JP2011160924A - Blood purifier and liquid discharge method inside blood circuit in blood purifier - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a blood purifier capable of eliminating the need for the connecting work of the distal end of an artery side blood circuit and the distal end of a vein side blood circuit and preventing liquid from remaining in the blood circuit, and to provide a liquid discharge method inside a blood circuit in the blood purifier. <P>SOLUTION: The blood purifier includes a control means 8 for discharging liquid in a blood flow path and the blood circuit through a dialysate discharge line Lb to the outside by making the liquid pressure on the dialysate flow path side of a dialyzer 3 lower than the liquid pressure on a blood flow path side, and introducing air from the distal end of the artery side blood circuit 1 or air from the distal end of the vein side blood circuit 2 and replacing it with the liquid in the blood flow path and the blood circuit by turning a solenoid valve V1 or a solenoid valve V2 to an open state. <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 the extracorporeal blood with a blood purification means connected to the arterial blood circuit and the venous blood circuit. The present invention relates to a blood purification device for the purpose and a method for discharging a liquid in a blood circuit in the blood purification device.

  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, and an iron-type blood pump is disposed in the middle of the arterial blood circuit. By driving the blood pump while the patient is punctured with the arterial puncture needle and the venous side puncture needle, blood can be purified while circulating the patient's blood extracorporeally.

  Usually, after blood purification treatment, blood return in the blood flow path in the blood circuit or dialyzer is returned to the patient by introducing a replacement fluid such as dialysate or physiological saline into the blood circuit. A series of operations has been completed by removing the arterial puncture needle and the venous puncture needle from the patient. In this case, a liquid such as a replacement liquid remains in the blood circuit after blood return and the blood flow path in the dialyzer, and various techniques for processing this liquid have been proposed.

  For example, Patent Document 1 discloses that a closed circuit is formed by connecting the distal end of an arterial blood circuit and the distal end of a venous blood circuit, and the dialysate flow path side of the dialyzer is made smaller than the fluid pressure on the blood flow path side. Discloses a blood purification device configured to discharge the liquid in the blood flow channel and the blood circuit to the outside via the dialysate discharge line (this blood purification device will be referred to as Prior Art 1). . Further, in Patent Document 2, the tip of the arterial blood circuit and the tip of the venous blood circuit are not connected, and clamp means disposed in the vicinity of the tip of the arterial blood circuit and the tip of the venous blood circuit are provided. Each channel is closed and the dialysate channel side of the dialyzer is made smaller than the fluid pressure on the blood channel side to discharge the blood channel and the liquid in the blood circuit to the outside through the dialysate discharge line. A blood purification apparatus configured as described above (this blood purification apparatus will be referred to as Conventional Technology 2) is disclosed.

Special table 2003-515539 gazette Special table 2009-529392

However, the conventional blood purification apparatus has the following problems.
In the prior art 1, since it is necessary to form a closed circuit by connecting the tip of the arterial blood circuit and the tip of the venous blood circuit, when the operator forms the closed circuit, it adheres to the tip. There is a possibility that the patient's blood may be touched. In the prior art 2, the flow path from the tip of the blood circuit to the clamp means (particularly, the flow path from the tip of the venous blood circuit to the clamp means) There was a problem that the liquid could not be discharged.

  The present invention has been made in view of such circumstances, and can eliminate the need for connection work between the tip of the arterial blood circuit and the tip of the venous blood circuit, and liquid remains in the blood circuit. It is an object of the present invention to provide a blood purification device that can prevent the liquid from leaking and a method for discharging a liquid in a blood circuit in the blood purification device.

  The invention according to claim 1 is a blood purification means in which a blood flow path through which a patient's blood flows and a dialysate flow path through which a dialysate flows are formed via a blood purification film for purifying blood, and the blood purification means The blood of the patient is extracorporeally circulated from the distal end of the arterial blood circuit to the distal end of the venous blood circuit via the blood purification means. A blood circuit, a blood pump disposed in the middle of the arterial blood circuit, a dialysate introduction line and a dialysate discharge line connected to the dialysate flow path side of the blood purification means, and the arterial blood circuit Arterial valve means disposed near the distal end and capable of opening and closing the flow path at an arbitrary timing; and venous side valve means disposed near the distal end of the venous blood circuit and capable of opening and closing the flow path at arbitrary timing. Blood with A purification device, wherein after the blood purification treatment, the fluid pressure on the dialysate channel side of the blood purification means is made smaller than the fluid pressure on the blood channel side, thereby draining the fluid in the blood channel and blood circuit from the dialysate The blood is discharged to the outside through the line and air is introduced from the tip of the artery-side blood circuit or the tip of the vein-side blood circuit by opening the artery-side valve means or the vein-side valve means. Control means for replacing the fluid in the tract and blood circuit is provided.

  According to a second aspect of the present invention, in the blood purification apparatus according to the first aspect, the arterial pressure detecting means capable of detecting the pressure in the flow path on the blood purification means side from the arterial valve means in the arterial blood circuit. Or a venous side pressure detecting means capable of detecting the pressure in the flow path on the blood purification means side from the venous side valve means in the venous side blood circuit, and the control means in the arterial side blood circuit Air is introduced from the tip of the arterial blood circuit by opening the arterial valve means on the condition that the pressure in the flow path on the blood purification means side is lower than a predetermined value from the arterial valve means, or On the condition that the pressure in the flow path on the blood purification means side from the venous valve means in the venous blood circuit is lower than a predetermined value, the venous valve means is opened and the venous blood circuit is opened. It characterized in that it is controlled so as to introduce the air from the end.

  According to a third aspect of the present invention, in the blood purification apparatus according to the first or second aspect, a closed circuit capable of circulating a liquid by a branch line branched from a predetermined portion of the blood circuit is formed, and the control means Circulates the liquid in the closed circuit while reducing the dialysate flow path side of the blood purification means to be less than the liquid pressure on the blood flow path side, thereby allowing the liquid in the blood flow path and the blood circuit to flow through the dialysate discharge line. It is characterized by discharging through the outside.

