JP2006238915A - Peritoneal dialysis apparatus and method and program for controlling the same - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a peritoneal dialysis apparatus which allows a patient to automatize dialysis treatment, has clear and easy operability, has excellent precision in flow control, and performs dialysis treatment in the most optimum condition, and also to provide a method and a program for controlling the same. <P>SOLUTION: The peritoneal dialysis apparatus performs dialysis by supplying dialysis fluid into the peritoneal cavity of the patient at a predetermined flow rate and collecting the used dialysis fluid as drainage. The peritoneal dialysis apparatus comprises a dialysis fluid container containing the dialysis fluid, a drainage container for receiving the used dialysis fluid, a fluid supplying means for supplying the dialysis fluid from the dialysis fluid container to the drainage container, an electromagnetic flow rate measuring means for measuring the flow rate of the dialysis fluid supplied by the fluid supplying means by generating a magnetic field, and a flow rate control means for controlling, on the basis of the flow rate of the dialysis fluid measured by the electromagnetic flow rate measuring means, the supply amount of the dialysis fluid to the peritoneal cavity of the patient and/or the draining amount of the used dialysis fluid from the peritoneal cavity of the patient by the fluid supplying means. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to a peritoneal dialysis apparatus that allows a patient to perform dialysis at home (at home) or the like and a control method thereof.

  The peritoneal dialysis method (Continuous Ambulatory Peritoneal Dialysis, also referred to as “CAPD”) is easy to return to society because patients can exchange dialysate containers (bags) at home or at work. Yes.

  In this CAPD, a catheter tube (peritoneal catheter) is placed in the peritoneum of a patient, a transtube is connected to the outer end of the catheter tube, and a bag tube of a dialysate bag (injection bag) containing dialysate therein. The dialysate in the bag is injected into the peritoneum through each tube, and after dialyzing for a predetermined time, the dialysate drainage in the peritoneum is collected in the drainage bag through each tube. The tubes are connected aseptically by fitting male and female connectors respectively attached to the ends of both tubes.

  By the way, in this CAPD, the dialysate is injected into the peritoneum by placing the dialysate bag at a position about 1 m higher than the patient's abdomen. To the abdomen). Further, in the recovery of the dialysate drainage from the peritoneum, the drainage bag is placed at a position about 1 m lower than the patient's abdomen, and the dialysate is transferred from the peritoneum to the drainage bag due to its ease.

  On the other hand, in such a dialysate infusion and drainage method, for example, when the patient performs peritoneal dialysis while sleeping, the patient is put to a position about 70 to 100 cm above the floor using a bed, It is necessary to set the dialysate bag at a position about 1 m higher than the patient. For this reason, the height of the entire apparatus is about 2 m, which is difficult to handle and transport, and may cause the apparatus to fall over when a sleeping patient turns over. Furthermore, there is a drawback that the sleeping position (height) of the patient cannot be freely selected in order to ensure a head required for drainage.

  In order to compensate for such drawbacks, a peritoneal dialysis apparatus has been proposed that automates injection and drainage and is not subject to restrictions on the installation height of the dialysate and drainage bag. For example, according to the peritoneal dialysis apparatus described in Patent Document 1, the valve is opened and closed by a valve actuator, and the flow path of the disposable cassette is switched at the time of selection. A disposable cassette in which a pump part (diaphragm) for feeding peritoneal dialysate and a heating part are integrally formed is described in Patent Document 2. This cassette is heated from both sides, and is configured such that the heated peritoneal dialysis fluid is sent into the abdominal cavity of the patient by two pump parts (diaphragms).

In these peritoneal dialysis apparatuses, the amount of the injected peritoneal dialysis solution is measured, and when a predetermined amount of solution is reached, the pump is stopped and the injection is terminated. The amount of the peritoneal dialysis solution injected is measured by measuring in advance the amount of liquid delivered by a single press of the pump at a predetermined temperature and integrating the amount by the number of pump presses.
Japanese Patent No. 3113887 JP 11-347115 A

  However, in the measurement of the injection volume with the above-mentioned peritoneal dialysis machine, the pumping volume is calculated according to Boyle-Charle's law in the process of moving the diaphragm membrane by compressing and decompressing the outside air with a pump. However, when the temperature of the dialysate is different from the outside air in the process of compressed air pushing the membrane, heat exchange occurs between the liquid and the compressed air, which reduces the accuracy of the measured injection volume. There's a problem.

  In this way, if the measured injection volume is significantly different from the actual injection volume, the pump may be stopped even though it has not reached the volume that must be injected, or the predetermined volume has already been reached. However, the liquid injection is continued, and in such a case, the effect of peritoneal dialysis itself may be reduced and a situation may occur.

  The present invention has been made in view of such a situation, and it is possible to automate dialysis treatment by the patient himself. Further, the operability is extremely clear and easy to understand. It is intended to provide a peritoneal dialysis apparatus capable of performing dialysis treatment and a control method thereof.

