JP2006255394A - Blood purifying apparatus, and its priming method - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a blood purifying apparatus, wherein the labor for cleaning and priming is reduced to improve workability, and a work time is shortened, and an artificial mistake is suppressed, and to provide its priming method. <P>SOLUTION: The blood purifying apparatus includes: an artery side blood circuit 1; a vein side blood circuit 2; blood circuits for externally circulating the blood of a patient; a dialyzer 3 arranged between the artery side blood circuit 1 and the vein side blood circuit 2, so as to purify the blood flowing in the blood circuits; and an anticoagulant injection line L2 branched from the blood circuit, and extended, so as to inject an anticoagulant to the blood circuits. The apparatus also comprises a connecting means 9 for connecting the distal ends of the artery and vein blood circuits 1, 2, so as to form a closing circuit, and connecting the distal end L2a of the anticoagulant injection line L2, so as to distribute a priming liquid even between the anticoagulant injection line L2 and the blood circuits. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to a blood purification apparatus for purifying a patient's blood while circulating outside the body, such as dialysis treatment using a dialyzer, and a priming method thereof.

  As shown in FIG. 7, the dialysis device as a blood purification device has an arterial blood circuit 101 in which an arterial puncture needle (not shown) is attached to the tip 101a, and a venous puncture needle (not shown) in the tip 102a. A blood circuit comprising a venous blood circuit 102, a dialyzer 103 interposed between the arterial blood circuit 101 and the venous blood circuit 102 to purify blood flowing through the blood circuit, and the arterial blood circuit 101. Blood pump 104, arterial drip chamber 105 and venous drip chamber 106 disposed in venous blood circuit 101 and venous blood circuit 102, respectively, and dialyser main body 108 capable of supplying dialysate to dialyzer 103 And is composed mainly of.

  Further, an anticoagulant injection line L2 is branched and extended from the middle of the arterial blood circuit 101 so that the anticoagulant can be injected into blood circulating outside the body during dialysis treatment. . Furthermore, a saline bag 107 containing a priming solution (saline) is connected between the tip 101a of the arterial blood circuit 101 and the blood pump 104 via a saline line L1, and washing before dialysis treatment is performed.・ Replacement fluid during priming and dialysis treatment can be performed.

  For example, at the time of washing and priming, the tip 101a of the arterial blood circuit 101 and the tip 102a of the venous blood circuit 102 before attaching the arterial puncture needle and the venous puncture needle are conventionally connected to, for example, a shunt connector cap or the like. Are connected to form a closed circuit, and the part A in the figure is clamped with forceps or the like to block the flow path. When the blood pump 104 is driven in such a state, the priming solution in the saline bag 107 reaches the anticoagulant injection line L2 through the arterial blood circuit 101 and is discharged from the tip of the anticoagulant injection line. Wash L2.

  Thereafter, the forceps and the like in part A are removed and the clamp is released, and the part B is clamped with forceps and the flow path is closed, so that the priming solution is fed from the branch of the anticoagulant injection line L2 in the arterial blood circuit 101. Also flows downstream and reaches the dialyzer 103 and the venous blood circuit 102. In this process, the priming solution overflowing the venous drip chamber 106 is discharged through the overflow line L3, filling the entire blood circuit with the priming solution, and the cleaning / priming is completed. In addition, since this prior art is not related to the literature known invention, there is no prior art document to be described.

  However, at the start of dialysis treatment, an arterial puncture needle and a venous puncture needle are attached to the distal end of the arterial blood circuit 101 and the venous blood circuit 102, puncture the patient, and then dialyze from the dialyzer body 108 to the dialyzer 103. By driving the blood pump 104 while supplying the liquid, the patient's blood is introduced into the blood circuit via the arterial puncture needle, purified and drained through the dialyzer 103, and then the venous puncture needle is removed. Through the patient's body. On the other hand, a syringe or the like is connected to the tip of the anticoagulant injection line L2, so that the anticoagulant can be injected into blood in the extracorporeal circulation process.