  According to a fourth aspect of the present invention, in the blood purification apparatus according to the third aspect, the branch line branches off from the distal end side of a portion where the blood pump is disposed in the arterial blood circuit. A physiological saline supply line capable of supplying a physiological saline solution therein, an overflow line or level adjustment line extending from an upper part of an air trap chamber connected to the blood circuit, and a replacement fluid connected to the blood circuit Any one or more of the fluid replacement lines to be obtained are connected.

  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 liquid in the blood flow path and the blood circuit of the blood purification means is externally supplied via the dialysate discharge line. A physiological saline supply line that can be connected to the arterial blood circuit and supply physiological saline, and a physiological saline in a receiving means that is connected to the tip of the physiological saline supply line and accommodates the physiological saline. It is characterized by discharging outside through a discharge line.

  According to a sixth aspect of the present invention, there is provided a blood purification means in which a blood flow path through which a patient's blood flows and a dialysate flow path through which a dialysate flows are formed via a blood purification film for purifying blood, and the blood purification means The blood of the patient is extracorporeally circulated from the distal end of the arterial blood circuit to the distal end of the venous blood circuit via the blood purification means. A blood circuit, a blood pump disposed in the middle of the arterial blood circuit, a dialysate introduction line and a dialysate discharge line connected to the dialysate flow path side of the blood purification means, and the arterial blood circuit Arterial valve means disposed near the distal end and capable of opening and closing the flow path at an arbitrary timing; and venous side valve means disposed near the distal end of the venous blood circuit and capable of opening and closing the flow path at arbitrary timing. Blood with A method for discharging a liquid in a blood circuit in a purification device, wherein after the blood purification treatment, the blood pressure on the dialysate flow channel side of the blood purification means is made smaller than the fluid pressure on the blood flow channel side. The liquid inside is discharged to the outside through the dialysate discharge line, and the arterial valve means or the venous valve means is opened to open the end of the arterial blood circuit or the end of the venous blood circuit. It is characterized in that air is introduced to replace the liquid in the blood flow path and the blood circuit.

  A seventh aspect of the present invention is the method for discharging a liquid in the blood circuit in the blood purification apparatus according to the sixth aspect, wherein the pressure in the flow path on the blood purification means side is greater than the arterial valve means in the arterial blood circuit. An arterial pressure detecting means capable of detecting, or a venous pressure detecting means capable of detecting the pressure in the flow path on the blood purification means side from the venous valve means in the venous blood circuit, and the arterial side Air is introduced from the distal end of the arterial blood circuit with the arterial valve means open, provided that the pressure in the flow path on the blood purification means side of the blood circuit in the blood circuit is lower than a predetermined value. Alternatively, the venous valve means is opened when the pressure in the flow path on the blood purification means side of the venous valve circuit in the venous blood circuit is lower than a predetermined value. And introducing the air from the tip of the artery side blood circuit.

  According to an eighth aspect of the present invention, in the method for discharging a liquid in the blood circuit in the blood purification apparatus according to the sixth or seventh aspect, the closed circuit capable of circulating the liquid by a branch line branched from a predetermined portion of the blood circuit. The liquid in the blood flow path and the blood circuit is removed from the dialysate by forming the dialysate flow path side of the blood purification means smaller than the liquid pressure on the blood flow path side while circulating the liquid in the closed circuit. It is characterized by discharging outside through a discharge line.

  A ninth aspect of the present invention is the method for draining liquid in the blood circuit in the blood purification apparatus according to the eighth aspect, wherein the branch line is from the distal end side to the site where the blood pump is disposed in the arterial blood circuit. A physiological saline supply line that can be branched to supply physiological saline into the arterial blood circuit, an overflow line or level adjustment line that extends from an upper portion of an air trap chamber connected to the blood circuit, and the blood circuit Any one or a plurality of fluid replacement lines that can be connected to each other to supply a fluid replacement are connected.

  A tenth aspect of the present invention is the method for discharging a liquid in a blood circuit in the blood purification apparatus according to any one of the sixth to ninth aspects, wherein the blood flow path of the blood purification means and the liquid in the blood circuit are supplied to the blood circuit. A physiological saline supply line that is connected to the arterial blood circuit and can supply a physiological saline when discharged outside via the dialysate drainage line, and a storage means that is connected to the tip of the physiological saline supply line and accommodates the physiological saline The physiological saline solution is discharged to the outside through the dialysate discharge line.

  The invention according to claim 11 is the method for discharging a liquid in the blood circuit in the blood purification apparatus according to any one of claims 6 to 10, wherein the liquid in the blood flow path and the blood circuit of the blood purification means is the liquid. In the process of discharging to the outside through the dialysate discharge line, the blood purification means is turned upside down.

  A twelfth aspect of the present invention is the method for discharging a liquid from a blood circuit in the blood purification apparatus according to any one of the sixth to eleventh aspects, wherein at least a part of the closed circuit is connected to the blood circuit. In the process of discharging the liquid in the blood flow path and the blood circuit of the blood purification means to the outside via the dialysate discharge line, the air trap being constituted by a branch line extending from the upper part of the trap chamber The chamber is turned upside down.

  According to the first and sixth aspects of the present invention, after the blood purification treatment, the fluid pressure on the dialysate channel side of the blood purification means is made smaller than the fluid pressure on the blood channel side, so that the liquid in the blood channel and blood circuit can be reduced. The blood is discharged to the outside through the dialysate discharge line, and air is introduced from the distal end of the arterial blood circuit or the distal blood circuit by opening the arterial valve means or the venous valve means. Since the liquid in the flow path and the blood circuit is replaced, the connection work between the tip of the arterial blood circuit and the tip of the venous blood circuit can be made unnecessary, and the liquid remains in the blood circuit. Can be suppressed.