  In order to solve the above-described problems, a peritoneal dialysis apparatus according to the present invention supplies dialysate into a patient's abdominal cavity at a predetermined flow rate and performs dialysis by collecting used dialysate as drainage. A dialysate container filled with dialysate; a drainage container for collecting used dialysate; and the dialysate container as a starting point or the drainage container as an end point. A liquid feeding means for feeding the liquid, an electromagnetic flow measuring means for measuring the flow rate of the dialysate fed by the liquid feeding means while generating a magnetic field, and a flow rate of the dialysate measured by the electromagnetic flow measuring means And a liquid volume control means for controlling the amount of dialysate injected into the abdominal cavity of the patient and / or the drainage volume of the used dialysate from the abdominal cavity of the patient by the liquid feeding means, It is characterized by providing.

  Here, the electromagnetic flow rate measuring means includes a flow rate measuring tube in which an electrode is incorporated and a terminal is exposed, and the dialysate passes through the flow rate measuring tube while the magnetic field is applied. Potential detection means for detecting a potential difference generated between the electrodes, and flow rate conversion means for converting the potential difference into a flow rate are provided.

  The electromagnetic flow rate measuring means includes a loading unit for loading the flow rate measuring tube. The flow rate measuring tube is detachable and discarded after use.

  Furthermore, the flow rate of the dialysate is an average flow rate within a unit time, and the liquid volume control means calculates a total injection volume based on the average flow rate within the unit time and reaches a set injection volume Then, the liquid injection operation by the liquid feeding means is stopped. The liquid amount control means stops the draining operation by the liquid feeding means when the average flow rate within the unit time is less than a predetermined amount.

  As the liquid feeding means, any of a diaphragm pump, a roller pump, a peristaltic pump, and a vacuum pump is used.

  A method for controlling a peritoneal dialysis device according to the present invention is a method for controlling a peritoneal dialysis device that performs dialysis by supplying dialysate into the abdominal cavity of a patient at a predetermined flow rate and collecting used dialysate as drainage. A dialysate container filled with dialysate, or a drainage container for collecting used dialysate as an end point, a liquid feeding step for feeding the dialysate, and generating a magnetic field. While measuring the flow rate of the dialysate to be sent in the liquid feeding step, and based on the flow rate of the dialysate measured in the electromagnetic flow measurement step, the patient in the liquid feeding step And a liquid volume control step of controlling a volume of dialysate injected into the abdominal cavity and / or a drainage volume of the used dialysate from the abdominal cavity of the patient.

  The electromagnetic flow rate measuring step detects a potential difference generated between the electrodes when the dialysate passes through a flow rate measuring tube in which an electrode is incorporated and a terminal is exposed while the magnetic field is applied. It is characterized by comprising a potential detection step and a flow rate conversion step for converting this potential difference into a flow rate.

  In addition, the peritoneal dialysis apparatus includes a loading unit for loading the flow rate measuring tube, and the flow rate measuring tube is detachable and discarded after use.

  Furthermore, the flow rate of the dialysate is an average flow rate within a unit time, and the liquid volume control step calculates a total injection volume based on the average flow rate within the unit time and reaches a set injection volume The liquid injection operation in the liquid feeding step is stopped. The liquid amount control step stops the draining operation in the liquid feeding step when the average flow rate within the unit time is less than a predetermined amount.

  In the liquid feeding step, the liquid feeding operation is performed by any of a diaphragm pump, a roller pump, a peristaltic pump, and a vacuum pump.

  Furthermore, the control program according to the present invention is a control program for controlling a peritoneal dialysis device that performs dialysis by supplying dialysate into the abdominal cavity of a patient at a predetermined flow rate and collecting used dialysate as drainage. A program for executing a liquid feeding step of feeding the dialysate from a dialysate container filled with dialysate or from a drainage container for collecting used dialysate as an end point A code, a program code for executing an electromagnetic flow rate measuring step for measuring a flow rate of the dialysate fed in the liquid feeding step while generating a magnetic field, and a dial code for the dialysate measured in the electromagnetic flow rate measuring step Based on the flow rate, in the liquid feeding step, a liquid amount control step of controlling the amount of dialysate injected into the abdominal cavity of the patient and / or the amount of drainage of the used dialysate from the abdominal cavity of the patient Characterized in that it comprises a program code for performing.

  Here, the program code for executing the electromagnetic flow rate measuring step is such that the dialysate passes through the flow rate measuring tube in which an electrode is incorporated and a terminal is exposed while the magnetic field is applied. Program code for executing a potential detection step for detecting a potential difference generated between the electrodes, and program code for executing a flow rate conversion step for converting the potential difference into a flow rate.

