JP2008154766A - Peritoneal dializer and cassette - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a peritoneal dializer capable of suppressing the repeated return of a dialysing liquid, remaining inside a tube, into an abdominal cavity after draining the liquid. <P>SOLUTION: A cassette to be mounted on the peritoneal dializer comprises: a cassette body for performing a liquid injecting treatment to inject the peritoneal dialising liquid to the abdominal cavity and a draining treatment to drain the peritoneal dialising liquid from the abdominal cavity; and the tube which has one end part connected to the cassette body, the other end part constituted to be connected to the abdominal cavity, and where a Y shape tube is formed at the other end part, and the tube has a storage bag connected to one end of the Y shape tube so as to store the peritoneal dialising liquid, the other end of the Y shape tube is connected to the abdominal cavity. <P>COPYRIGHT: (C)2008,JPO&INPIT

Description

  The present invention relates to a peritoneal dialysis apparatus and a cassette for performing a filling process and a draining process of a peritoneal dialysis solution.

  The peritoneal dialysis device is a liquid injection process for injecting peritoneal dialysate (hereinafter referred to as dialysate) into the abdominal cavity through a single tube connected to the abdominal cavity of the human body and a drainage process for discharging the dialysate from the abdominal cavity. Do both. This tube usually has a length of about 2 m. When performing the liquid injection process and the liquid discharge process, the dialysate after the liquid injection process or the liquid discharge process remains in the 2 m tube. For this reason, when switching from the drainage process to the liquid injection process, the dialysate (hereinafter referred to as the residual liquid) after the drainage process remaining in the tube returns to the abdominal cavity. Usually, the dialysate to be injected is sent after being heated by a peritoneal dialysis machine. However, the temperature of the residual liquid is lowered while it remains in the tube. Moreover, the residual liquid already used has a low therapeutic effect compared with a new dialysate. Therefore, it is desirable to reduce the residual liquid returned into the abdominal cavity as much as possible.

Patent Document 1 shows a small peritoneal dialysis apparatus using a disposable cassette in which a diaphragm and a heating unit are integrally formed, the flow path switching operation is quiet, and the heating capability is high.
Japanese Patent Laid-Open No. 2003-000704

  In the prior art described above, there is no problem that the residual liquid in the tube returns to the abdominal cavity when switching from the draining process to the liquid injection process. This is because in the case of peritoneal dialysis performed for adults, the amount of residual liquid in the tube is negligible compared to the amount of dialysate to be injected. However, in the case of peritoneal dialysis performed on children, it is performed with a smaller amount (for example, 100 ml) of dialysate than the amount of dialysate used for adult peritoneal dialysis. When the inner diameter of the tube is 4 mm, the amount of residual liquid is about 25 mL with a length of 2 m. In this case, when switching from the drainage process to the liquid injection process, the amount of the residual liquid that returns to the abdominal cavity corresponds to 25% of the amount of dialysate to be injected, which may significantly reduce the therapeutic effect.

  The present invention has been made in view of the above-described problems, and an object thereof is to provide a peritoneal dialysis device that suppresses the return of dialysate remaining in a tube after drainage treatment into the abdominal cavity again. .

  The present invention corresponding to one embodiment for solving the above-described problem is a cassette that can be attached to a peritoneal dialysis device, and is an injection process for injecting peritoneal dialysis fluid into the abdominal cavity and discharging the peritoneal dialysis fluid from the abdominal cavity A tube having a cassette body for performing drainage treatment, one end connected to the cassette body, and the other end configured to be connected to the abdominal cavity, the other end A Y-tube is formed in the part, and has a storage bag for storing the peritoneal dialysate connected to one end of the Y-tube, and the other end of the Y-tube is connected to the abdominal cavity. And a tube configured as described above.

  ADVANTAGE OF THE INVENTION This invention can provide the peritoneal dialysis apparatus which suppresses that the dialysate which remains in a tube after a drainage process is returned in an abdominal cavity again.

  Hereinafter, embodiments according to the present invention will be described with reference to the drawings. The following embodiments do not limit the invention described in the claims, and all the combinations of features described in the embodiments are essential to the solution means of the present invention. Not exclusively.