  According to the second and seventh aspects of the present invention, the arterial valve means is opened when the pressure in the flow path on the blood purification means side of the arterial valve circuit in the arterial blood circuit is lower than a predetermined value. Air is introduced from the tip of the arterial blood circuit, or the venous valve means is conditioned on the condition that the pressure in the flow path on the blood purification means side is lower than a predetermined value from the venous valve means in the venous blood circuit. Since air is introduced from the distal end of the venous blood circuit in the open state, the fluid on the distal side from the arterial valve means in the arterial blood circuit or from the venous valve means in the venous blood circuit drips from the distal end. Can be suppressed.

  According to the third and eighth aspects of the present invention, a closed circuit capable of circulating the liquid is formed by the branch line branched from the predetermined part of the blood circuit, and dialysis of the blood purification means is performed while circulating the liquid in the closed circuit. By making the liquid flow path side smaller than the liquid pressure on the blood flow path side, the liquid in the blood flow path and the blood circuit is discharged to the outside through the dialysate discharge line, so that the liquid is discharged to the outside more efficiently and reliably. Can be made.

  According to the fourth and ninth aspects of the present invention, the branch line branches from the tip side from the site where the blood pump in the arterial blood circuit is disposed, and can supply physiological saline into the arterial blood circuit. Connect one or more of a saline solution supply line, an overflow line or level adjustment line extending from the upper part of the air trap chamber connected to the blood circuit, and a fluid replacement line connected to the blood circuit and capable of supplying a replacement fluid. Therefore, it is possible to divert the branch line that is required except when draining the blood circuit.

  According to the fifth and tenth aspects of the present invention, when the liquid in the blood flow path and the blood circuit of the blood purification means is discharged to the outside through the dialysate discharge line, the physiological saline is connected to the arterial blood circuit. Since the physiological saline supply line that can be supplied and the physiological saline in the housing means that is connected to the tip of the physiological saline and accommodates the physiological saline is discharged to the outside through the dialysate discharge line, the blood circuit is connected to the blood circuit. It is possible to further reduce the weight when discarding the physiological saline supply line and the storage means connected to the tip thereof.

  According to the eleventh aspect of the present invention, in the process of discharging the blood flow path of the blood purification means and the liquid in the blood circuit to the outside through the dialysate discharge line, the blood purification means is turned upside down. It is possible to further suppress the liquid from remaining.

  According to the twelfth aspect of the present invention, since the air trap chamber is turned upside down in the process of discharging the liquid in the blood flow path of the blood purification means and the blood circuit to the outside through the dialysate discharge line, the blood circuit and blood It is possible to further suppress the liquid from remaining in the blood flow path of the purification means.

The schematic diagram which shows the dialysis apparatus (blood purification apparatus) which concerns on embodiment of this invention. Schematic diagram showing the process of discharging the liquid in the blood circuit in the dialysis machine Schematic diagram showing the process of discharging the liquid in the blood circuit in the dialysis machine Schematic diagram showing the process of discharging the liquid in the blood circuit in the dialysis machine Schematic diagram showing the process of discharging the liquid in the blood circuit in the dialysis machine Schematic diagram showing the process of discharging the liquid in the blood circuit in the dialysis machine Schematic diagram showing the process of discharging the liquid in the blood circuit in the dialysis machine The schematic diagram which shows the process of discharging | emitting the liquid in the blood circuit in the dialysis apparatus which concerns on other embodiment of this invention. The schematic diagram which shows the process of discharging | emitting the liquid in the blood circuit in the dialysis apparatus which concerns on other embodiment of this invention. The schematic diagram which shows the process of discharging | emitting the liquid in the blood circuit in the dialysis apparatus which concerns on further another embodiment of this invention. The schematic diagram which shows the process of discharging | emitting the liquid in the blood circuit in the dialysis apparatus which concerns on further another embodiment of this invention. The schematic diagram which shows the process of discharging | emitting the liquid in the blood circuit in the dialysis apparatus which concerns on further another embodiment of this invention. The schematic diagram which shows the process of discharging | emitting the liquid in the blood circuit in the dialysis apparatus which concerns on further another embodiment of this invention. The schematic diagram which shows the dialysis apparatus (state at the time of blood purification treatment) which concerns on other embodiment of this invention. The schematic diagram which shows the dialysis apparatus (state at the time of blood purification treatment) which concerns on other embodiment of this invention. The schematic diagram which shows the dialysis apparatus (state at the time of blood purification treatment) which concerns on other embodiment of this 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 Arterial side air trap chamber 5 and venous side air trap chamber 6 respectively disposed in blood circuit 1 and venous side blood circuit 2, storage means 9 storing physiological saline, storage means 9 and arterial blood circuit 1 is mainly composed of a physiological saline solution supply line Lc connected to 1.

  The arterial blood circuit 1 is connected at its tip to an arterial puncture needle a via a connector c, and an iron-side blood pump 4 and an arterial air trap 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 air trap 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 venous 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 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.

  However, the fluid replacement line Ld extends from the upper part (air layer side) of the venous air trap chamber 6, and an electromagnetic valve V5 is disposed in the fluid replacement line Ld. That is, the tip of the replacement fluid line Ld is connected to the dialysate introduction line La, and the dialysate introduction line La is introduced into the venous air trap chamber 6 by opening the electromagnetic valve V5. Thus, a replacement fluid (post-replacement fluid) is performed. The venous air trap chamber 6 has a venous pressure that can detect the fluid pressure (venous pressure) in the flow path in the venous blood circuit 2 by detecting the pressure on the upper side (air layer side). Detection means PV is arranged.

  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, and the arterial blood circuit 1 and the venous blood circuit 2. Is connected to the blood flow path, and the dialysate introduction line La and the dialysate discharge line Lb are connected to the dialysate flow path. 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 wastes and the like 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 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. 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 drainage means (not shown), which is supplied from the dialysate supply device. After the dialysate reaches the dialyzer 3 through the dialysate introduction line La, it is sent to the drainage means through the dialysate discharge line Lb.