  The flow rate of the dialysate is an average flow rate within a unit time, and the program code for executing the liquid volume control step calculates and sets the total injection volume based on the average flow rate within the unit time. A program code for stopping the liquid injection operation in the liquid feeding process when the liquid injection amount is reached is included. The program code for executing the liquid amount control step stops the liquid discharge operation in the liquid supply step when the average flow rate within the unit time is less than a predetermined amount. Program code for.

  Other features of the present invention will become apparent from the following description of the best mode for carrying out the invention and the accompanying drawings.

  According to the present invention, it is possible to automate dialysis treatment by the patient himself / herself, and the operability is very clear and easy to understand, and the flow rate control accuracy is excellent, and dialysis treatment can be performed under optimum conditions.

  Below, the peritoneal dialysis apparatus of this invention is demonstrated in detail based on suitable embodiment shown to an accompanying drawing. It should be noted that the configuration of each embodiment described below is merely an example, and it goes without saying that the technical scope of the present invention is not limitedly interpreted.

<Appearance and usage of peritoneal dialysis machine>
First, FIG. 1 shows a tube 9 in which a peritoneal dialysis apparatus 1 according to an embodiment of the present invention, a cassette body 2, a plurality of dialysis bags 5 in which dialysate is stored, a spare bag 7, and a drainage bag 6 are connected. The external perspective view which showed the connection state which forms the flow path connected to a patient's abdominal cavity by connecting with the plugs 8a-8j provided in, and sends dialysate into the abdominal cavity 4 (broken line illustration) of a patient. is there.

  In this figure, the peritoneal dialysis device 1 is provided with a cassette body 2 for the peritoneal dialysis device that is detachably attached to the dialysis device 1. The peritoneal dialysis device 1 includes an opening 300 for mounting the cassette body 2 from the front, a lid member 301 that is fixed so as to cover the opening 300 by being rotated, a display unit 23, and the start of treatment. It has a start switch 24a for performing an operation and a stop switch 24b for performing a treatment stop operation.

  The shape and color of the operation unit 24a and the operation unit 24b are different from each other so that they can be easily distinguished from each other. One projection is formed on the operation unit 24a and two projections are formed on the operation unit 24b. Has been. Further, in order to prevent erroneous operation, the operation unit 24a and the operation unit 24b are spaced apart as illustrated with the display unit 23 interposed therebetween.

  The display unit 23 is composed of, for example, a touch panel provided with an LED, a liquid crystal display panel, and the like, and displays various information necessary for dialysis by a pressing operation of the touch panel and performs an operation instruction of the apparatus together with a voice guide. This ensures operability and convenience.

  The peritoneal dialysis device 1 has a main base and a sub-base as attachment bases, and each of the illustrated resin covers is provided, and the main base and the sub-base are made of an aluminum metal plate having a thickness of 1 to 2 mm. Furthermore, weight reduction is achieved by drilling large holes everywhere. A lightweight resin cover is fixed to each of these bases. Further, for example, a memory card having a storage capacity of 100 megabytes or more is provided so as to be able to be loaded into the card reader shown by the broken line from the back of the device. It is configured to make changes quickly.

  Further, a shield plate (not shown) is movably provided on the front side of the right side surface of the peritoneal dialysis device 1 so that the cassette body 2 is moved to the arrow direction by preventing mechanical interference with the tube 9 of the cassette body 2. It can be set in the loading position by moving in the direction.

  On the other hand, the cassette body 2 includes a cassette body main body 81 that is detachable from the cassette body mounting portion, a lower main body frame 811 that is continuously formed from the main body 81 of the cassette body 2, and a gap 86 from the lower main body frame 811. And an upper main body frame 812 provided so as to face each other.

  Further, the main body 81 of the cassette body 2 is integrally formed with diaphragms 20 and 21, which are actuated parts of the liquid feeding means, a heating part 60 and a flow path switching part as shown in the figure.

  On the other hand, six dialysis bags 5 having a volume of around 3500 ml are connected to the tube 9 via plugs 8a to 8f, and a pair of holes are formed with respect to a pair of hooks 3f provided on the stand 3 as shown in the figure. It is set in a suspended state by inserting the part 5k. As a result, the dialysate is supplied through the tube 9 connected to the bottom surface of the volume portion of each dialysis bag 5, and the used dialysate can be collected as will be described later.

  The stand 3 is provided between a base member 3c, left and right support members 3a and 3a which are provided upright from the back side of the base member 3c and bent toward the front side, and the support members 3a and 3a. The horizontal bar member 3b is fixed, and a pair of hooks 3f fixed below the horizontal bar member 3b. Further, as shown in the figure, the stand 3 has a height of the hook 3f for suspending the dialysis bag 5 and the spare bag 7, and adds the length of the tube and the plug to the vertical dimension of each bag. The tube and the plug are configured to be vertical as shown in the figure.