  The peritoneal dialysis device of the present invention includes a tube having one end connected to the cassette and the other end connected to the abdominal cavity of the human body. This tube is used for injecting and draining peritoneal dialysate (hereinafter referred to as dialysate). The tube according to the present invention forms a Y-tube at the other end and is connected to a residual bag for accommodating the drainage treatment remaining in the tube in addition to the abdominal cavity. As a result, the peritoneal dialysis apparatus of the present invention, when performing the liquid injection process after the drainage process, discharges the residual liquid remaining in the tube to the residual bag so as to push out with the dialysate, and injects only the new dialysate. sell. Therefore, the peritoneal dialysis apparatus of the present invention suppresses a reduction in the therapeutic effect due to the residual fluid in peritoneal dialysis performed on a child with a small amount of dialysate used in one peritoneal dialysis (for example, 100 ml). .

[First Embodiment]
The first embodiment will be described below with reference to FIGS. 1 to 6. FIG. 1 is a diagram illustrating an example of a cassette mounted on the peritoneal dialysis apparatus according to the first embodiment. Here, only the part related to the present invention in the cassette will be described.

  The cassette 100 is configured to be attachable to a peritoneal dialysis device (not shown). The cassette 100 also includes a cassette body 101 and a dialysis catheter 106 that functions as a tube connected to the cassette body 101. The cassette body 101 performs a liquid injection process for injecting the dialysate into the abdominal cavity 111 and a drainage process for discharging the dialysate from the abdominal cavity 111 through the dialysis catheter 106. The cassette body 101 also includes dialysate bags 107a and 107b for storing dialysate injected into the abdominal cavity 111 of the patient, and a drainage treatment tank 108 for storing dialysate discharged from the abdominal cavity 111 of the patient. Is connected.

  The cassette body 101 includes a diaphragm pump 102, a heating unit 103, a switching unit 104, and a connection tube 105. The diaphragm pump 102 is accommodated in a sealed state by a flange member. The diaphragm pump 102 is configured to contract when pressurized and expand when decompressed. Thus, the diaphragm pump 102 is pumped by expanding and contracting to send dialysate.

  The heating unit 103 includes a tube for injection treatment and a tube for drainage treatment, and warms the dialysate flowing through the tube for liquid treatment. Therefore, the heating unit 103 further includes a heater (not shown) and a heat transfer member (for example, an aluminum member). In addition, the heater includes the upper surface heater and the lower surface heater so as to sandwich the liquid injection processing tube, whereby the dialysate can be efficiently heated.

  The switching unit 104 switches the dialysate flow path in a tube stretched around the cassette. Mainly, the switching unit 104 switches to a flow path for liquid injection processing or liquid discharge processing. For example, when injecting dialysate contained in the dialysate bag 107a, the dialysate treatment flow path is a dialysate bag 107a, a diaphragm pump 102, a tube for injecting treatment of the heating unit 103, dialysis The flow path leads in the order of the catheter 106. On the other hand, the drainage treatment channel is a channel that leads in the order of the dialysis catheter 106, the drainage treatment tube of the heating unit 103, the diaphragm pump 102, and the drainage treatment tank 108.

  The connection tube 105 is a tube that connects the dialysis catheter 106, the dialysate bags 107 a and 107 b, and the drainage treatment tank 108 to the cassette body 101. The dialysis catheter 106 is a tube having one end connected to the cassette body and the other end configured to be connected to the abdominal cavity. In addition, a Y-shaped tube is formed at the other end, and a residual bag 110 that functions as a storage bag for storing dialysate connected to one end of the Y-shaped tube is provided. The other end of the Y-tube is configured to be connected to the abdominal cavity.