  The dialysate discharge line Lb is provided with a liquid feeding means 7 (a cascade pump, a water removal pump, a dual pump, etc.). Further, an electromagnetic valve V4 capable of opening and closing the flow path is connected in the middle of the dialysate introduction line La (between the dual pump and the dialyzer 3), and in the middle of the dialysate discharge line Lb (liquid feeding means). 7 and the dialyzer 3) is connected to an electromagnetic valve V3 that can open and close the flow path.

  On the other hand, an electromagnetic valve V1 (arterial valve means) capable of opening and closing the flow path at an arbitrary timing is disposed at the distal end side (near the connector c) of the arterial blood circuit 1, and the venous blood circuit. An electromagnetic valve V2 (vein side valve means) that can open and close the flow path at an arbitrary timing is disposed on the distal end side of 2 (in the vicinity of the connector d). These solenoid valves V1 to V4 (the same applies to the solenoid valve V5) are capable of closing and opening the flow paths in the respective portions provided by opening and closing operations. The opening and closing operations are performed by the control means 8 such as a microcomputer. Are configured to be controlled.

  The housing means 9 (a so-called “saline bag”) is composed of a flexible transparent container and can store a predetermined volume of physiological saline for priming and replacement fluid. It is attached to the tip of a pole (not shown) projecting from. The physiological saline supply line Lc is connected to a portion between the arterial puncture needle a and the blood pump 4 at the distal end of the arterial blood circuit 1, and the physiological saline in the accommodating means 9 is supplied to the blood circuit (arterial blood circuit 1). Can be supplied inside. In other words, the physiological saline supply line Lc is a flow path that can branch from the distal end side of a portion of the artery-side blood circuit 1 where the blood pump 4 is disposed to supply physiological saline into the artery-side blood circuit 1. It is configured.

  Here, in the present embodiment, the replacement fluid line Ld and the physiological saline supply line Lc constitute a branch line branched from a predetermined part of the blood circuit (arterial blood circuit 1 and venous blood circuit 2). As shown in FIGS. 2-7, the closed circuit which can circulate a liquid is formed by these branch lines (the replacement fluid line Ld and the physiological saline supply line Lc). That is, the distal end of the replacement fluid line Ld is removed from the dialysate introduction line La, the distal end of the physiological saline supply line Lc is removed from the housing means 9, and these distal ends are connected to each other to form a closed circuit.

  After blood purification treatment (after returning blood in the present embodiment), the control means 8 makes the blood flow by making the fluid pressure on the dialysate flow path side of the dialyzer 3 (blood purification means) smaller than the fluid pressure on the blood flow path side. It is possible to control the fluid in the tract and blood circuit (arterial blood circuit 1 and venous blood circuit 2) to be discharged to the outside via the dialysate discharge line Lb. In this embodiment, after the blood return is completed and the arterial puncture needle a and the venous puncture needle b are removed from the patient, the control means 8 is arranged on the dialysate discharge line Lb while the electromagnetic valve V4 is closed. By driving the liquid supply means 7 provided, the fluid pressure on the dialysate flow path side of the dialyzer 3 (blood purification means) is made smaller than the fluid pressure on the blood flow path side.

  Furthermore, the control means 8 according to the present embodiment makes the blood flow path and the blood circuit (the blood circuit (the blood purification means), as described above, by making the fluid pressure on the dialysate flow path side smaller than the fluid pressure on the blood flow path side as described above. The liquid in the arterial blood circuit 1 and the venous blood circuit 2) is discharged to the outside through the dialysate discharge line Lb, and the electromagnetic valve V1 (arterial valve means) or the electromagnetic valve V2 (venous valve means) is provided. Air is introduced from the distal end of the arterial blood circuit 1 (see FIG. 4) or the distal end of the venous blood circuit 2 (see FIG. 3) by opening the blood circuit and the blood circuit (arterial blood circuit 1). And fluid in the venous blood circuit 2).

Hereinafter, the liquid discharging process in the blood circuit performed by the dialysis apparatus according to the present embodiment will be described.
After blood purification treatment, the blood flow path side and blood circuit (arterial side blood circuit 1 and venous side blood circuit 2) of dialyzer 3 (blood purification means) are filled with blood collected from the patient. While the needle a and the venous puncture needle b are connected to the patient, the physiological saline contained in the accommodation means 9 is introduced into the blood flow path and the blood circuit via the physiological saline supply line Lc, and blood components are introduced. While returning to the patient, the blood flow path and the blood circuit are replaced with physiological saline (so-called blood return step).

  When the arterial puncture needle a and the venous puncture needle b are removed from the patient after the blood return step as described above, as shown in FIG. 2, the tip of the replacement fluid line Ld and the tip of the physiological saline supply line Lc Are connected to each other to form a closed circuit through which liquid can circulate. At this time, the electromagnetic valve V1 (arterial valve means), the electromagnetic valve V2 (venous valve means), and the electromagnetic valve V5 are closed, and between the electromagnetic valve V1 and the connector c, and between the electromagnetic valve V2 and the connector d. Also, the flow path is closed by a clamping means (not shown). The tip of the arterial blood circuit 1 and the tip of the venous blood circuit 2 are open to the outside and are not connected.

  However, the dialyzer 3 (blood purification means) side of the dialysate flow path is driven by driving the liquid feeding means (for example, a flow rate of about 50 to 100 mL / min) while the electromagnetic valve V4 is closed under the control of the control means 8. The fluid pressure in the blood flow path and the blood circuit (arterial blood circuit 1 and venous blood circuit 2) is sent to the dialysate flow path through the blood purification membrane. . Thereby, the liquid in the blood flow path and the blood circuit (arterial blood circuit 1 and venous blood circuit 2) can be discharged to the outside through the dialysate discharge line Lb. In this process, the negative pressure gradually increases in the blood flow path and the blood circuit (arterial blood circuit 1 and venous blood circuit 2).