  Further, the base member 3c of the stand 3 has a sufficiently large area so that the drainage bag 6 can be placed on the side, and a fixing portion having sufficient mechanical strength for fixing the supporting members 3a and 3a vertically. Forming.

<Configuration of peritoneal dialysis machine>
Next, FIG. 2 forms a flow path that communicates with the abdominal cavity of a patient by connecting a plurality of dialysis bags storing a dialysate, a spare bag, and a drainage bag to the peritoneal dialysis apparatus 1 of FIG. It is the schematic diagram made into the connection state to do.

  If similar components that have already been described in the figure are given the same reference numerals and omitted, the drainage bag 6 is connected to the tube 9h using the plug 8h. Here, for the plugs 8h to 8j, the state after the connection is illustrated, and in the state before the connection, one of the plugs and the other of the plugs are in separate states and are illustrated by being connected. It becomes a state. Further, one end of a clamp 10h constituting the flow path switching means is connected to the tube 9h, and a tube 9k serving as a common flow path is connected to the other end of the clamp 10h.

  Moreover, the dialysis bag 5a set to the state suspended as shown in FIG. 1 is connected to the tube 9a using the plug 8a. One of the clamps 10a constituting the flow path switching means is connected to the tube 9a, and the tube 9k serving as a common flow path is connected to the other of the clamps 10a.

  Similarly, dialysis bags 5b-5f are connected to tubes 9b-9f using plugs 8b-8f. One of the clamps 10b to 10f constituting the channel switching means is connected to these tubes 9b to 9f, and the tube 9k serving as a common channel is connected to the other of these clamps 10b to 10f.

  Further, the spare bag 7 set in a suspended state as shown in FIG. 1 is connected to the tube 9g using a plug 8g. One of the clamps 10g constituting the flow path switching means is connected to the tube 9g, and the tube 9k serving as a common flow path is connected to the other of the clamps 10g.

  Each of these clamps 10h to 10g and clamps 10k, 10m, 10n, 10p, 10q, and 10j described later are built in a cassette body 2 shown by a one-dot chain line in the drawing, and the peritoneal dialysis device 1 is loaded with the cassette body 2 The tube 9 is closed by a cam mechanism which will be described later in a state of being loaded in the position, and each clamp functions so as to be opened by returning to the original state by an elastic force.

  As described above, the tube 9k to which the drainage bag, the spare bag, and the dialysis bag are connected via the plug and the clamp is joined to the tube 19 by the T-shaped tube. In addition, a bubble sensor 14a is provided so as to surround the tube 19, and by detecting a large bubble flowing into the tube 19, when there is a mixture of bubbles, the fact is notified and the operation is stopped. This prevents air bubbles from entering the abdominal cavity.

  From the middle of the tube 19, a tube 29 connected to the clamp 10k is branched through a T-shaped tube. A diaphragm 20 is connected to the tube 29, and a clamp 10 m is connected to the diaphragm 20. A meandering flow path serving as the heating unit 60 is connected from the clamp 10m, and the heating unit 60 is sandwiched from above and below by the surface heaters 91, 92, and 93 so that the temperature rises in a short time. It is configured. The temperature of each surface heater 91, 92, 93 is monitored by the temperature sensor 13, and the temperature is controlled so that each heater has an appropriate temperature.

  Temperature sensors 12A and 12B are provided upstream and downstream of the heating unit 60, detect the temperature of the dialysate whose temperature has been increased by the heating unit 60, and control the temperature together with the temperature sensor 13 described above. A feedback system is configured to maintain the dialysate at a temperature close to body temperature.

  A clamp 10n is connected to the outlet of the heating unit 60, and a tube 59 is connected to the clamp 10n. The tube 39 and the tube 49 are branched from the middle of the tube 59, the clamp 10 p is connected to the tube 39, and the tube 39 is connected so as to return to the tube 29. A clamp 10q is connected to the tube 49 branched from the middle of the tube 59, and is connected so as to return to the tube 19 through the diaphragm 21.

  A clamp 10j is connected to the tube 59, and a tube 9m is connected to the clamp 10j. The clamp 9j is connected to the abdominal cavity 4 of the patient via a plug 8j connected to the tube 9m. In the middle of the tube 9m, an electromagnetic flow meter 17 and a bubble sensor 14b for detecting bubbles are provided. In addition, the apparatus 1 is provided with an outside air temperature sensor 16b that detects the outside air temperature. Furthermore, a clamp (not shown) for opening and closing each tube is provided everywhere to prevent liquid leakage during setting.

  Here, as a constituent material of each bag, tube and heating unit, and diaphragm, a soft resin material is used. Examples of the soft resin material include polyolefins such as polyethylene, polypropylene, ethylene-propylene copolymer, ethylene-vinyl acetate copolymer (EVA), polyvinyl chloride, polyvinylidene chloride, polystyrene, polyamide, polyimide, poly- (4-methylpentene-1), ionomer, acrylic resin, polyester such as polyethylene terephthalate (PET), polybutylene terephthalate (PBT), styrene, polyolefin, polyvinyl chloride, polyurethane, polyester, polyamide And various other thermoplastic elastomers, silicone resins, polyurethanes, and the like, and copolymers, blends, polymer alloys, etc. mainly composed of these, and combinations of one or more of these (for example, two layers) As a laminate of the upper) it can be used.

