JP2009153640A - Blood purifying device and its priming method - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a blood purifying device capable of easily automating a priming process and quickly and surely removing air bubbles in a blood purifying means, and to provide its priming method. <P>SOLUTION: In the blood purifying device, the blood introducing port 3a of the dialyzer 3 is in the state facing upward to execute following processes: a first priming process of supplying priming liquid from a priming liquid supply line Lc, making the priming liquid flow to a vein side blood circuit side by the tare, and filling the priming liquid while being discharged from an overflow line 8 from the blood deriving port 3b of a dialyzer 3 through a blood introducing port 3a; a second priming process of driving a blood pump 4, making the priming liquid flow to the opposite side compared to the first priming process and filling it; and a third priming process of introducing a dialysate to a dialysate flow path and discharging the dialysate from a dialysate discharge line Lb. <P>COPYRIGHT: (C)2009,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 priming method thereof.

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

  Among these, the arterial blood circuit is provided with a squeezed blood pump, and by driving the blood pump, blood is sent from the patient's body to the dialyzer side, while the arterial blood circuit and the venous blood are supplied. An arterial drip chamber and a venous drip chamber are connected to the circuit so that blood is returned to the patient's body after defoaming.

  In addition, a priming solution supply line (saline solution line) for supplying physiological saline at the time of priming or blood return is provided upstream of the blood pump in the arterial blood circuit (that is, the arterial puncture needle side). Prior to dialysis treatment, the blood circuit and components such as the drip chamber connected to the blood circuit are primed by flowing and filling physiological saline before dialysis treatment. Blood is returned by replacing the residual blood remaining in the circuit and the like with physiological saline and returning the residual blood to the patient. Note that a dialysis apparatus provided with a priming solution supply line is disclosed in Patent Document 1, for example.

  In particular, the priming operation will be specifically described with reference to FIGS. Reference numeral 103 in the figure denotes a dialyzer as blood purification means, in which a blood channel for circulating the patient's blood and a dialysate channel for circulating dialysate are formed. However, at both ends of the blood flow path, a blood introduction port a for introducing blood by being connected to an arterial blood circuit 101 in which a blood pump 104 is disposed, and a venous blood circuit 102 are connected to lead out blood. A blood outlet b is formed, and at both ends of the dialysate flow path, a dialysate inlet c connected to the dialysate inlet line 107 for introducing the dialysate and a dialysate outlet line 108 are connected. A dialysate outlet d for leading dialysate is formed.

  Before the dialysis treatment, the physiological pump (priming solution) in the saline bag 105 is supplied to the arterial blood circuit 101 via the priming solution supply line 106 by driving the blood pump. At this time, the dialyzer 103 is installed so that the blood outlet port b faces upward, and the physiological saline introduced from the blood inlet port a is led out from the blood outlet port b. And it fills the blood circuit while circulating physiological saline (see FIG. 13).

  Thereafter, the dialyzer 103 is turned upside down while clamping the priming solution supply line 106, and the dialyzer 103 is installed so that the blood introduction port a faces upward (see FIG. 14). Thereafter, the dialysate is introduced from the dialysate introduction line 107 and circulated through the dialysate flow path, and then the dialysate flow path is filled while being discharged from the dialysate discharge line 108. Thereby, the priming on the dialysate flow path side is performed after the blood flow path.

That is, when priming the blood flow path with physiological saline, since the bubbles in the blood flow path move upward, the blood outlet b is directed upward and led to the venous blood circuit 102 side. However, if it is attempted to prime the dialysis channel with dialysate in this state, the dialysate flows from the top to the bottom, and the direction of movement of the bubbles is opposite. For this reason, the dialysis fluid is flowed from the lower side to the upper side by inverting the upper and lower sides, thereby ensuring the smooth movement of the air bubbles and enabling more reliable air bubble removal.
JP 2000-93449 A

  However, in the above-described conventional blood purification apparatus, it is necessary to turn the dialyzer 103 upside down after priming on the blood flow path side and before priming on the dialysate flow path side, so that the priming process (and the subsequent treatment process is included) ) Is difficult to automate. In other words, since it is necessary for the operator to manually flip the dialyzer, it is difficult to automate including this.