  Then, the pressure in the flow path upstream (dialyzer 3 side) from the electromagnetic valve V2 (venous valve means) in the venous blood circuit 2 falls below a predetermined value (for example, the venous pressure detecting means PV is negative pressure (50). 3), the electromagnetic valve V2 (vein side valve means) is opened and air is introduced from the tip of the venous blood circuit 2 on the condition that a negative pressure (about 100 mmHg) is detected). At this time, the liquid replaced with air introduced from the distal end of the venous blood circuit 2 flows toward the dialyzer 3 through the venous air trap chamber 6. As a result, the negative pressure of the blood flow path and blood circuit (arterial blood circuit 1 and venous blood circuit 2) is released, and air is introduced from the distal end of the venous blood circuit 2 so that the blood flow path and blood circuit are introduced. The liquid in the (venous blood circuit 2) can be replaced.

  Thereafter, when it is detected by a timer or the like that the predetermined time has elapsed, the electromagnetic valve V2 is closed again to the state shown in FIG. 2, and the liquid feeding means is turned on while the electromagnetic valve V4 is closed by the control of the control means 8. By driving (for example, a flow rate of about 50 to 100 mL / min), the fluid pressure on the dialysate channel side of the dialyzer 3 (blood purification means) is made smaller than the fluid pressure on the blood channel side, and the blood channel and blood circuit ( The liquid in the arterial blood circuit 1 and the venous blood circuit 2) is sent to the dialysate flow path through the blood purification membrane. Thereby, the liquid in the blood flow path and the blood circuit (arterial blood circuit 1 and venous blood circuit 2) can be discharged to the outside through the dialysate discharge line Lb. In this process, the negative pressure gradually increases in the blood flow path and the blood circuit (arterial blood circuit 1 and venous blood circuit 2).

  Then, the pressure in the flow path downstream of the electromagnetic valve V1 (arterial valve means) in the arterial blood circuit 1 (blood pump 4 and dialyzer 3 side) falls below a predetermined value (for example, the venous pressure detecting means PV is As long as the negative pressure (a negative pressure of about 50 to 100 mmHg) is detected), the electromagnetic valve V1 (arterial valve means) is opened to air from the tip of the arterial blood circuit 1 as shown in FIG. Is introduced. At this time, the liquid replaced by the air introduced from the tip of the arterial blood circuit 1 is the physiological saline supply line Lc, the replacement fluid line Ld, the venous air trap chamber 6 and the venous blood circuit 2 on the dialyzer 3 side thereof. It will flow toward the dialyzer 3 via. As a result, the negative pressure of the blood flow path and the blood circuit (arterial blood circuit 1 and venous blood circuit 2) is released, and air is introduced from the tip of the arterial blood circuit 1 to thereby release the blood flow path and blood circuit. The liquid in the (arterial blood circuit 1) can be replaced.

  Thereafter, when it is detected by a timer or the like that a predetermined time has elapsed, the solenoid valve V1 (arterial valve means) and the solenoid valve V2 (venous valve means) are controlled by the control means 8 as shown in FIG. The electromagnetic valve V5 is opened while the valve is closed, and the blood pump 4 is driven (for example, a flow rate of about 100 (mL / min)) to circulate the liquid in the closed circuit. Then, as shown in FIG. 6, by driving the liquid feeding means (for example, a flow rate of about 50 to 100 mL / min), the liquid pressure on the dialysate flow path side of the dialyzer 3 (blood purification means) is changed to the liquid flow on the blood flow path side. The pressure in the blood flow path and blood circuit (arterial blood circuit 1 and venous blood circuit 2) is reduced to less than the pressure, and the liquid is sent to the dialysate flow path through the blood purification membrane. Thereby, the liquid circulating in the closed circuit can be sequentially discharged to the outside via the dialysate discharge line Lb. In this process, the degree of negative pressure gradually increases in the closed circuit.

  However, in the course of the above process, the pressure in the flow path upstream (dialyzer 3 side) from the electromagnetic valve V2 (venous side valve means) in the venous blood circuit 2 is reduced below a predetermined value (for example, venous side pressure detecting means). As shown in FIG. 7, the distal end of the arterial blood circuit 1 is opened with the electromagnetic valve V1 (arterial valve means) open, on condition that PV has detected negative pressure (negative pressure of about 50 to 100 mmHg). Introduce air from. As a result, the negative pressure in the closed circuit is released, and air can be introduced from the tip of the arterial blood circuit 1 to replace the liquid in the blood flow path and blood circuit (arterial blood circuit 1). .

  Thus, by causing the control means 8 to repeatedly perform the process shown in FIG. 6 and the process shown in FIG. 7, the liquid is circulated in the closed circuit, and the air from the distal end of the arterial blood circuit 1 to the closed circuit is circulated. The liquid in the closed circuit is fed into the dialysate flow path of the dialyzer 3 while taking in the blood, and the liquid in the blood flow path and blood circuit (arterial blood circuit 1 and venous blood circuit 2) is passed through the dialysate discharge line Lb. It can be discharged to the outside.

  According to the above-described embodiment, after the blood purification treatment and the blood return process are finished, the blood pressure on the dialysate flow path side of the dialyzer 3 (blood purification means) is made smaller than the liquid pressure on the blood flow path side. The liquid in the circuit (arterial blood circuit 1 and venous blood circuit 2) is discharged to the outside via the dialysate discharge line Lb, and the electromagnetic valve V1 (arterial valve means) or the electromagnetic valve V2 (venous valve means) ) In the open state, air is introduced from the tip of the arterial blood circuit 1 or the tip of the venous blood circuit 2 to enter the blood flow path and blood circuit (arterial blood circuit 1 and venous blood circuit 2). Therefore, the connection work between the tip of the arterial blood circuit 1 and the tip of the venous blood circuit 2 can be made unnecessary, and the blood valve (particularly, the solenoid valve from the tip of the arterial blood circuit 2 can be used). V2 (Venous valve hand A) during) can be inhibited from liquid will remain.