  In addition, although each said diaphragm 20, 21 can perform liquid feeding with the air circuit described in detail in Unexamined-Japanese-Patent No. 2003-000704, it is not limited to this but acts on the outer peripheral surface of a tube. It may be a peristaltic type that performs a peristaltic motion, or a roller pump type.

<Circuit configuration of peritoneal dialysis machine>
Next, FIG. 3 is a block diagram showing a circuit configuration of the peritoneal dialysis apparatus 1. The control system 15 which is a control means in this figure includes a CPU 150 and a storage unit 152. The CPU 150 includes a clamp control unit 153 for controlling opening and closing of the plurality of clamps 10a to 10q, and a plurality of surfaces. A heater control unit 154 for controlling the temperatures of the heaters 91, 92, and 93 and a pumping operation control unit 155 for controlling the pumping operation unit 10 that is a liquid feeding unit are electrically connected. The CPU 150 is connected to the temperature sensors 12A and 12B, the temperature sensor 13 for each heater, the display unit 23, and the operation units 24a and 24b. The bubble sensors 14 a and 14 b are connected to the CPU 150 via the bubble sensor unit 14.

  The CPU 150 is electrically connected to a power supply circuit 156, a battery circuit 157, a sound generation circuit 400, and a cassette body loading control unit 301 for controlling the cassette body loading means 300. The display unit 23 is electrically connected to a card reader 203 that can be loaded with the memory card.

  Further, the electromagnetic flow meter 17 and the outside air temperature sensor 16 are also connected to the CPU 150. As will be described later, the electromagnetic flow meter 17 is provided to measure the amount of injected dialysate, and can accurately measure the flow rate regardless of the temperature of the dialysate.

  According to the control system 15, when the temperature measured by the temperature sensor 12A is equal to or higher than a predetermined temperature of 39 ° C., the clamp control unit 153 controls the clamp to perform the clamp state and the unclamp state. In addition, the heater control unit 154 controls the energization of the surface heaters 91, 92, and 93.

  Moreover, the output value of each surface heater 91, 92, 93 is selected based on the temperature of the dialysate. That is, the control system 15 controls the temperature of the dialysate to be injected within a predetermined temperature range based on the temperature measured by the temperature sensor 12A and the temperature measured by the temperature sensor 12B. The energization control to each surface heater 91, 92, 93 is performed.

  Then, the clamp control unit 153 which is a flow path switching unit switches each clamp to a clamped state and an unclamped state as described later, thereby allowing the used dialysate stored in the abdominal cavity of the patient for a predetermined time to be fed. To send to each bag.

  Specifically, a first liquid-feeding state in which a used dialysate stored in the abdominal cavity of a patient for a predetermined time is sent to the drainage bag 6 and a dialysate stored in one of the dialysis bags are supplied. The liquid is fed to the spare bag 7 by the means, the second liquid feed state is heated by the warming means and accumulated in the spare bag 7, and the dialysate is sent from the spare bag 7 to the abdominal cavity 4 of the patient by the liquid feed means. For example, after the third liquid feeding state for storing the liquid in the abdominal cavity of the patient for a predetermined time and after the third liquid feeding state, the liquid feeding unit emptied the second liquid feeding state. The flow path is switched to the fourth liquid supply state in which the used dialysate is supplied to the dialysis bag 5a.

<Configuration of electromagnetic flow meter 17>
The configuration of the electromagnetic flow meter 17 will be described with reference to FIGS. FIG. 4 shows an external configuration of the disposable unit 171 constituting a part of the electromagnetic flow meter, and FIG. 5 shows a block diagram of the electromagnetic flow measurement unit 172. The electromagnetic flow meter 17 is composed of two parts, a disposable part 171 composed of two parallel plate electrodes and a flow tube for detecting a flow rate in a disposable part (disposal cassette) through which dialysate is passed, and an electromagnetic flow rate measuring part 172. When used as a dialysis device, the disposable part 171 is inserted into the device so that the electrode of the device and the electrode protruding from the flow tube are brought into contact with each other.

  4A is a view of the disposable part 171 as viewed from above, FIG. 4B is a view of the disposable part 171 as viewed from the front, and FIG. 4C is a view of the disposable part 171 as viewed from the side.

