JP2011206324A - Blood purifying apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a blood purifying apparatus which can prevent an excessive condensation to the blood which extracorporeally circulates from occurring when the on-line HDF or the on-line HF of a replacement fluid is performed.SOLUTION: The blood purifying apparatus includes: a dialyzer 1; an artery-side blood circuit 2; a vein-side blood circuit 3; a dialysate introducing line L1; a dialysate discharging line L2 which discharges a dialysate from the dialyzer 1; a replacement fluid line L3; and a replacement fluid pump 9 which can feed the dialysate having flown in the replacement fluid line L3 to the artery-side blood circuit 2. The blood purifying apparatus is equipped with a control means 10 which can perform the control in such a manner that the flow rate of the dialysate which is introduced to the dialyzer 1 may be made approximately the same as the flow rate of the dialysate which is discharged from the blood purifying implement until a specified period of time has passed from the starting of the feeding of the dialysate to the artery-side blood circuit 2 by the replacement fluid pump 9 on condition that the blood flowing in a dilution flow channel section A is not diluted with the dialysate.

Description

  The present invention relates to a blood purification apparatus for performing blood purification treatment with a blood purifier connected to a blood circuit.

  Recently, in a dialysis machine as a blood purification apparatus, there is a technique for performing priming, blood return and replacement (emergency replacement) using dialysate for supplying to a dialyzer during dialysis treatment (particularly, on-line HDF or on-line HF). Has been proposed. For example, Patent Document 1 discloses a replacement fluid in which one end is connected to a sampling port formed in a predetermined part of the dialysate introduction line and the other end is connected to a blood circuit (arterial blood circuit or venous blood circuit). A dialysis apparatus including a line and a replacement fluid pump disposed in the replacement fluid line is disclosed. In order to perform priming, blood return or replacement fluid (emergency replacement fluid) with such a dialysis device, the dialysate introduction line dialysate is supplied to the blood circuit (arterial blood circuit or venous blood circuit) by driving the replacement fluid pump. It comes to supply.

  By the way, in the case where the blood purifier is applied to hemodiafiltration (HDF) and uses a dialysate as a replacement fluid (hereinafter referred to as online HDF), water removal corresponding to filtration therapy as HDF therapy is performed. Only the patient's blood needs to be supplemented with dialysate (there is a pre-replacement fluid that is supplemented by the arterial blood circuit and a post-replacement fluid that is supplemented by the venous blood circuit). As disclosed in Patent Document 2, as applied to such an online HDF, a dialyzer, a blood circuit including an arterial blood circuit and a venous blood circuit in which a blood pump is disposed, and a dialysate in the dialyzer The dialysate introduction line for introducing the dialysate, the dialysate discharge line for discharging the dialysate from the dialyzer, and the replacement fluid line for supplying the dialysate from the dialysate introduction line to the blood circuit without passing through the dialyzer (pre-replacement fluid) A dialyzer having a line or a post-replacement line) has been proposed.

  Among these, in a dialysis device having a pre-replacement line and capable of pre-replacement, the patient's blood circulating extracorporeally is replenished before reaching the dialyzer. Filtration will be performed. Therefore, a dialysis apparatus that applies such a pre-replacement fluid can normally drive the replacement fluid pump faster than a device that applies a post-replacement solution, and can sufficiently perform dilution with the replenishment solution.

JP 2004-313522 A Japanese Patent Laid-Open No. 2001-112863

  However, the blood purification apparatus that applies the pre-replacement solution among the above conventional techniques has the following problems. That is, immediately after the start of blood purification treatment or immediately after the start of driving after the replacement fluid pump is temporarily stopped, the flow path from the connection site to the replacement fluid line in the arterial blood circuit to the dialyzer (hereinafter referred to as “dilution”). The dialysis fluid as a replacement fluid is not supplied or a sufficient dialysis fluid is not supplied to the flow path portion), and blood that is not sufficiently diluted and has a high concentration flows.

