JP2005087610A - Blood purifying device and method of autotransfusion - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a blood purifying device and a method of autotransfusion for the autotransfusion by reversely rotating a blood pump while reversely filtrating a dialysis solution, capable of preventing the thrombosis attached to a filtrating means of an artery side drip chamber from returning into the body of a patient, improving the workability without requiring the change of connection, and preventing the structure from becoming so complicated that management of circuits is necessary. <P>SOLUTION: The dialysis device can autotransfuse the blood left in an artery side blood circuit 3 including the artery side drip chamber 8 and a vein side blood circuit 4 inside a hollow fiber membrane to the patient by reversely rotating the blood pump 5 and discharging the reversely filtrated dialysis solution from a dialyzer 1. The device also has a four-way valve 10 in the artery side blood circuit 3 to make the blood stream at the time of dialysis treatment in the artery side drip chamber 8 and make the residual blood and dialysis solution stream at the time of autotransfusion in the same direction. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

  The present invention relates to a blood purification apparatus in which an arterial drip chamber is connected to an arterial blood circuit and a blood return method.

  Generally, at the time of dialysis treatment, a blood circuit for circulating the collected patient's blood extracorporeally and returning it to the body is used. Such a blood circuit is, for example, a dialyzer (blood purification means) having a hollow fiber membrane. It is mainly composed of an arterial blood circuit and a venous blood circuit that can be connected to each other. For example, in a double-needle blood circuit, an arterial puncture needle and a venous puncture needle are connected to the tips of an arterial blood circuit and a venous blood circuit, respectively, which are punctured by a patient and used for blood extracorporeal in dialysis treatment Circulation will take place.

  Among these, the arterial blood circuit is provided with a squeezed blood pump, and by driving the blood pump, blood is sent from the patient's body to the dialyzer side, while the arterial blood circuit and the venous blood are supplied. An arterial drip chamber and a venous drip chamber are connected to the circuit so that blood is returned to the patient's body after slow foaming. Specifically, these drip chambers have a storage space in which an air layer is formed in the upper part and a liquid layer (a part where blood has accumulated) is formed in the lower part, and temporarily stores the blood flowing through the blood circuit. The filter means is formed so as to be gradually bubbled by being exposed to the air layer, and usually a filtering means made of a mesh or the like is formed in order to capture foreign substances or the like in the blood before being discharged from the drip chamber.

  By the way, the blood pump is stopped at the end of the dialysis treatment, but since the patient's blood remains in the blood circuit, dialyzer, arterial drip chamber, venous drip chamber, etc. Blood return work is required to return to In such blood return operation, for example, as disclosed in Patent Document 1, the blood pump is driven in the opposite direction to that during dialysis treatment while the dialysate is back-filtered from the dialysate flow path of the dialyzer to the blood flow path. By replacing the dialyzed solution that has been reverse-filtered with the residual blood, the residual blood has been returned to the patient's body from the arterial puncture needle and the venous side puncture needle.

  However, in the above blood return method, the dialysate is back-filtered in the state of dialysis treatment (that is, the state where each of the arterial puncture needle and the venous side puncture needle is punctured into the patient), so the arterial blood The residual blood returned from the circuit will flow in the opposite direction to that during dialysis treatment. Therefore, there is a possibility that thrombus or the like attached to the filtering means in the artery-side drip chamber peels off from the filtering means and flows into the patient's body. The prior art relating to such blood return will be referred to as a first conventional example.

  On the other hand, as disclosed in Patent Document 2, for example, a connecting member is provided between the venous drip chamber and the dialyzer, and the tip of the arterial blood circuit is connected to the connecting member during blood return work. However, it has also been proposed that the blood pump is driven in the opposite direction to that during dialysis treatment to replace the reversely filtered dialysate with residual blood. According to this blood return method, the back-filtered dialysate flows in the direction opposite to that during dialysis treatment in the arterial blood circuit, and adheres to the filtering means in the arterial drip chamber as in the first conventional example. However, the thrombus that has flowed by the filtering means of the arterial drip chamber can be captured and passed into the patient's body. Can be avoided. The prior art relating to such blood return will be referred to as a second conventional example.

Further, for example, as disclosed in Patent Document 3, a bypass circuit that connects the vicinity of the tip of the arterial blood circuit and the venous drip chamber is provided, and the flow paths are opened near the tip of the artery side blood circuit and the bypass circuit, respectively. Or what provided the opening-and-closing means to interrupt has been proposed. According to such a dialysis device, the open / close means on the arterial blood circuit side is opened while closing the open / close means on the bypass circuit side, and the blood pump is rotated forward to perform normal dialysis treatment. The open / close means on the arterial blood circuit side is closed while opening the open / close means on the bypass circuit side, the dialysate passing through the arterial blood circuit is bypassed by reversely filtering the dialysate from the dialyzer and reversing the blood pump. Residual blood was configured to return to the patient's body from the tip of the venous blood circuit via the circuit and venous drip chamber. The prior art relating to such blood return will be referred to as a third conventional example.
JP 2001-259024 A JP 2001-252352 A JP 2001-61959 A

  However, the conventional blood return method has the following problems. That is, in the first conventional example, as described above, there is a possibility that the thrombus etc. that flowed away from the filtering means of the arterial drip chamber may be returned to the patient's body, and in the second conventional example, Although the flowed thrombus and the like can be captured by the filtering means of the drip chamber on the venous side, it is necessary to reconnect the tip of the arterial blood circuit to the connecting member when returning the blood, and workability deteriorates. There was a problem.

