JP2006280775A - Blood purification apparatus and its retransfusion method - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a blood purification apparatus and its retransfusion method which reduce the labor of a healthcare worker or the like in retransfusion and avoide a working loss by discriminating whether displacement by the dead weight of a displacement liquid is possible or not and facilitate automate retransfusion work. <P>SOLUTION: This blood purification apparatus which displaces the blood from a connecting part between an artery side blood circuit 1 and a saline line L1 to an artery side puncture needle (a) at the distal end of the artery blood circuit 1 with saline by the dead weight of the saline generated by the head of a saline bag 7 in a direction of the artery side puncture needle (a) to execute the retransfusion after the treatment, discriminates whether the displacement by the dead weight of the saline is possible or not based on the arterial pressure P1 and a hydrostatic pressure P2. <P>COPYRIGHT: (C)2007,JPO&INPIT

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 blood return method thereof.

  As shown in FIG. 9, a dialysis apparatus as a blood purification apparatus includes a blood circuit including an arterial blood circuit 101 to which an arterial puncture needle a is attached and a venous blood circuit 102 to which a venous puncture needle b is attached. A dialyzer 103 interposed between the arterial blood circuit 101 and the venous blood circuit 102 to purify blood flowing through the blood circuit, a blood pump 104 disposed in the arterial blood circuit 101, and a venous blood circuit 101 and an arterial drip chamber 105 and a venous drip chamber 106 disposed in the venous blood circuit 102, respectively, and a dialyzer body 108 that can supply dialysate 103 to the dialyzer 103.

  In addition, a saline bag 107 containing physiological saline is connected between the artery side puncture needle a and the blood pump 104 in the artery side blood circuit 101 via a saline line L1, so that washing and dialysis treatment before dialysis treatment can be performed. Priming, fluid replacement during dialysis treatment, blood return after dialysis treatment, and the like can be performed.

  For example, when returning blood, after the blood pump 104 is stopped, the electromagnetic valve V3 is opened, and physiological saline is introduced into the arterial blood circuit 101 from the saline line L1. At this time, the physiological saline reaches the artery side blood circuit 101 via the saline line L1 due to its own weight caused by the drop T in the direction of the artery side puncture needle a of the saline bag 107, and the saline line L1 in the artery side blood circuit 101 and The blood from the connecting portion to the arterial puncture needle a is replaced. As a result, the blood upstream from the connecting portion with the saline line L1 in the arterial blood circuit 101 is returned to the patient's body and returned.

Thereafter, the blood pump 104 is driven while the electromagnetic valve V1 is closed, and physiological saline is introduced into the arterial blood circuit 101 from the saline line L1. At this time, the physiological saline is guided to the blood pump 104 side from the connecting portion with the saline line L1 in the arterial blood circuit 101 by the driving force of the blood pump 104, and circulates in the dialyzer 103 and the venous blood circuit 102. Thus, the blood up to the vein side puncture needle b is replaced. Thereby, the blood in the dialyzer 3 and the venous blood circuit 102 (of course, including the arterial drip chamber 105 and the venous drip chamber 106) is removed from the connection with the saline line L 1 in the arterial blood circuit 101. The blood is returned to the body to return blood, and a series of blood return operations is completed. In addition, the blood return operation | work of the conventional dialysis apparatus is disclosed by patent document 1, for example.
JP 2004-222884 A

  However, in the above conventional blood purification device, in the arterial blood circuit 101 using the dead weight of the physiological saline (substitution fluid) generated by the drop T in the direction of the arterial puncture needle a of the saline bag 107 at the time of blood return. Since it was configured to replace the blood from the connecting portion with the saline line L1 to the arterial puncture needle a, when the patient's arterial pressure is higher than the pressure of the weight, the physiological saline does not flow down, There was a problem that good replacement could not be performed.

  In order to avoid such problems, it is ideal that medical workers etc. constantly check visually whether or not the replacement by normal weight of physiological saline has been performed successfully. There was a problem that the labor of the company would become excessive. However, when the replacement due to its own weight is not performed well, generally, the raw food bag 107 is grasped from the outside and pressed, and pressure is applied to the physiological saline in the raw food bag 107 to assist the replacement. Actually, in this case, there is a problem that it is difficult to automate the blood return operation while causing work loss because it is assistance after the actual replacement is not performed.