  The residual bag 110 is desirably disposed at a position lower than the position of the abdominal cavity 111 into which the dialysis catheter 106 is inserted when peritoneal dialysis is performed. Thereby, the residual liquid in the dialysis catheter 106 is easily accommodated in the residual bag 110. This is because the water pressure causing the liquid to flow into the residual bag 110 is lower than the water pressure causing the liquid to flow into the abdominal cavity 111 because the residual bag 110 is disposed at a position lower than the position of the abdominal cavity. Accordingly, the residual liquid first flows into the residual bag 110 by being pushed out by the new dialysate injected during the injection process. The residual bag 110 is a flexible bag that contracts and expands, and the dialysate flows in and expands during the injection process, and the dialysate flows and contracts during the draining process.

  Further, the residual bag 110 has a capacity equal to or larger than the capacity in the tube from one end of the dialysis catheter 106 to the branch position where the Y-shaped tube 109 is formed (corresponding to the section 112 shown in FIG. 1). desirable. Specifically, after the drainage treatment, residual liquid remains inside the dialysis catheter 106 and inside the cassette body 101. Here, the volume of the remaining liquid remaining in the cassette body 101 is about 1 to 2 ml. The volume of the residual liquid remaining in the dialysis catheter 106 is about 25 ml when the dialysis catheter 106 has a length of 2 m and an inner diameter of 4 mm. Furthermore, in the dialysis catheter 106, the volume of residual liquid from the branch position of the Y-shaped tube 109 to the connection to the abdominal cavity 111 is about 1 to 2 ml. Therefore, the volume of the residual liquid in the section 112 is 23 to 24 ml. According to the present embodiment, the residual bag 110 has a capacity that is at least equal to the capacity of the section 112. The upper limit of the volume is desirably a volume (for example, about 24 to 26 ml) obtained by adding the volume of the residual liquid remaining in the section 112 and the volume of the residual liquid remaining in the cassette body 101. For example, when the residual bag 110 has a volume exceeding 26 ml, the liquid stored in excess of 26 ml becomes a new dialysate to be injected in the liquid injection process. Therefore, it is necessary to provide the above-mentioned upper limit in order to suppress discarding a new dialysate wastefully. In addition, the remaining liquid from the branch position of the Y-shaped tube 109 to the connection to the abdominal cavity 111 is returned to the abdominal cavity 111. However, the amount of the residual fluid is not a problem because it is negligible compared to the amount of dialysate used for one peritoneal dialysis (for example, 100 ml) even in peritoneal dialysis for children.

  Next, functional blocks of the peritoneal dialysis device 200 will be described with reference to FIG. FIG. 2 is a diagram illustrating an example of functional blocks in the peritoneal dialysis device according to the first embodiment. Here, only the main functional blocks of the peritoneal dialysis device 200 will be described. That is, the peritoneal dialysis apparatus 200 of the present invention is not limited to the functional blocks described below, and may include other functional blocks.

  The peritoneal dialysis device 200 includes a CPU 201, an operation unit 202, a power supply circuit 203, a flow rate control unit 204, a storage unit 205, a switching control unit 206, a heater control unit 207, and a pumping operation unit 208. The CPU 201 comprehensively controls each functional block described below.

  The operation unit 202 is disposed on the outer surface of the peritoneal dialysis device 200, receives an input from the operator, and notifies the CPU 201 of the input. For example, the operation unit 202 is used by the operator to instruct the start of treatment when starting peritoneal dialysis. The power supply circuit 203 supplies power to the CPU 201. When performing the liquid injection process, the flow rate control unit 204 controls the flow rate so that the amount of dialysate flowing increases according to the amount accommodated in the residual bag 110. Specifically, the flow control unit 204 increases the flow rate assuming the amount of dialysate that will flow into the residual bag 110 when performing the liquid injection process in a state where the residual liquid does not accumulate in the dialysis catheter 106. To control. The storage unit 205 stores in advance each parameter necessary for performing peritoneal dialysis, for example, the temperature of the dialysate to be injected. The switching control unit 206 controls the dialysis fluid flow path by controlling the switching unit 104. The heater control unit 207 controls the upper surface heater 211 a and the lower surface heater 211 b included in the heating unit 103. The pumping operation unit 208 controls the diaphragm pump 102 by increasing or decreasing the pressure.