  However, in the above conventional blood purification apparatus, it is necessary to perform clamping work with forceps at the time of washing and priming, and it is necessary to switch the clamping position, so that excessive labor is required and workability is poor. It was. In addition, there is a problem that the anticoagulant injection line L2 and the blood circuit must be cleaned and primed separately, which increases the work time and easily causes human error. It was.

  The present invention has been made in view of such circumstances, and can reduce work during cleaning and priming to improve workability, reduce work time, and suppress human error. An object of the present invention is to provide a blood purification apparatus and a priming method thereof.

  The invention according to claim 1 comprises an arterial blood circuit in which an arterial puncture needle is attached to the tip and a venous blood circuit in which a venous puncture needle is attached to the tip, and from the arterial puncture needle to the venous puncture needle A blood circuit capable of extracorporeally circulating a patient's blood, blood purification means for purifying blood flowing between the arterial blood circuit and the venous blood circuit of the blood circuit, and the blood circuit; A blood purification apparatus comprising a branch line that extends and branches and can inject an anticoagulant or a drug solution into the blood circuit, and connects the tips of the arterial blood circuit and the venous blood circuit together to form a closed circuit And connecting means for connecting the tip of the branch line to allow the priming liquid to flow between the branch line and the blood circuit.

  According to a second aspect of the present invention, in the blood purification apparatus according to the first aspect, the connecting means includes a priming liquid flowing downstream from a branch point of the branch line in the blood circuit, and a priming liquid flowing through the branch line. An orifice capable of adjusting the flow rate is formed.

  According to a third aspect of the present invention, in the blood purification apparatus according to the first or second aspect, an antibacterial filter or a check valve is formed at a branch line connecting portion that can connect the tip of the branch line in the connecting means. It is characterized by.

  The invention according to claim 4 connects the tip of the arterial blood circuit and the tip of the venous blood circuit interposing the blood purification means to form a closed circuit, and a branch line branched from the blood circuit to the connection site The priming liquid is also circulated between the branch line and the blood circuit.

  The invention according to claim 5 is the priming method of the blood purification apparatus according to claim 4, wherein the flow rates of the priming liquid flowing downstream from the branch point of the branch line in the blood circuit and the priming liquid flowing through the branch line are determined. It is characterized by adjusting.

  According to invention of Claim 1 and Claim 4, while connecting the front-end | tip of an artery side blood circuit and a venous side blood circuit, a closed circuit is formed, the front-end | tip of a branch line is connected, and the said branch line and blood circuit Since the priming liquid can be circulated even between the two, the workability during cleaning and priming can be reduced, the workability can be improved, the working time can be shortened, and human error can be suppressed.

  According to the inventions of claim 2 and claim 5, since the flow rates of the priming liquid flowing downstream from the branch point of the branch line in the blood circuit and the priming liquid flowing through the branch line are adjusted, the diameter is usually relatively small. A sufficient amount of the priming liquid can also be circulated through the branch line such as the anticoagulant injection line, and the branch line can be reliably washed.

  According to the invention of claim 3, since the antibacterial filter or the check valve is formed at the branch line connecting portion that can connect the tip of the branch line in the connecting means, the tips of the arterial blood circuit and the venous blood circuit are connected to each other. In a state in which the tip of the branch line is removed from the branch line connection part while maintaining the state where the closed circuit is formed, foreign matters such as air and bacteria enter the connection means via the branch line connection part. Can be avoided.

Hereinafter, embodiments of the present invention will be specifically described with reference to the drawings.
The blood purification apparatus according to this embodiment includes a dialysis apparatus for performing dialysis treatment. As shown in FIG. 1, a blood circuit including an arterial blood circuit 1 and a venous blood circuit 2, and an arterial blood circuit 1. And a dialyzer 3 (blood purification means) interposed between the venous blood circuit 2 and purifying blood flowing through the blood circuit, a blood pump 4, an arterial drip chamber 5 and a venous drip chamber 6, and a branch line As an anticoagulant injection line L2, an overflow line L3, and a dialyzer body 8 capable of supplying dialysate to the dialyzer 3.