  The present invention has been made in view of such circumstances, and by determining whether or not replacement by the dead weight of the replacement liquid is possible, the labor of the medical staff at the time of returning blood is reduced and work loss is reduced. It is an object of the present invention to provide a blood purification apparatus and a blood return method thereof that can be avoided and can automate blood return work easily.

  The invention according to claim 1 is composed of an arterial blood circuit and a venous blood circuit, a blood circuit capable of extracorporeally circulating a patient's blood from the tip of the arterial blood circuit to the tip of the venous blood circuit, and the blood A blood purification means for purifying blood flowing between the arterial blood circuit and the venous blood circuit of the circuit and capable of opening and closing the vicinity of the tip of the arterial blood circuit; An arterial valve that can be occluded and opened; a housing means that contains a replacement fluid for replacing blood in the blood circuit after treatment; and the arterial blood circuit and the housing means, A replacement liquid supply line capable of supplying the replacement liquid in the storage means into the blood circuit; and a replacement liquid valve provided to be able to open and close the replacement liquid supply line and capable of closing and opening the flow path. The arterial blood circulation The blood from the connecting portion with the replacement fluid supply line to the tip of the arterial blood circuit is replaced with the blood and the replacement fluid by the dead weight of the replacement fluid generated by a drop in the distal direction of the arterial blood circuit of the housing means. In the blood purification apparatus for returning blood after treatment, the blood purification apparatus is characterized in that it comprises a discriminating means for discriminating whether or not the substitution liquid can be replaced by its own weight.

  The invention according to claim 2 is the blood purification apparatus according to claim 1, further comprising a blocking means capable of closing a flow path downstream from a connection portion with the replacement fluid supply line in the arterial blood circuit, The discriminating means includes a measuring means capable of measuring a fluid pressure at a site upstream from the closing means, and the flow path is closed by the closing means, and the arterial valve is in the open state and the replacement fluid. The arterial pressure measured by the measuring means when the valve is closed, and the measuring means when the flow path is closed by the closing means, the arterial valve is closed and the replacement fluid valve is open It is determined whether or not the replacement liquid can be replaced by its own weight based on the hydrostatic pressure measured in step (1).

  According to a third aspect of the present invention, in the blood purification apparatus according to the second aspect, the measuring means measures a fluid pressure in an arterial drip chamber disposed upstream of the closing means in the arterial blood circuit. It is possible to do it.

  According to a fourth aspect of the present invention, in the blood purification apparatus according to the second or third aspect of the present invention, the blocking means comprises a squeezed blood pump.

  According to a fifth aspect of the present invention, in the blood purification apparatus according to any one of the first to fourth aspects, when it is determined by the determination means that the replacement by the weight of the replacement liquid is impossible. The storage means can be raised by a predetermined dimension to increase the weight of the replacement liquid accompanying the drop.

  According to a sixth aspect of the present invention, in the blood purification apparatus according to any one of the first to fourth aspects, when it is determined by the determining means that replacement by the weight of the replacement liquid is impossible The pressure is applied to the replacement liquid in the storage means.

  The invention according to claim 7 comprises an arterial blood circuit and a venous blood circuit, a blood circuit capable of extracorporeally circulating a patient's blood from the distal end of the arterial blood circuit to the distal end of the venous blood circuit, and the blood A blood purification means for purifying blood flowing between the arterial blood circuit and the venous blood circuit of the circuit and capable of opening and closing the vicinity of the tip of the arterial blood circuit; An arterial valve that can be occluded and opened; a housing means that contains a replacement fluid for replacing blood in the blood circuit after treatment; and the arterial blood circuit and the housing means, A replacement liquid supply line capable of supplying the replacement liquid in the storage means into the blood circuit; and a replacement liquid valve provided to be able to open and close the replacement liquid supply line and capable of closing and opening the flow path. The arterial blood circulation The blood from the connecting portion with the replacement fluid supply line to the tip of the arterial blood circuit is replaced with the blood and the replacement fluid by the dead weight of the replacement fluid generated by a drop in the distal direction of the arterial blood circuit of the housing means. In the blood return method of the blood purification apparatus for returning blood after treatment, it is determined whether or not the replacement liquid can be replaced by its own weight.