  Further, the CPU 201 receives signals from the temperature sensor 209 and the bubble sensor 210 arranged in the cassette body 101. The temperature sensor 209 is disposed, for example, in the vicinity of an outlet through which dialysate is sent to the upper surface heater 211a, the lower surface heater 211b, and the dialysis catheter 106. Here, as the temperature sensor 209 provided in the vicinity of the dialysate outlet, it is desirable to use a thermopile type infrared sensor (non-contact type temperature sensor) having a very fast response speed. Thereby, the temperature of the upper surface heater 211a and the lower surface heater 211b can be controlled with high accuracy. The bubble sensor 210 is disposed on the inlet side and the outlet side of the dialysate in the switching unit 104, and detects bubbles in the dialysate.

  Next, the flow of dialysate during the conventional drainage process will be described with reference to FIGS. 3 and 4. FIG. 3 is a view showing a state of a conventional dialysis catheter after drainage treatment. FIG. 4 is a diagram illustrating a state of a conventional dialysis catheter in which a liquid injection process is performed after the liquid discharge process.

  A conventional cassette 300 to be attached to a peritoneal dialysis machine is composed of a cassette body 301 and a dialysis catheter 302. The dialysis catheter 302 has one end connected to the cassette body 301 and the other end connected to the abdominal cavity 111. FIG. 3 shows the state of the residual liquid 303 remaining in the dialysis catheter 302 after the drainage treatment. As described above, after the drainage process is performed, the dialysis catheter 302 is filled with the residual liquid 303.

  When the liquid injection process is performed from the state of FIG. 3, as shown in FIG. 4, the residual liquid 303 is pushed out by feeding a new dialysate 304 in the direction of the arrow L1. Thereby, in the conventional cassette 300, when the liquid injection process is performed after the drainage process, all the residual liquid 303 remaining in the dialysis catheter 302 is returned to the abdominal cavity 111 again.

  Normally, the dialysate 304 to be injected is heated and injected into the abdominal cavity. However, the temperature of the residual liquid 303 remaining after the drainage process is lowered before the liquid injection process is performed again. If the residual liquid 303 whose temperature has been lowered is returned to the abdominal cavity 111, an unexpected side effect may be caused to the patient. The residual fluid 303 is a dialysis fluid that has been once injected into the abdominal cavity 111. Therefore, the residual liquid 303 cannot be expected to have a very high therapeutic effect. In the case of peritoneal dialysis performed on adults, the amount of dialysate used at a time is about 2000 ml, and the amount of residual fluid is negligibly small compared to the amount of dialysate (for example, 25 ml). ) So there is no problem. However, in the case of peritoneal dialysis performed on children, the amount of dialysate used at one time is about 100 ml, and the residual solution 303 is about 25% of the dialysate used at one time and is ignored. Can not. Therefore, it is necessary to reduce the residual liquid 303 injected into the abdominal cavity 111 again. The cassette 100 according to the present invention suppresses such residual liquid from being returned into the abdominal cavity 111. Hereinafter, this mechanism will be described with reference to FIGS. 5 and 6.

  FIG. 5 is a diagram illustrating a state of the dialysis catheter after the drainage treatment according to the first embodiment. As shown in FIG. 5, during the drainage treatment, the residual bag 110 is contracted, so that the dialysate does not flow into the residual bag 110. Specifically, during the drainage process, the pumping operation unit 208 controls the diaphragm pump 102 to repeatedly pressurize and depressurize the drainage process. Here, the switching control unit 206 switches to the drainage treatment flow path via the switching unit 104. Thereby, in the diaphragm pump 102, a pumping operation is performed so that the used dialysate flows in the direction of the arrow. Further, since the drainage treatment flow path is in a sealed state, the used dialysate flows out, and the inside of the residual bag 110 is decompressed and contracts. Therefore, the dialysate does not flow into the residual bag 110 during the drainage treatment. When the drainage process is completed, the dialysis catheter 106 is filled with the residual liquid 501.

