JP2011136003A - Blood purifying device and priming method thereof - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a blood purifying device smoothly and securely discharging bubbles in a priming liquid to outside, suppressing the quantity of use of the priming liquid, and easily recognizing the quantity of the priming liquid to be fed in priming; and a priming method for the device. <P>SOLUTION: The priming method includes both a circulation step of circulating the liquid in an artery-side blood circuit 1, a vein-side blood circuit 2 and a channel within a dialyzer 3 by reversely driving a blood pump 4, and an overflowing step of letting the liquid overflow from an artery-side overflow line 13 while opening an artery-side valve means (V6) and a priming valve means (V3) and feeding the priming liquid from a priming liquid feeding line Lc. The step is shifted from the circulation step to the overflowing step on condition that bubbles are detected by a bubble detecting means (9 or 10). <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

  The present invention circulates a patient's blood extracorporeally with an arterial blood circuit and a venous blood circuit, and purifies extracorporeal blood with a blood purifier connected to the arterial blood circuit and the venous blood circuit. The present invention relates to a blood purification apparatus and a priming method therefor.

  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 air trap chamber and a venous air trap 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). It was connected via a T-shaped tube or the like, and an accommodation bag containing priming solution (physiological saline) was connected to the tip of the priming solution supply line. Thus, prior to dialysis treatment, priming can be performed by flowing a priming solution such as physiological saline from the priming solution supply line to the blood circuit and components such as an air trap chamber connected to the blood circuit. It is configured to be done. Note that a dialysis apparatus provided with a priming solution supply line is disclosed in Patent Document 1, for example.

JP 2000-93449 A

  However, in the conventional blood purification apparatus, when the priming liquid is supplied and filled in the blood circuit, there is a possibility that bubbles remaining in the blood circuit or the blood purification device may remain without being discharged to the outside. In order to discharge and remove the remaining bubbles to the outside, it is necessary to continue supplying a large amount of priming liquid for a relatively long time. For this reason, the physiological saline solution in a storage bag required at the time of blood purification treatment is insufficient, or there has been a problem that high cost is caused by using a large amount of priming solution. In addition, there is a problem in that it is impossible to grasp how much priming liquid has been supplied during priming.

  The present invention has been made in view of such circumstances, and can smoothly and surely discharge bubbles in the priming liquid to the outside, thereby suppressing the amount of the priming liquid used, and at the time of priming. An object of the present invention is to provide a blood purification apparatus and a priming method thereof that can easily grasp the supply amount of the priming liquid.

  The invention according to claim 1 is a blood purifier having a blood purification membrane and having a blood inlet, a blood outlet, a dialysate inlet and a dialysate outlet, and one end of which is introduced into the blood purifier. An arterial blood circuit connected to the mouth and provided with a blood pump in the middle thereof, a venous blood circuit having one end connected to the blood outlet of the blood purifier, and formed in the middle of the arterial blood circuit An arterial air trap chamber, an arterial overflow line that extends from the upper side of the arterial air trap chamber, and can discharge the liquid overflowing the arterial air trap chamber to the outside, and the arterial overflow line An arterial valve means capable of arbitrarily closing or opening the flow path of the arterial side, and a connection between the arterial blood circuit tip and the blood pump in the arterial blood circuit, A priming solution supply line capable of supplying a priming solution; priming valve means capable of arbitrarily closing or opening a flow path of the priming solution supply line; and a predetermined portion of the arterial blood circuit or venous blood circuit. In the blood purification apparatus comprising bubble detecting means capable of detecting bubbles in the liquid flowing through the part, and control means capable of controlling at least the blood pump, the arterial valve means and the priming valve means at any timing, At the time of priming, the arterial blood circuit tip and the venous blood circuit tip are connected to be in communication with each other, and the control means closes the arterial valve means and the priming valve means while blocking the blood pump. By driving in reverse, the fluid is circulated in the arterial blood circuit, the venous blood circuit, and the flow path in the blood purifier. An annulus step and the arterial valve means and the priming valve means are opened while the blood pump is driven to rotate in the forward direction, thereby supplying the priming liquid from the priming liquid supply line and overflowing the liquid from the arterial overflow line. An overflow process is performed, and the process is shifted from the circulation process to the overflow process on condition that a bubble is detected by the bubble detection means.

  According to a second aspect of the present invention, in the blood purification apparatus according to the first aspect, the control unit repeatedly performs the circulation step and the overflow step until the bubble detection by the bubble detection unit is eliminated.

  According to a third aspect of the present invention, in the blood purification apparatus according to the first or second aspect, a venous air trap chamber formed in the middle of the venous blood circuit and an upper side of the venous air trap chamber A venous overflow line which is extended and can discharge the liquid overflowing the venous air trap chamber to the outside; and a venous valve means which can arbitrarily close or open the flow path of the venous overflow line. In addition, the control means opens the venous valve means to overflow the liquid from the venous overflow line between the start of the circulation process and the end of the overflow process.