  According to an eighth aspect of the present invention, in the blood return method of the blood purification device according to the seventh aspect, the flow path downstream of the connecting portion with the replacement fluid supply line in the arterial blood circuit is blocked by the blocking means. The arterial pressure measured when the occlusion means is closed and the arterial valve is open and the replacement fluid valve is closed; and the occlusion means is closed and the arterial valve is closed and Based on the hydrostatic pressure measured when the replacement liquid valve is open, it is determined whether or not the replacement liquid can be replaced by its own weight.

  The invention according to claim 9 is the blood return method of the blood purification apparatus according to claim 7, wherein the arterial pressure and the hydrostatic pressure are provided on the arterial drip disposed upstream of the blocking means in the arterial blood circuit. It is obtained by measuring the fluid pressure in the chamber.

  According to a tenth aspect of the present invention, in the blood return method of the blood purification apparatus according to the eighth or ninth aspect, the blocking means comprises a iron-type blood pump.

  The invention according to claim 11 is the blood return method of the blood purification apparatus according to any one of claims 7 to 10, when it is determined that the replacement by the weight of the replacement liquid is impossible. The containing means can be raised by a predetermined dimension, and the weight of the replacement liquid accompanying the drop can be increased.

  The invention according to claim 12 is the blood return method of the blood purification apparatus according to any one of claims 7 to 10, when it is determined that the replacement by the weight of the replacement liquid is impossible. A pressure is applied to the replacement liquid in the storage means.

  According to the first and seventh aspects of the invention, it is possible to determine whether or not the replacement liquid can be replaced by its own weight, so that it is possible to reduce the labor of the medical staff at the time of returning blood and to avoid work loss. In addition, the blood return work can be easily automated.

  According to the second and eighth aspects of the invention, since it is determined whether or not the replacement liquid can be replaced by its own weight based on the arterial pressure and the hydrostatic pressure, the determination can be performed by a more direct and accurate method. Can be done. That is, whether or not the replacement fluid can be replaced by its own weight is mainly based on the magnitude relationship between the arterial pressure of the patient and the hydrostatic pressure of the replacement fluid. Therefore, the relationship between the arterial pressure and the hydrostatic pressure is directly measured. It is possible to make a judgment.

  According to the third and ninth aspects of the present invention, the arterial pressure and the hydrostatic pressure are obtained by measuring the fluid pressure in the arterial drip chamber disposed upstream of the blocking means in the arterial blood circuit. Therefore, it is possible to determine whether or not the replacement of the replacement liquid by its own weight is possible by diverting the existing blood purification apparatus including the artery-side drip chamber.

  According to the fourth and tenth aspects of the present invention, the occlusion means comprises the ironing type blood pump provided in the arterial blood circuit, so that the existing blood purification apparatus equipped with the blood pump is diverted and replaced. It can be determined whether or not replacement by the weight of the liquid is possible.

  According to the fifth, sixth, eleventh and twelfth aspects of the invention, when it is determined that the replacement by the dead weight of the replacement liquid is impossible, the storage means is raised by a predetermined size, and the replacement accompanying the drop is performed. Since the weight of the liquid can be increased or a pressure is applied to the replacement liquid in the storage means, the blood return operation can be automated more easily.

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 in the blood circuit, and a squeezing blood pump 4 (occlusion means) disposed in the arterial blood circuit 1 An arterial drip chamber 5 and a venous drip chamber 6 disposed in the venous blood circuit 1 and the venous blood circuit 2, respectively, a dialyzer body 8 capable of supplying dialysate to the dialyzer 3, and a replacement liquid Is composed mainly of a saline bag 7 serving as a housing means for storing the physiological saline and a saline line L1 (substitution fluid supply line) connecting the saline bag 7 and the arterial blood circuit 1.