  On the other hand, since a predetermined amount of dialysate is supplied as a replacement fluid from the dialysate introduction line to the arterial blood circuit side, the flow rate of the dialysate introduced into the dialyzer is higher than the dialysate discharged from the dialyzer. As a result, the flow rate is reduced by the supplied flow rate, and filtration by the dialyzer is performed even if the water removal pump or the like is not driven. As a result, there is a risk that the blood that has been insufficiently diluted may be further filtered, resulting in excessive concentration of blood circulating outside the body. In addition, as described above, in the blood purification apparatus that applies the pre-replacement liquid, since it is usually set to drive the replacement liquid pump faster than the one that applies the post-replacement liquid, the overconcentration is more likely to occur. There is.

  This invention is made | formed in view of such a situation, and it is providing the blood purification apparatus which can prevent the excessive concentration with respect to the blood circulated extracorporeally when performing a pre-replacement liquid.

  According to the first aspect of the present invention, there is provided a blood purifier that contains a blood purification membrane and purifies blood with the blood purification membrane, a proximal end is connected to the blood purification device, and a blood pump is disposed in the middle thereof. An arterial blood circuit, a venous blood circuit whose proximal end is connected to the blood purifier, a dialysate introduction line for introducing dialysate into the blood purifier, and discharging the dialysate from the blood purifier A dialysate discharge line, a replacement fluid line having one end connected to the replacement fluid source and the other end connected to the arterial blood circuit, and a replacement fluid capable of supplying the replacement fluid flowing into the replacement fluid line to the artery blood circuit A blood purification device comprising a supply means, wherein the blood flowing through a dilution flow path comprising a flow path from a connection site with the replacement fluid line in the artery side blood circuit to the blood purification device is a replacement fluid. Diluted The flow rate of the dialysate introduced into the blood purifier and the dialysis discharged from the blood purifier until a predetermined time has elapsed from the start of the supply of the replacement fluid to the arterial blood circuit by the replacement fluid supply means. Control means capable of controlling the liquid flow rate to be substantially the same is provided.

  The invention according to claim 2 is the blood purification apparatus according to claim 1, wherein the control means stops the flow of dialysate to the blood purifier and the flow of dialysate from the blood purifier. The flow rate of the dialysate introduced into the blood purifier and the flow rate of the dialysate discharged from the blood purifier are set to be the same with zero.

  According to a third aspect of the present invention, in the blood purification apparatus according to the second aspect, the replacement fluid source is the dialysate introduction line, and dialysate as a replacement fluid flows into the replacement fluid line, and the blood Pump means for supplying dialysate to the purifier and the replacement fluid line and discharging dialysate from the blood purifier, and a connecting portion between the pump means in the dialysate introduction line and downstream of the pump means And an opening / closing means capable of arbitrarily opening and closing the flow path on the blood purifier side and the flow path on the upstream side of the pump means in the dialysate discharge line, and the control means includes the replacement fluid line by the pump means. The dialysis fluid flow to the blood purifier and the dialysate flow from the blood purifier are stopped by closing the opening / closing means while maintaining the supply of dialysate to the blood purifier It is characterized in.

  According to a fourth aspect of the present invention, in the blood purification apparatus according to the third aspect, the pump means comprises a dual pump disposed across the dialysate introduction line and the dialysate discharge line, and the dialysate discharge. The line has a bypass line that bypasses the duplex pump, and the dialysate is circulated through the bypass line.

  The invention according to claim 5 is the blood purification apparatus according to claim 1, wherein the control means maintains the flow of dialysate to the blood purifier and the flow of dialysate from the blood purifier while maintaining the fluid replacement line. It is characterized in that the replacement fluid is supplied from.

  According to a sixth aspect of the present invention, in the blood purification apparatus according to the fifth aspect, the replacement fluid source is the dialysate introduction line, and a dialysate as a replacement fluid is allowed to flow into the replacement fluid line. A dial pump that is disposed across the fluid introduction line and the dialysate discharge line and that supplies the dialysate to the blood purifier and the replacement fluid line and discharges the dialysate from the blood purifier; A bypass line that bypasses the duplex pump in the discharge line, and a dewatering pump that is connected to the bypass line and is capable of normal rotation and reverse rotation, wherein the control means is a dialysate for the replacement fluid line by the duplex pump The dehydration pump is driven in reverse so that the flow rate of the dewatering pump is substantially the same as that of the dialysate for the replacement fluid line, and the dialysate is circulated through the bypass line. Characterized in that to.

