JP2011172797A - Ascites treatment system and cleaning method thereof - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an ascites treatment system for treating a large amount of ascites by easily cleaning a filter in a short period of time. <P>SOLUTION: The ascites treatment system (1) includes: the filter (3) having a filter member (35) for selectively removing a specific substance in the ascites; and a concentrator (5) which is connected to the ascites discharge port (3b) of the filter (3) via a filter ascites transfer passage (19) and filters and concentrates the filtered ascites (A2) filtered by the filter. The filter (3) includes: a cleaning liquid supply port (3c) through which a cleaning liquid (CL) is supplied to the filter member (35) from an external part during the cleaning of the ascites treatment system in which the filter ascites transfer passage is blocked; and a cleaning waste liquid discharge port (3e) for discharging the substance (61) selectively removed by the filter member together with the cleaning liquid when cleaning. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

  The present invention relates to an ascites treatment system for collecting and collecting ascites by filtering and concentrating it in order to remove harmful substances from the ascites collected from the patient and return them to the body of the patient, and a method for cleaning the system.

  In recent years, for intractable ascites found in cirrhosis, visceral disease, cancerous peritonitis, etc., cell components such as bacteria and cancer cells that are harmful substances in ascites are removed, and self-proteins such as albumin that are useful substances are removed. Concentrated and reused ascites filtered concentrated re-injection treatment for recycle to patients is performed as part of cancer treatment and palliative treatment. As a device for filtering and concentrating ascites in such a treatment method, ascites is fed from a filter for removing harmful substances from ascites and a concentrator for concentrating ascites from the upstream side of the ascites and concentrated. An ascites treatment system is known in which negative pressure is applied to the concentrator membrane using a vacuum pump or the like, and the ascites is concentrated and recovered using only the ultrafiltration effect due to the pressure gradient in the concentrator membrane (for example, Patent Documents 1 and 2).

JP-A-55-16664 JP 57-31867 A

  However, in such a conventional system, the pores of the filtration membrane are blocked in a short time due to the removal of cancer cells, blood cells, fibrin and the like attached to the surface of the filtration membrane during the filtration of ascites. . Therefore, for example, the filtration membrane may be blocked only by treating about 1 to 3 L of ascites, and it has been difficult to continuously treat a large amount of ascites. .

  This invention is made | formed in view of the said subject, The place made into the objective is providing a structure which can perform the washing | cleaning of a filter in a short time and easily, and a large amount of ascites is made in a short time. It is an object of the present invention to provide an ascites treatment system that can be treated and a method for cleaning the system.

  In order to achieve the above-described object, an ascites treatment system according to the present invention includes a filter including a filter member that selectively removes a specific substance in ascites, and a filter ascites transfer path to the ascites discharge port of the filter. And a concentrator for filtering and concentrating the filtered ascites filtered through the filter, and the filter is externally disposed during the cleaning of the ascites treatment system in which the filtration ascites transfer path is blocked. A cleaning liquid supply port through which the cleaning liquid is supplied to the filtration member, and a cleaning waste liquid discharge port for discharging the material selectively removed by the filtration member together with the cleaning liquid during the cleaning.

  According to this configuration, since the filter can be washed in a short time, a large amount of ascites can be treated continuously while appropriately washing. Furthermore, it becomes possible to treat ascites or bloody ascites containing a large amount of cell components and mucus components, which easily cause clogging of the membrane.

  In the ascites treatment system according to one embodiment of the present invention, the cleaning liquid supply is such that the filtration member of the filter is a hollow fiber membrane, and one end of the hollow fiber membrane that is open at both ends by an external pressure method is closed during ascites treatment It is preferable that the port communicates with the other end and communicates with the ascites discharge port. By using a hollow fiber membrane as a filtration member in ascites treatment and configuring the filter as an external pressure filtration device, substances such as cell components attached to the outer surface of the membrane are peeled from the inside to the outside of the membrane. Can be made. As a result, the filter member can be effectively cleaned and the ascites can be effectively treated.