  The arterial blood circuit 1 has a distal end 1a to which an arterial puncture needle can be connected, and an iron-type blood pump 4 and an arterial drip chamber 5 for defoaming are disposed on the way. On the other hand, the venous blood circuit 2 has a tip 2a that can be connected to a venous puncture needle, and a venous drip chamber 6 connected to the venous blood circuit 2 in the middle. When the blood pump 4 is driven with the patient punctured with the arterial puncture needle and the vein puncture needle, the blood of the patient reaches the dialyzer 3 through the arterial blood circuit 1, and then the dialyzer 3. As a result, blood purification is performed, and bubbles are removed in the venous drip chamber 6 and returned to the patient's body through the venous blood circuit 2. That is, the patient's blood is purified by the dialyzer 3 while being circulated extracorporeally in the blood circuit.

  The dialyzer 3 is formed with a blood introduction port 3a, a blood outlet port 3b, a dialysate inlet port 3c, and a dialysate outlet port 3d in the casing. Among these, the blood inlet port 3a includes the arterial blood circuit 1. However, the venous blood circuit 2 is connected to the blood outlet port 3b. The dialysate introduction port 3c and the dialysate lead-out port 3d are connected to a dialysate introduction line La and a dialysate discharge line Lb extending from the dialyzer main body 8, respectively.

  A plurality of hollow fibers are accommodated in the dialyzer 3, the inside of the hollow fibers is used as a blood flow path, and the flow of dialysate is between the hollow fiber outer peripheral surface and the inner peripheral surface of the housing. It is considered a road. A hollow fiber membrane is formed in the hollow fiber by forming a large number of minute holes (pores) penetrating the outer circumferential surface and the inner circumferential surface, and impurities in the blood are passed through the membrane in the dialysate. It is comprised so that it can permeate | transmit.

  On the other hand, the dialyzer body 8 is provided with a water removal pump (not shown) for removing water from the blood of the patient flowing in the dialyzer 3, and one end of the dialysate introduction line La is connected to the dialyzer. 3 (dialysate introduction port 3c), and the other end is connected to a dialysate supply device (not shown) for preparing a dialysate having a predetermined concentration. One end of the dialysate discharge line Lb is connected to the dialyzer 3 (dialysate outlet port 3d), and the other end is connected to a waste fluid means (not shown), so that the dialysate supplied from the dialysate supply device is After reaching the dialyzer 3 through the dialysate introduction line La, the dialysate discharge line Lb is sent to the waste liquid means.

  Between the artery side puncture needle a and the blood pump 4 in the artery side blood circuit 1, a saline line L1 is extended, and a saline bag 7 containing a priming solution (saline) is connected to the tip thereof. At the same time, an overflow line L3 extends from the air layer (upper) side of the venous drip chamber 6. Further, an anticoagulant injection line L2 made of a tube having a smaller diameter than the tube constituting the blood circuit is branched and extended from between the blood pump 4 and the artery drip chamber 5 in the artery side blood circuit 1. . Such an anticoagulant injection line L2 is configured such that, during dialysis treatment, a syringe or the like is connected to the tip L2a so that the anticoagulant can be injected into the blood flowing through the blood circuit.

  Here, the dialysis apparatus (blood purification apparatus) according to the present embodiment includes the connecting means 9 for use during washing and priming. As shown in FIGS. 2 and 3, the connection means 9 includes an arterial side connection portion 9 a that can connect the distal end 1 a of the arterial blood circuit 1 and a venous connection that can connect the distal end 2 a of the venous blood circuit 2. It is comprised from the part 9b and the branch line connection part 9c which can connect the front-end | tip L2a of the anticoagulant injection line L2. The connecting means 9 comprises a conventional shunt connector cap formed with a branch line connecting portion 9c on the side surface, and reference numeral P in the drawing indicates a lid portion.

  More specifically, the arterial side connection portion 9a and the venous side connection portion 9b communicate with each other in a substantially straight line to form a flow passage, and the branch line connection portion 9c is joined to substantially the center of the flow passage. The whole flow path is formed in a substantially T shape. As shown in FIG. 3, when the tips of the arterial blood circuit 1, the venous blood circuit 2 and the anticoagulant infusion line L2 are connected to the connecting portions 9a to 9c, respectively, they communicate with each other to perform priming. The liquid can be distributed to each other.