  According to the first aspect of the present invention, the condition is that the blood flowing through the dilution flow path portion including the flow path from the connection site with the replacement fluid line in the arterial blood circuit to the blood purifier is not diluted with the replacement fluid. The flow rate of the dialysate introduced into the blood purifier and the flow rate of the dialysate discharged from the blood purifier are substantially the same until a predetermined time has elapsed from the start of supplying the replacement fluid to the arterial blood circuit by the replacement fluid supply means. Since it can be controlled by the control means, the filtering action in the blood purifier is not performed for the predetermined time, and excessive concentration of blood circulating extracorporeally when the pre-replacement fluid is performed can be prevented.

  According to the invention of claim 2, the control means stops the flow of the dialysate to the blood purifier and the flow of the dialysate from the blood purifier, thereby allowing the flow rate of the dialysate introduced into the blood purifier and Since the flow rate of the dialysate discharged from the blood purifier is the same with zero, it is not necessary to change the piping configuration of the existing blood purifying apparatus, and the filtering action in the blood purifier for a predetermined time. Can be prevented, and excessive concentration of the blood circulating extracorporeally when the pre-replacement fluid is performed can be prevented.

  According to the invention of claim 3, the replacement fluid source is the dialysate introduction line, and the dialysate as the replacement fluid is allowed to flow into the replacement fluid line, and the blood purifier, the supply of the dialysate to the replacement fluid line, and the blood Pump means for discharging the dialysate from the purifier, and pump means in the dialysate introduction line, downstream of the pump means in the dialysate introduction line and on the blood purifier side from the connection with the replacement fluid line, and in the dialysate discharge line Opening and closing means that can arbitrarily open and close the upstream flow path, and the control means keeps the supply of dialysate to the replacement fluid line by the pump means and closes the opening and closing means to dialysate for the blood purifier Since the flow of dialysis fluid and the flow of dialysate from the blood purifier are stopped, the electromagnetic valve or the like of a conventional existing blood purification device can be used as an opening / closing means.

  According to the invention of claim 4, the pump means comprises a dual pump disposed across the dialysate introduction line and the dialysate discharge line, and has a bypass line that bypasses the dual pump in the dialysate discharge line. Since the dialysate is circulated through the bypass line, even when a dual pump is used as the pump means, the switching means is closed while maintaining the supply of the dialysate to the replacement fluid line. The flow of dialysate and the flow of dialysate from the blood purifier can be stopped easily and reliably.

  According to the invention of claim 5, the control means causes the supply of the replacement fluid from the replacement fluid line while maintaining the flow of the dialysate to the blood purifier and the flow of the dialysate from the blood purifier. It is possible to prevent filtration from being performed while circulating the dialysate through the vessel, and to prevent excessive concentration of blood circulating extracorporeally when the pre-replacement fluid is performed.

  According to the sixth aspect of the present invention, the replacement fluid source is the dialysate introduction line, and the dialysate as the replacement fluid is allowed to flow into the replacement fluid line, and is disposed across the dialysate introduction line and the dialysate discharge line. A bypass pump for supplying the dialysate to the blood purifier and the replacement fluid line and discharging the dialysate from the blood purifier, and bypassing the dual pump in the dialysate discharge line, and the bypass A dewatering pump connected to the line and capable of normal rotation and reverse rotation, and the control means maintains the supply of the dialysate to the replacement fluid line by the dual pump while the drainage pump is substantially the same as the dialysate for the replacement fluid line. Since the dialysate is circulated through the bypass line by being driven reversely so as to have the same flow rate, filtration is performed while easily and reliably circulating the dialysate through the blood purifier. Is prevented that, it is possible to prevent excessive enrichment for blood extracorporeal circulation Upon causing the pre-replacement fluid.