  As shown in FIG. 4, the disposable part 171 includes a rectangular flow tube 1710, electrodes 1713 and 1714 embedded in the tube, and exposed terminals 1711 and 1712. A dialysate is passed through the rectangular flow tube 1710 and connected to the patient's abdominal cavity through other tubes, plugs and pumps (see FIG. 1). Then, the amount of dialysate that has passed through the rectangular flow tube 1710 is measured. This part (disposable part 171) is discarded after being used once due to sanitary problems. When the dialysate passes through the rectangular flow tube 1710, a voltage is generated by an applied magnetic field and is output from terminals 1711 and 1712 as described later.

  5 includes an amplifier 1721 that amplifies the voltage supplied from the disposable unit 171 attached to the loading unit 173, an A / D converter 1722 that converts the amplified voltage value to a digital value, It comprises a CPU 1723 for controlling the operation of the entire measurement unit, a coil 1725 for generating a static magnetic field, and a constant current circuit 1724 for generating a current (alternating current or direct current) flowing through the coil 1725. By making the current generated by the constant current circuit 1724 an alternating current, polarization in the electrode can be prevented.

  At the time of treatment, the disposable part 171 (cassette) is loaded onto the loading part 173. As a result, the loading unit 173 of the electromagnetic flowmeter unit 172 and the terminals 1711 and 1712 of the disposable unit 171 come into contact with each other, and electrical communication is possible.

  The CPU 1723 reports the measurement result (flow velocity) of the flow rate measured continuously based on the voltage value detected from the flow rate of the dialysate flowing through the flow tube to the CPU 15 on the automatic peritoneal dialysis device side. Needless to say, the CPU 15 of the peritoneal dialysis apparatus can also serve as the operation of the CPU 1723.

  The constant current circuit 1724 creates a current that flows through the coil 1725. When the switch of the constant current circuit 1724 is turned on and the magnetic flux density B is created, the coil 1725 generates a static magnetic field perpendicular to the flow tube and the two parallel plate electrodes. Then, the voltage generated between the electrodes according to the flow velocity in the flow tube is amplified by the amplifier 1721, and the value N digitized by the A / D converter 1722 is read by the CPU 1723. At that time, there is a relationship of flow rate V [mL / min] = C × N [V], and A / D value N multiplied by proportionality constant C is flow velocity V. The measurement results are reported to the CPU 15 continuously or periodically.

  On the other hand, the CPU 15 of the peritoneal dialysis device calculates the amount of liquid that has been injected or drained at that time based on the following formula by adding the flow velocity V reported at a constant time interval ΔT. Can do.

Volume [mL] = Σ (V ・ △ T)
^{0 → N}
<Dialysis fluid injection operation>
FIG. 6 is a flowchart for explaining the operation when the dialysate is injected. This operation is controlled by the CPU 15 unless otherwise specified.

  In step S101, the flow path is switched to the injection clamp pattern. This ensures a flow path for injecting dialysate from the dialysis bag into the peritoneum.

  In step S102, the injection amount (measured value) of the electromagnetic flow meter 17 is initialized to 0 ml. This prepares the liquid injection.

  In step S103, pump operation is started for liquid injection, and liquid injection starts.

  In step S104, it is determined whether or not the liquid injection volume measured so far has reached a preset liquid injection volume. Here, since the injection volume is measured by the ammeter 17 as described above, it is not affected by the temperature change of the injected dialysate. The set liquid injection amount is a predetermined liquid injection amount set from, for example, an input device. In step S104, when the measured liquid injection amount is equal to or larger than the set liquid injection amount, the process proceeds to step S105. When the measured liquid injection amount is smaller than the set liquid injection amount, the process proceeds to step S108.

  In step S105, since the measured liquid injection amount has reached the set liquid injection amount, the operation of the liquid injection pump is stopped. In step S106, the clamps are all closed from the injection pattern.

  Further, in step S107, the liquid injection amount is left as a treatment record, and the liquid injection process is completed.

  On the other hand, if the measured injection volume is smaller than the set injection volume at step S104, the current flow velocity V is read from the electromagnetic flow meter 17 at every predetermined period ΔT at step S108. The liquid amount is updated, and the process returns to step S104.

  As described above, the injection operation is controlled while accurately measuring the injection volume, so that the effect of dialysis can be sufficiently secured, and the amount of dialysate to be injected into the patient can be accurately and accurately. Since it can be injected reliably, it does not impose an extra physical burden.

<Dialysis fluid draining action>
FIG. 7 is a flowchart for explaining the operation when the dialysate is drained. Note that this operation is also controlled by the CPU 15 unless otherwise specified.

  In step S201, the flow path is switched to the drainage clamp pattern. As a result, a flow path for taking out the used dialysate accumulated in the peritoneum is secured.

  In step S202, the pump operation is started for drainage, and drainage starts.

  In step S203, the injection amount (measured value) of the electromagnetic flow meter 17 is initialized to 0 ml. This prepares for drainage.