  Further, in the conventional blood purification apparatus, it is necessary to turn the dialyzer 103 upside down in order to remove air bubbles, so that there is a problem that the number of priming work steps increases and the priming time becomes longer. . Thus, if the priming time is lengthened, the treatment start time is delayed, and there is a problem in that it imposes a burden on the patient and medical staff.

  The present invention has been made in view of such circumstances, and a blood purification apparatus capable of easily automating the priming process and allowing quick and reliable air bubble removal in the blood purification means and the priming thereof. It is to provide a method.

  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 flow path that is interposed between the arterial blood circuit and the venous blood circuit of the circuit to purify blood flowing through the blood circuit, and through which a patient's blood flows through a blood purification film for purifying the blood; Blood purification means having a dialysate flow path through which the dialysate flows, a blood pump disposed in the arterial blood circuit, and dialysate introduction connected to the dialysate flow path inlet and outlet of the blood purification means A priming fluid supply line connected to the arterial blood circuit and supplying a priming fluid into the blood circuit, and formed at both ends of the blood purification means. A blood introduction port connected to the side blood circuit to introduce blood into the blood flow path, a blood outlet port connected to the venous side blood circuit to derive blood from the blood circuit, and a side surface of the blood purification means, respectively A dialysate inlet for introducing dialysate into the dialysate flow path connected to the dialysate introduction line, and a dialysate outlet for connecting dialysate from the dialysate flow path connected to the dialysate discharge line In the blood purification device comprising the above, at the time of priming before treatment, the tip of the arterial blood circuit and the tip of the venous blood circuit are connected to communicate with each other, and the blood pump and blood in the arterial blood circuit A priming liquid discharge port formed between the blood introduction port of the purifying means and capable of discharging the priming liquid supplied from the priming liquid supply line; The priming liquid is supplied from the priming liquid supply line, and the priming liquid is allowed to flow to the venous blood circuit side and discharged from the priming liquid discharge port through the blood introduction port from the blood outlet of the blood purification means. A first priming step for filling the liquid, and a first pump for driving the blood pump to flow the priming liquid to a side opposite to the first priming step and filling the priming liquid while discharging it from the priming liquid discharge port. A second priming step, and the introduction of the dialysate into the dialysate flow path from the dialysate introduction line, and filling the dialysate while discharging the dialysate from the dialysate discharge line via the dialysate outlet port The priming step is performed with the blood inlet of the blood purification means facing upward. Features.

  According to a second aspect of the present invention, in the blood purification apparatus according to the first aspect, the blood pump is driven at a predetermined speed so that the first priming step and the second priming step are performed simultaneously.

  According to a third aspect of the present invention, in the blood purification apparatus according to the first or second aspect, after the first priming step and the second priming step, the blood pump is driven to circulate the filled priming solution. It is characterized by that.

  Invention of Claim 4 is the blood purification apparatus as described in any one of Claims 1-3. WHEREIN: The said priming liquid discharge port is from the artery side drip chamber arrange | positioned in the middle of the said artery side blood circuit. It is formed in an extended overflow line.

  According to a fifth aspect of the present invention, there is provided a blood circuit comprising an arterial blood circuit and a venous blood circuit, and 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 flow path that is interposed between the arterial blood circuit and the venous blood circuit of the circuit to purify blood flowing through the blood circuit, and through which a patient's blood flows through a blood purification film for purifying the blood; Blood purification means having a dialysate flow path through which the dialysate flows, a blood pump disposed in the arterial blood circuit, and dialysate introduction connected to the dialysate flow path inlet and outlet of the blood purification means A priming fluid supply line connected to the arterial blood circuit and supplying a priming fluid into the blood circuit, and formed at both ends of the blood purification means. A blood introduction port connected to the side blood circuit to introduce blood into the blood flow path, a blood outlet port connected to the venous side blood circuit to derive blood from the blood circuit, and a side surface of the blood purification means, respectively A dialysate inlet for introducing dialysate into the dialysate flow path connected to the dialysate introduction line, and a dialysate outlet for connecting dialysate from the dialysate flow path connected to the dialysate discharge line In the priming method of the blood purification apparatus, the blood purification apparatus is configured to connect the arterial blood circuit tip and the venous blood circuit tip to communicate with each other at the time of priming before treatment. Priming formed between the blood pump in the side blood circuit and the blood inlet of the blood purification means and capable of discharging the priming liquid supplied from the priming liquid supply line And a priming fluid supply line from the priming fluid supply line, the priming fluid to flow to the venous blood circuit side, and from the blood outlet port of the blood purification means through the blood inlet port. A first priming step of filling the priming solution while discharging it from the priming solution discharge port; and driving the blood pump to cause the priming solution to flow to the opposite side of the first priming step; A second priming step in which the priming solution is filled while being discharged from the dialysis solution, and the dialysis solution is introduced from the dialysis solution introduction line into the dialysis solution flow path, and the dialysis solution is discharged from the dialysis solution discharge line through the dialysis solution outlet. A third priming step of filling the dialysate while draining, and introducing blood into the blood purification means It is performed with the mouth facing upward.