  According to a fourth aspect of the present invention, in the blood purification apparatus according to the third aspect, the venous air trap chamber has a filtration network formed therein, and a space between the tip of the arterial blood circuit and the blood pump. Or a blood circuit valve means capable of opening and closing a flow path from the distal end of the venous blood circuit to the venous air trap chamber, and the circulation step is performed by opening and closing the blood circuit valve means. The circulating liquid flow is changed, and bubbles adhering to the filtration network in the venous air trap chamber can be captured above the venous air trap chamber.

  According to a fifth aspect of the present invention, in the blood purification apparatus according to any one of the first to fourth aspects, the control means operates the blood pump at a high speed for a short time after the circulation step and the overflow step are completed. The agitation step of agitating the air bubbles in the vicinity of the blood introduction port in the blood purifier only by forward rotation, and after the agitation step, the blood pump is reversely driven for a predetermined time to Capture step of capturing in the side air trap chamber, and after the capture step, opening the arterial valve means and the priming valve means and driving the blood pump forward to overflow from the artery side overflow line It is what makes it perform.

  The invention according to claim 6 is a blood purifier having a blood purification membrane and having a blood inlet, a blood outlet, a dialysate inlet and a dialysate outlet, and one end of which is introduced into the blood purifier. An arterial blood circuit connected to the mouth and provided with a blood pump in the middle thereof, a venous blood circuit having one end connected to the blood outlet of the blood purifier, and formed in the middle of the arterial blood circuit An arterial air trap chamber, an arterial overflow line that extends from the upper side of the arterial air trap chamber, and can discharge the liquid overflowing the arterial air trap chamber to the outside, and the arterial overflow line An arterial valve means capable of arbitrarily closing or opening the flow path of the arterial side, and a connection between the arterial blood circuit tip and the blood pump in the arterial blood circuit, A priming solution supply line capable of supplying a priming solution; priming valve means capable of arbitrarily closing or opening a flow path of the priming solution supply line; and a predetermined portion of the arterial blood circuit or venous blood circuit. In the priming method of the blood purification apparatus comprising the bubble detecting means capable of detecting bubbles in the liquid flowing through the part, the arterial blood circuit tip and the venous blood circuit tip are connected to each other at the time of priming. In addition, by closing the arterial valve means and the priming valve means and driving the blood pump in a reverse direction, the fluid is supplied to the arterial blood circuit, the venous blood circuit, and the flow path in the blood purifier. Circulating the circulation step and driving the blood pump forward while opening the arterial valve means and the priming valve means And an overflow step of overflowing the fluid from the arterial overflow line while supplying the priming fluid from the priming fluid supply line, and on the condition that bubbles are detected by the bubble detection means , The circulation process is shifted to the overflow process.

  According to a seventh aspect of the present invention, in the priming method of the blood purification apparatus according to the sixth aspect, the circulation step and the overflow step are repeatedly performed until the bubble detection by the bubble detection means is eliminated.

  The invention according to claim 8 is the priming method of the blood purification apparatus according to claim 6 or 7, wherein the vein-side air trap chamber formed in the middle of the vein-side blood circuit, and the vein-side air trap chamber A venous side overflow line extending from above and capable of discharging the liquid overflowing the venous side air trap chamber to the outside, and venous side valve means capable of arbitrarily closing or opening the flow path of the venous side overflow line And the venous valve means is opened to allow the liquid to overflow from the venous overflow line between the start of the circulation process and the end of the overflow process.

  According to a ninth aspect of the present invention, in the blood purification apparatus priming method according to the eighth aspect, the venous air trap chamber has a filtration network formed therein, and the blood pump from the distal end of the arterial blood circuit. Or a blood circuit valve means capable of opening and closing a flow path between the distal end of the venous blood circuit and the venous air trap chamber, and the circulation step opens and closes the blood circuit valve means. Thus, the circulating liquid flow is changed, and bubbles adhering to the filtration network in the venous air trap chamber can be captured above the venous air trap chamber.

  A tenth aspect of the present invention is the blood purification apparatus priming method according to any one of the sixth to ninth aspects, wherein the blood pump is rotated at a high speed for a short time after the circulation step and the overflow step are completed. An agitation step of agitating bubbles in the vicinity of the blood introduction port in the blood purifier by driving, and after the agitation step, the blood pump is driven reversely for a predetermined time to remove the agitated bubbles from the arterial air trap A capturing step for capturing in the chamber, and an opening step for opening the arterial valve means and the priming valve means and causing the blood pump to normally rotate to overflow from the arterial overflow line are performed after the capturing step. It is characterized by making it.

  According to the first and sixth aspects of the invention, on the condition that bubbles are detected by the bubble detection means, the circulation process shifts to the overflow process, so that the bubbles are not sent to the blood purifier, and the overflow process is performed as follows: By opening the arterial valve means and the priming valve means and driving the blood pump forward, the liquid overflows from the arterial overflow line while supplying the priming liquid from the priming liquid supply line. Can be discharged smoothly and reliably to the outside, and the amount of the priming liquid used can be suppressed.

  If a pump tube with a known discharge amount per rotation angle of the blood pump is used, the supply amount of the priming liquid at the time of priming based on the normal rotation driving amount (rotation speed) of the blood pump at the time of the overflow process Can be easily grasped. Therefore, even a blood purification device that uses the priming fluid as a replacement fluid at the time of replacement or a replacement fluid at the time of returning blood, it is possible to grasp the amount of priming fluid used at the time of priming. In this case, it is possible to avoid the shortage of the replacement fluid or the replacement fluid.