In step S204, the current flow velocity V is read from the electromagnetic flow meter 17 at a predetermined period ΔT. In step S205, the drainage amount is updated (drainage amount _{this time} = drainage amount _{last time} + V · ΔT), and the process proceeds to step S206.

  In step S206, it is determined whether or not the flow velocity V is less than 2 ml. If it is smaller, the process proceeds to step S207 as it is, and if it is more than that, the process returns to step S204.

  In step S207, it is determined that the liquid has been sufficiently drained because the flow velocity V is less than 2 ml, and the pump operation for draining is stopped. In step S208, all the clamps are closed from the draining pattern.

  Further, in step S209, the drainage amount is left as a treatment record, and the drainage process is terminated.

  As described above, the drainage operation is controlled while accurately measuring the drainage volume, so that the effect of dialysis can be sufficiently ensured, and the amount of dialysate to be discharged to the patient can be accurately and Since it can be discharged reliably, there is no physical burden.

  In the present invention, a storage medium in which a program code of software that realizes the functions of the embodiments is recorded is provided to a system or apparatus, and a computer (or CPU or MPU) of the system or apparatus is stored in the storage medium. It is also achieved by reading and executing the program code. In this case, the program code itself read from the storage medium realizes the functions of the above-described embodiments, and the storage medium storing the program code constitutes the present invention. As a storage medium for supplying such a program code, for example, a floppy (registered trademark) disk, hard disk, optical disk, magneto-optical disk, CD-ROM, CD-R, magnetic tape, nonvolatile memory card, ROM Etc. can be used.

  Further, by executing the program code read by the computer, not only the functions of the above-described embodiments are realized, but also an OS (operating system) running on the computer based on the instruction of the program code Includes a case where the function of the above-described embodiment is realized by performing part or all of the actual processing.

  Furthermore, after the program code read from the storage medium is written to the memory provided in the function expansion board inserted into the computer or the function expansion unit connected to the computer, the function is based on the instruction of the program code. This includes the case where the CPU of the expansion board or function expansion unit performs part or all of the actual processing, and the functions of the above-described embodiments are realized by the processing.

  Further, the program code of the software that realizes the functions of the above embodiments is distributed via a network, so that it can be stored in a storage means such as a hard disk or memory of a system or apparatus or a storage medium such as a CD-RW or CD-R Needless to say, this can also be achieved by the computer (or CPU or MPU) stored in the system or apparatus reading and executing the program code stored in the storage means or the storage medium.

It is a figure which shows the external appearance and use condition of the peritoneal dialysis apparatus 1 which is one Embodiment of this invention. 1 is a schematic view showing a connection state in which a plurality of dialysis bags storing a dialysate, a spare bag, and a drainage bag are connected to each other using a plug to form a channel communicating with the abdominal cavity of a patient. It is. 1 is a block diagram of a peritoneal dialysis device 1. FIG. 2 is an external view of a disposable part 171 that constitutes a part of an electromagnetic flow meter 17; 3 is a block diagram showing a configuration of an electromagnetic flow rate measuring unit 172. FIG. 4 is a flowchart for explaining an operation during injection in the peritoneal dialysis device 1. 4 is a flowchart for explaining an operation during drainage in the peritoneal dialysis device 1.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Peritoneal dialysis apparatus 2 Cassette body 3 Stand 4 Abdominal cavity 5a-5f Dialysis bag 6 Drainage bag 7 Spare bag 8a-8j Plug 9 Tube 10a-10q Clamp 17 Electromagnetic flowmeter 19, 29, 39, 49, 59 Tube 20, 21 Diaphragm 60 heating part

Claims (16)