  The invention according to claim 6 is the priming method of the blood purification apparatus according to claim 5, wherein the blood pump is driven at a predetermined speed so that the first priming step and the second priming step are performed simultaneously. To do.

  The invention according to claim 7 is the priming method of the blood purification apparatus according to claim 5 or claim 6, wherein after the first priming step and the second priming step, the blood pump is driven to fill the priming solution. It is characterized by circulating.

  The invention according to claim 8 is the priming method of the blood purification apparatus according to any one of claims 5 to 7, wherein the priming fluid discharge port is provided on the artery side disposed in the middle of the artery side blood circuit. It is formed in the overflow line extended from the drip chamber.

  According to the first and fifth aspects of the present invention, the first priming step and the second priming step, which are priming steps on the blood flow channel side, and the third priming step, which is a priming step on the dialysate flow channel side, are both of Since it is performed with the blood inlet facing upward, the upside down operation of the blood purification means is unnecessary, the priming process can be easily automated, and quick and reliable air bubble removal in the blood purification means Can be done.

  According to the second and sixth aspects of the invention, the blood pump is driven at a predetermined speed so that the first priming step and the second priming step are performed simultaneously, so that the first priming step and the second priming step are sequentially performed. Compared with the one to be made, it is possible to perform the air bubble removal in the blood purification means at the time of priming more quickly.

  According to the third and seventh aspects of the present invention, after the first priming step and the second priming step, the blood pump is driven and the filled priming liquid is circulated, so that air bubble removal can be performed more reliably. .

  According to the fourth and eighth aspects of the present invention, the priming fluid discharge port is formed in the overflow line extending from the arterial drip chamber disposed in the middle of the arterial blood circuit, so that the existing blood circuit is almost intact. It can be used as the blood purification apparatus according to the present invention.

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 purifying means) interposed between the venous blood circuit 2 and purifying blood flowing in the blood circuit, a squeezed blood pump 4 disposed in the arterial blood circuit 1, and a venous side Arterial drip chamber 5 and venous drip chamber 6 disposed in blood circuit 1 and venous blood circuit 2, respectively, accommodating means 7 containing physiological saline as a priming solution, and accommodating means 7 and the arterial side The priming liquid supply line Lc connected to the blood circuit 1 is mainly configured.

  The arterial blood circuit 1 is connected to an arterial puncture needle a via a connector c at its tip, and an iron-type blood pump 4 and an arterial drip chamber 5 for defoaming are disposed in the middle. On the other hand, a venous puncture needle b is connected to the distal end of the venous blood circuit 2 via a connector d, and a venous drip chamber 6 is connected midway. 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.

  However, the arterial drip chamber 5 and the venous drip chamber 6 have overflow lines 8 and 9 extending from the respective upper portions (air layer side), and electromagnetic valves V3 and V4 are respectively connected to the overflow lines 8 and 9, respectively. It is arranged. In particular, the opening (mouth opened to the atmosphere) at the tip of the overflow line 8 extending from the artery-side drip chamber 5 is the priming fluid discharge port (the blood pump 4 in the artery-side blood circuit 1 and the blood inlet 3a of the dialyzer 3). Between the priming liquid supply line Lc and the priming liquid supplied from the priming liquid supply line Lc.

  The dialyzer 3 includes a blood inlet 3a (blood inlet port), a blood outlet 3b (blood outlet port), a dialysate inlet 3c (dialysate inlet port), and a dialysate outlet 3d (dialysate). A blood outlet port 3a is connected to the arterial blood circuit 1, and the blood outlet port 3b is connected to the venous blood circuit 2. The dialysate inlet 3c and dialysate outlet 3d are respectively connected to a dialysate inlet line La and a dialysate outlet line Lb extending from the dialyzer body.