  In the ascites treatment system according to an embodiment of the present invention, a cleaning liquid supplier that supplies the cleaning liquid to the filter during the cleaning, and a cleaning waste liquid collection container that recovers the cleaning waste liquid discharged from the filter You may have. According to this configuration, the filter can be more easily cleaned.

  In order to achieve the above object, the ascites treatment apparatus cleaning method according to the present invention includes: cutting off the filtered ascites transfer path; supplying the cleaning liquid from the outside to the filter; Discharging the substance selectively removed by the member together with the cleaning liquid. According to this configuration, since the filtration member can be prepared in a short time, a large amount of ascites can be treated by the ascites treatment system.

  Thus, according to the ascites treatment system and the ascites treatment method according to the present invention, the filter can be easily washed in a short time, so that a large amount of ascites can be treated continuously.

It is a schematic block diagram which shows the ascites processing system which concerns on one Embodiment of this invention. It is a longitudinal cross-sectional view which shows the filter used for the ascites processing system of FIG. It is sectional drawing which shows the principle of the washing | cleaning method of the ascites processing system of FIG.

  Hereinafter, embodiments according to the present invention will be described with reference to the drawings. However, the present invention is not limited to the embodiments.

  FIG. 1 is a schematic diagram showing a configuration of an ascites treatment system 1 according to an embodiment of the present invention. This ascites treatment system 1 is a system for collecting and collecting ascites by filtering and concentrating to remove harmful substances from the ascites collected from the human body and returning them to the patient's body. A container 3, a concentrator 5, a circuit breaker 7, a cleaning liquid supplier 9 and a cleaning waste liquid recovery container 11 are provided. A storage container 13 for storing the ascites A1 to be processed is connected to the upstream portion of the filter 3, and a collection container 15 for recovering the processed ascites A3 is connected to the concentrator 5.

  Ascites A1 collected from the human body is first stored in the storage container 13, and the ascites A1 is supplied from the storage container 13. Downstream of the storage container 13, the filter 3 is connected via a first communication tube 17 that forms a communication path. An open valve 18 is provided in the middle of the first communication tube 17. Further, the concentrator 5 is connected to the downstream of the filter 3 via a second communication tube 19 that forms a transfer path for the filtered ascites A2 filtered by the filter 3. That is, the ascites supply port 13 a for discharging the ascites A1 from the storage container 13 and the ascites introduction port 3 a for introducing the ascites A1 from the storage container 13 to the filter 3 are connected via the first communication tube 17. Furthermore, an ascites discharge port 3 b for discharging the filtered ascites A 2 and a filtered ascites introduction port 5 a for introducing the filtered ascites A 2 into the concentrator 5 are connected via the second communication tube 19.

  On the downstream side of the concentrator 5, a waste liquid port 5b for discharging the waste liquid and a recovery port 5c for discharging the concentrated ascites A3 concentrated by the concentrator 5 are provided. A waste liquid suction device 21 for sucking the waste liquid W from the concentrator 5 is connected to the waste liquid port 5b via a waste liquid tube 23 that forms a waste liquid passage. On the other hand, a collection container 15 for collecting the concentrated ascites A3 is connected to the collection port 5c via a collection tube 25 that forms a collection passage. Further, a negative pressure generating device 27 that generates a negative pressure is disposed in the middle of the collection tube 25.

  Further, in the middle of the waste liquid tube 23, a negative pressure release tube 29 that forms a negative pressure release passage is connected. The negative pressure release tube 29 has an open valve 31 capable of communicating the inside of the tube with the outside.

  The filter 3 is a device for selectively removing harmful substances such as bacteria and cancer cells in the ascites A1 by filtration. As the filter 3, any substance can be used as long as it can pass proteins such as albumin and globulin, which are useful substances in the ascites A1, and can capture the harmful substances. In the present embodiment, a plurality of hollow fiber membranes 35 having a maximum pore diameter of about 0.2 μm are housed in a resin cylindrical filter housing 33 as a filtering member. As will be described in detail later, the filter 3 is configured as an external pressure filtration type filtration device using the hollow fiber membrane 35 as a filtration member.