  Further, the electromagnetic valve V1 is opened and the arterial blood circuit is opened under the condition that the pressure in the flow path on the dialyzer 3 side from the electromagnetic valve V1 (arterial valve means) in the arterial blood circuit 1 is reduced below a predetermined value. 1 on the condition that air is introduced from the tip of 1 (see FIG. 4) or the pressure in the flow path on the dialyzer 3 side from the electromagnetic valve V2 (venous side valve means) in the venous side blood circuit 2 falls below a predetermined value. Since the electromagnetic valve V2 is opened and air is introduced from the distal end of the venous blood circuit 2 (see FIG. 3), the distal side of the electromagnetic valve V1 in the arterial blood circuit 1 or the electromagnetic valve V2 in the venous blood circuit 2 It is possible to suppress the liquid on the tip side from dripping from the tip.

  Further, a closed circuit that can circulate liquid is formed by a branch line (in this embodiment, a physiological saline supply line Lc and a replacement fluid line Ld) branched from a predetermined part of the blood circuit, and the closed circuit allows the liquid to be circulated. In the blood flow path and blood circuit (arterial blood circuit 1 and venous blood circuit 2) by making the dialysate flow path side of the dialyzer 3 (blood purification means) smaller than the fluid pressure on the blood flow path side Since the liquid is discharged to the outside via the dialysate discharge line Lb, the liquid can be discharged to the outside more efficiently and reliably.

  Further, the branch line is a physiological saline supply line Lc that can branch from the distal end side of the portion where the blood pump 4 is disposed in the arterial blood circuit 1 and supply physiological saline into the arterial blood circuit 1. Since the replacement fluid line Ld, which is connected to the blood circuit (in this embodiment, the arterial air trap chamber 6 of the venous blood circuit 2) and can supply the replacement fluid, is connected, the drainage of the blood circuit is discharged. It is possible to divert the branch line that is required in other cases. In addition to the physiological saline supply line Lc and the replacement fluid line Ld, an overflow line extending from the upper part of the air trap chamber (arterial air trap chamber 5 or venous air trap chamber 6) connected to the blood circuit or Any one or more of the level adjustment lines may be connected to form a closed circuit. Even in this case, a branch line required other than when draining the blood circuit is used. Can be made.

  However, in the process of discharging the liquid in the blood flow path and blood circuit of the dialyzer 3 (blood purification means) to the outside via the dialysate discharge line Lb, the dialyzer 3 (blood purification means) as shown in FIG. As shown in FIG. 9, in the process of discharging the liquid in the blood flow path and blood circuit of the dialyzer 3 (blood purification means) to the outside through the dialysate discharge line Lb. The venous air trap chamber 9 may be turned upside down. Further, in the process of discharging the liquid in the blood flow path and blood circuit of the dialyzer 3 (blood purification means) to the outside via the dialysate discharge line Lb, the dialyzer 3 (blood purification means) is turned upside down, and The venous air trap chamber 9 may be turned upside down. Thereby, it is possible to further suppress the liquid from remaining in the blood circuit (arterial blood circuit 1 and venous blood circuit 2) or the blood flow path of the dialyzer 3.

  Although the present embodiment has been described above, the present invention is not limited to this. For example, the pressure in the flow path on the dialyzer 3 side is detected from the electromagnetic valve V2 (venous valve means) in the venous blood circuit 2. Instead of the venous pressure detecting means PV that can be used, an arterial pressure detecting means that can detect the pressure in the flow path on the dialyzer 3 side from the electromagnetic valve V1 (arterial valve means) in the arterial blood circuit 1 is arranged. The negative pressure in the closed circuit may be detected by the arterial pressure detection means.

  Further, as shown in FIG. 10, a closed circuit may be formed by connecting the tip of the replacement fluid line Ld in the middle of the physiological saline supply line Lc. In this case, the liquid in the blood circuit and the blood flow path can be discharged to the outside without removing the storage means 9, and the blood flow path and blood circuit (the arterial blood circuit 1 and the blood circuit of the dialyzer 3 (blood purification means)). When the liquid in the venous blood circuit 2) is discharged to the outside via the dialysate discharge line Lb, the physiological saline in the housing means 9 is connected to the physiological saline supply line Lc and the tip thereof to receive the physiological saline. The liquid can be discharged to the outside through the dialysate discharge line Lb. Therefore, the weight at the time of discarding the blood circuit (arterial blood circuit 1 and venous blood circuit 2), the physiological saline supply line Lc connected to the blood circuit, and the accommodating means 9 connected to the tip of the blood circuit is further reduced. Can do.

  Further, as shown in FIG. 11, an electromagnetic valve V7 is disposed in the middle of the physiological saline supply line Lc constituting the closed circuit, and the artery side air trap branches off from the middle of the replacement fluid line Ld constituting the closed circuit. A line Lf extending to the upper part (air layer side) of the chamber 5 may be formed, and the electromagnetic valve V6 may be disposed in the line Lf. In this case, the liquid remaining in the line Lf opens the electromagnetic valve V6 and the electromagnetic valve V7 while the electromagnetic valve V1 (arterial valve means), the electromagnetic valve V2 (venous side valve means) and the electromagnetic valve V5 are closed. By collecting the blood pump 4, the blood can be collected in the arterial air trap chamber 5.

  Further, a line Lf (overflow line or the like) is extended from the upper part (air layer side) of the artery-side air trap chamber 5, and an electromagnetic valve V6 is disposed in the middle thereof, and the tip of the line Lf and physiological saline supply A closed circuit may be formed by connecting the tip of the line Lc. In this case, the solenoid valve V1 (arterial valve means), the solenoid valve V2 (vein side valve means), and the solenoid valve V6 are closed while the fluid pressure (negative pressure state) is monitored by the vein pressure detecting means PV. The closed circuit is made negative pressure by driving the liquid feeding means while maintaining the state.