  FIG. 6 is a diagram illustrating a state of the dialysis catheter in which the liquid injection process is performed after the liquid discharge process according to the first embodiment. FIG. 6 shows a state in which a new dialysis solution 601 used for the injection process is injected into the dialysis catheter 106 in the order of FIG. 6A, FIG. 6B, and FIG. 6C. Show. During the liquid injection process, the pumping operation unit 208 controls the diaphragm pump 102 to repeatedly pressurize and depressurize the liquid injection process. Here, the switching control unit 206 switches to the flow path for liquid injection processing via the switching unit 104. Thereby, in the diaphragm pump 102, pumping operation | movement is performed so that the new dialysate 601 may be flowed in the arrow direction.

  As shown in FIG. 6A, when a new dialysate 601 is injected into the dialysis catheter 106, the residual liquid 501 is first pushed out and flows into the residual bag 110. The residual bag 110 expands according to the amount of the residual liquid 501 that flows in. As shown in FIG. 6B, when the liquid injection process is continued, the residual liquid 501 remaining in the dialysis catheter 106 flows into the residual bag 110. Here, the maximum capacity of the residual bag 110 is determined in advance by the length L2 and the inner diameter of the dialysis catheter 106. That is, it is desirable that the maximum capacity of the residual bag 110 is equal to the amount of the residual liquid 501 pushed out by the new dialysate 601.

  As shown in FIG. 6C, the residual liquid 501 remaining in the tube portion 602 having a length L3 from the branch position of the Y-shaped tube 109 shown in FIG. It will be returned to the abdominal cavity 111 again. However, in the dialysis catheter 106 according to the present embodiment, the volume of the residual liquid 501 remaining in the tube portion 602 is about 1 to 2 ml. Therefore, the residual liquid returned to the abdominal cavity 111 is at a level that can be ignored even in the case of peritoneal dialysis performed on a child.

  Further, as described above, the peritoneal dialysis device 200 includes the flow rate control unit 204 that controls the amount of the peritoneal dialysis fluid that flows according to the amount accommodated in the residual bag 110 when performing the liquid injection process. This is effective for always producing a certain therapeutic effect. For example, when an infusion process is first performed using a dialysis catheter in a new state, the infused dialysate first flows into the residual bag 110 because the residual liquid 501 does not exist. Therefore, the amount of dialysate used for peritoneal dialysis is insufficient by the capacity to flow into the residual bag 110. In such a case, the amount of dialysate necessary for peritoneal dialysis is not injected, and the therapeutic effect is reduced. Therefore, the flow control unit 204 performs control so as to add the amount of dialysate to be injected by the amount that flows into the residual bag 110. Specifically, the flow rate control unit 204 determines that a predetermined amount of dialysate is abdominal cavity based on the state during the liquid injection process (for example, when the liquid injection process is continuously performed after the liquid discharge process). It controls so that it may inject into 111.

  As described above, the cassette attached to the peritoneal dialysis apparatus according to the present embodiment has one end connected to the cassette body and the other end connected to the abdominal cavity and the residual bag by forming a Y-shaped tube. Tube. Thereby, this cassette suppresses that the residual liquid which remains in the dialysis catheter after a drainage process is returned in an abdominal cavity again. Therefore, even if this cassette is peritoneal dialysis performed with respect to a child, the bad influence by a residual liquid can be reduced. Therefore, this cassette can realize peritoneal dialysis with a high therapeutic effect.

  The present invention is not limited to the above embodiment, and various modifications are possible. The residual bag which concerns on this embodiment may be arrange | positioned in the position lower than the position of the abdominal cavity to which a dialysis catheter is connected. Thus, when the liquid injection process is performed after the drainage process, the residual liquid is pushed out by the new dialysate to be injected and automatically flows into the residual bag. Therefore, since this peritoneal dialysis apparatus does not require switching of the flow path by a clamp or the like, the peritoneal dialysis apparatus can be easily switched from the drainage process to the liquid injection process. Moreover, since this peritoneal dialysis apparatus does not require the clamp for flowing a residual liquid to a residual bag, it can suppress the increase in cost.