  A plurality of hollow fibers (not shown) are accommodated in the dialyzer 3, and these hollow fibers constitute a blood purification membrane for purifying blood. Thus, the dialyzer 3 is formed with a blood flow path through which the patient's blood flows and a dialysate flow path through which the dialysate flows through the blood purification membrane. The hollow fiber constituting the blood purification membrane is formed with a large number of minute holes (pores) penetrating the outer peripheral surface and the inner peripheral surface to form a hollow fiber membrane, and blood is passed through the membrane. It is configured so that impurities therein can permeate into the dialysate.

  The dual pump (not shown) is disposed across the dialysate introduction line La and the dialysate discharge line Lb in the dialyzer body, and from the patient's blood flowing in the dialyzer 3 to the dialyzer body. A water removal pump (not shown) for removing water is provided. 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 dialysate having a predetermined concentration. In addition, one end of the dialysate discharge line Lb is connected to the dialyzer 3 (dialysate outlet 3d), and the other end is connected to a drain means (not shown), and the dialysate supplied from the dialysate supply device After reaching the dialyzer 3 through the dialysate introduction line La, it is sent to the drainage means through the dialysate discharge line Lb.

  In the middle of the dialysate introduction line La (between the duplex pump and the dialyzer 3), an electromagnetic valve V6 capable of closing and opening the flow path is connected, and in the middle of the dialysate discharge line Lb (with the duplex pump and An electromagnetic valve V5 capable of closing and opening the flow path is connected to the dialyzer 3). In addition, even in the middle of the arterial blood circuit 1, an electromagnetic valve V1 capable of closing and opening the flow path is connected.

  These solenoid valves V1, V5 and V6 (the same applies to solenoid valves V2 to V4 which will be described later) can close and open the flow paths at the respective locations by opening and closing operations as described above. The opening / closing operation is controlled by a control means such as a microcomputer. That is, the control means extends from the solenoid valve V1, V5 and V6 as described above, the solenoid valve V2 disposed in the middle of the priming fluid supply line Lc, and the upper part (air layer side) of the artery side drip chamber 5. The solenoid valve V3 disposed in the middle of the overflow line 8 and the solenoid valve V4 disposed in the middle of the overflow line 9 extending from the upper part (air layer side) of the vein drip chamber 6 are also electrically connected. The opening / closing operation can be controlled.

  The storage means 7 (so-called “saline bag”) is made of a flexible transparent container and can store a predetermined volume of physiological saline (priming solution). It is attached to the tip of a pole (not shown). The priming liquid supply line Lc is connected to a site (connecting portion P) between the arterial puncture needle a and the arterial drip chamber 5 in the arterial blood circuit 1 to supply physiological saline (priming liquid) in the storage means 7. It can be supplied into the blood circuit.

  Here, the dialysis apparatus (blood purification apparatus) according to the present embodiment performs priming before treatment (priming liquid such as physiological saline is flowed through the blood flow path or the dialysis liquid flow path to wash the priming liquid. When the blood flow path or dialysate flow path is filled in advance, the tip of the arterial blood circuit 1 and the tip of the venous blood circuit 2 are connected to communicate with each other (specifically, the connector c and the connector d) As described above, it is formed between the blood pump 4 in the arterial blood circuit 1 and the blood inlet 3a of the dialyzer 3 to supply the priming solution. An overflow line 8 (priming liquid discharge port) that can discharge the priming liquid supplied from the line Lc is provided.

Hereinafter, the priming process performed by the dialysis apparatus according to the present embodiment will be described.
At the time of priming, as shown in FIG. 2, the blood introduction port 3a of the dialyzer 3 is in a state facing upward (fixed by a fixing means (not shown)), and the connector c and the connector d are connected to each other. After the communication, the other solenoid valves (V3, V5, and V6) are closed while the solenoid valves V2, V1, and V4 are opened.

  Thus, the physiological saline (priming solution) in the storage means 7 reaches the venous drip chamber 6 by its own weight (drop pressure) generated by the drop, and extends from the upper part thereof as shown in FIG. It is discharged from the overflow line 9. Thereby, the liquid level of the venous drip chamber 6 can be secured. This process is referred to as a “pre-priming process” for convenience.