  The arterial blood circuit 1 is connected to an arterial puncture needle a at the tip thereof, and an iron-type blood pump 4 and an arterial drip chamber 5 for defoaming are disposed in the middle. A venous puncture needle b is connected to the distal end of the side blood circuit 2 and a venous drip chamber 6 is connected in the middle. The drip chamber is provided with a filtration network (not shown) inside, and can capture, for example, a thrombus when returning blood. Further, the arterial drip chamber 5 is disposed between the blood pump 4 and the connecting portion with the saline line L 1 in the arterial blood circuit 1.

  Then, when the blood pump 4 is driven with the patient punctured with the arterial puncture needle a and the vein puncture needle b, the patient's blood passes through the arterial blood circuit 1 and reaches the dialyzer 3, Blood purification is performed by the dialyzer 3, and bubbles are removed in the venous drip chamber 6, and then returned to the patient's body through the venous blood circuit 2. That is, the blood of the patient is purified by the dialyzer 3 while circulating externally from the tip of the arterial blood circuit 1 to the tip of the venous blood circuit 2 of 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 through the dialyzer 3. Furthermore, one end of the dialysate introduction line La is connected to the dialyzer 3 (dialyte introduction port 3c), and the other end is connected to a dialysate supply device (not shown) for preparing a predetermined concentration of dialysate. 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.

  Monitor tubes M1 and M2 are extended from the arterial drip chamber 5 and the venous drip chamber 6, respectively, and their tips are connected to the dialyzer body 8. The dialysis machine main body 8 includes a pressure sensor 9 as a measuring means, and the fluid in the artery drip chamber 5 (dialyzer inlet pressure) and the fluid in the vein drip chamber 6 are monitored by the monitor tubes M1 and M2. Each pressure (venous pressure) can be measured.

  Further, in the vicinity of the artery side puncture needle a in the artery side blood circuit 1 (near the tip of the artery side blood circuit 1 and between the connecting portion of the saline line L1 and the artery side puncture needle a), and in the vein side blood circuit 2 In the vicinity of the venous puncture needle b (near the distal end of the venous blood circuit 2 and between the venous drip chamber 6 and the venous puncture needle b), an electromagnetic valve V1 and an electromagnetic valve V2 as arterial valves are respectively provided. It is arranged. These solenoid valves V1 and V2 are capable of closing and opening the flow paths in the respective portions provided by opening and closing operations, and the opening and closing operations are configured to be controlled by the dialyzer body 8. .

  The raw food bag 7 is formed of a flexible transparent container and can store a predetermined volume of physiological saline. For example, the raw food bag 7 is attached to the tip of a pole (not shown) protruding from the dialyzer body 8. Such a pole can be expanded and contracted by a control signal from the control means 12 to be described later, and the raw food bag 7 can be lowered by elongating and raising the raw food bag 7.

  The saline line L1 is connected to a portion of the artery side blood circuit 1 between the artery side puncture needle a and the artery side drip chamber 5, and can supply physiological saline (substitution fluid) in the saline bag 7 into the blood circuit. Is. In the middle of the raw eating line L1, an electromagnetic valve V3 (replacement liquid valve) that can close and open the flow path of the raw eating line L1 by an opening / closing operation is disposed, and the electromagnetic valve V3 is the electromagnetic valve V1 described above. And the opening / closing operation | movement is comprised by the dialyzer main body 8 similarly to V2.

  When the dialysis treatment by the dialysis apparatus is completed, the blood circuit and blood in the dialyzer 3 are returned to the patient's body. Blood is returned from the connecting portion of the arterial blood circuit 1 to the saline line L1 to the arterial puncture needle a (the tip of the arterial blood circuit 1) and from the connecting portion via the dialyzer 3 to the venous puncture needle. This is performed separately for the part extending to b (the tip of the venous blood circuit 2). In particular, the return of blood from the portion of the artery side blood circuit 1 connected to the saline line L1 to the artery side puncture needle a is in the direction of the artery side puncture needle a of the saline bag 7 (that is, the distal direction of the artery side blood circuit). This is performed by substituting the blood and the physiological saline with the dead weight of the physiological saline generated by the head of the head.