  According to the second and seventh aspects of the present invention, since the circulation process and the overflow process are repeatedly performed until the bubble detection by the bubble detection means is eliminated, the bubbles in the blood circuit can be more reliably discharged outside during priming. In addition, if an arterial blood circuit with a known priming fluid channel volume (priming volume) is used, the overflow amount of the priming fluid in the overflow process can be further suppressed.

  According to the third and eighth aspects of the invention, since the venous valve means is opened and the liquid overflows from the venous overflow line between the start of the circulation process and the end of the overflow process, the venous air trap chamber is filled with liquid. Filling can prevent air bubbles from being sent to the blood purifier.

  According to the fourth and ninth aspects of the invention, the circulation step changes the circulating liquid flow by opening and closing the blood circuit valve means, and the bubbles attached to the filtration network in the venous air trap chamber are removed from the venous air. Since it can be trapped at the upper side of the trap chamber, it is possible to simplify the bubble removal confirmation before shifting to the extracorporeal circulation of blood, and the bubble removal operation when bubbles remain, and the addition of a priming solution for removing bubbles It becomes unnecessary.

  According to the fifth and tenth aspects of the present invention, after the circulation step and the overflow step are completed, the stirring step of stirring the air bubbles in the vicinity of the blood inlet in the blood purifier by driving the blood pump to rotate forward at high speed only for a short time. And after the agitation step, the blood pump is reversely driven for a predetermined time to capture the agitated bubbles in the artery side air trap chamber, and after the acquisition step, the artery side valve means and the priming valve means Is opened and the blood pump is driven to rotate forward to overflow from the arterial overflow line, so even if relatively fine bubbles remain near the blood inlet in the blood purifier, the bubbles are reliably Can be discharged to the outside.

FIG. 1 is an overall schematic diagram showing a blood purification apparatus according to an embodiment of the present invention. Overall schematic diagram showing the blood purification device (priming pre-process) Overall schematic diagram showing the blood purification device (priming pre-process) Overall schematic diagram showing the blood purification device (priming pre-process) Overall schematic diagram showing the blood purification device (circulation process) Overall schematic diagram showing the blood purification device (transfer process) Overall schematic diagram showing the blood purification device (overflow process) Overall schematic diagram showing the blood purification device (venous side overflow process) Overall schematic diagram showing the blood purification device (stirring process) Overall schematic diagram showing the blood purification device (capture process) Overall schematic diagram showing the blood purification device (opening process) Overall schematic view showing a blood purification apparatus according to another embodiment of 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 purification means) interposed between the venous blood circuit 2 and purifying blood flowing in the blood circuit, a squeezing blood pump 4 disposed in the arterial blood circuit 1, and an arterial side An arterial air trap chamber 5 connected to the blood circuit 1, a venous air trap chamber 6 connected to the venous blood circuit 2, a containing means 7 containing a physiological saline solution as a priming solution, and the containing means 7 and the arterial blood circuit 1 as a priming liquid supply line Lc, a priming liquid chamber 8 connected in the middle of the priming liquid supply line Lc, and priming valve means It is mainly composed of a solenoid valve V3 Metropolitan.

  An arterial puncture needle a is connected to the distal end of the arterial blood circuit 1 via a connector c, and an iron blood pump 4 is disposed in the middle, and an arterial air trap chamber 5 is connected. . A venous puncture needle b is connected to the distal end of the venous blood circuit 2 via a connector d, and a venous air trap chamber 6 is connected in the middle. 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 is defoamed in the arterial air trap chamber 5 while the arterial blood is removed. After reaching the dialyzer 3 through the circuit 1, blood purification is performed by the dialyzer 3, and defoaming is performed in the venous air trap 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 arterial air trap chamber 5 is provided with an arterial overflow line 13 extending from the upper side (air layer side) and having the tip released to the atmosphere, and the liquid ( Priming solution such as physiological saline) and air bubbles trapped in the arterial air trap chamber 5 are configured to be discharged to the outside. The arterial overflow line 13 is provided with an electromagnetic valve V6 serving as an arterial valve means, and the arterial overflow line 13 can be arbitrarily closed or opened.

  Similarly, the venous air trap chamber 6 is provided with a venous overflow line 14 extending from the upper side (air layer side) and having the tip opened to the atmosphere, and overflows the venous air trap chamber 6. The liquid (priming solution such as physiological saline) and the air bubbles trapped in the vein-side air trap chamber 6 can be discharged to the outside. The venous overflow line 14 is provided with an electromagnetic valve V7 as a venous valve means, and the venous overflow line 14 can be arbitrarily closed or opened.

  The dialyzer 3 (blood purifier) 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 guide. An outlet 3d (dialysate outlet port) is formed, of which the blood inlet 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, in the dialyzer 3, a blood flow path (flow path between the blood inlet 3a and the blood outlet 3b) through which the patient's blood flows through the blood purification membrane and a dialysate flow path through which the dialysate flows. (A flow path between the dialysate inlet 3c and the dialysate outlet 3d) is formed. The hollow fiber constituting the blood purification membrane has a number of minute holes (pores) penetrating the outer peripheral surface and the inner peripheral surface thereof to form a hollow fiber type semipermeable membrane, The material is exchanged between the blood side and the dialysate side through the blood to purify the blood.