  As a filtration member used for the filter 3, a flat membrane can be used in addition to the hollow fiber membrane 35. However, the membrane area per unit volume can be increased, and the removed substance adhering to the surface can be washed. A porous hollow fiber membrane is preferably used from the viewpoint that it can be easily formed. The material of the hollow fiber membrane used for the filter 3 is not particularly limited, but it has practical strength and pressure resistance and can be sterilized with polysulfone, polyethylene, polypropylene, polyvinyl alcohol, and ethylene-vinyl alcohol. A polymer or the like is preferably used.

  The filter 3 in the present embodiment is provided with a cleaning liquid introduction port 3c at an upstream end thereof, and a cleaning liquid supply device is connected to the cleaning liquid introduction port 3c via a cleaning liquid introduction tube 37 forming a cleaning liquid introduction passage. 9 is connected. An opening valve 39 is provided in the middle of the cleaning liquid introduction tube 37. As the cleaning liquid supply device 9, any cleaning liquid CL may be used as long as it stores the cleaning liquid CL and can discharge the cleaning liquid CL under pressure. In this embodiment, a syringe is used. As the cleaning liquid CL, a liquid in which cells are not destroyed by osmotic pressure can be used. For example, physiological saline is preferably used.

  Further, the ascites introduction port 3a is provided in the upstream side portion of the peripheral wall 3d of the filter 3, and the washing waste liquid CW is discharged from the filter 3 to the downstream side of the ascites introduction port 3a in the peripheral wall 3d. A cleaning waste liquid discharge port 3e is provided. That is, the cleaning waste liquid discharge port 3e is provided at a portion downstream of the cleaning liquid introduction port 3c that connects the filter 3 and the cleaning liquid introduction port 3c. The cleaning waste liquid discharge port 3e of the filter 3 is connected to the cleaning waste liquid recovery container 11 via a cleaning waste liquid recovery tube 41 that forms a cleaning waste liquid recovery path. An open valve 42 is provided in the middle of the cleaning waste liquid collection tube 41.

  As shown in detail in FIG. 2, the cleaning liquid introduction port 3 c of the filter 3 is a through-hole extending in parallel to the longitudinal direction X of the hollow fiber membrane 35 formed in the connection protrusion provided at the upstream end of the filter 3. It consists of holes 3ca. Similarly, the ascites discharge port 3b is composed of a through hole 3ba formed along a longitudinal direction X of the hollow fiber membrane 35 formed in a connection projection provided at the downstream end of the filter 3. On the other hand, the ascites introduction port 3a and the washing waste liquid discharge port 3e are formed of through-holes 3aa and 3ea formed in connection protrusions provided in the upstream portion and the downstream portion of the peripheral wall 3d of the filter 3, respectively. The through holes 3aa and 3ea of the ascites introduction port 3a and the washing waste liquid discharge port 3e are formed so as to extend in a direction substantially orthogonal to the longitudinal direction X of the hollow fiber membrane 35, respectively.

  A circle for fixing and binding one open end portion (first end portion) 35a of many hollow fiber membranes 35 in the axial direction between the cleaning liquid introduction port 3c and the ascites introduction port 3a in the filter housing 33. A plate-like first end fixing member 43 is provided. In addition, a disk-shaped second member that fixes and binds the other open ends (second ends) 35b of the multiple hollow fiber membranes at an axial position between the ascites discharge port 3b and the cleaning waste liquid discharge port 3e. An end fixing member 45 is provided. By these fixing members 43 and 45, the cleaning liquid introduction space 47 closer to the cleaning liquid introduction port 3c than the first end fixing member 43, the filtration space 49 between the fixing members 43 and 45, and the second end are provided in the filter 3. The filtration ascites discharge space 51 of the ascites discharge port 3b is defined more than the part fixing member 45.