  Then, as shown in FIG. 3, the electromagnetic valve V4 is closed and the electromagnetic valve V3 is opened. Also at this time, the physiological saline (priming solution) in the storage means 7 reaches the artery-side drip chamber 5 and extends from the upper part thereof by its own weight (drop pressure) generated by the drop, as shown in FIG. It will be discharged from the overflow line 8. In this way, physiological saline (priming fluid) is supplied from the priming fluid supply line Lc, and the physiological saline is caused to flow to the venous blood circuit 2 side by its own weight, and blood is supplied from the blood outlet 3b of the dialyzer 3. The physiological saline is filled in the flow path while being discharged from the overflow line 8 (priming liquid discharge port) through the introduction port 3a (this is referred to as a “first priming step”). Thus, bubbles (air) in the blood flow path of the dialyzer 3 reach the arterial drip chamber 5 from the blood introduction port 3a and are discharged from the overflow line 8.

  After that, as shown in FIG. 4, the blood pump 4 is driven to flow the physiological saline (priming solution) to the opposite side to the first priming step, and is discharged from the overflow line 8 (priming solution discharge port). Then, the physiological saline is filled in the flow path (this is referred to as “second priming step”). At this time, the driving of the blood pump 4 is controlled so that the physiological saline flows from the connecting portion P to both the blood pump 4 side and the vein drip chamber 6 side.

  In addition, in the 1st priming process and the 2nd priming process, since the physiological saline is discharged | emitted from the overflow line 8, the liquid level of the discharge artery side drip chamber 5 is securable. Further, through the first priming step and the second priming step, the blood flow paths of the arterial blood circuit 1, the venous blood circuit 2 and the dialyzer 3 are filled with physiological saline.

  Further, as shown in FIG. 5, the blood pump 4 is stopped, the electromagnetic valves V1 to V4 are closed, and the electromagnetic valves V5 and V6 are opened. At this time, the dual pump is driven to introduce the dialysate from the dialysate introduction line La into the dialysate flow path, and the dialysate is discharged from the dialysate discharge line Lb via the dialysate outlet 3d. The liquid is filled in the flow path (this is referred to as a “third priming step”). By passing through the third priming step, the dialysate flow path is filled with the dialysate. Thus, bubbles (air) in the dialysate flow path of the dialyzer 3 are discharged from the dialysate outlet 3d through the dialysate discharge line Lb.

  After completion of the third priming step, as shown in FIG. 6, the electromagnetic valves V5 and V6 are closed (the closed state of the electromagnetic valve V2 is also maintained), the electromagnetic valve V1 is opened, and the blood pump By driving 4, physiological saline is circulated in the closed circuit. As described above, after the first priming step and the second priming step, the blood pump 4 is driven to circulate the filled priming liquid, thereby circulating the air bubbles remaining in the flow path, and the arterial drip chamber 5. Or can be trapped in the venous drip chamber 6 (this is called a “circulation process”).

  Subsequently, as shown in FIG. 7, the electromagnetic valves V2 and V4 are opened, and the physiological saline (priming solution) in the storage means 7 is supplied from the venous drip chamber 6 while being supplied again into the blood circuit. Excess saline is discharged from the overflow line 9. The electromagnetic valve V1 is closed. Thereby, the path | route from the connection part P to the venous drip chamber 6 via the artery side drip chamber 5 and the dialyzer 3 can be reliably wash | cleaned with the fresh physiological saline in the accommodating means 7. This is called “first cleaning step”).

  Then, as shown in FIG. 8, the blood pump 4 is stopped, and the electromagnetic valve V1 is opened, so that the physiological saline (priming solution) in the storage means 7 has its own weight (head pressure) generated by the head. Then, it reaches the venous drip chamber 6 and is discharged from the overflow line 9 extending from the upper part thereof. Thereby, the path | route from the connection part P to the venous drip chamber 6 can be reliably wash | cleaned with the fresh physiological saline in the accommodating means 7 (this is a "2nd washing | cleaning process"). Called).