  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 blood of the patient 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 predetermined concentration of dialysate. 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 passing through the dialysate introduction line La to the dialyzer 3, 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 V4 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). Further, the distal end side of the arterial blood circuit 1 (near the connector c) (between the distal end of the arterial blood circuit 1 to the blood pump 4) and the distal end side of the venous blood circuit 2 (near the connector d) (venous blood) Electromagnetic valves V1 and V2 (blood circuit valve means) capable of closing and opening the flow path are connected to the circuit 2 (from the tip to the venous air trap chamber 6) and a priming fluid supply line Lc. A solenoid valve V3 as a priming valve means capable of closing and opening the flow path is connected midway.

  Furthermore, an arterial-side bubble detecting means 9 capable of detecting bubbles in the liquid flowing through the site is disposed on the distal end side of the arterial blood circuit 1, and on the distal end side of the venous blood circuit 2, A venous-side bubble detection means 10 that can detect bubbles in the liquid flowing through the region is provided. In the figure, reference numerals 11 and 12 denote blood discriminators disposed on the distal end side of the arterial blood circuit 1 and the distal end side of the venous blood circuit 2, respectively. In addition, tube detectors may be disposed on the distal end side of the arterial blood circuit 1, the distal end side of the venous blood circuit 2, and in the middle of the priming fluid supply line Lc.

  These solenoid valves V1 to V7 are capable of closing and opening the flow passages at the respective locations by the opening / closing operation as described above, and the opening / closing operation is controlled by the control means 15 comprising a microcomputer or the like. It is configured to be. In particular, the control means 15 in this embodiment receives a detection signal from the bubble detection means 9 (or the bubble detection means 10), and serves as a blood pump 4, electromagnetic valves V1, V2, V4, V5, and priming valve means. The electromagnetic valve V3, the electromagnetic valve V6 as the artery side valve means, and the electromagnetic valve V7 as the vein side valve means can be controlled, and are electrically connected to these components.

  The storage means 7 (so-called “physiological saline bag”) is made of a flexible transparent container and can store a predetermined volume of physiological saline (priming liquid). It is attached to the tip of a protruding pole (not shown). The priming liquid supply line Lc is connected to a portion (connecting portion P) between the arterial puncture needle a and the arterial air trap chamber 5 in the arterial blood circuit 1, and a physiological saline solution (priming liquid) in the storage unit 7. Can be supplied into the blood circuit. In the middle of the priming liquid supply line Lc, a priming liquid chamber 8 is connected so that the supply (dropping) of physiological saline (priming liquid) can be visually observed.

  However, priming before treatment (priming solution such as physiological saline is washed by flowing in the blood channel or dialysate channel, and the blood channel or dialysate channel is filled with the priming solution in advance. When working), 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 connectors c and d are connected to communicate with each other in the flow path). Yes.

  Here, in the dialysis apparatus (blood purification apparatus) according to the present embodiment, the control means 15 receives a detection signal (bubble detection signal) from the bubble detection means 9 (or the bubble detection means 10) during priming before treatment. In addition, the drive control of the blood pump 4 and the solenoid valves V1 to V5 can be controlled to open and close at any timing, and the priming fluid (physiology) in the blood flow paths of the arterial blood circuit 1, the venous blood circuit 2 and the dialyzer 3 can be used. A preliminary process (FIGS. 2 to 4) filled with a saline solution, a circulation process (FIG. 5), a transfer process (FIG. 6), and an overflow process (FIG. 7) are sequentially performed.

  In particular, in this embodiment, the arterial blood circuit 1 and the venous blood are driven by reversely driving the blood pump 4 while closing the electromagnetic valve V6 (arterial valve means) and the electromagnetic valve V3 (priming valve means). The circulation process of circulating the fluid in the flow path in the circuit 2 and the dialyzer 3 (blood purifier) and the blood pump 4 while opening the solenoid valve V6 (arterial valve means) and the solenoid valve V3 (priming valve means). By performing normal rotation driving, an overflow step of overflowing the fluid from the artery side overflow line 13 while supplying the priming fluid from the priming fluid supply line Lc is performed, and the bubble detection means 9 (or the bubble detection means) On the condition that air bubbles are detected in 10), the control means 1 shifts from the circulation process to the overflow process. Control by is performed, is configured to repeatedly perform the circulating step and the overflow process by the bubble detection means 9 (or bubble detection means 10) until no air bubble detection.

Hereinafter, each step of priming 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 communicating, a pre-process is performed. As shown in FIGS. 2 to 4, the pre-process includes a physiological saline solution (priming solution) in the storage means 7 through the priming solution supply line Lc by the dead weight of the physiological saline solution (priming solution) or the forward rotation of the blood pump 4. Liquid) in the flow paths of the arterial blood circuit 1, the venous blood circuit 2, and the dialyzer 3.