  In addition, when blood is returned after dialysis treatment, the connection work to the connection member at the tip of the arterial blood circuit is required, so that the blood return time becomes longer and quick blood return work is performed. There was a risk of hindrance. If the blood return time becomes longer, the residual blood will increase in contact time with each component (inner wall of the blood circuit, etc.) and may solidify and become a thrombus. This is because of the need to return blood quickly after extracorporeal circulation.

  On the other hand, in the third prior art, the switching between the dialysis treatment and the blood return operation is performed by opening and closing the opening / closing means, so that a quick blood return operation can be performed. Since it is necessary to provide a relatively long bypass circuit extending from the vicinity of the distal end to the venous drip chamber, the circuit becomes complicated, and it is necessary to arrange the bypass circuit so that it does not get entangled with the blood circuit. . Also, when actually used in dialysis treatment etc., it is necessary to fill the priming solution in the bypass circuit in advance, but the priming solution in the bypass circuit should also be returned to the patient's body when returning blood. There was a problem.

  The present invention has been made in view of such circumstances, and even in the case of returning blood by driving the blood pump while reversely filtering the dialysate, thrombus or the like attached to the filtering means of the arterial drip chamber It is possible to avoid returning to the patient's body, to improve workability by eliminating the need to change connections, and to avoid the complexity of the configuration that requires circuit handling. An object is to provide a blood purification apparatus and a blood return method.

  The invention according to claim 1 is a blood purification means in which a blood flow path through which a patient's blood flows and a dialysate flow path through which a dialysate flows are formed via a blood purification film for purifying blood, and the blood purification means An arterial blood circuit for feeding blood from the patient's body to the blood purification means by driving the blood pump, and the blood purification means An arterial blood circuit connected to the blood flow path outlet for returning the blood purified by the blood purification means to the body of the patient, and an artery connected to the artery side blood circuit and provided with a filtering means A side drip chamber and a dialysate introduction line and a dialysate discharge line connected to the inlet and outlet of the dialysate flow path of the blood purification means, and after the blood purification treatment, the dialysate is reverse-filtered from the dialysate path Do Both of the blood pumps are driven to discharge the back-filtered dialysate from the inlet and outlet of the blood flow path, respectively, so that the blood flow path of the blood purification means, the arterial blood circuit including the arterial drip chamber, and In a blood purification apparatus capable of returning blood remaining in a venous blood circuit to a patient's body, the direction of blood flowing in the arterial drip chamber during blood purification treatment and the residual flowing in the arterial drip chamber during blood return The arterial blood circuit is provided with flow direction changing means for making the flow directions of blood and dialysate the same.

  According to a second aspect of the present invention, in the blood purification apparatus according to the first aspect, the flow direction changing means comprises a four-way valve, and after the blood purification treatment is completed, a switching operation is performed, whereby the arterial drip chamber The direction in which residual blood and dialysate flow when returning blood is the same as that during blood purification treatment.

  According to a third aspect of the present invention, there is provided a blood purification means in which a blood flow path through which a patient's blood flows and a dialysate flow path through which a dialysis fluid flows are formed via a blood purification membrane for purifying blood, and the blood purification means An arterial blood circuit for feeding blood from the patient's body to the blood purification means by driving the blood pump, and the blood purification means An arterial blood circuit connected to the blood flow path outlet for returning the blood purified by the blood purification means to the body of the patient, and an artery connected to the artery side blood circuit and provided with a filtering means After blood purification treatment with a blood purification apparatus comprising a side drip chamber and a dialysate introduction line and a dialysate discharge line connected to the inlet and outlet of the dialysate passage of the blood purification means, From Including the blood flow path of the blood purification means and the arterial drip chamber by reversely filtering the analysis solution and driving the blood pump to discharge the back-filtered dialysate from the inlet and the outlet of the blood flow path, respectively. In a blood return method for returning blood remaining in an arterial blood circuit and a venous blood circuit to a patient's body, the direction of blood flowing in the arterial drip chamber during blood purification treatment, and the arterial drip during blood return The residual blood flowing in the chamber and the dialysate flow direction are the same.

  According to the first and third aspects of the present invention, even in the case where the blood pump is driven to return blood while reversely filtering the dialysate, thrombus or the like adhering to the filtering means of the arterial drip chamber is in the patient's body. In addition to being able to avoid returning, it is possible to improve workability by eliminating the need to change the connection, etc., and to prevent the configuration from becoming so complex that circuit handling becomes necessary.

  According to the invention of claim 2, by switching the four-way valve after blood purification treatment is completed, the direction of blood flowing in the arterial drip chamber during blood purification treatment and the arterial drip during blood return Since the flow direction of the residual blood flowing in the chamber and the dialysate is the same, the operability at the time of returning blood can be further improved, and the residual blood that still remains after returning blood is almost eliminated. Can do.

Hereinafter, embodiments of the present invention will be specifically described with reference to the drawings.
The blood purification apparatus according to the first embodiment is composed of a dialysis treatment apparatus used during dialysis treatment. As shown in FIG. 1, a dialyzer 1 (blood purification means), a dialysis apparatus body 2, and an artery Side blood circuit 3, vein side blood circuit 4, blood pump 5, artery side puncture needle 6, vein side puncture needle 7, artery side drip chamber 8, vein side drip chamber 9, and flow direction changing means The arterial puncture needle 6 and the venous puncture needle 7 are punctured into the patient's artery and vein, respectively, and purified by the dialyzer 1 while circulating the patient's blood extracorporeally. To do.