  Finally, as shown in FIG. 9, the electromagnetic valve V4 is closed, the electromagnetic valve V3 is opened, and the physiological saline (priming solution) in the storage means 7 is caused by its own weight (drop) Pressure) through the dialyzer 3 to the arterial drip chamber 5 and drain from the overflow line 8 extending from the upper part. Thereby, bubbles remaining in the vicinity of the blood inlet 3a of the dialyzer 3 can be discharged from the overflow line 8 (this is referred to as a “header bubble removal process”).

  Through the above steps (pre-priming step, first priming step, second priming step, third priming step, circulation step, first washing step, second washing step, header bubble removal step) It is possible to perform washing and priming of the part through which blood, dialysate, etc. circulate, and it is possible to reliably discharge bubbles to the outside. Further, in the present embodiment, since the blood introduction port 3a of the dialyzer 3 is directed upward throughout all the priming steps, the upside down operation of the dialyzer 3 is not required, and the priming step is facilitated. In addition to being able to automate, the dialyzer 3 can be quickly and surely vented.

  In addition, after the first priming step and the second priming step, the blood pump 4 is driven to circulate the filled priming liquid (through the circulation step), so that air bubble removal can be performed more reliably. Further, since the priming fluid discharge port is formed in the overflow line 8 extending from the artery side drip chamber 5 disposed in the middle of the artery side blood circuit 1, the existing blood circuit is used almost as it is in the present invention. Such a blood purification device (dialysis device) can be obtained.

  In this embodiment, in order to discharge bubbles more smoothly to the outside, it is preferable to use at least the artery-side drip chamber 5 that does not have a mesh inside. Further, when a pressure monitor line (line for detecting air layer side pressure) or the like extends from the upper part of the arterial drip chamber 5 or the venous drip chamber 6, the base ends of the overflow lines 8 and 9 are used. Is preferably lowered below the pressure monitor line so that it does not flow into the pressure monitor line when the priming solution (saline) overflows.

  Although the present embodiment has been described above, the present invention is not limited to this. For example, the prepriming step is omitted, and the venous drip chamber 6 does not have an overflow line as shown in FIG. It may be a thing. Further, while omitting the step shown in FIG. 3, it is preferable to drive the blood pump 4 at a predetermined speed so that the first priming step and the second priming step are performed simultaneously as shown in FIG. In this case, it is possible to perform air bubble removal in the dialyzer 3 during priming more quickly than in the case where the first priming step and the second priming step are sequentially performed.

  Furthermore, it suffices to pass through the first priming step, the second priming step (including those for simultaneously performing these steps), and the third priming step, and the order can be variously changed or omitted. For example, after the pre-priming step, the first priming step, and the second priming step, the circulation step, the first cleaning step and the second cleaning step, and the header bubble removal step are performed, and then the third priming step is performed, After the priming process, the first priming process, the second priming process, and the third priming process, the circulation process, the first cleaning process, and the second cleaning process may be omitted, and the header bubble removing process may be performed.

  Further, after the first priming step and the second priming step (including those that perform the pre-priming step or those that simultaneously perform the first priming step and the second priming step while omitting the pre-priming step), the third priming step The order in the circulation step, the first cleaning step, and the second cleaning step may be changed as appropriate, and the steps may be deleted (however, the third priming step is essential).

  Furthermore, in the present embodiment, physiological saline as a priming liquid is supplied from the storage means 7 by its own weight. However, a physiological saline is provided by installing liquid feeding means such as a pump in the priming liquid supply line Lc. May be supplied. Further, as shown in FIG. 11, a priming fluid supply line Lc is extended from the dialysate introduction line La to the arterial blood circuit 1 (position between the connector c and the blood pump 4), and as a priming fluid in the blood circuit. The dialysate may be supplied. In this case, it is preferable that a filter is interposed in the priming liquid supply line Lc. However, the priming solution may be other (for example, various electrolyte solutions).

  In the present embodiment, the priming fluid outlet is formed in the overflow line 8 extending from the arterial drip chamber 5 disposed in the middle of the arterial blood circuit 1. As long as it is formed between the blood pump 4 and the blood inlet 3a of the dialyzer 3 and can discharge the priming liquid supplied from the priming liquid supply line Lc, it may be formed at any location. As shown in FIG. 12, the arterial drip chamber may not be provided, and may be formed in a flow path 8 ′ branched from an arbitrary position in the middle of the arterial blood circuit 1. In this case, the flow path 8 ′ can be extended by a branch pipe such as a T pipe, a Y pipe, or a three-way cock, and may be connected to an access port such as a rubber button.