  Specifically, as shown in FIG. 2, the control of the control means 15 maintains the stop of the blood pump 4, opens the solenoid valves V <b> 1 to V <b> 3 and the solenoid valve V <b> 7, and closes the solenoid valve V <b> 6. And Thereby, the physiological saline solution (priming solution) in the storage means 7 is the dead weight (drop pressure) generated by the drop, and between the priming solution supply line Lc and the connection part P to the tip of the arterial blood circuit 1, and From the distal end of the venous blood circuit 2 to the venous air trap chamber 6, it is discharged to the outside through the venous overflow line 14 extending from the upper part thereof.

  Thereafter, as shown in FIG. 3, the blood pump 4 is driven to rotate forward, and the electromagnetic valves V1, V2 and the electromagnetic valve V6 are closed, and the electromagnetic valves V3, V7 are opened. Thereby, when the dialyzer 3 is a wet type (a type prefilled with a filling liquid), the prefilled filling liquid is pushed out from the blood outlet 3b of the dialyzer 3 to reach the vein-side air trap chamber 6 and the vein It is discharged to the outside through the side overflow line 14. Therefore, the space from the blood outlet 3b in the venous blood circuit 2 to the venous air trap chamber 6 can be filled with the filling liquid in the dialyzer 3 in advance, and air is sent to the dialyzer 3 during the subsequent circulation process. Therefore, the physiological saline solution (priming solution) can be fed.

  In this embodiment, the process is controlled so that the dialyzer 3 is either a wet type or a dry type (a type in which the filling liquid is not filled), but the dialyzer 3 is a wet type. You may control to perform this process only in the case. However, if this step is performed regardless of whether the wet type or dry type dialyzer 3 is used, the pre-process can be automatically performed regardless of the type of the dialyzer 3.

  Then, as shown in FIG. 4, the normal rotation drive of the blood pump 4 is maintained, the electromagnetic valves V1, V2 and the electromagnetic valve V7 are closed, and the electromagnetic valves V3 and V6 are opened. Thereby, the physiological saline solution (priming solution) in the storage means 7 is a tube in which the blood pump 4 is disposed from the priming solution supply line Lc and the connecting portion P of the artery side blood circuit 1 by the driving force of the blood pump 4. It passes through the artery side air trap chamber 5 through the artery side overflow line 13 extending from the upper part thereof, and is discharged to the outside. Thus, the preliminary process is completed.

  Subsequently, under the control of the control means 15, as shown in FIG. 5, the electromagnetic valve V6 (arterial side valve means), V7 (venous side valve means) and the electromagnetic valve V3 (priming valve means) are blocked. By rotating the pump 4 in the reverse direction, the fluid is circulated in the flow paths in the arterial blood circuit 1, the venous blood circuit 2, and the dialyzer 3 (blood purifier) (circulation process). In the circulation process, the solenoid valves V1 and V2 are opened. According to such a circulation process, bubbles discharged from the blood introduction port 3a of the dialyzer 3 are circulated to the distal end side (connector c side) of the arterial blood circuit 1 in the process of circulating the liquid filled in the previous preliminary process. Can be moved.

  However, it is preferable to open and close the electromagnetic valve V1 or V2 (blood circuit valve means) in a short time and at an arbitrary timing in the circulation step. In that case, by the opening and closing operation, fine bubbles adhering to the filtration network (mesh, mesh cone, etc.) in the venous air trap chamber 6 are removed away from the filtration network, and then released to the outside in the subsequent overflow process. It can be discharged. Note that the opening / closing timing of the electromagnetic valve V1 or V2 is such that if the closing time is long, the internal pressure of the blood circuit on the blood pump discharge side may increase excessively, so 0.1 to 1.0 seconds is set as the closing time. It is good to do. The open state is desirably set to 1.0 to 3.0 seconds longer than the closed state time in order to ensure separation of the sent liquid and bubbles and return of the internal pressure.

  As described above, in the circulation step, the circulating fluid flow is changed by opening and closing the electromagnetic valve V1 or V2 (blood circuit valve means), and bubbles adhering to the filtration network in the vein side air trap chamber 6 are removed from the vein side. Since it can be trapped on the upper side (air layer) of the air trap chamber 6, it is possible to simplify the bubble removal confirmation before moving to the extracorporeal circulation of blood, and for the bubble removal operation and bubble removal when bubbles remain. No additional priming solution is required. That is, in the circulation process, by opening and closing the electromagnetic valve V1 or V2 (blood circuit valve means), the flow rate and pressure of the circulating liquid are caused to be slow, so that the venous air trap chamber is combined with the upward liquid flow. Air bubbles are trapped above 6 (air layer).

  In the circulation step, when a bubble is detected by the bubble detection means 9 (or the bubble detection means 10), the blood pump 4 is temporarily stopped under the control of the control means 15, and then, as shown in FIG. The electromagnetic valves V3, V6, and V7 are closed while V1 and V2 are opened, and the blood pump 4 is driven to rotate forward (transfer process). As a result, the bubbles in the vicinity of the bubble detection means 9 (or the bubble detection means 10) are transferred to the arrangement position of the blood pump 4 (between the connecting portion P of the arterial blood circuit 1 and the arrangement position of the blood pump 4). be able to.