Schematic diagram showing a dialysis apparatus according to the first embodiment of the present invention. Schematic diagram showing the state of the control process by the control means in the dialysis machine The schematic diagram which shows the dialysis apparatus which concerns on the 2nd Embodiment of this invention. Schematic diagram showing the state of the control process by the control means in the dialysis machine Schematic diagram showing a dialysis 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 the present embodiment is applied to a hemodialysis apparatus (online HDF) in which a pre-replacement fluid is supplied to the arterial blood circuit 2 side in the blood purification treatment process. As shown in FIG. 1, a dialysis apparatus having a blood circuit in which an arterial blood circuit 2 and a venous blood circuit 3 are connected to a dialyzer 1 as a blood purifier, and a dialysate introduction line L1 and a dialysate discharge line L2. It is mainly composed of a main body B, a replacement fluid line L3, a replacement fluid pump 9 as a replacement fluid supply means, and a control means 10.

  The dialyzer 1 contains a blood purification membrane (not shown) (in this embodiment, a hollow fiber type hemodiafiltration membrane, but includes a flat membrane type, a hemodialysis membrane, and a blood filtration membrane), and blood into which blood is introduced. The inlet 1a and the blood outlet 1b for leading the introduced blood are formed, and the dialysate inlet 1c for introducing the dialysate and the dialysate outlet 1d for discharging the introduced dialysate are formed. The blood is purified by bringing the dialysate into contact with the blood introduced from the blood introduction port 1a through the hollow fiber membrane.

  The arterial blood circuit 2 is mainly composed of a flexible tube, one end of which is connected to the blood inlet 1a of the dialyzer 1 and guides blood collected from the blood vessel of the patient into the hollow fiber membrane of the dialyzer 1. At the other end of the arterial blood circuit 2, a connector c to which an arterial puncture needle a can be attached is formed, an arterial air trap chamber 5 is connected in the middle, and a blood pump 4 is disposed. ing. The blood pump 4 is an iron-type pump (with a structure that, when rotated forward, a flexible tube is squeezed to flow blood from the arterial puncture needle a side toward the blood inlet 1a of the dialyzer 1). is there.

  Similar to the arterial blood circuit 2, the venous blood circuit 3 is mainly composed of a flexible tube, and one end of the venous blood circuit 3 is connected to the blood outlet 1b of the dialyzer 1 to derive blood that has passed through the hollow fiber membrane. is there. At the other end of the venous blood circuit 3, a connector d to which a venous puncture needle b can be attached is formed, and a venous air trap chamber 6 is connected midway. . Thus, the patient's blood collected by the arterial puncture needle a reaches the dialyzer 1 via the arterial blood circuit 2, and after blood purification, flows through the venous blood circuit 3 and venous puncture. It is configured to return to the patient's body through the needle b, and thereby to perform extracorporeal circulation.

  A dialysate introduction line L1 and a dialysate discharge line L2 are connected to the dialysate introduction port 1c and the dialysate discharge port 1d of the dialyzer 1, respectively, and introduced into the dialyzer 1 through the dialysate introduction line L1. The dialysate can be discharged from the dialysate discharge line L2 through the outside of the hollow fiber membrane. An electromagnetic valve V1 and an electromagnetic valve V2 are connected to the dialysate introduction line L1 and the dialysate discharge line L2, respectively.

  In addition, the dialysate introduction line L1 and the dialysate discharge line L2 are disposed across the dialysate introduction line L1 and the dialysate discharge line L2, and the dialysate adjusted to a predetermined concentration is supplied to the dialyzer 1. A dual pump 7 (pump means) for discharging from the dialyzer 1 is connected. Further, in the dialyzer main body B, bypass lines L5 and L6 for communicating the dialysate introduction line L1 and the dialysate discharge line L2 without the dialyzer 1 are disposed, and in the middle of the bypass lines L5 and L6. Electromagnetic valves V3 and V4 are respectively provided. In the figure, reference numerals f1 and f2 denote filtration filters disposed in the dialysate introduction line L1, and an electromagnetic valve V6 is disposed between the filtration filters f1 and f2.

