.

Further, the device for measuring the blood flow rate in those arteries is not limited to the one having the structure in the above embodiment, and the blood flow rate in the arteries can be determined noninvasively. However, the structure is not particularly limited.

Therefore, as an apparatus for obtaining such a blood flow rate, for example, a measuring section for measuring a change in energy of an artery that feeds blood to the head of a patient during dialysis of blood in the dialyzer 10 is provided in the measuring section. And an estimation unit that estimates a variation in blood flow rate of an artery that feeds blood to the patient's head from the measured change amount of energy, and the blood flow rate of the artery during dialysis of blood in the dialyzer 10. It is also possible to use one having a structure configured to obtain a relative value with respect to the blood flow rate at the start of such an operation based on the fluctuation amount estimated by the estimation section. Even when using a device with such a structure,
Fluctuations of the blood flow in the brain of the patient during dialysis of blood can be grasped with certainty, and thus the blood purification operation of the patient can be carried out more efficiently and safely.

Further, in the above-described embodiment, when the blood flow in the brain becomes less than the limit value during dialysis of blood in the dialyzer 10, the dialysate flow device 22 and the blood pump 16 are automatically controlled by the control device 24. Controlled by
The amount of water removed is reduced or reduced to zero, or conversely, the dialysate is pushed to the blood side or the inflow of blood into the dialyzer 10 is reduced, thereby increasing the blood pressure of the patient. The blood flow in the brain could be returned to the normal value, but when the blood flow in the brain became less than the limit value, based on the display on the monitor of the blood flow measuring device 26 or the built-in printer, Or alarm device 3
It is of course possible that the operator of the system is configured to manually perform the above-described operation control of the dialysate circulating device 22 and the blood pump 16 based on the alarm from 4.

Furthermore, the treatment carried out when the blood flow in the brain falls below the limit value is by no means limited to the treatment shown in the above embodiment as long as it is for increasing the blood pressure of the patient. However, for example, a dropper is provided as a replenishing device for replenishing a patient, and when the blood flow in the brain falls below a limit value, the dropper is automatically or manually operated to To start fluid replacement for
Alternatively, an auxiliary tank for storing a dialysate having a higher Na concentration than the dialysate supplied into the dialyzer 10 is provided during normal dialysis of the blood so that when the blood flow in the brain becomes less than the limit value, the assistance is provided. A dialysate having a high Na concentration may be automatically or manually supplied into the dialyzer 10 from the tank through the dialysate flow device 22 or the like to increase the blood pressure of the patient. Of.

In addition, in place of or in addition to the above-mentioned various devices, a known blood pressure measuring device for performing a treatment for increasing the blood pressure of a patient when the blood flow rate in the brain falls below a limit value. It is also possible that the blood pressure of the patient is automatically or manually measured by the blood pressure measuring device when the blood flow rate in the brain becomes less than the limit value. Thereby, the blood pressure of the patient can be surely grasped before the treatment for the blood pressure decrease, and as a result, it is possible to smoothly perform the appropriate treatment accurately corresponding to the decrease in the blood pressure. It will be possible.

Further, in the above-mentioned embodiment, the alarm means is constituted by the alarm device 34 which issues an alarm when the value measured by the blood flow rate measuring device 26 falls below the limit value. However, the structure of this alarm means is also: Anything is not limited to this, for example, by simply lighting or blinking a warning lamp or the like, it is also possible to adopt a structure for notifying that the measured value is below the limit value, Of course it is possible.

Furthermore, in the above embodiment, the controller 24 controls the inflow amount of fresh dialysate into the dialyzer 10 and the outflow amount of dialysate drainage from the dialyzer 10 by the dialysate flow device 22. , The outflow amount is made larger than the inflow amount to remove water, and the water removal amount is adjusted by the difference between the outflow amount and the inflow amount, and such a difference is made zero. As a result, water removal is stopped, and by making such a difference negative, the dialysate is pushed to the blood side,
That is, the liquid replacement was performed, but the mechanism for reducing the water removal and the liquid replacement is not limited to this, and various known structures can be appropriately adopted. Of.

In addition, in the above-described embodiment, an example in which the present invention is applied to a hemodialysis system in which the blood of a patient is purified by a dialysis action is shown. Needless to say, it can be advantageously used for any blood purification system in which the blood is purified by dialysis and / or filtration.