  However, on the condition that the fluid pressure of the predetermined value (predetermined negative pressure state) is detected by the venous pressure detecting means PV, the electromagnetic valve V2 is opened and air is introduced from the tip of the venous blood circuit 2. The negative pressure is released to replace the fluid in the venous blood circuit 2 with air. Thereafter, the electromagnetic valve V2 is closed, and the liquid feeding means is driven again to make negative pressure in the closed circuit.

  Then, on the condition that the fluid pressure of a predetermined value (predetermined negative pressure state) is detected by the venous pressure detection means PV, the electromagnetic valve V1 and the electromagnetic valve V6 are opened and the distal end of the arterial blood circuit 1 is opened. Air is introduced to release the negative pressure, and the fluid in the arterial blood circuit 1 is replaced with air. In addition, instead of opening the electromagnetic valve V1, the electromagnetic valve V2 is opened to drain the flow path between the dialyzer 3 and the venous air trap chamber 6 in the venous blood circuit 2. be able to. At this time, the vein-side air trap chamber 6 is turned upside down and the side connected to the dialyzer 3 is turned downward, so that a larger amount of liquid can be drained.

  Furthermore, as shown in FIG. 13, the tip of the replacement fluid line Ld (including other branch lines branching from the blood circuit) is connected to the tip (connector c) of the arterial blood circuit 1 to form a closed circuit. Also good. In this case, there is a risk of touching the arterial puncture needle a or the like at the tip of the arterial blood circuit 1 in the operation of forming the closed circuit, but touching the venous puncture needle b or the like at the tip of the venous blood circuit 2. In addition, there is no fear that liquid will remain between the distal end of the arterial blood circuit 1 and the electromagnetic valve V1.

  Further, if a closed circuit can be configured by connecting the physiological saline supply line Lc and the replacement fluid line Ld (including other branch lines (including a level adjustment line or an overflow line) branching from the blood circuit), the connection during blood purification treatment is possible. For example, as shown in FIG. 14, the tip of the replacement fluid line Ld is connected to a separate storage unit F that stores the replacement fluid, and a so-called bottle in which the replacement fluid is supplied from the storage unit. It may be applied to a type HDF (bottle type hemodiafiltration). In this case, the distal end of the physiological saline solution supply line Lc and the distal end of the replacement fluid line Ld are configured to be removable from the respective storage means (9, F) and to be connectable to each other. It is used when blood purification treatment does not want to inject dialysate into the blood.

  Further, as shown in FIG. 15, the present invention may be applied to the case where the tip of the replacement fluid line Ld is connected to the separate storage means F and the tip of the physiological saline supply line Lc is connected to the dialysate introduction line La. Good. A dialysis solution is used for priming and blood return, and a special replacement fluid (drug) is used during blood purification treatment when it is desired to infuse blood. Furthermore, as shown in FIG. 16, the present invention may be applied to one in which both the physiological saline supply line Lc and the replacement fluid line Ld are connected to the dialysate introduction line La. In this case, all of the priming solution, the replacement fluid, the replacement fluid for returning blood, etc. are performed with the dialysate, and the physiological saline supply line Lc and the replacement fluid line are used to control the supply of the dialysate from the dialysate introduction line La. A solenoid valve is provided for both Ld.

  After the blood purification treatment, the fluid pressure on the dialysate channel side of the blood purification means is made smaller than the fluid pressure on the blood channel side, so that the liquid in the blood channel and the blood circuit is discharged to the outside through the dialysate discharge line. At the same time, by opening the arterial side valve means or the venous side valve means, air is introduced from the distal end of the arterial blood circuit or the distal end of the venous blood circuit to replace the blood flow path and the liquid in the blood circuit. Any other function or process may be added as long as it is a blood purification method in the blood purification device and the blood circuit in the blood purification device.

1 Arterial blood circuit 2 Venous blood circuit 3 Dialyzer (blood purification means)
4 Blood Pump 5 Arterial Side Air Trap Chamber 6 Vein Side Air Trap Chamber 7 Liquid Supply Unit 8 Control Unit 9 Storage Unit V1 Electromagnetic Valve (Arterial Side Valve Unit)
V2 Solenoid valve (Venous valve means)
La Dialysate introduction line Lb Dialysate discharge line Lc Saline supply line (branch line)
Ld fluid replacement line (branch line)
PV vein pressure detection means

Claims (12)