  More specifically, after the dialysis treatment is completed, when the blood pump 4 serving as the blocking means is stopped, because of the ironing type, the site (downstream from the connection with the replacement fluid supply line in the arterial blood circuit) Since the flow path is closed, if the electromagnetic valve V3 is changed from the closed state to the open state while maintaining the open state of the electromagnetic valve V1, the drop T in the arterial puncture needle a direction of the saline bag 7 is maintained. The physiological saline is naturally introduced into the arterial blood circuit 1 by the dead weight of the physiological saline generated in the above, and the blood and the physiological saline are replaced against the arterial pressure of the patient. Thereafter, when the blood pump 4 is driven with the electromagnetic valve V1 closed, the blood and physiology at the site from the connecting portion with the saline line L1 in the arterial blood circuit 1 to the venous puncture needle b through the dialyzer 3 are obtained. Replacement with saline will be performed. Prior to the blood return operation, the blood pump 4 is driven for a short time, and a thrombus in the blood circuit (for example, a thrombus generated at the connection with the saline line L1 in the arterial blood circuit 1) is exchanged with the saline line L1. You may make it move to a downstream side from a connection part.

  Here, the dialysis apparatus main body 8 of the present embodiment includes a determination unit 10 electrically connected to the pressure sensor 9, and a notification unit 11 and a control unit 12 electrically connected to the determination unit 10, respectively. It is arranged. Among these, the determination means 10 determines whether or not the replacement by the dead weight of the physiological saline is possible. When it is determined that the replacement is impossible, the notification means 11 notifies (for example, voice guidance or display). Warning display by the means, etc.) and replacement assistance by the control means 12 is performed.

  Specifically, the discriminating means 10 is in a state where the blood pump 4 is stopped (that is, a state where the flow path of the part is closed) and the electromagnetic valve V1 is open and the electromagnetic valve V3 is closed. The fluid pressure (arterial pressure: P1) in the artery-side drip chamber 5 measured by the pressure sensor 9 and when the blood pump 4 is stopped and the solenoid valve V1 is closed and the solenoid valve V3 is open. The pressure (hydrostatic pressure: P2) measured by the pressure sensor 9 is compared and calculated, and when the arterial pressure P1 is higher than the hydrostatic pressure P2, it is determined that the replacement by the dead weight of the physiological saline is impossible.

  That is, in order to bring physiological saline to the arterial puncture needle a by its own weight, the fluid pressure (hydrostatic pressure P2) accompanying the dead weight must be greater than the patient's arterial pressure (arterial pressure P1). If the pressure is higher than the arterial pressure P1, it can be determined that the replacement by the weight of the physiological saline is possible. Conversely, if the pressure of the arterial pressure P1 is higher than the hydrostatic pressure P2, the replacement by the weight of the physiological saline is performed. It can be determined that it is impossible.

  The control unit 12 transmits a control signal to the auxiliary unit 13 when it is determined by the comparison calculation in the determination unit 10 that the arterial pressure P1 is higher than the hydrostatic pressure P2 and replacement is impossible. . The auxiliary means 13 is composed of a driving means or the like that can extend a pole (described above) protruding from the dialyzer main body 8 so as to support the raw food bag 7. In addition, the dead weight of the physiological saline accompanying the drop in the direction of the arterial puncture needle a is increased. As a result, the hydrostatic pressure P2 can be made larger than the arterial pressure P1, and replacement with physiological saline blood can be performed, and the blood return operation can be automated more easily.

Next, the blood return operation by the dialysis apparatus will be described with reference to the flowchart of FIG. 2 and FIGS.
After the dialysis treatment is completed, as shown in FIG. 3, the blood pump 4 is driven while the electromagnetic valves V1 and V2 are opened, and blood is allowed to flow in the same direction as the dialysis treatment. It moves to the downstream side rather than the connection part with the raw food line L1 (S1). After that, as shown in FIG. 4, the electromagnetic valve V3 is changed from the open state to the closed state while maintaining the open state of the electromagnetic valve V1, and the hydraulic pressure (arterial pressure P1) in the artery side drip chamber 5 is measured by the pressure sensor 9. (S2).