  In addition, the flow rate of the priming liquid that flows from the venous side connecting portion 9b to the arterial side connecting portion 9a in the connecting means 9 and from the merging point from the branch line connecting portion 9c to the venous side connecting portion 9b side. An orifice 9d for adjusting the angle is formed. With such an orifice 9d, it is possible to adjust the flow rates of the priming liquid flowing downstream from the branch point of the anticoagulant injection line L2 in the blood circuit and the priming liquid flowing through the anticoagulant injection line L2.

  That is, although the priming liquid hardly flows into the anticoagulant injection line L2 having a diameter smaller than that of the blood circuit in a normal state, the priming liquid flowing from the branching point to the blood circuit side by the orifice 9d of the connecting means 9. The flow rate of the priming liquid flowing to the anticoagulant injection line L2 side can be sufficiently secured. Therefore, a sufficient amount of the priming liquid can be circulated also to the anticoagulant injection line L2 that is usually of a relatively small diameter, and the anticoagulant injection line L2 can be reliably washed.

Next, a priming method for the dialysis apparatus will be described.
As shown in FIG. 4, the tip 1a of the arterial blood circuit 1 and the tip 2a of the venous blood circuit 2 interposing the dialyzer 3 are respectively connected to the arterial side connecting portion 9a and the venous side connecting portion 9b of the connecting means 9. A closed circuit is formed by connection, and the distal end L2a of the anticoagulant injection line L2 is connected to the branch line connecting portion 9c of the connecting means 9 (see FIG. 3) to obtain the state shown in FIG.

  In this state, the blood pump 4 is driven, the priming solution (saline) in the saline bag 7 is guided into the blood circuit, and the venous drip chamber 6 overflows while circulating in the formed closed circuit. While discharging in the overflow line L3, the priming liquid is also flowed into the anticoagulant injection line L2 for cleaning. That is, the tip L2a of the anticoagulant injection line L2 can be connected to the connecting means 9 so that the priming liquid can be circulated between the anticoagulant injection line L2 and the blood circuit. The coagulant injection line L2 can be cleaned at the same time.

  Therefore, the labor at the time of cleaning and priming can be reduced to improve workability, and the work time can be shortened. In addition, since clamping work with forceps or the like is not required as in the prior art, it is possible to avoid a clamping mistake such as clamping an incorrect part or insufficient clamping force, and suppressing human error. be able to.

  Further, as described above, the orifice 9d of the connecting means 9 allows the flow rate of the priming liquid flowing downstream from the branch point of the anticoagulant injection line L2 in the blood circuit and the flow rate of the priming liquid flowing through the anticoagulant injection line L2. Since it is adjusted, a sufficient amount of the priming liquid also flows into the anticoagulant injection line L2. The clamping means K (see FIG. 4) disposed in the middle of the venous blood circuit 2 is used to suppress the flow rate of the priming fluid flowing downstream from the branch point of the anticoagulant injection line L2 in the blood circuit. Thus, a sufficient amount of priming liquid may be allowed to flow to the anticoagulant injection line L2 side.

  After the above operation is continued for a predetermined time, the connecting means 9 is removed in a state where the blood circuit is filled with the priming solution, and the cleaning and priming are completed. Thereafter, an arterial puncture needle and a venous puncture needle are attached to the distal end 1a of the arterial blood circuit 1 and the distal end 2a of the venous blood circuit 2 of the blood circuit filled with the priming solution, respectively, and the patient is punctured and the blood pump The dialysis treatment is performed by driving 4 and purifying and removing water from the dialyzer 3 while circulating the blood extracorporeally in the blood circuit.