  Furthermore, after the second priming step, the blood pump 4 is stopped, the electromagnetic valve V5 is opened while the electromagnetic valve V3 is kept open, and the other electromagnetic valves are all closed. Good. That is, after the second priming step, the blood flow channel side of the dialyzer 3 is filled with the priming solution, but the dialysate flow channel side is empty. A negative pressure corresponding to a height difference (fall) from the tip of the overflow line 8 of the artery side chamber 5 is applied to the blood flow path side.

  However, since the dialysate side is in an atmospheric pressure state, if there is a damage such as a pinhole in the blood flow path (dialysis membrane such as hollow fiber) of the dialyzer 3, air is sucked from there and the sucked air flows into the blood flow. It appears as a continuous bubble on the roadside. Therefore, a leak test of the dialyzer 3 (blood purification means) can be performed depending on whether or not the bubbles are generated.

  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.

  At the time of priming before treatment, the tip of the arterial blood circuit and the tip of the venous blood circuit can be connected to communicate with each other and formed between the blood pump in the arterial blood circuit and the blood inlet of the blood purification means. A priming liquid discharge port through which the priming liquid supplied from the priming liquid supply line can be discharged, and the priming liquid is supplied from the priming liquid supply line and flows to the venous blood circuit side. A first priming step in which the priming solution is filled while being discharged from the priming solution discharge port through the blood introduction port from the blood outlet of the blood purification means, and the first priming step by driving the blood pump To the opposite side of the priming liquid while discharging from the priming liquid outlet. A second priming step for filling the dialysate, and introducing the dialysate into the dialysate flow path from the dialysate introduction line and discharging the dialysate from the dialysate discharge line via the dialysate outlet port As long as the third priming step for filling the blood purification device is a blood purification device and its priming method in which the blood introduction port of the blood purification means faces upward, it can be applied to other forms and applications. it can.

The schematic diagram which shows the dialysis apparatus (blood purification apparatus) which concerns on embodiment of this invention. Schematic diagram showing a state in which the pre-priming process is performed by the dialysis machine The schematic diagram which shows the state in which the 1st priming process by the dialyzer is performed The schematic diagram which shows the state in which the 2nd priming process by the dialyzer is performed The schematic diagram which shows the state in which the 3rd priming process by the dialyzer is performed Schematic diagram showing the state where the circulation process by the dialysis machine is performed The schematic diagram which shows the state in which the 1st washing | cleaning process by the dialyzer is performed The schematic diagram which shows the state in which the 2nd washing | cleaning process by the same dialysis apparatus is performed Schematic diagram showing a state in which the header bubble removal process by the dialysis device is performed Schematic diagram showing a dialysis apparatus according to another embodiment of the present invention. Schematic diagram showing a dialysis apparatus according to another embodiment of the present invention. Schematic diagram showing a dialysis apparatus according to another embodiment of the present invention. Schematic showing the state where the priming process (blood flow path side) is performed by a conventional dialysis machine Schematic diagram showing a state in which the priming process (dialysate flow path side) is performed by a conventional dialyzer

Explanation of symbols

1 Arterial blood circuit 2 Venous blood circuit 3 Dialyzer (blood purification means)
4 Blood pump 5 Arterial drip chamber 6 Venous drip chamber 7 Storage means 8 Overflow line (priming fluid discharge port)
9 Overflow line La Dialysate introduction line Lb Dialysate discharge line Lc Priming solution supply line

Claims (8)