  Thereafter, under the control of the control means 15, as shown in FIG. 7, the blood pump 4 is driven to rotate forward while the electromagnetic valve V6 (arterial valve means) and the electromagnetic valve V3 (priming valve means) are opened. Then, while supplying the priming liquid from the priming liquid supply line Lc, the liquid is overflowed from the artery side overflow line 13 (overflow process). In the overflow process, the electromagnetic valves V1, V2 and V7 (vein side valve means) are closed. According to the overflow process, the bubbles transferred in the previous transfer process can be discharged to the outside through the overflow line 13.

  This is the end of the bubble removal process in the priming process. Then, while the solenoid valves V4 and V5 are opened, the dialysate is introduced into the dialysate introduction line La, the dialysate flow path in the dialyzer 3, and the dialysate discharge line Lb. Priming of the liquid flow path is performed. The gas purge process may be performed in parallel with the series of bubble removal processes or after the bubble removal process.

  In the present embodiment, after the overflow process as described above is performed for a predetermined time or after the blood pump 4 is driven at a predetermined rotational speed, the circulation process is performed again. That is, the circulation process and the overflow process (in this embodiment, the circulation process, the transfer process, and the overflow process) are repeated until the bubble detection by the bubble detection means 9 (or the bubble detection means 10) is eliminated. is there. The bubble detecting means can be installed between the connecting portion P of the arterial blood circuit 1 and the position where the blood pump 4 is disposed, and the circulation process is performed on the condition that the bubble is detected by the bubble detecting means. If it is assumed that the process is shifted to the overflow process, the transfer process can be omitted.

  According to the above embodiment, on the condition that the bubble is detected by the bubble detection means 9 (or the bubble detection means 10), the flow is transferred from the circulation process to the overflow process via the transfer process. By opening the V6 (arterial valve means) and the electromagnetic valve V3 (priming valve means) while driving the blood pump 4 in the normal direction, the priming liquid is supplied from the priming liquid supply line Lc and the arterial overflow line 13 is supplied. Since the liquid is overflowed, for example, the physiological saline (priming liquid) in the storage means 7 is smoothly and reliably discharged to the outside as compared with the case where the physiological saline (priming liquid) is supplied by its own weight (drop pressure) generated by the drop. The amount of the priming solution used can be suppressed.

  Further, if a pump tube 4a having a known discharge amount per rotation angle is used in the blood circuit, the priming liquid at the time of priming is determined based on the normal rotation driving amount (rotation speed) of the blood pump 4 during the overflow process. The supply amount can be easily grasped. Therefore, a blood purification device that uses the priming solution as a replacement fluid at the time of replacement or a replacement fluid at the time of returning blood (as in this embodiment, a physiological saline solution is used as a replacement fluid and a replacement fluid at the time of returning blood in addition to the priming solution) Even so, since the amount of the priming solution used at the time of priming can be grasped, it is possible to avoid the shortage of the replacement fluid or the replacement fluid during the subsequent blood purification treatment or blood return.

  Further, the circulation process and the overflow process (in this embodiment, the circulation process, the transfer process, and the overflow process) are repeatedly performed until the bubble detection by the bubble detection means 9 (or the bubble detection means 10) disappears. During priming, air bubbles in the blood circuit can be discharged to the outside more reliably, and if the volume of the priming fluid channel (priming volume) is used, the arterial blood circuit can be used. The overflow amount of the priming liquid can be further suppressed.

  However, as shown in FIG. 8, the control means 15 opens the electromagnetic valve V7 (vein side valve means) to overflow the liquid from the venous overflow line 14 between the start of the circulation process and the end of the overflow process. Is preferable. In this case, it is possible to prevent bubbles from being sent to the dialyzer 3 (blood purifier) by filling the vein-side air trap chamber 6 with the liquid.

  In addition, after the circulation process and the overflow process (including the transfer process in the present embodiment) are completed, the blood flow near the blood inlet 3a in the dialyzer 3 (blood purifier) (on the upper end side of the dialyzer 3 and through which blood flows). In order to remove relatively fine bubbles adhering to the inside, the control unit 15 may sequentially perform a stirring step (FIG. 9), a capturing step (FIG. 10), and an opening step (FIG. 11).

  The stirring step is a step of stirring bubbles in the vicinity of the blood inlet 3a in the dialyzer 3 (blood purifier) by driving the blood pump 4 to rotate forward at a high speed for a short time. That is, as shown in FIG. 9, under the control of the control means 15, the electromagnetic valve V1 (priming valve means), the electromagnetic valves V6 (arterial valve means), and V7 (venous valve means) are closed while the electromagnetic valve V1 is closed. , V2 is opened, and the blood pump 4 is rotated at high speed in the forward rotation direction for a short time, whereby the bubbles in the vicinity of the blood inlet 3a in the dialyzer 3 (blood purifier) are stirred and scattered, and the bubbles are compared. It makes it easy to move. The operating conditions of the blood pump 4 are as follows: a normal rotation drive at a high flow rate of 300 mL / min or more for 2 to 10 seconds, and then a stop (0 mL / min) or reverse rotation (a high flow rate of 300 mL / min or more for 2 to 10 seconds). ) Is repeated several times, and the flow in the vicinity of the blood inlet 3a is preferably agitated.