  Although the present embodiment has been described above, the present invention is not limited to this. For example, the tip of a branch line different from the anticoagulant injection line L2 is connected to the branch line connection portion 9c of the connection means 9. It may be. For example, the present invention can be applied to a device that is branched from a blood circuit and has a drug injection line (branch line) for injecting a hematopoietic factor (erythropoietin) or an iron agent. Cleaning and priming are performed by connecting the tip of the line to the branch line connecting portion 9c of the connecting means 9.

  Furthermore, in the present embodiment, the connecting means 9 is configured by diverting a conventional shunt connector cap, but a new component may be used separately. In that case, the external shape may be different or the lid portion P may not be provided, or the configuration as in the following other embodiments may be employed.

  As shown in FIG. 5, the first other embodiment connects the tips 1a and 2a of the arterial blood circuit 1 and the venous blood circuit 2 to form a closed circuit, and an anticoagulant injection line. The connecting means 9 ′ is connected to the tip L2a of the L2 (branch line) to allow the priming liquid to flow between the anticoagulant injection line L2 and the blood circuit. An arterial connection 9′a to which the tip 1a of the side blood circuit 1 can be connected, a venous connection 9′b to which the tip 2a of the venous blood circuit 2 can be connected, and a tip L2a of the anticoagulation infusion line L2. And a branch line connecting portion 9'c that can be connected.

  Of these, the branch line connecting portion 9'c is provided with an antibacterial filter 10 as shown in the figure, and connects the tips 1a and 2a of the arterial blood circuit 1 and the venous blood circuit 2 to each other. In a state in which the tip L2a of the anticoagulant injection line L2 is removed from the branch line connection portion 9′c while maintaining the state in which the closed circuit is formed, foreign matters such as germs are passed through the branch line connection portion 9′c. It is configured to avoid intrusion into the connecting means 9 ′.

  More specifically, the antibacterial filter 10 is composed of a hydrophilic filter having a size that is difficult to pass through, such as bacteria, and can pass the priming liquid during priming, while the anticoagulant injection line L2 Even after the distal end L2 is removed, even if the branch line connection portion 9′c is opened to the outside, the sanitary condition in the connection means 9 ′ can be kept good by restricting passage of germs and the like. It can be done.

  In addition, as shown in FIG. 6, the second other embodiment connects the tips 1a and 2a of the arterial blood circuit 1 and the venous blood circuit 2 to form a closed circuit, and an anticoagulant. The connecting means 9 ″ is connected to the tip L2a of the injection line L2 (branch line) to allow the priming liquid to flow between the anticoagulant injection line L2 and the blood circuit. The arterial side connection portion 9 ″ a that can connect the distal end 1a of the arterial blood circuit 1, the venous side connection portion 9 ″ b that can connect the distal end 2a of the venous side blood circuit 2, and the distal end of the anticoagulation infusion line L2. And a branch line connecting portion 9 ″ c to which L2a can be connected.

  Of these, a check valve 11 is disposed at the branch line connecting portion 9 ″ c, as shown in FIG. 1, and the tips 1a and 2a of the arterial blood circuit 1 and the venous blood circuit 2 are connected to each other. In the state where the tip L2a of the anticoagulant injection line L2 is removed from the branch line connection portion 9 "c while maintaining the closed circuit, the branch line connection portion 9" c is opened to the atmosphere. In this way, it is possible to prevent air from entering the connecting means 9 ″ and preventing the priming liquid in the connecting means 9 ″ from leaking to the outside.

  More specifically, the check valve 11 is formed of a so-called duck bill type valve in which, for example, the base end 11a is fixed to the inner peripheral wall of the branch line connecting portion 9 ″ c and the tip end 11b can be opened and closed. When the injection line L2 is connected to the branch line connection 9 ″ c and the priming liquid flows into the connection means 9 ″ from the anticoagulant injection line L2, the tip 11b opens to allow the inflow of the priming liquid, When the tip L2 of the anticoagulant injection line L2 is removed and no priming liquid flows in from the anticoagulant injection line L2, the tip 11b is configured to be tightly closed by the elasticity.