  The dialyzer 1 includes a blood introduction port 1 a connected to one end of the arterial blood circuit 3, a blood outlet port 1 b connected to one end of the venous blood circuit 4, and a dialysate introduction line L 1 extending from the dialyzer body 2. A dialysate discharge port 1d connected to a dialysate introduction port 1c connected to the dialysate discharge line L2 extending from the dialyzer body 2 is formed, and a plurality of hollow fiber membranes 1e (blood purification membranes) are formed therein. ) Is arranged. The inside of the hollow fiber membrane 1e is connected to the blood introduction port 1a and the blood outlet port 1b to form a blood flow path through which the patient's blood flows, and outside the hollow fiber membrane 1e and inside the housing. Is connected to the dialysate introduction port 1c and the dialysate discharge port 1d, and forms a dialysate passage 1f through which the dialysate supplied from the dialyzer body 2 flows via the dialysate introduction line L1.

  Further, since the hollow fiber membrane 1e has a plurality of micropores (pores), blood passes through the blood channel (inside the hollow fiber membrane 1e) and dialysate passes through the dialysate channel 1f. In addition, it is configured such that unnecessary substances (waste materials) and a predetermined amount of water in the blood can be removed by dialysis to the dialysate side through the hollow fiber membrane 1e. The dialysis machine main body 2 supplies the dialysate prepared at a predetermined concentration to the dialyzer 1 via the dialysate introduction line L1, and the dialysate passing through the dialysate flow path 1f via the dialysate discharge line L2. Can be introduced. Thereby, the blood of the patient circulated extracorporeally can be purified.

  As described above, the venous blood circuit 4 has one end connected to the blood outlet port 1b of the dialyzer 1 and the other end attached with a venous puncture needle 7 to be purified by the dialyzer 1. The blood is returned to the patient's body. In addition, a venous drip chamber 9 is connected in the middle, and slow bubbles are applied in the venous drip chamber 9. The vein-side drip chamber 9 has the same configuration as the artery-side drip chamber 8 described later in detail, and a mesh 9a (filtering means) for capturing foreign substances such as thrombus is formed inside. Yes.

  As described above, one end of the arterial blood circuit 3 is connected to the blood introduction port 1a of the dialyzer 1, and the arterial puncture needle 6 is attached to the other end. Further, an iron-type blood pump 5 is disposed in the middle, and an arterial drip chamber 8 and a four-way valve 10 are connected to each other. Of these, the blood pump 5 can be driven in the forward direction in the direction of arrow a shown in FIGS. 1 and 2 and can be driven in the reverse direction in the direction of arrow b shown in FIG. 3. Sometimes it is controlled to drive in reverse.

  As shown in FIG. 2, the arterial drip chamber 8 forms an upper air layer S and a lower liquid layer L in the internal space during dialysis treatment, and the blood constituting the liquid layer L is the air in the air layer S. It is comprised so that a slow bubble may be given by exposing to. In addition, the air layer S side (side wall portion) of the artery side drip chamber 8 is formed with an introduction portion 8b for introducing the blood of the patient during dialysis treatment, while the liquid layer L side (bottom surface portion) The lead-out part 8c for leading the patient's blood is formed. And in the derivation | leading-out part 8c, the mesh 8a (filtering means) for catching foreign materials, such as a thrombus, is formed similarly to the vein side drip chamber 8.

  The four-way valve 10 is used to make the direction in which blood flows during dialysis treatment (during blood purification treatment) in the arterial drip chamber 8 and the direction in which residual blood and dialysate flow during return of blood flow substantially the same. An open end 10a and an open end 10b of one flow path, and an open end 10c and an open end 10d of the other flow path are formed on the four side surfaces of the casing. That is, as shown in the figure, these open end portions 10a and 10b and open end portions 10c and 10d are connected to form two flow paths, and the flow of blood and dialysate is allowed in each flow path. It has come to be.

  During dialysis treatment, blood is introduced into the arterial blood circuit 3 from the arterial puncture needle 6 punctured by the patient by driving the blood pump forward in the direction a. The introduced blood first enters from the open end 10a of the four-way valve 10 and exits from the open end 10b, and then enters the arterial drip chamber 8 from the introducer 8b. Then, after being temporarily stored as the liquid layer L and subjected to slow foaming, it passes through the mesh 8a to reach the open end 10d of the four-way valve 10 from the outlet 8c, and the blood in the dialyzer 1 through the open end 10c. It will flow in the hollow fiber membrane 1e as a blood channel from the introduction port 1a. Here, when the patient's blood passes through the mesh 8a, a foreign substance such as a thrombus is captured on the surface side of the mesh 8a and adheres thereto.

  Thereafter, as described above, the blood is purified by the dialyzer 1, and the purified blood flows from the blood outlet port 1b through the venous blood circuit 4 (including the venous drip chamber 9), thereby venous puncture. It returns to the patient's body through the needle 7. When the series of dialysis treatments as described above is completed, the blood pump 5 is stopped to stop the extracorporeal circulation of blood. In this state, the arterial blood circuit 3 including the arterial drip chamber 8 and the dialyzer 1 are stopped. Since the blood of the patient remains in the venous blood circuit 4 including the hollow fiber membrane 1e and the venous drip chamber 9, a blood return operation for returning the residual blood to the patient is performed after the dialysis treatment.

  Before starting the blood return operation, the four-way valve 10 in the state of FIG. 2 is rotated in the right direction (in the direction of the white arrow) in FIG. After such a switching operation, a flow path as shown in FIG. 3 is formed. In this state, for example, the dialysate flow path is supplied by blocking the dialysate discharge line L2 with a clamp or the like. The dialysate is press-fitted into 1f and back-filtered into the hollow fiber membrane 1e. That is, during dialysis treatment, waste and water are filtered from blood flowing in the hollow fiber membrane 1e into the dialysate flow channel 1f, whereas during blood return work, the dialysate flow channel 1f enters the hollow fiber membrane 1e. The dialysate is filtered (reverse filtration).