A blood purification means in which a blood flow path through which a patient's blood flows and a dialysate flow path through which a dialysate flows are formed through a blood purification membrane for purifying the blood;
It consists of an arterial blood circuit and a venous blood circuit connected to the blood flow path side of the blood purification means, and passes the patient's blood from the tip of the arterial blood circuit to the tip of the venous blood circuit via the blood purification means. A blood circuit that can be circulated extracorporeally;
A blood pump disposed in the middle of the arterial blood circuit;
A dialysate introduction line and a dialysate discharge line connected to the dialysate flow path side of the blood purification means,
An arterial valve means disposed near the tip of the arterial blood circuit and capable of opening and closing the flow path at an arbitrary timing;
A venous valve means disposed near the tip of the venous blood circuit and capable of opening and closing the flow path at an arbitrary timing;
A blood purification apparatus comprising:
After the blood purification treatment, the fluid pressure on the dialysate channel side of the blood purification means is made smaller than the fluid pressure on the blood channel side, so that the fluid in the blood channel and the blood circuit are externally passed through the dialysate discharge line. While discharging, air is introduced from the tip of the arterial blood circuit or the tip of the venous blood circuit by opening the arterial valve means or the venous side valve means. A blood purification apparatus comprising control means for replacing liquid. Arterial pressure detecting means capable of detecting the pressure in the flow path on the blood purification means side from the arterial valve means in the arterial blood circuit, or the blood purification means from the venous valve means in the venous blood circuit. A vein-side pressure detecting means capable of detecting the pressure in the side flow path,
The control means sets the arterial valve means to an open state on the condition that the pressure in the flow path on the blood purification means side is lower than a predetermined value from the arterial valve means in the arterial blood circuit. Air is introduced from the tip of the blood circuit, or the vein side valve means is opened on the condition that the pressure in the flow path on the blood purification means side is lower than a predetermined value from the vein side valve means in the vein side blood circuit. 2. The blood purification apparatus according to claim 1, wherein the blood purification apparatus is controlled to introduce air from the tip of the venous blood circuit as a state.   A closed circuit that can circulate the liquid is formed by a branch line branched from a predetermined part of the blood circuit, and the control means circulates the liquid in the closed circuit while the dialysis fluid channel side of the blood purification means is 3. The blood purification according to claim 1, wherein the blood pressure in the blood flow path and the blood circuit is discharged to the outside through the dialysate discharge line by making the pressure lower than the fluid pressure on the blood flow path side. apparatus.   The said branch line is a physiological saline supply line which can branch from the front end side from the site | part in which the said blood pump is arrange | positioned in the said arterial blood circuit, and can supply the physiological saline into the said arterial blood circuit, The said blood circuit One or more of an overflow line or a level adjustment line extending from the upper part of the air trap chamber connected to the blood circuit and a replacement fluid line connected to the blood circuit and capable of supplying a replacement fluid are connected. The blood purification apparatus according to claim 3.   A physiological saline supply line that is connected to the arterial blood circuit and can supply physiological saline when the blood in the blood purification means and the fluid in the blood circuit are discharged outside via the dialysate discharge line. And the physiological saline in the housing means connected to the tip of the physiological saline is discharged to the outside through the dialysate discharge line. Blood purification device. A blood purification means in which a blood flow path through which a patient's blood flows and a dialysate flow path through which a dialysate flows are formed through a blood purification membrane for purifying the blood;
It consists of an arterial blood circuit and a venous blood circuit connected to the blood flow path side of the blood purification means, and passes the patient's blood from the tip of the arterial blood circuit to the tip of the venous blood circuit via the blood purification means. A blood circuit that can be circulated extracorporeally;
A blood pump disposed in the middle of the arterial blood circuit;
A dialysate introduction line and a dialysate discharge line connected to the dialysate flow path side of the blood purification means,
An arterial valve means disposed near the tip of the arterial blood circuit and capable of opening and closing the flow path at an arbitrary timing;
A venous valve means disposed near the tip of the venous blood circuit and capable of opening and closing the flow path at an arbitrary timing;
A method for discharging liquid in a blood circuit in a blood purification apparatus comprising:
After the blood purification treatment, the fluid pressure on the dialysate channel side of the blood purification means is made smaller than the fluid pressure on the blood channel side, so that the fluid in the blood channel and the blood circuit are externally passed through the dialysate discharge line. While discharging, air is introduced from the tip of the arterial blood circuit or the tip of the venous blood circuit by opening the arterial valve means or the venous side valve means. A method for discharging liquid in a blood circuit in a blood purification apparatus, wherein the liquid is replaced with liquid. Arterial pressure detecting means capable of detecting the pressure in the flow path on the blood purification means side from the arterial valve means in the arterial blood circuit, or the blood purification means from the venous valve means in the venous blood circuit. A vein-side pressure detecting means capable of detecting the pressure in the side flow path,
The arterial valve means is opened from the tip of the arterial blood circuit under the condition that the pressure in the flow path on the blood purification means side of the arterial blood circuit in the arterial blood circuit is lower than a predetermined value. Air is introduced or the vein side valve means is opened on the condition that the pressure in the flow path on the blood purification means side is lower than a predetermined value from the vein side valve means in the vein side blood circuit. The method for discharging liquid from the blood circuit in the blood purification apparatus according to claim 6, wherein air is introduced from the tip of the blood circuit.   A closed circuit that can circulate the liquid is formed by a branch line branched from a predetermined part of the blood circuit, and the dialysis fluid flow channel side of the blood purification means is connected to the blood flow channel side liquid while circulating the liquid in the closed circuit. 8. The blood circuit in the blood purification apparatus according to claim 6 or 7, wherein the liquid in the blood channel and the blood circuit is discharged outside through the dialysate discharge line by making the pressure smaller than the pressure. Liquid discharge method.   The said branch line is a physiological saline supply line which can branch from the front end side from the site | part in which the said blood pump is arrange | positioned in the said arterial blood circuit, and can supply the physiological saline into the said arterial blood circuit, The said blood circuit One or more of an overflow line or a level adjustment line extending from the upper part of the air trap chamber connected to the blood circuit and a replacement fluid line connected to the blood circuit and capable of supplying a replacement fluid are connected. A method for discharging a liquid in a blood circuit in the blood purification apparatus according to claim 8.   A physiological saline supply line that is connected to the arterial blood circuit and can supply physiological saline when the blood in the blood purification means and the fluid in the blood circuit are discharged outside via the dialysate discharge line. And the physiological saline in the housing means connected to the tip of the physiological saline is discharged to the outside through the dialysate discharge line. For discharging liquid in the blood circuit of the blood purification apparatus.   11. The blood purification means is turned upside down in the process of draining the liquid in the blood flow path and blood circuit of the blood purification means to the outside through the dialysate discharge line. A method for discharging a liquid in a blood circuit in the blood purification apparatus according to claim 1.   At least a part of the closed circuit is constituted by a branch line extending from an upper portion of an air trap chamber connected to the blood circuit, and the blood flow path of the blood purification means and the liquid in the blood circuit are dialyzed. 12. The method of discharging a liquid in a blood circuit in a blood purification apparatus according to claim 6, wherein the air trap chamber is turned upside down in the process of discharging to the outside through a liquid discharge line. .

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