  The trapping step is a step in which the blood pump 4 is reversely driven for a predetermined time after the stirring step to trap the stirred bubbles in the artery-side air trap chamber 5. That is, as shown in FIG. 10, the solenoid valve V1 is maintained while the solenoid valve is kept open and closed (the solenoid valve V3 (priming valve means), the solenoid valve V6 (arterial side valve means), and V7 (vein side valve means)). , V2 is opened) and the blood pump 4 is driven in reverse to move the bubbles, which have been made relatively large in the agitation process, together with the liquid, and reach the upper side (air layer) of the artery side air trap chamber 5. To capture. The operating condition of the blood pump 4 is preferably a flow rate of 50 to 200 mL / min, and the pump tube 4a with a known discharge amount per rotation angle and the volume of the priming fluid channel (priming volume) on the known arterial side. If it is a combination of blood circuits, it is possible to set conditions according to time.

  In the opening process, as shown in FIG. 11, after the capturing process, the electromagnetic valve V6 (arterial valve means) and the electromagnetic valve V3 (priming valve means) are opened, and the blood pump 4 is driven to rotate forward so that the artery overflows. This is a step of overflowing from the line 13. That is, by opening the electromagnetic valve V6 (arterial valve means), the bubbles captured in the arterial air trap chamber 5 in the capturing process are discharged to the outside through the arterial overflow line 13 together with the overflowing liquid. It is. Even if relatively fine bubbles remain in the vicinity of the blood inlet 3a in the blood purifier through the above-described stirring step, capturing step, and opening step, the bubbles can be reliably discharged to the outside.

  Although the present embodiment has been described above, the present invention is not limited to this. For example, as shown in FIG. 12, the priming solution supply line Lc ′ is branched from the dialysate introduction line La, and the tip thereof is arterial. A liquid feeding means comprising a liquid feeding pump or the like connected to a portion (connecting portion P) between the artery side puncture needle a and the artery side air trap chamber 5 in the side blood circuit 1 and in the middle of the priming liquid supply line Lc ′. You may apply to the blood purification apparatus which connected 16 and electromagnetic valve V3 '(priming valve means). In this case, the priming solution supplied to the blood circuit at the time of priming is a dialysis solution. 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, the arterial blood circuit tip and the venous blood circuit tip are connected to be in communication with each other, and the blood pump is reversely driven while closing the arterial valve means and the priming valve means, so that the arterial side Priming fluid supply by circulating the fluid in the blood circuit, the venous blood circuit and the flow path in the blood purifier, and driving the blood pump forward while opening the arterial valve means and the priming valve means It is assumed that an overflow process for overflowing the fluid from the arterial overflow line while supplying priming liquid from the line is performed, and a transition from the circulation process to the overflow process is performed on the condition that bubbles are detected by the bubble detection means. If the blood purification device and its priming method are used, other configurations and functions are attached. It can be applied to are ones like.

1 Arterial blood circuit 2 Venous blood circuit 3 Dialyzer (blood purification means)
DESCRIPTION OF SYMBOLS 4 Blood pump 5 Arterial side air trap chamber 6 Vein side air trap chamber 7 Accommodating means 8 Priming liquid chamber 9, 10 Bubble detection means 11, 12 Blood discriminator 13 Arterial side overflow line 14 Vein side overflow line 15 Control means 16 Liquid feeding Means La Dialysate introduction line Lb Dialysate discharge line Lc Priming fluid supply line V1, V2 Solenoid valve (blood circuit valve means)
V3 Solenoid valve (priming valve means)
V4, V5 Solenoid valve V6 Solenoid valve (arterial valve means)
V7 Solenoid valve (Venous valve means)

Claims (10)