  At the same time, the reversely filtered dialysate flows to the arterial blood circuit 3 in addition to the venous blood circuit 4 by driving the blood pump 5 in the reverse direction in the direction b. The dialysate that has flowed to the venous blood circuit 4 side passes through the venous drip chamber 9 to the venous puncture needle 7 and is replaced with residual blood in the venous blood circuit 4 and venous drip chamber 9. The residual blood is returned to the patient's body through the venous puncture needle 7. Since the flow of the dialysate is the same as the direction of blood flow during dialysis treatment, thrombus or the like attached to the mesh 9a of the venous drip chamber 9 does not flow to the patient side.

  On the other hand, the reversely filtered dialysate flowing toward the arterial blood circuit 3 reaches the introduction part 8b of the arterial drip chamber 8 via the opening end 10d and the opening end 10c of the four-way valve 10 and flows down from there. A liquid layer L is formed and flows out from the outlet 8c. The dialysate flowing out from the lead-out portion 8c enters the open end portion 10a of the four-way valve 10 and flows out from the open end portion 10b, and flows to the arterial puncture needle 6. Therefore, the residual blood in such a path is passed into the patient's body. Can return blood. That is, by operating the four-way valve 10, the flow direction of dialysate and residual blood flowing through the arterial drip chamber 8 is the same as the direction of blood flow during dialysis treatment (inflow from the introduction portion 8b and lead-out portion 8c). Outflow).

  Therefore, compared to the conventional case where the reversely filtered dialysate flows in the arterial drip chamber 8 in the direction opposite to that during dialysis treatment, foreign matters such as thrombus adhering to the mesh 8a are returned to the patient together with the residual blood. The trouble can be avoided. In addition, since it is possible to eliminate the need to change the connection of the arterial blood circuit 3, it is possible to improve workability when returning blood. At the same time, it is possible to quickly return blood by improving workability at the time of returning blood, and it is possible to surely avoid a problem that residual blood is solidified.

  Further, it is not necessary to previously form a bypass circuit extending from the arterial blood circuit to the venous blood circuit as in the prior art, and it can be avoided that the configuration becomes so complicated that the circuit needs to be routed. In addition, since a conventional bypass circuit is unnecessary, the priming solution filled in the bypass circuit is not returned to the patient's body when returning blood. Furthermore, after the dialysis treatment (blood purification treatment) is finished, the direction of the flow of residual blood and dialysate when returning blood in the arterial drip chamber 8 is changed during the dialysis treatment (blood purification) by switching the four-way valve. Therefore, the operability at the time of returning blood can be further improved, and residual blood that still remains after returning blood can be almost eliminated.

Next, a second embodiment according to the present invention will be described.
The blood purification apparatus according to this embodiment is composed of a dialysis treatment apparatus used during dialysis treatment, as in the first embodiment, and operates the four-way valve 10 as a flow direction changing means to return the artery side when returning blood. The flow direction of the dialysate flowing through the drip chamber 8 and the residual blood is the same as the flow direction of blood during dialysis treatment, but the blood pump 10 is located at the position (four-way valve 10 shown in FIGS. And the introduction portion 8b of the artery side drip chamber 8). The venous blood circuit 4 has the same configuration as that shown in FIG. 1, and the same components as those in the first embodiment are denoted by the same reference numerals, and detailed description thereof is omitted.

  In such a configuration, during dialysis treatment, blood is introduced into the arterial blood circuit 3 from the arterial puncture needle 6 punctured by the patient by driving the blood pump 10 to rotate forward in the direction a. The introduced blood enters from the opening end 10a of the four-way valve 10 and exits from the opening end 10b, reaches the artery drip chamber 8 from the introduction 8b, and then forms a liquid layer L in the artery drip chamber 8. Temporarily stored and gradually bubbled, it flows from the blood introduction port 1a of the dialyzer 1 through the mesh 8a into the hollow fiber membrane 1e as a blood channel. Here, when the patient's blood passes through the mesh 8a, a foreign substance such as a thrombus is captured on the surface side of the mesh 8a and adheres thereto. The blood is purified by the dialyzer 1, and the purified blood flows from the blood outlet port 1 b through the venous blood circuit 4 (including the venous drip chamber 9) and passes through the venous puncture needle 7. It will return to the body.

  In order to perform the blood return operation after the dialysis treatment is completed, first, as in the first embodiment, the four-way valve 10 in the state of FIG. 4 is rotated rightward (in the direction of the white arrow) in FIG. Perform switching operation. After such a switching operation, a flow path as shown in FIG. 5 is formed. In this state, for example, the dialysate flow path is supplied by blocking the dialysate discharge line L2 with a clamp or the like. The dialysate is press-fitted into 1f and back-filtered into the hollow fiber membrane 1e. At the same time, the blood pump 5 is driven to rotate forward in the direction a, which is the same direction as during dialysis treatment, so that the reversely filtered dialysate flows to the arterial blood circuit 3 in addition to the venous blood circuit 4.

  The reversely filtered dialysate flowing toward the arterial blood circuit 3 side reaches the introduction portion 8b of the arterial drip chamber 8 via the opening end portion 10d and the opening end portion 10c of the four-way valve 10, and flows down from there. A liquid layer L is formed and flows out from the outlet 8c. The dialysate flowing out from the lead-out portion 8c enters the open end portion 10a of the four-way valve 10 and flows out from the open end portion 10b, and flows to the arterial puncture needle 6. Therefore, the residual blood in such a path is passed into the patient's body. Can return blood. Therefore, the flow direction of the dialysate and residual blood flowing through the artery-side drip chamber 8 can be the same as the direction of blood flow during dialysis treatment (inflow from the introduction portion 8b and outflow from the lead-out portion 8c). In addition, it is possible to avoid the problem that foreign matters such as thrombus attached to the mesh 8a are returned to the patient together with the residual blood. In addition, since it is possible to eliminate the need to change the connection of the arterial blood circuit 3, it is possible to improve workability when returning blood.