Although not listed one by one, the present invention
It can be carried out in an embodiment in which various changes, modifications, improvements, etc. are added based on the knowledge of those skilled in the art, and such an embodiment does not depart from the gist of the present invention.
Both are included within the scope of the present invention,
Needless to say.

[0055]

As is clear from the above description, in the blood purification system according to the present invention, in order to protect the life of the patient when the blood pressure of the patient undergoing blood purification decreases.
Only those that need to be treated for such a decrease in blood pressure can be dealt with more appropriately, and thus the blood purification operation of the patient can be performed more efficiently and with a minimum work load. It can be carried out safely.

[Brief description of drawings]

FIG. 1 is a system diagram showing an example of a blood purification system according to the present invention.

[Explanation of symbols]

10 dialyzer 12 blood supply flow path 14 blood return flow path 16 blood pump 18 dialysate supply flow path 20 dialysate discharge flow path 22 dialysate flow device 24 control device 26 blood flow measurement device 28 probe 30 main body 32 headband 34 alarm device

Continued front page    F-term (reference) 4C017 AA08 AA11 AB06 AC23 BC11                       CC02 DD14 FF30                 4C077 AA05 BB01 DD15 EE01 EE02                       EE03 HH03 HH13 HH15 HH18                       JJ02 JJ03 JJ04 JJ13 JJ14                       JJ20 JJ24 KK30 LL01 NN01                       NN14 PP29                 4C301 AA03 DD01 DD02 DD09 DD30                       EE13 EE19 GA01 JB22 JB27                       JB50 LL17                 4C601 DD03 DD06 DD30 DE01 EE11                       EE16 GA01 JB34 JB35 JB40                       JB60 LL17

Claims (8)

[Claims] 1. A system for purifying blood of a patient by dialysis and / or filtration, which is provided on a blood circuit in which the blood is circulated, and the blood flows in through a dialysate flow path. The dialysate to be flowed out is contacted through a semipermeable membrane, and dialysis and / or
Alternatively, a dialyzer for performing a filtering operation, a dialysate flow device for performing inflow of the dialysate into the dialyzer and outflow of the dialysate from the dialyzer through the dialysate flow path, and a head of the patient. At least one of the blood flow rate of the artery that feeds blood and the blood flow rate of the artery that allows the blood fed to the head to flow into the brain, during dialysis and / or filtration operation of the blood in the dialyzer, A blood purification system comprising: a blood flow rate measuring means that is non-invasively determined. 2. The blood flow rate measuring means detects the blood flow velocity of at least one of the arteries by an ultrasonic Doppler method, and based on the blood flow velocity detected by the detector. The blood purification system according to claim 1, further comprising: a calculation unit that calculates a blood flow rate of at least one of the arteries. 3. A measuring unit for measuring the change in energy of pulsation of an artery that feeds blood to the head of the patient during the dialysis and / or filtration operation of the blood in the dialyzer. And an estimation unit that estimates the amount of change in the blood flow rate of the artery from the amount of change in energy measured by the measurement unit, and during the dialysis and / or filtration operation of blood in the dialyzer, The blood purification system according to claim 1, wherein the blood flow rate of the artery is determined relative to the blood flow rate at the start of the operation based on the amount of fluctuation estimated by the estimation unit. . 4. An informing means is further provided for automatically informing when the value obtained by the blood flow rate measuring means falls below a preset limit value. The blood purification system according to any one of 1. 5. When the value obtained by the blood flow rate measuring means falls below a preset limit value, the dialysate circulation device adjusts the value of the dialysate so that the value is returned to the limit value or more. The control device for controlling the inflow amount to the dialyzer and the outflow amount from the dialyzer, and / or the circulation amount of the blood in the blood circuit is further provided. The blood purification system according to any one of claims. 6. When the value obtained by the blood flow rate measuring means falls below a preset limit value, fluid replacement for the patient is automatically started so as to restore the value to the limit value or more. The blood purification system according to claim 1, further comprising a fluid replacement device. 7. A dialysate having a high Na concentration is added to the dialysate so that when the value obtained by the blood flow rate measuring means falls below a preset limit value, the value is returned to the limit value or more. The blood purification system according to any one of claims 1 to 6, further comprising a supply unit that automatically supplies the flow path. 8. The blood pressure measuring means is further provided for automatically measuring the blood pressure of the patient when the value obtained by the blood flow measuring means falls below a preset limit value. The blood purification system according to claim 7.