  Next, as shown in FIG. 5, the electromagnetic valve V3 is changed from the closed state to the open state while the electromagnetic valve V1 is changed from the open state to the closed state, and the hydraulic pressure (hydrostatic pressure P2) in the arterial drip chamber 5 is detected by the pressure sensor 9. Is measured (S3). And it is discriminate | determined by the discrimination | determination means 10 whether the hydrostatic pressure P2 measured in the said S3 is larger than predetermined value (S4), and when it is less than predetermined value, the physiological saline in the raw food bag 7 runs short. After proceeding to S6 and instructing the replacement of the raw food bag 7, the process returns to S3. The instruction to replace the saline bag 7 is made by displaying on the display device of the dialysis machine main body 8 or by generating sound through a speaker or the like.

  If it is determined in S4 that the hydrostatic pressure P2 is greater than the predetermined value, the process proceeds to S5, and the determination means 10 determines whether or not the hydrostatic pressure P2 is greater than the arterial pressure P1. If it is determined that the hydrostatic pressure P2 is greater than the arterial pressure P1, as shown in FIG. 6, the electromagnetic valve V1 is changed from the closed state to the open state while the electromagnetic valve V3 is maintained in an open state, It is introduced by its own weight and replaced with blood in the blood circuit.

  On the other hand, if it is determined in S5 that the arterial pressure P1 is greater than the hydrostatic pressure P2 in the determining means 10, the process proceeds to S7, and the blood is returned to raise the saline bag 7 by the auxiliary means 13 as described above. After the control unit 12 instructs the auxiliary operation and the notification unit 11 notifies that the replacement is impossible, the process returns to S3 and the hydrostatic pressure P2 is measured again. In addition, after the blood return upstream from the connecting portion with the saline line L1 in the arterial blood circuit 1 is finished, the blood pump 4 is driven while the electromagnetic valve V1 is closed, and the blood downstream from the connecting portion. Let the circuit return blood.

  Therefore, since it is possible to determine in advance whether or not replacement by the dead weight of physiological saline is possible, it is possible to reduce the labor of the medical staff at the time of blood return, avoid work loss, and automate the blood return work. Can be easily performed. Further, since it is determined whether or not the replacement by the dead weight of the physiological saline is possible based on the arterial pressure and the hydrostatic pressure, the determination can be performed by a more direct and accurate method. That is, whether or not replacement by the weight of physiological saline is possible is mainly based on the magnitude relationship between the patient's arterial pressure and the physiological saline's hydrostatic pressure. Therefore, the relationship between the arterial pressure and the hydrostatic pressure is measured. A direct determination can be made.

  Further, the arterial pressure P1 and the hydrostatic pressure P2 are obtained by measuring the fluid pressure in the arterial drip chamber 5 disposed upstream of the blood pump 4 in the arterial blood circuit 1, and thus the arterial drip chamber. It is possible to determine whether or not replacement with the own weight of physiological saline is possible by diverting the existing blood purification apparatus having 5. In addition, when it is determined that the physiological saline cannot be replaced by its own weight, the saline bag 7 can be raised by a predetermined dimension and the physiological weight of the physiological saline accompanying the drop can be increased. It can be easily achieved.

  Although the present embodiment has been described above, the present invention is not limited to this. For example, when it is determined that the arterial pressure P1 is greater than the hydrostatic pressure P2, the auxiliary unit 13 that is controlled by the control unit 12 is used. The following means may be used instead of the pole that supports the raw food bag 7.

  For example, as shown in FIG. 7, when an airbag 13a that is inflated by driving the pump P is disposed on the side surface of the raw food bag 7, it is determined that replacement by the weight of physiological saline is impossible. The hydrostatic pressure P2 may be increased by driving the pump P and applying pressure to the physiological saline from the outside of the saline bag 7. Further, as shown in FIG. 8, when the saline bag 7 and the pump P are connected and it is determined that the replacement by the dead weight of the physiological saline is impossible, the pump P is driven and the inside of the saline bag 7 is The arterial pressure P2 may be increased by applying pressure to the physiological saline.