A blood purifier having a blood purification membrane and having a blood inlet, a blood outlet, a dialysate inlet, and a dialysate outlet;
One end is connected to the blood inlet of the blood purifier, and an arterial blood circuit in which a blood pump is disposed in the middle,
A venous blood circuit having one end connected to the blood outlet of the blood purifier,
An arterial air trap chamber formed in the middle of the arterial blood circuit;
An artery-side overflow line that extends from the upper side of the artery-side air trap chamber and can discharge the liquid overflowing the artery-side air trap chamber to the outside;
Arterial valve means capable of arbitrarily closing or opening the flow path of the arterial overflow line;
A priming fluid supply line connected to the arterial blood circuit tip and a blood pump in the arterial blood circuit and capable of supplying a priming fluid;
Priming valve means capable of optionally closing or opening the flow path of the priming liquid supply line;
A bubble detecting means disposed at a predetermined site of the arterial blood circuit or the venous blood circuit and capable of detecting bubbles in the liquid flowing through the site;
Control means capable of controlling at least the blood pump, the arterial valve means and the priming valve means; and
In the blood purification apparatus comprising
At the time of priming, the arterial blood circuit tip and the venous blood circuit tip are connected to be in a communicating state, and the control means includes:
A circulation step of circulating fluid in the flow path in the arterial blood circuit, the venous blood circuit, and the blood purifier by reversing the blood pump while closing the arterial valve means and the priming valve means; ,
An overflow step of overflowing the fluid from the arterial overflow line while supplying the priming fluid from the priming fluid supply line by driving the blood pump forward while opening the arterial valve means and the priming valve means; ,
The blood purification apparatus is characterized in that, on the condition that air bubbles are detected by the air bubble detection means, the circulation process is shifted to the overflow process.   The blood purification apparatus according to claim 1, wherein the control means repeatedly performs the circulation step and the overflow step until the bubble detection by the bubble detection means is eliminated. A venous air trap chamber formed in the middle of the venous blood circuit;
A venous overflow line extending from the upper side of the venous air trap chamber and capable of discharging the liquid overflowing the venous air trap chamber to the outside;
Venous valve means capable of optionally closing or opening the flow path of the venous overflow line;
The control means opens the venous valve means to overflow the liquid from the venous overflow line between the start of the circulation process and the end of the overflow process. Or the blood purification apparatus of Claim 2.   The venous air trap chamber has a filtration network formed therein, and between the tip of the arterial blood circuit and the blood pump or between the tip of the venous blood circuit and the venous air trap chamber. A blood circuit valve means capable of opening and closing the flow path, and the circulating step changes the circulating fluid flow by opening and closing the blood circuit valve means, and the filtration network in the venous air trap chamber The blood purification apparatus according to claim 3, wherein bubbles adhering to the blood can be trapped on the upper side of the vein-side air trap chamber. The control means, after the circulation step and the overflow step,
An agitation step of agitating bubbles in the vicinity of the blood inlet in the blood purifier by driving the blood pump to rotate forward at a high speed for a short time;
After the agitation step, the blood pump is driven reversely for a predetermined time, and the agitation step of capturing the agitated bubbles in the artery-side air trap chamber;
After the trapping step, the arterial valve means and the priming valve means are opened and the blood pump is driven to rotate in the forward direction so as to overflow from the arterial overflow line;
The blood purification apparatus according to any one of claims 1 to 4, wherein A blood purifier having a blood purification membrane and having a blood inlet, a blood outlet, a dialysate inlet, and a dialysate outlet;
One end is connected to the blood inlet of the blood purifier, and an arterial blood circuit in which a blood pump is disposed in the middle,
A venous blood circuit having one end connected to the blood outlet of the blood purifier,
An arterial air trap chamber formed in the middle of the arterial blood circuit;
An artery-side overflow line that extends from the upper side of the artery-side air trap chamber and can discharge the liquid overflowing the artery-side air trap chamber to the outside;
Arterial valve means capable of arbitrarily closing or opening the flow path of the arterial overflow line;
A priming fluid supply line connected to the arterial blood circuit tip and a blood pump in the arterial blood circuit and capable of supplying a priming fluid;
Priming valve means capable of optionally closing or opening the flow path of the priming liquid supply line;
A bubble detecting means disposed at a predetermined site of the arterial blood circuit or the venous blood circuit and capable of detecting bubbles in the liquid flowing through the site;
In the priming method of the blood purification apparatus comprising
At the time of priming, the arterial blood circuit tip and the venous blood circuit tip are connected to be in a communicating state,
A circulation step of circulating fluid in the flow path in the arterial blood circuit, the venous blood circuit, and the blood purifier by reversing the blood pump while closing the arterial valve means and the priming valve means; ,
An overflow step of overflowing the fluid from the arterial overflow line while supplying the priming fluid from the priming fluid supply line by driving the blood pump forward while opening the arterial valve means and the priming valve means; ,
The priming method of the blood purification apparatus is characterized in that a transition is made from the circulation step to the overflow step on condition that bubbles are detected by the bubble detection means.   7. The priming method for a blood purification apparatus according to claim 6, wherein the circulation step and the overflow step are repeatedly performed until the bubble detection by the bubble detection means disappears. A venous air trap chamber formed in the middle of the venous blood circuit;
A venous overflow line extending from the upper side of the venous air trap chamber and capable of discharging the liquid overflowing the venous air trap chamber to the outside;
Venous valve means capable of optionally closing or opening the flow path of the venous overflow line;
8. The liquid from the venous overflow line is opened by opening the venous valve means between the start of the circulation process and the end of the overflow process. Priming method for blood purification apparatus.   The venous air trap chamber has a filtration network formed therein, and between the tip of the arterial blood circuit and the blood pump or between the tip of the venous blood circuit and the venous air trap chamber. A blood circuit valve means capable of opening and closing the flow path, and the circulating step changes the circulating fluid flow by opening and closing the blood circuit valve means, and the filtration network in the venous air trap chamber The method for priming a blood purification apparatus according to claim 8, wherein air bubbles adhering to the blood can be trapped on an upper side of the vein-side air trap chamber. After the circulation process and the overflow process are completed,
An agitation step of agitating bubbles in the vicinity of the blood inlet in the blood purifier by driving the blood pump to rotate forward at a high speed for a short time;
After the agitation step, the blood pump is driven reversely for a predetermined time, and the agitation step of capturing the agitated bubbles in the artery-side air trap chamber;
After the trapping step, the arterial valve means and the priming valve means are opened and the blood pump is driven to rotate in the forward direction so as to overflow from the arterial overflow line;
The priming method of the blood purification apparatus according to any one of claims 6 to 9, wherein the priming method is performed.

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