  The concentrator 5 of FIG. 1 is an apparatus for removing the water that does not contain albumin or the like, which is a useful substance, from the filtered ascites A2 as waste liquid W and increasing the useful substance concentration in the filtered ascites A2. Any concentrator 5 may be used as long as it can separate and discharge only water and an electrolyte dissolved in water from filtered ascites A2 containing albumin having a molecular weight of about 66,000. However, in the present embodiment, a hollow concentrator housing 55 made of resin contains a hollow fiber membrane 57 having a molecular weight cut off of about 5000 or less as a filtering member.

  As a filtration member used in the concentrator 5, a flat membrane can be used in addition to the hollow fiber membrane 57, but a porous hollow fiber membrane that is less likely to be clogged is preferably used. As the material of the hollow fiber membrane 57 used in the concentrator 5, a concentrated membrane having practical strength and durability can be obtained, so that polysulfone, polyacrylonitrile, polyethylene, polypropylene, polyvinyl alcohol, ethylene-vinyl alcohol A copolymer or the like can be preferably used.

  The waste liquid suction device 21 is preferably one that can arbitrarily set the suction pressure and can keep the set pressure constant. It is also possible to use a wall-mounted suction device that is generally installed in a hospital facility. In that case, the suction pressure is set to about -300 to -400 mmHg and the wastewater treatment from the concentrator 5 is performed well. Can do.

  The storage container 13 and the collection container 15 can aseptically store the ascites A1 or the concentrated ascites A3 collected from the patient, and denature the ascites A1 and the concentrated ascites A3 collected from the patient. There are no restrictions on the material and shape as long as harmful substances do not elute inside and can be sterilized. In general, an infusion bag made of a soft material such as vinyl chloride, polypropylene, or polyethylene, preferably having a capacity of about 3 to 4 L as the storage container 13 and about 1 to 2 L as the collection container 15.

  The cleaning waste liquid collection container 11 is capable of aseptically storing cancer cells in the cleaning waste liquid CW, as long as no harmful substances are eluted in the cleaning waste liquid CW and can be sterilized. There are no restrictions on the material and shape. Generally, an infusion bag made of a soft material such as vinyl chloride, polypropylene, or polyethylene, and having a capacity of about 3 to 4 L is preferably used.

  The negative pressure generator 27 is provided to prevent clogging of the hollow fiber membrane 57 of the concentrator 5. The negative pressure generating device 27 is preferably an infusion pump that is capable of generating a negative pressure by arbitrarily setting a flow rate and that can maintain the set flow rate constant, and is generally installed in a hospital facility. Can be used. However, the negative pressure generator 27 may be omitted.

  The circuit breaker 7 may be any member as long as it can reliably block the second communication tube 19 as necessary and can block the transfer path of the filtered ascites A2 formed by the second communication tube 19. In this embodiment, a resin tube clamp is used. As the circuit breaker 7, a member that is separate from the second communication tube 19 and closes the second communication tube 19 from the outside, such as a tube clamp, may be used. A flow path opening / closing valve may be provided in the middle of the tube 19.

  Next, the operation of the ascites treatment system 1 according to the present embodiment will be described.

  In the normal operation state of the ascites treatment system 1 shown in FIG. 1, the opening valve 39 of the cleaning liquid introduction tube 37 is closed, and the second communication tube 19 is not blocked by the circuit breaker 7. In this state, the inside of the ascites treatment passage 59 formed by the storage container 13, the first communication tube 17, the filter 3, the second communication tube 19, the concentrator 5, and the recovery tube 25 has a negative pressure generator 27 and waste liquid. By starting the suction device 21, a negative pressure state is established. Due to this negative pressure, ascites A1 in the storage container 13 is introduced into the filter 3 through the ascites introduction port 3a. In the filter 3, harmful substances such as cancer cells in the ascites A <b> 1 are removed by the hollow fiber membrane 35 as the removal substance 61 and adhere to the outer surface of the hollow fiber membrane 35. On the other hand, the filtered ascites A2 containing albumin, globulin and the like, which are useful substances filtered by the filter 3, is discharged from the ascites discharge port 3b.