  According to the auxiliary means as described above, when it is determined by the determining means 10 that replacement by the weight of the physiological saline is impossible, the outside of the saline bag 7 or the physiological saline in the saline bag 7 Since the pressure is applied from the inside, the blood return operation can be automated more easily. It should be noted that a predetermined gas or the like may be used instead of the air supplied into the airbag 13a or the raw food bag 7.

  Furthermore, in the present embodiment, physiological saline is contained in the saline bag 7 and blood replacement is performed by replacing the blood with the physiological saline. It is good also as a liquid (For example, dialysate is supplied to the artery side blood circuit 1 with dead weight). Furthermore, in the present embodiment, it is determined whether or not the replacement by the dead weight of the physiological saline is possible based on the arterial pressure P1 and the hydrostatic pressure P2, but with parameters obtained from other means, It may be determined whether or not the replacement is possible. However, in this embodiment, the iron-type blood pump constitutes the occlusion means, but other forms of the occlusion means are separately provided on the downstream side of the connection portion with the replacement fluid supply line in the arterial blood circuit. In that case, the blood pump need not be ironed.

  In the present embodiment, the thrombus movement step S1 is performed before the arterial pressure measurement step S2, but the method of performing the arterial pressure measurement step S2 directly after dialysis treatment is performed without performing the S1. Can be applied. 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.

  The blood from the connecting portion with the replacement fluid supply line in the arterial blood circuit to the tip of the arterial blood circuit is replaced with the blood and the replacement fluid by the dead weight of the replacement fluid generated by the drop in the distal direction of the arterial blood circuit In the blood purification device and blood return method for returning blood after treatment, it can be applied to other forms and uses as long as it can be determined whether or not the replacement liquid can be replaced by its own weight. can do.

The schematic diagram which shows the dialysis apparatus (blood purification apparatus) which concerns on embodiment of this invention. Flow chart showing blood return method by the dialysis machine It is a figure which shows the blood return method (thrombus movement process S1) by the same dialysis apparatus, Comprising: The schematic diagram which shows the state of each component in an artery side blood circuit It is a figure which shows the blood return method (arterial pressure measurement process S2) by the same dialysis apparatus, Comprising: The schematic diagram which shows the state of each component in an artery side blood circuit It is a figure which shows the blood return method (hydrostatic pressure measurement process S3) by the same dialysis apparatus, Comprising: The schematic diagram which shows the state of each component in an artery side blood circuit The figure which shows the blood return method (after substitution start) by the same dialysis apparatus, Comprising: The schematic diagram which shows the state of each component in an artery side blood circuit The schematic diagram which shows the auxiliary | assistant means in the dialysis apparatus (blood purification apparatus) which concerns on other embodiment of this invention. The schematic diagram which shows the auxiliary | assistant means in the dialysis apparatus (blood purification apparatus) which concerns on other embodiment of this invention. Schematic diagram showing a conventional dialysis machine

Explanation of symbols

1 Arterial blood circuit 2 Venous blood circuit 3 Dialyzer (blood purification means)
4 Blood pump (occlusion means)
DESCRIPTION OF SYMBOLS 5 Arterial side drip chamber 6 Vein side drip chamber 7 Saline bag 8 Dialyzer main body 9 Pressure sensor 10 Discriminating means 11 Notification means 12 Control means 13 Auxiliary means a Arterial side puncture needle b Vein side puncture needle L1 Saline line V1 Electromagnetic valve (artery Side valve)
V3 Solenoid valve (substitution valve)

Claims (12)