  Moreover, the residual bag which concerns on this embodiment may have a capacity | capacitance more than the capacity | capacitance in the tube from the one end of a tube to the branch position which a Y-shaped tube forms. Thus, the cassette, that is, the residual bag, may be a flexible bag that contracts and expands. Thereby, in the peritoneal dialysis apparatus, the discharged dialysate does not flow into the residual bag during the drainage treatment. Therefore, the present peritoneal dialysis apparatus can realize peritoneal dialysis with a high therapeutic effect because the residual liquid flows into the residual bag only during the liquid injection process.

[Second Embodiment]
Next, a second embodiment will be described with reference to FIG. This embodiment uses a defining member (for example, a hard bag) that defines the volume of the residual bag, instead of defining the amount of residual liquid contained in the residual bag by the maximum capacity of the residual bag. FIG. 7 is a diagram illustrating an example of a cassette according to the second embodiment. Here, only the parts different from the first embodiment will be described.

  As shown in FIG. 7, the dialysis catheter 106 includes a hard bag 701 that functions as a defining member arranged to cover the outside of the residual bag 110. The hard bag 701 defines the amount of liquid flowing into the residual bag 110 to the capacity in the dialysis catheter 106 at the length L2 shown in FIG. 6B. Specifically, the hard bag 701 defines a width L4 in which the residual bag 110 can be inflated according to the amount to be defined. As a result, the residual bag 110 does not expand beyond the width L4. Therefore, the cassette 100 according to the present embodiment has a higher accuracy of the capacity to be defined than the method of defining the maximum capacity of the residual bag 110 that is the flexible bag used in the first embodiment. Therefore, the peritoneal dialysis apparatus according to the present embodiment can provide peritoneal dialysis with a higher therapeutic effect.

It is a figure which shows an example of the cassette which concerns on 1st Embodiment. It is a figure which shows an example of the functional block in the peritoneal dialysis apparatus which concerns on 1st Embodiment. It is a figure which shows the mode of the conventional dialysis catheter after a drainage process. It is a figure which shows the mode of the conventional dialysis catheter in which the liquid injection process is performed after the drainage process. It is a figure which shows the mode of the dialysis catheter after the waste_water | drain process which concerns on 1st Embodiment. It is a figure which shows the mode of the dialysis catheter in which the liquid injection process is performed after the drainage process which concerns on 1st Embodiment. It is a figure which shows an example of the cassette which concerns on 2nd Embodiment.

Explanation of symbols

DESCRIPTION OF SYMBOLS 100: Peritoneal dialysis apparatus 101: Cassette 102: Diaphragm pump 103: Heating part 104: Switching part 105: Connection tube 106: Dialysis catheter 107a, b: Dialysate bag 108: Drainage processing tank 109: Y-shaped pipe 110: Residual Bag 111: abdominal cavity

Claims (5)

A cassette that can be attached to a peritoneal dialysis machine,
A cassette body for injecting peritoneal dialysate into the abdominal cavity and performing drainage processing for discharging the peritoneal dialysate from the abdominal cavity;
A tube having one end connected to the cassette body and the other end configured to be connected to the abdominal cavity, wherein the other end is formed with a Y-tube, A tube configured to contain the peritoneal dialysis fluid connected to one end of the Y-tube, and the other end of the Y-tube connected to the abdominal cavity;
A cassette characterized by comprising: The containing bag is
The cassette according to claim 1, wherein when performing peritoneal dialysis, the cassette is disposed at a position lower than a position of the abdominal cavity to which the tube is connected. The containing bag is
The cassette according to claim 1 or 2, wherein the cassette has a capacity equal to or greater than a capacity in the tube from one end of the tube to a branching position formed by the Y-shaped tube. The tube
The cassette according to claim 3, further comprising a defining member that is disposed so as to cover an outer side of the storage bag and that defines an amount of the peritoneal dialysis solution stored in the storage bag. A peritoneal dialysis device to which the cassette according to any one of claims 1 to 4 can be attached,
A peritoneal dialysis apparatus, comprising: a flow rate control unit that controls a flow rate so that an amount of the peritoneal dialysis fluid flowing in accordance with an amount accommodated in the accommodation bag when performing the liquid injection process.

Images