  The filtered ascites A2 discharged from the filter 3 is then introduced into the concentrator 5. Inside the concentrator 5, the filtered ascites A2 passes inside the hollow fiber membrane 57. At this time, a part of the filtered ascites A2 which does not contain a useful substance such as albumin is sucked by the waste liquid suction device 21 communicating with the waste liquid port 5b and discharged from the waste liquid port 5b as the waste liquid W. The portion of the filtered ascites A2 from which the waste liquid W has been removed is discharged as a concentrated ascites A3 from the collection port 5c and collected in the collection container 15.

  When cleaning the ascites treatment system 1, first, the open valve 18 is closed to block the first communication tube 17, and the second communication tube 19 is blocked by the circuit breaker 7. Next, the opening valve 39 of the cleaning liquid introduction tube 37 and the opening valve 42 of the cleaning waste liquid recovery tube 41 are opened, and then the cleaning liquid CL is supplied to the filter 3 by the cleaning liquid supplier 9. As shown in FIG. 2, the cleaning liquid CL supplied to the filter 3 flows from the cleaning liquid introduction space 47 into the hollow fiber membrane 35. At this time, since the second communication tube 19 is closed by the circuit breaker 7, the cleaning liquid CL is applied to the surface of the hollow fiber membrane 35 by the pressure applied by the cleaning liquid supplier 9 as a syringe, as shown in FIG. It flows out from the inside of the hollow fiber membrane 35 through the hole 35c. With this cleaning liquid CL, the removal substance 61 is peeled off from the outer surface of the hollow fiber membrane 35 and is recovered as a cleaning waste liquid CW in the cleaning waste liquid recovery container 11 of FIG.

  According to the ascites treatment system 1 according to the present embodiment, since the filter 3 can be easily washed in a short time, a large amount of ascites can be treated continuously for a long time. Experiments have confirmed that 13 liters of ascites can be treated in about 7 minutes per liter. Furthermore, it becomes possible to treat ascites and bloody ascites containing a large amount of cell components and mucus components. In addition, cancer cells contained in the removed substance 61 collected by washing the filter 3 may be used for immunotherapy and anticancer drug sensitivity tests.

  As described above, the preferred embodiments of the present invention have been described with reference to the drawings, but various additions, modifications, or deletions can be made without departing from the spirit of the present invention. Therefore, such a thing is also included in the scope of the present invention.

DESCRIPTION OF SYMBOLS 1 Ascites treatment system 3 Filter 3a Cleaning liquid supply port 3b Ascites discharge port 3e Cleaning waste liquid discharge port 5 Concentrator 7 Circuit breaker 9 Cleaning liquid supply 11 Cleaning waste liquid collection container 35 Hollow fiber membrane (filter member)
61 Substances to be removed A1 Ascites A2 Filtration ascites CL Cleaning fluid CW Cleaning waste fluid

Claims (4)

A filter comprising a filtering member for selectively removing specific substances in ascites;
A concentrator that connects to the ascites discharge port of the filter through a filter ascites transfer path, and filters and concentrates the filtered ascites filtered by the filter;
With
The filter includes a cleaning liquid supply port through which a cleaning liquid is supplied from the outside to the filtering member during cleaning of the ascites treatment system in which the filtration ascites transfer path is blocked, and a substance selectively removed by the filtering member. An ascites treatment system having a cleaning waste liquid discharge port for discharging together with the cleaning liquid during cleaning.   In Claim 1, the said filtration member of the said filter is a hollow fiber membrane, and the one end part of the hollow fiber membrane which both ends opened by the external pressure system is connected to the said washing | cleaning liquid supply port obstruct | occluded at the time of ascites treatment, An ascites treatment system having an end communicating with the ascites discharge port.   The ascites treatment system according to claim 1, further comprising a cleaning liquid supplier that supplies the cleaning liquid to the filter during the cleaning, and a cleaning waste liquid recovery container that recovers the cleaning waste liquid discharged from the filter. . A method for cleaning the ascites treatment system according to any one of claims 1 to 3,
Blocking the filtration ascites transfer path;
Supplying the cleaning liquid from the outside to the filter;
Discharging the substance selectively removed by the filter member together with the cleaning liquid;
A method for cleaning an ascites treatment system.

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