A peritoneal dialysis device for dialysis by supplying dialysate into the abdominal cavity of a patient at a predetermined flow rate and collecting used dialysate as drainage,
A dialysate container filled with dialysate;
A drainage container for collecting used dialysate;
A liquid feeding means for feeding the dialysate from the dialysate container as a starting point or the drainage container as an end point;
Electromagnetic flow rate measuring means for measuring the flow rate of the dialysate sent by the liquid feeding means while generating a magnetic field;
Based on the flow rate of the dialysate measured by the electromagnetic flow rate measuring means, the amount of dialysate injected into the abdominal cavity of the patient and / or the spent from the abdominal cavity of the patient by the liquid feeding means. Fluid volume control means for controlling the amount of dialysate drainage;
A peritoneal dialysis device comprising:   The electromagnetic flow rate measuring means includes a flow rate measuring tube in which an electrode is incorporated and a terminal is exposed, and the dialysate passes between the electrodes by passing the flow rate measuring tube while the magnetic field is applied. The peritoneal dialysis apparatus according to claim 1, further comprising: a potential detection unit that detects a potential difference that is generated; and a flow rate conversion unit that converts the potential difference into a flow rate.   The peritoneal dialysis apparatus according to claim 2, wherein the electromagnetic flow measuring means includes a loading unit for loading the flow measuring tube, and the flow measuring tube is detachable. The flow rate of the dialysate is an average flow rate within a unit time,
The liquid volume control means calculates the total liquid injection volume based on the average flow rate within the unit time, and stops the liquid injection operation by the liquid feed means when the set liquid injection volume is reached. The peritoneal dialysis apparatus according to any one of claims 1 to 3. The flow rate of the dialysate is an average flow rate within a unit time,
4. The liquid volume control unit according to claim 1, wherein when the average flow rate within the unit time is less than a predetermined amount, the liquid flow control unit stops the drain operation by the liquid feeding unit. The peritoneal dialysis apparatus described in the item.   The peritoneal dialysis apparatus according to any one of claims 1 to 5, wherein the liquid feeding means is any one of a diaphragm pump, a roller pump, a peristaltic pump, and a vacuum pump. A method for controlling a peritoneal dialysis apparatus that performs dialysis by supplying dialysate into the abdominal cavity of a patient at a predetermined flow rate and collecting used dialysate as drainage,
A liquid feeding step of feeding the dialysate, starting from a dialysate container filled with dialysate, or a drainage container for collecting used dialysate;
An electromagnetic flow rate measuring step for measuring the flow rate of dialysate sent in the liquid feeding step while generating a magnetic field;
Based on the flow rate of the dialysate measured in the electromagnetic flow rate measuring step, the amount of dialysate injected into the patient's abdominal cavity and / or the spent from the abdominal cavity of the patient in the liquid feeding step. A liquid volume control process for controlling the amount of dialysate drainage;
A method for controlling a peritoneal dialysis device. The electromagnetic flow measurement step includes
While applying the magnetic field, a potential detection step of detecting a potential difference generated between the electrodes by passing the dialysate through a flow rate measuring tube in which an electrode is incorporated and a terminal is exposed;
A flow rate conversion step for converting this potential difference into a flow rate;
The control method of the peritoneal dialysis apparatus of Claim 7 characterized by the above-mentioned. The peritoneal dialysis device includes a loading unit for loading the flow rate measuring tube,
The method for controlling a peritoneal dialysis device according to claim 7, wherein the flow rate measuring tube is detachable. The flow rate of the dialysate is an average flow rate within a unit time,
The liquid volume control step calculates the total liquid injection volume based on the average flow rate within the unit time, and stops the liquid injection operation in the liquid transfer process when the set liquid injection volume is reached. The method for controlling a peritoneal dialysis device according to any one of claims 7 to 9. The flow rate of the dialysate is an average flow rate within a unit time,
10. The liquid volume control process according to claim 7, wherein when the average flow rate within the unit time is less than a predetermined amount, the liquid discharge operation in the liquid feeding process is stopped. The control method of the peritoneal dialysis apparatus as described in the paragraph.   The peritoneal dialysis device according to any one of claims 7 to 11, wherein in the liquid feeding step, a liquid feeding operation is performed by any of a diaphragm pump, a roller pump, a peristaltic pump, and a vacuum pump. Control method. A control program for controlling a peritoneal dialysis device that performs dialysis by supplying dialysate into the abdominal cavity of a patient at a predetermined flow rate and collecting used dialysate as drainage,
A program code for executing a liquid feeding step of feeding the dialysate, starting from a dialysate container filled with dialysate, or starting from a drainage container for collecting used dialysate,
A program code for executing an electromagnetic flow rate measuring step for measuring a flow rate of dialysate sent in the liquid feeding step while generating a magnetic field;
Based on the flow rate of the dialysate measured in the electromagnetic flow rate measuring step, the amount of dialysate injected into the patient's abdominal cavity and / or the spent from the abdominal cavity of the patient in the liquid feeding step. A program code for executing a liquid volume control process for controlling the amount of dialysate drainage;
A control program for a peritoneal dialysis device. The program code for executing the electromagnetic flow measurement step is:
In order to execute a potential detection step of detecting a potential difference generated between the electrodes as the dialysate passes through the flow rate measuring tube in which the electrode is built in and the terminal is exposed while the magnetic field is applied. Program code,
Program code for executing a flow rate conversion process for converting this potential difference into a flow rate,
The control program for the peritoneal dialysis device according to claim 13. The flow rate of the dialysate is an average flow rate within a unit time,
The program code for executing the liquid volume control step calculates the total liquid injection amount based on the average flow rate within the unit time, and performs the liquid injection operation in the liquid supply step when the set liquid injection amount is reached. 15. The control program for a peritoneal dialysis device according to claim 13 or 14, comprising a program code for stopping. The flow rate of the dialysate is an average flow rate within a unit time,
The program code for executing the liquid amount control step is characterized in that when the average flow rate within the unit time is less than a predetermined amount, the liquid discharge operation in the liquid supply step is stopped. 15. The control program for a peritoneal dialysis device according to claim 13 or 14, comprising a program code.

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