  As a result, even when the tip L2 of the anticoagulant injection line L2 is removed, it is possible to avoid the branch line connection portion 9 ″ from being released to the atmosphere, and to improve the sanitary condition in the connection means 9 ′. The check valve is not limited to the so-called duckbill type as described above, and can be replaced with various general-purpose ones.

  However, both the antibacterial filter and the check valve as described above may be arranged at the branch line connecting portion to which the tip L2a of the anticoagulant injection line L2 is connected. In addition, the part containing the antibacterial filter (antibacterial filter internal part) or the part containing the check valve (check valve internal part) is a separate member from the connection means, and these parts are connected to the branch line connection part of the connection means. You may comprise. In this case, the antibacterial filter internal part and the check valve internal part can be detached and replaced, which can further improve hygiene. In FIGS. 5 and 6, reference numerals 9′d and 9 ″ d denote orifices for adjusting the flow rate of the flowing priming liquid as in the previous embodiment. d may not be formed.

  In this embodiment, the present invention is applied to a dialysis apparatus used at the time of dialysis treatment, but is used in other apparatuses that can purify the patient's blood while circulating it outside the body (for example, blood filtration dialysis, blood filtration, AFBF). The present invention may be applied to blood purification devices, plasma adsorption devices, and the like.

  A closed circuit is formed by connecting the distal end of the arterial blood circuit and the distal end of the venous blood circuit intervening the blood purification means, and the distal end of the branch line branched from the blood circuit is connected to the connection site. The blood purification apparatus and the priming method for circulating the priming liquid between the line and the blood circuit can be applied to other forms and uses.

The schematic diagram which shows the dialysis apparatus (blood purification apparatus) which concerns on embodiment of this invention. External view showing connection means in the dialysis machine Longitudinal sectional view showing the connection means Schematic diagram showing the same dialyzer with a closed circuit formed A longitudinal sectional view showing connection means according to another first embodiment of the present invention The longitudinal cross-sectional view which shows the connection means which concerns on 2nd other embodiment of this invention Schematic diagram showing a conventional dialysis machine

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Arterial blood circuit 2 Vein side blood circuit 1a, 2a Tip 3 Dialyzer (blood purification means)
4 Blood Pump 5 Arterial Drip Chamber 6 Venous Drip Chamber 7 Saline Bag 8 Dialyzer Main Body 9, 9 ', 9 "Connection Means 9c, 9'c, 9" c Branch Line Connection L1 Saline Line L2 Anticoagulant Injection Line (branch line)
L2a Tip L3 Overflow line

Claims (5)

It consists of an arterial blood circuit with an arterial puncture needle attached to the tip and a venous blood circuit with a venous puncture needle attached to the tip, and can circulate the patient's blood extracorporeally from the arterial puncture needle to the venous puncture needle Blood circuit,
Blood purification means for purifying blood flowing between the arterial blood circuit and the venous blood circuit of the blood circuit and flowing through the blood circuit;
A branch line extending from the blood circuit and capable of injecting an anticoagulant or drug into the blood circuit;
In the blood purification apparatus comprising
A connection in which the tips of the arterial blood circuit and the venous blood circuit are connected to form a closed circuit, and the tip of the branch line is connected to allow the priming fluid to flow between the branch line and the blood circuit. A blood purification apparatus comprising the means.   The orifice that can adjust the flow rates of the priming liquid flowing downstream from the branch point of the branch line in the blood circuit and the priming liquid flowing through the branch line is formed in the connection means. 1. The blood purification apparatus according to 1.   The blood purification device according to claim 1 or 2, wherein an antibacterial filter or a check valve is formed at a branch line connecting portion where the tip of the branch line in the connecting means can be connected.   A closed circuit is formed by connecting the distal end of the arterial blood circuit and the distal end of the venous blood circuit intervening the blood purification means, and the distal end of the branch line branched from the blood circuit is connected to the connection site. A priming method for a blood purification apparatus, characterized in that a priming liquid is also circulated between a line and a blood circuit.   5. The priming method for a blood purification apparatus according to claim 4, wherein the flow rates of the priming liquid flowing downstream from the branch point of the branch line in the blood circuit and the priming liquid flowing through the branch line are adjusted.

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