  Furthermore, by disposing the blood pump 5 at the position as in the present embodiment, the blood pump 5 is driven to rotate forward both during dialysis treatment and during blood return. Therefore, as in the first embodiment, during blood return. Compared with the pump that drives the blood pump 5 in the reverse direction, the switching operation of the driving direction can be eliminated, the workability can be further improved, and the blood pump 5 can only be driven in the forward direction (reverse rotation). Can be used).

  Furthermore, usually, the ironing portion in the blood pump 5 is a flexible tube (not shown) having a diameter larger than that of other tubes, and a step is formed in the connecting portion. Etc. may occur. In the present embodiment, a thrombus or the like that flows away from the step during blood return can be captured by the mesh 8a of the arterial drip chamber 8. Therefore, compared to that in the first embodiment, It is possible to more reliably avoid a thrombus or the like from flowing into the patient's body.

  The four-way valve as the flow direction changing means is not limited to the one having the above-described configuration, and may have another form. For example, as shown in FIGS. 6 to 9, a four-way valve 11 (flow direction changing means) having a bag body 11a made of a flexible member and a clamp means 11b that defines the bag body 11a in two flow paths. May be used. Specifically, the bag body 11a is connected to the arterial blood circuit 3 as shown in FIG. 6, and the bag body 11a is clamped as shown in FIG. By forward rotation, the patient's blood passes from the arterial puncture needle 6 to the introduction portion 8b of the arterial drip chamber 8 through the flow path on the right side of the bag 11a in FIG. 7, and the view of the bag 11a through the mesh 8a. After passing through the left-side channel 7, the blood flows into the dialyzer 1 from the blood introduction port 1 a.

  On the other hand, in order to return blood after dialysis treatment, the clamp by the clamp unit 11b is released and the clamp unit 11b is re-clamped as shown in FIG. After clamping in this way, as in the previous embodiment, the dialysate is press-fitted into the dialysate flow path 1f and back-filtered into the hollow fiber membrane 1e, and the blood pump 5 is driven to rotate forward. The dialysate flows together with the remaining blood in the arterial blood circuit 3 simultaneously with the venous blood circuit 4. That is, the dialysate and the residual blood that flowed out from the blood introduction port 1a reach the introduction part 8b of the arterial drip chamber 8 through the flow path on the upper side in FIG. 9 of the bag 11a, and pass through the mesh 8a to the bag 11a. After passing through the lower flow path in FIG. 9, the artery side puncture needle 6 reaches the patient's body.

  Moreover, you may make it use what is shown in FIG.10 and FIG.11 as a four-way valve (flow direction conversion means) of another form. The four-way valve 12 has, for example, a pair of rollers 12b and a tube 12c formed across the rollers 12b in a space in a resin casing 12a. Both ends of the tube 12c are used during dialysis treatment and blood return. Are in contact with the upper and lower surfaces (see FIG. 10) and the left and right surfaces (see FIG. 11) of the housing 12a to form different flow paths.

  Specifically, at the time of dialysis treatment, as shown in FIG. 10, the blood of the patient is guided from the artery side puncture needle 6 to the artery side blood circuit 3 by driving the blood pump 5 in the normal direction, and the blood is fed to the four-way valve 12. After passing through the right flow path in the figure and introducing into the arterial drip chamber 8 from the introduction part 8b, the left flow path in the figure of the four-way valve 12 is passed through the mesh 8a. Such blood is then introduced into the dialyzer 1 from the blood introduction port 1a. On the other hand, when the dialysis treatment is completed, the pair of rollers 12b and the tube 12c are rotated to form a flow path as shown in FIG. 11 in the housing 12a. Then, the blood pump 5 is driven forward again to perform the blood return operation. As described above, the reversely filtered dialysate and residual blood passed through the upper flow path of the four-way valve 12 in FIG. Then, it reaches the arterial drip chamber 8 from the introduction part 8b, and passes through the lower flow path in the figure of the four-way valve 12 through the mesh 8a. Thereafter, residual blood such as in the arterial blood circuit 3 is returned to the patient's body through the arterial puncture needle 6.

  Further, as shown in FIG. 12 and FIG. 13, a four-way valve (flow direction changing means) of another form may be used. As shown in FIG. 12, the four-way valve 13 includes an upper member 13a in which two open end portions 13ab and 13ac are formed, and a lower member 13b in which two open end portions 13bb and 13bc are similarly formed. The annular convex part 13ba formed in the upper part of the lower member 13b is fitted to the annular concave part 13aa formed in the lower part of the upper member 13a, and assembled as shown in FIG.

  With this configuration, the upper member 13a can be rotated with respect to the lower member 13b (rotation as indicated by an arrow in FIG. 13), and the open end portions 13ab and 13bb and the open end portion 13ac as shown in FIG. When the upper member 13a is rotated from the state where 13bc communicates, the opening end portions 13ac and 13bb and the opening end portions 13ab and 13bc can be switched to a communicated state. The four-way valve 13 is connected to the arterial blood circuit 3 as shown in FIG.

  At the time of dialysis treatment, the blood pump 5 is driven to rotate forward to introduce the patient's blood from the artery side puncture needle 6 into the artery side blood circuit 3. Specifically, the blood of the patient introduced from the arterial puncture needle 6 passes from the open end portion 13ac to 13bc of the four-way valve 13 and reaches the introduction portion 8b of the arterial drip chamber 8, and through the mesh 8a. After passing through the open end portions 13bb to 13ab of the four-way valve 13, the blood is introduced into the dialyzer 1 from the blood introduction port 1a. When the dialysis treatment is completed, the upper member 13a is rotated with respect to the lower member 13b to obtain the state shown in FIG.