A blood circuit comprising an arterial blood circuit and a venous blood circuit, and capable of extracorporeally circulating the patient's blood from the distal end of the arterial blood circuit to the distal end of the venous 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;
An arterial valve provided near the distal end of the arterial blood circuit as being openable and closable and capable of closing and opening the flow path;
Storage means for storing a replacement fluid for performing replacement with blood in the blood circuit after treatment;
A replacement fluid supply line for connecting the arterial blood circuit and the housing means, and supplying a replacement fluid in the housing means into the blood circuit;
A replacement liquid valve provided to be capable of opening and closing the replacement liquid supply line, and capable of closing and opening the flow path;
A replacement fluid produced by a drop in the distal direction of the arterial blood circuit of the housing means from the connecting portion with the replacement fluid supply line in the arterial blood circuit to the distal end of the arterial blood circuit In the blood purification device that replaces the blood and replacement fluid by its own weight, and returns blood after treatment,
A blood purification apparatus comprising: a determination unit that determines whether or not the replacement liquid can be replaced by its own weight.   A blocking means capable of closing a flow path downstream of a connection portion with the replacement fluid supply line in the arterial blood circuit; and the determination means measures a fluid pressure at a site upstream of the blocking means. An arterial pressure measured by the measuring means when the arterial valve is in an open state and a replacement fluid valve is in a closed state, with the measuring means being obtained, Based on the hydrostatic pressure measured by the measuring means when the arterial valve is closed and the replacement liquid valve is open when the flow path is closed by the closing means, replacement by the weight of the replacement liquid is performed. The blood purification apparatus according to claim 1, wherein it is determined whether or not it is possible.   3. The blood purification apparatus according to claim 2, wherein the measuring means is capable of measuring a fluid pressure in an arterial drip chamber disposed upstream of the blocking means in the arterial blood circuit. .   4. The blood purification apparatus according to claim 2, wherein the closing means is a squeezed blood pump.   2. The method according to claim 1, wherein when it is determined by the determining means that replacement by the weight of the replacement liquid is impossible, the storage means can be raised by a predetermined dimension to increase the weight of the replacement liquid due to a drop. The blood purification apparatus according to any one of claims 1 to 4.   The pressure is applied to the replacement liquid in the storage means when it is determined by the determination means that the replacement by the dead weight of the replacement liquid is impossible. The blood purification apparatus according to any one of the above. A blood circuit comprising an arterial blood circuit and a venous blood circuit, and capable of extracorporeally circulating the patient's blood from the distal end of the arterial blood circuit to the distal end of the venous 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;
An arterial valve provided near the distal end of the arterial blood circuit as being openable and closable and capable of closing and opening the flow path;
Storage means for storing a replacement fluid for performing replacement with blood in the blood circuit after treatment;
A replacement fluid supply line for connecting the arterial blood circuit and the housing means, and supplying a replacement fluid in the housing means into the blood circuit;
A replacement liquid valve provided to be capable of opening and closing the replacement liquid supply line, and capable of closing and opening the flow path;
A replacement fluid produced by a drop in the distal direction of the arterial blood circuit of the housing means from the connecting portion with the replacement fluid supply line in the arterial blood circuit to the distal end of the arterial blood circuit In the blood return method of the blood purification apparatus that replaces the blood and the replacement liquid by its own weight and returns blood after treatment,
A blood return method for a blood purification apparatus, wherein it is determined whether or not the replacement liquid can be replaced by its own weight.   The flow path downstream from the connecting portion with the replacement fluid supply line in the arterial blood circuit is closed by a closing means, the closed state by the closing means, the arterial valve is open, and the replacement fluid valve is Based on the arterial pressure measured in the closed state and the hydrostatic pressure measured when the arterial valve is closed and the replacement fluid valve is in the closed state by the blocking means, 8. The blood return method of the blood purification apparatus according to claim 7, wherein it is determined whether or not replacement by its own weight is possible.   8. The arterial pressure and hydrostatic pressure are obtained by measuring a fluid pressure in an arterial drip chamber disposed upstream of the blocking means in the arterial blood circuit. A blood return method of the blood purification apparatus described.   10. The blood return method of the blood purification apparatus according to claim 8 or 9, wherein the blocking means comprises a squeezed blood pump.   11. The method according to claim 7, wherein when it is determined that the replacement liquid cannot be replaced by its own weight, the storage means can be raised by a predetermined dimension to increase the weight of the replacement liquid due to a drop. The blood return method of the blood purification apparatus as described in any one of these.   11. The pressure according to claim 7, wherein when it is determined that the replacement liquid cannot be replaced by its own weight, a pressure is applied to the replacement liquid in the storage unit. A blood return method of the blood purification apparatus described.

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