  On the other hand, the dialysate discharge line L2 is formed with bypass lines L4 and L7 for bypassing the duplex pump 7, and one bypass line L4 is used to remove water from the blood of the patient flowing in the dialyzer 1. A dewatering pump 8 is disposed, and an electromagnetic valve V5 that can open and close the flow path is disposed in the other bypass line L7. Thus, during blood purification treatment (the control by the control means 10 will be described later), normally, the solenoid valves V1, V2, and V6 are opened, the solenoid valves V3 and V4 are closed, and the dialysate is dialyzed from the dialyzer 1 and artery. The side air trap chamber 5 can be supplied.

  One end of the replacement fluid line L3 is connected to a sampling port (not shown) formed in a predetermined portion (replacement fluid source) of the dialysate introduction line L1, so that dialysate (replacement fluid) can flow from the one end. The flow path (for example, a flexible tube etc.) which the end was connected to the upper part of the artery side air trap chamber 5 consists of. The collection port is composed of a port formed in the dialyzer main body B, and the dialysate introduction line L1 and the artery side air trap chamber 5 are communicated with each other by connecting one end of the replacement fluid line L3 to the collection port. Can do.

  The replacement fluid line L3 according to the present embodiment is connected to the artery side air trap chamber 5, but the artery side blood circuit 2 is connected to another part of the artery side blood circuit 2 (for example, via a connecting member such as a T-shaped tube). It may be connected directly to the flow path constituting. Here, in the present invention, the blood flow path from the connection site (the arterial air trap chamber 5 in this embodiment) to the dialyzer 1 (blood purifier) in the arterial blood circuit 2. Is defined as “dilution channel section A”.

  A replacement fluid pump 9 as a replacement fluid supply means is provided in the replacement fluid line L3, and can supply dialysate (replacement fluid) flowing into the replacement fluid line L3 to the artery side blood circuit 2 via the artery side air trap chamber 5. It is. As a result, one end and the other end of the replacement fluid line L3 are connected to the dialysate introduction line L1 and the arterial air trap chamber 5, respectively, and the replacement fluid pump 9 is driven (forward rotation drive). A pre-replacement solution (a form of replacement fluid that supplies dialysate as a replacement solution to the arterial blood circuit 2 side) can be performed. Note that the replacement fluid pump 9 is a squeezing type pump (with a configuration in which the dialyzing fluid can be flowed by squeezing a tube constituting the replacement fluid line L3 when driven) like the blood pump 4.

  The replacement fluid line L3 is provided with clamping means (not shown) that can open and close the flow path until the dialysate is circulated after the operator connects the replacement fluid line L3 to the sampling port. The clamp means is closed and the flow path is closed. When necessary (priming, returning blood, replacement fluid, etc.), the clamp means is opened by the operator, and the dialysate introduction line L1 and the blood circuit (arterial blood circuit 2) communicate with each other. ing.

  By the way, the duplex pump 7 according to the present embodiment is configured to cause the dialyzer 1 (blood purifier) to supply dialysate to the replacement fluid line L3 and discharge the dialysate from the dialyzer 1 (blood purifier). In addition, the solenoid valves V1, V2 and V4 (or may be solenoid valves V1, V2 and V3) are downstream of the dual pump 7 (pump means) in the dialysate introduction line L1 and are connected to the replacement fluid line L3. Opening / closing means that can arbitrarily open and close the flow path on the dialyzer 1 (blood purifier) side from the connecting portion and the flow path upstream of the dual pump 7 (pump means) in the dialysate discharge line L2.

  The control means 10 is composed of, for example, a microcomputer that can control the opening and closing of various electromagnetic valves V1 to V6 and actuators such as the blood pump 4 and the replacement fluid pump 9 provided in the dialysis apparatus. In the arterial blood circuit 2, the blood flowing through the dilute flow path portion A consisting of the flow path from the connection site (the arterial air trap chamber 5 in this embodiment) to the fluid replacement line L 3 to the dialyzer 1 is dialysate The flow rate of the dialysate introduced into the dialyzer 1 until a predetermined time has elapsed from the start of the supply of the dialysate (replacement fluid) to the arterial blood circuit 2 by the replacement fluid pump 9 on the condition that it has not been diluted with (replacement fluid) The flow rate of the dialysate discharged from the dialyzer 1 can be controlled to be substantially the same.