  In this state, if the dialysate is reverse filtered while the blood pump 5 is driven to rotate forward, the dialysate and the residual blood pass from the open end 13ab to 13bc of the four-way valve 13 and the introduction of the arterial drip chamber 8 After reaching the portion 8b and passing through 13ac from the open end 13bb of the four-way valve 13 via the mesh 8a, the residual blood is returned to the patient's body via the arterial puncture needle 6. According to the four-way valve of this embodiment, the flow path can be switched with a simple configuration, the direction of blood flowing in the artery-side drip chamber 8 during dialysis treatment (during blood purification treatment), and the artery side during blood return The direction in which the residual blood flowing in the drip chamber 8 and the dialysate flow can be made the same.

Next, a third embodiment according to the present invention will be described.
As in the first and second embodiments, the blood purification apparatus according to the present embodiment is composed of a dialysis treatment apparatus used during dialysis treatment, and includes a dialyzer 1 (blood purification means), a dialysis apparatus body 2, and The arterial blood circuit 3, the venous blood circuit 4, the blood pump 5, the arterial puncture needle 6, the venous puncture needle 7, the arterial drip chamber 8, the venous drip chamber 9, and the flow direction. It is mainly composed of conversion means, and punctures the artery and vein of the artery side puncture needle 6 and the vein side puncture needle 7 respectively, and purifies the blood of the patient by the dialyzer 1 while circulating the patient extracorporeally. is there. In addition, the same code | symbol shall be attached | subjected to the component similar to previous embodiment, and the detailed description is abbreviate | omitted.

  As shown in FIGS. 16 and 17, the flow direction changing means of the present embodiment includes bypass lines L3 and L4 that connect the upstream side and the downstream side of the arterial drip chamber 8 in the arterial blood circuit 3, and these bypasses. Mainly composed of electromagnetic valves V3 and V4 disposed on the lines L3 and L4, and electromagnetic valves V1 and V2 disposed on the upstream side and the downstream side of the arterial drip chamber 8, respectively. Each of the solenoid valves V1 to V4 can open or close a part of the bypass lines L3 and L4 and the arterial blood circuit 3 (predetermined portions on the upstream side and the downstream side). As shown, the solenoid valves V1 and V2 are closed and the solenoid valves V3 and V4 are opened.

  In this state, blood is introduced into the arterial blood circuit 3 from the arterial puncture needle 6 punctured by the patient by driving the blood pump 5 to rotate forward (rotation drive in the direction a in FIG. 1). The introduced blood passes through the bypass line L3 and then reaches the introduction part 8b of the arterial drip chamber 8, flows down from there, forms a liquid layer L, is gradually bubbled, and is led out through the mesh 8a. Derived from the part 8c. After that, it passes through the bypass line L4 and passes through the hollow fiber membrane 1e from the blood introduction port 1a of the dialyzer 1, and the dialysis action as in the first embodiment is performed. The blood purified by dialysis flows through the venous blood circuit 4 including the venous drip chamber 9 and returns to the patient's body through the venous puncture needle 7.

  After the dialysis treatment is completed and the blood pump 5 is stopped, the blood return operation is performed according to the following procedure. That is, as shown in FIG. 17, the electromagnetic valves V3 and V4 are closed and the electromagnetic valves V1 and V2 are opened, and the blood pump 5 is operated while reversely filtering the dialysate by press-fitting dialysate from the dialyzer body 2. Reverse rotation drive (rotation drive in the direction b in the same figure) is performed. As a result, the dialysate flows through both the venous blood circuit 4 and the arterial blood circuit 3. In particular, in the arterial blood circuit 3, the bypass lines L3 and L4 are blocked by the electromagnetic valves V3 and V4. Therefore, the dialysate flowing out from the blood introduction port 1a flows down from the introduction part 8b into the arterial drip chamber 8, and flows out from the outlet part 8c through the mesh 8a.

  Thereafter, the dialysate that has flowed through reverse filtration reaches the arterial puncture needle 6 and is replaced with residual blood, whereby the residual blood can be returned to the patient's body. Here, since the flow of dialysate and residual blood in the arterial drip chamber 8 at the time of returning blood is in the same direction as at the time of dialysis treatment, foreign matters such as thrombus adhering to the mesh 8a are returned to the patient's body. The trouble can be avoided. The flow of dialysate and residual blood in the venous blood circuit 7 is the same as in the first embodiment.

  According to this embodiment, the flow path of blood, dialysate, and residual blood is changed by the selective opening and closing operation of the solenoid valve, and the flow direction during dialysis treatment and return of blood in the arterial drip chamber 8 is made the same. Therefore, it is possible to automatically switch between dialysis treatment and blood return work. Since the bypass lines L3 and L4 are relatively short flow paths connecting the upstream side and the downstream side of the arterial drip chamber 8 in the arterial blood circuit 3, the arterial blood circuit and the venous blood circuit as in the prior art are used. The configuration can be simplified compared to a bypass circuit or the like connecting a part of the circuit. In place of the electromagnetic valves V1 to V4, a medical staff such as a doctor may manually perform clamping means such as forceps for opening and closing the flow path.

  It should be noted that, instead of the one shown in FIGS. 16 and 17, between the end portion of the bypass line L3 (the junction portion with the line where the electromagnetic valve V1 is disposed) and the introduction portion 8b of the arterial drip chamber 8. A blood pump 5 may be provided. By disposing the blood pump 5 at the position, it is not necessary to change the driving direction of the blood pump 5 between dialysis treatment and blood return, as in the second embodiment, and the workability at the time of blood return is further improved. In addition to being able to improve, a thrombus or the like generated in a connection portion with a large-diameter flexible tube that is a covered portion of the blood pump 5 can be captured by the mesh 8a when returning the blood, It is possible to more reliably avoid blood clots and the like from flowing in.