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;
A blood flow that is interposed between the arterial blood circuit and the venous blood circuit of the blood circuit to purify the blood flowing through the blood circuit and to which the patient's blood flows through a blood purification film for purifying the blood Blood purification means in which a dialysis fluid flow path through which the passage and dialysis fluid flow is formed;
A blood pump disposed in the arterial blood circuit;
A dialysate introduction line and a dialysate discharge line connected to the dialysate flow path inlet and outlet of the blood purification means;
A priming fluid supply line connected to the arterial blood circuit and capable of supplying a priming fluid into the blood circuit;
Blood that is formed at both ends of the blood purification means, is connected to the arterial blood circuit and introduces blood into the blood flow path, and blood is connected to the venous blood circuit and derives blood from the blood circuit The outlet,
A dialysate introduction port that is formed on each side of the blood purification means and is connected to the dialysate introduction line to introduce the dialysate into the dialysate flow path, and a dialysate discharge line that is connected to the dialysate discharge line. A dialysate outlet for extracting dialysate;
In the blood purification apparatus comprising
During priming before treatment, the arterial blood circuit tip and the venous blood circuit tip are connected to communicate with each other and between the blood pump in the arterial blood circuit and the blood inlet of the blood purification means. A priming liquid outlet that is formed to allow the priming liquid supplied from the priming liquid supply line to be discharged; and
While supplying the priming liquid from the priming liquid supply line, the priming liquid flows to the venous blood circuit side, and is discharged from the priming liquid discharge port through the blood introduction port from the blood outlet of the blood purification means. A first priming step of filling the priming liquid;
A second priming step in which the blood pump is driven to flow the priming solution to the opposite side of the first priming step, and the priming solution is filled while being discharged from the priming solution discharge port;
A third priming step of introducing the dialysate from the dialysate introduction line into the dialysate flow path and filling the dialysate while discharging the dialysate from the dialysate discharge line via the dialysate outlet;
Is performed with the blood inlet of the blood purification means facing upward.   The blood purification apparatus according to claim 1, wherein the blood pump is driven at a predetermined speed so that the first priming step and the second priming step are performed simultaneously.   3. The blood purification apparatus according to claim 1, wherein after the first priming step and the second priming step, the blood pump is driven to circulate the filled priming solution.   The said priming liquid discharge port is formed in the overflow line extended from the artery side drip chamber arrange | positioned in the middle of the said artery side blood circuit, The Claim 1 characterized by the above-mentioned. Blood purification device. 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;
A blood flow that is interposed between the arterial blood circuit and the venous blood circuit of the blood circuit to purify the blood flowing through the blood circuit and to which the patient's blood flows through a blood purification film for purifying the blood Blood purification means in which a dialysis fluid flow path through which the passage and dialysis fluid flow is formed;
A blood pump disposed in the arterial blood circuit;
A dialysate introduction line and a dialysate discharge line connected to the dialysate flow path inlet and outlet of the blood purification means;
A priming fluid supply line connected to the arterial blood circuit and capable of supplying a priming fluid into the blood circuit;
Blood that is formed at both ends of the blood purification means, is connected to the arterial blood circuit and introduces blood into the blood flow path, and blood is connected to the venous blood circuit and derives blood from the blood circuit The outlet,
A dialysate introduction port that is formed on each side of the blood purification means and is connected to the dialysate introduction line to introduce the dialysate into the dialysate flow path, and a dialysate discharge line that is connected to the dialysate discharge line. A dialysate outlet for extracting dialysate;
In the priming method of the blood purification apparatus comprising
The blood purification apparatus is configured to connect the arterial blood circuit tip and the venous blood circuit tip to communicate with each other at the time of priming before treatment, and the blood pump and blood purification means in the arterial blood circuit. A priming liquid discharge port formed between the blood introduction port and capable of discharging the priming liquid supplied from the priming liquid supply line; and
While supplying the priming liquid from the priming liquid supply line, the priming liquid flows to the venous blood circuit side, and is discharged from the priming liquid discharge port through the blood introduction port from the blood outlet of the blood purification means. A first priming step of filling the priming liquid;
A second priming step in which the blood pump is driven to flow the priming solution to the opposite side of the first priming step, and the priming solution is filled while being discharged from the priming solution discharge port;
A third priming step of introducing the dialysate from the dialysate introduction line into the dialysate flow path and filling the dialysate while discharging the dialysate from the dialysate discharge line via the dialysate outlet;
Is performed in a state where the blood introduction port of the blood purification means faces upward.   6. The priming method for a blood purification apparatus according to claim 5, wherein the blood pump is driven at a predetermined speed so that the first priming step and the second priming step are performed simultaneously.   The blood purification apparatus priming method according to claim 5 or 6, wherein after the first priming step and the second priming step, the blood pump is driven to circulate the filled priming solution.   The said priming liquid discharge port is formed in the overflow line extended from the artery side drip chamber arrange | positioned in the middle of the said artery side blood circuit, The any one of Claims 5-7 characterized by the above-mentioned. Priming method of blood purification apparatus.

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