Next, a fourth embodiment according to the present invention will be described.
As in the first to third embodiments, the blood purification apparatus according to the present embodiment is composed of a dialysis treatment apparatus used during dialysis treatment, and includes a dialyzer 1 (blood purification means), a dialysis apparatus body 2, The arterial blood circuit 3, the venous blood circuit 4, the blood pump 5, the arterial puncture needle 6, the venous puncture needle 7, the arterial drip chamber 8, the venous drip chamber 9, and the flow direction. It is mainly composed of conversion means, and punctures the artery and vein of the artery side puncture needle 6 and the vein side puncture needle 7 respectively, and purifies the blood of the patient by the dialyzer 1 while circulating the patient extracorporeally. is there. In addition, the same code | symbol shall be attached | subjected to the component similar to 1st Embodiment, and the detailed description is abbreviate | omitted.

  As shown in FIGS. 18 and 19, the flow direction changing means of the present embodiment has a first introduction portion 8 ba and a second introduction portion 8 bb formed on the air layer S side of the artery drip chamber 8. A first line L5 leading to the air layer S side of the side drip chamber 8, a second line L6 leading to the liquid layer L side, and a check valve disposed upstream of the arterial drip chamber 8 of the first line L5 C2, check valve C4 disposed on the downstream side, check valve C1 disposed on the upstream side of the arterial drip chamber 8 in the second line L6, and check valve disposed on the downstream side. It is mainly composed of a stop valve C3.

  When dialysis treatment is performed with the dialysis treatment apparatus having the above-described configuration, as shown in FIG. 18, the blood pump 5 is driven to rotate forward (rotation drive in the direction of FIG. Blood is introduced from the side puncture needle 6 into the arterial blood circuit 3. Since the check valve C1 is closed by the pressure and the second line L6 is closed, the introduced blood flows on the first line L5 side, and the check valve C2 (opened by the pressure of the blood flow). To the second introduction portion 8bb of the arterial drip chamber 8.

  The blood that has reached the second introduction part 8bb flows down in the arterial drip chamber 8, forms a liquid layer L, and flows out from the outlet part 8c via the mesh 8a. After that, it reaches the blood introduction port 1a of the dialyzer 1 through the check valve C3 (which is opened by the pressure of the blood flow), and passes through the hollow fiber membrane 1e, as in the first embodiment. Dialysis is performed. The blood purified by dialysis flows through the venous blood circuit 4 including the venous drip chamber 9 and returns to the patient's body through the venous puncture needle 7. The blood that has passed through the check valve C3 also flows to the check valve C4 side of the first line L5, but the check valve C4 is closed by the flowing pressure.

  After the dialysis treatment is completed and the blood pump 5 is stopped, the blood return operation is performed according to the following procedure. That is, as shown in FIG. 19, the blood pump 5 is reversely driven (rotation driven in the direction b in FIG. 19) while reversely filtering the dialysate by press-fitting the dialysate from the dialyzer body 2. As a result, the dialysate flows through both the venous blood circuit 4 and the arterial blood circuit 3. In particular, in the arterial blood circuit 3, the check valve C3 is caused by the pressure through which the dialysate and residual blood flow. Is closed, and therefore flows on the first line L5 side and reaches the first introduction portion 8ba of the arterial drip chamber 8 via the check valve C4.

  The dialysate and residual blood that have reached the first introduction portion 8ba flow down from there to form the liquid layer L of the arterial drip chamber 8, and then pass through the mesh 8a to the check valve C1 of the second line L6. It reaches. Since the check valve C1 is opened by the pressure of the flow of dialysate and residual blood, the dialysate and residual blood pass through the check valve C1 and reach the arterial puncture needle 6, thereby The blood return on the side blood circuit 3 side is completed. On the other hand, the dialysate and residual blood that have passed through the check valve C1 also flow to the first line L5 side, but the check valve C2 is closed by the pressure due to the flow, and the outflow beyond that is avoided. .

  Here, since the flow of dialysate and residual blood in the arterial drip chamber 8 at the time of returning blood is in the same direction as at the time of dialysis treatment, foreign matters such as thrombus adhering to the mesh 8a are returned to the patient's body. The trouble can be avoided. In addition, according to the present embodiment, the check valves C1 to C4 are used to selectively perform the flow of blood, dialysate, and residual blood, so that no separate control is required like an electromagnetic valve. The The flow of dialysate and residual blood in the venous blood circuit 7 is the same as in the previous embodiment.

  As mentioned above, although 1st-4th embodiment was described, this invention is not limited to these, A flow direction conversion means is formed in an arterial blood circuit, and blood at the time of dialysis treatment in an arterial drip chamber Other configurations may be used as long as the direction in which the blood flows and the direction in which the residual blood and dialysate flow when returning blood are the same. Further, instead of the mesh provided in the artery-side drip chamber, a filtering means having another configuration capable of capturing a foreign substance such as a thrombus may be used.

  In addition to the dialysis apparatus used at the time of dialysis treatment as in this embodiment, the present invention can be applied to other blood purification apparatuses equipped with blood purification means capable of purifying blood.

1 is an overall schematic view showing a blood purification apparatus according to a first embodiment of the present invention. It is a schematic diagram showing components (arterial drip chamber, four-way valve, blood pump, etc.) connected to the artery side blood circuit side, and shows a state at the time of dialysis treatment (at the time of blood purification) It is a schematic diagram showing components (arterial drip chamber, four-way valve, blood pump, etc.) connected to the artery side blood circuit side, and shows a state when returning blood FIG. 6 is a schematic diagram showing components (arterial drip chamber, four-way valve, blood pump, etc.) connected to the arterial blood circuit side in the blood purification apparatus according to the second embodiment of the present invention, during dialysis treatment ( Diagram showing the state of blood purification It is a schematic diagram showing components (arterial drip chamber, four-way valve, blood pump, etc.) connected to the artery side blood circuit side, and shows a state when returning blood Schematic diagram showing another form of four-way valve applied to the present invention (during dialysis treatment) VII-VII line sectional view in FIG. Schematic diagram showing another form of four-way valve applied to the present invention (when returning blood) IX-IX sectional view in FIG. Schematic diagram showing another form of four-way valve applied to the present invention (during dialysis treatment) Schematic diagram showing another form of four-way valve applied to the present invention (when returning blood) Exploded sectional view showing another form of four-way valve applied to the present invention Sectional drawing which shows the state which assembled | attached the four-way valve Schematic diagram showing the state in which the four-way valve is connected to the arterial blood circuit (during dialysis treatment) Schematic diagram showing the state of connecting the four-way valve to the arterial blood circuit (when returning blood) FIG. 9 is a schematic diagram showing components (arterial drip chamber, bypass line, solenoid valve, etc.) connected to the arterial blood circuit side in the blood purification apparatus according to the third embodiment of the present invention, during dialysis treatment ( Diagram showing the state of blood purification It is a schematic diagram showing components (arterial drip chamber, bypass line, electromagnetic valve, etc.) connected to the artery side blood circuit side, and shows a state when returning blood FIG. 10 is a schematic diagram showing components (arterial drip chamber, first line, second line, check valve, etc.) connected to the arterial blood circuit side in the blood purification apparatus according to the fourth embodiment of the present invention. The figure which shows the state at the time of dialysis treatment (at the time of blood purification) FIG. 4 is a schematic diagram showing components (arterial drip chamber, first line, second line, check valve, etc.) connected to the artery side blood circuit side, and shows a state when returning blood

Explanation of symbols

1 Dialyzer (blood purification means)
2 Dialyzer main body 3 Arterial blood circuit 4 Venous blood circuit 5 Blood pump 6 Arterial puncture needle 7 Venous puncture needle 8 Arterial drip chamber 8a Mesh (filtering means)
9 Vein side drip chamber 9a Mesh (filtering means)
10 Four-way valve (flow direction changing means)
11 Four-way valve (flow direction changing means)
12 Four-way valve (flow direction changing means)
13 Four-way valve (flow direction changing means)
L1 Dialysate introduction line L2 Dialysate discharge line L3, L4 Bypass line L5 First line L6 Second line V1 to V4 Solenoid valve C1 to C4 Check valve

Claims (3)

A blood purification means in which a blood flow path through which a patient's blood flows and a dialysate flow path through which a dialysate flows are formed through a blood purification membrane for purifying the blood;
An arterial blood circuit connected to the blood flow path inlet of the blood purification means, and a blood pump may be provided in the middle, and blood is sent from the patient's body to the blood purification means by driving the blood pump;
A venous blood circuit connected to the blood flow path outlet of the blood purification means and for returning the blood purified by the blood purification means to the patient's body;
An arterial drip chamber connected in the middle of the arterial blood circuit and provided with filtering means;
A dialysate introduction line and a dialysate discharge line connected to the dialysate flow path inlet and outlet of the blood purification means;
And after blood purification treatment, by reversely filtering the dialysate from the dialysate flow path and driving the blood pump to discharge the back-filtered dialysate from the inlet and the outlet of the blood flow path, respectively, In a blood purification apparatus capable of returning blood remaining in the blood flow path of the blood purification means, the artery side blood circuit including the artery side drip chamber, and the blood in the vein side blood circuit to the body of the patient,
The arterial blood circuit includes a flow direction changing means for making the direction of blood flowing in the arterial drip chamber during blood purification treatment the same as the direction of flow of residual blood and dialysate flowing in the arterial drip chamber during blood return. A blood purification apparatus comprising:   The flow direction changing means comprises a four-way valve, and after the blood purification treatment is completed, the direction of flow of residual blood and dialysate when returning blood in the arterial drip chamber is changed by performing a switching operation at the time of blood purification treatment. The blood purification apparatus according to claim 1, wherein the blood purification apparatus is the same. A blood purification means in which a blood flow path through which a patient's blood flows and a dialysate flow path through which a dialysate flows are formed through a blood purification membrane for purifying the blood;
An arterial blood circuit connected to the blood flow path inlet of the blood purification means, and a blood pump may be provided in the middle, and blood is sent from the patient's body to the blood purification means by driving the blood pump;
A venous blood circuit connected to the blood flow path outlet of the blood purification means and for returning the blood purified by the blood purification means to the patient's body;
An arterial drip chamber connected in the middle of the arterial blood circuit and provided with filtering means;
A dialysate introduction line and a dialysate discharge line connected to the dialysate flow path inlet and outlet of the blood purification means;
After blood purification treatment with a blood purification apparatus equipped with a blood purification device, the dialysate fluid is reverse-filtered from the dialysate flow channel and the blood pump is driven, so that the reversely filtered dialysate is respectively introduced from the inlet and the outlet of the blood channel. In the blood return method of returning the blood remaining in the blood flow path of the blood purification means, the arterial blood circuit including the arterial drip chamber, and the venous blood circuit to the patient's body by draining,
A blood return method characterized in that the direction of blood flowing in the arterial drip chamber during blood purification treatment and the direction of residual blood flowing in the artery drip chamber during return of blood and the direction of dialysate flow are the same.

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