  Here, in this embodiment, the control means 10 stops the flow of the dialysate with respect to the dialyzer 1 and the flow of the dialysate from the dialyzer 1, thereby allowing the flow rate of the dialysate introduced into the dialyzer 1 and the dialyzer. The flow rate of the dialysate discharged from 1 is the same as zero (0) (in other words, both flow rates are set to “0” (flow rate stopped state)). That is, the control means 10 is provided on the condition that the blood flowing through the dilution flow path section A is not diluted with the dialysate (replacement fluid), and a predetermined time from the start of supply of the dialysate to the arterial blood circuit 2 by the replacement fluid pump 9. Until the time elapses, the solenoid valves V1, V2 and V4 (opening / closing means) are closed and the other solenoid valves (specifically, the solenoid valves V3, V5 and V6) are opened as shown in FIG. Is controlled.

  The predetermined time during which such control is performed is determined in advance as an arbitrary fixed value, so that the blood flowing through the dilution flow path portion A is sufficiently diluted with dialysate (replacement fluid) from the volume of the dilution flow path portion A. A hydraulic pressure meter is disposed near the inlet of the dialyzer 1 in the dilution flow path section A for calculating the expected time, and when the hydraulic pressure gauge falls below a predetermined pressure.

  In this state, the control means 10 drives (forward rotation drive) the duplex pump 7, the replacement fluid pump 9 and the blood pump 4, thereby supplying the dialysate (replacement fluid) to the replacement fluid line L3 by the duplex pump 7 (pump means). The dialysate flow to the dialyzer 1 and the dialysate flow from the dialyzer 1 are controlled to be stopped while maintaining the above. At this time, since the solenoid valve V5 is in an open state, the dialysate is circulated through the bypass line L7 that bypasses the duplex pump 7 in the dialysate discharge line L2.

  The start of the control by the control means 10 as described above is based on the condition that the blood flowing through the dilution flow path part A is not diluted with the replacement fluid (dialysis fluid). For example, at the start of the replacement fluid (that is, the replacement fluid pump 9 At the start of driving), a blood concentration meter is disposed in the dilution channel portion A, and when it is determined that the blood concentration measured by the blood concentration meter is greater than a predetermined value, a pressure meter is disposed in the dilution channel portion A. And measuring the fluid pressure of the blood flowing through the dilution flow path A, and determining that the fluid pressure is greater than a predetermined value, the blood pump 4 is in a predetermined amount ( For example, when the blood pump 4 is driven by an arbitrary flow rate or time set in a state in which the replacement fluid pump 9 is stopped when it is driven by the volume of the dilution flow path portion A), etc. Listed as a condition where the blood is not diluted .

  According to the above-described embodiment, on the condition that the blood flowing through the dilution flow path portion A is not diluted with the dialysate, the dialysate (replacement fluid) of the arterial blood circuit 2 by the replacement fluid pump 9 (replacement fluid supply means) is supplied. The control means 10 is configured so that the flow rate of the dialysate introduced into the dialyzer 1 (blood purifier) and the flow rate of the dialysate discharged from the dialyzer 1 (blood purifier) until the predetermined time has elapsed from the start of supply. Therefore, the filtering action in the dialyzer 1 is not performed for the predetermined time, and excessive concentration of blood circulating extracorporeally when the pre-replacement fluid is performed can be prevented.

  Moreover, the control means 10 stops the flow of the dialysate with respect to the dialyzer 1 (blood purifier) and the flow of the dialysate from the dialyzer 1 (blood purifier), whereby the flow rate of the dialysate introduced into the dialyzer 1. And the flow rate of the dialysate discharged from the dialyzer 1 is the same with zero flow, so that it is not necessary to change the piping configuration of the existing blood purification apparatus, and the filtering action in the blood purification device for a predetermined time. Can be prevented, and excessive concentration of the blood circulating extracorporeally when the pre-replacement fluid is performed can be prevented.

  Further, a dual pump 7 (pump means) for supplying dialysate to the dialyzer 1 (blood purifier) and the replacement fluid line L3 and discharging the dialysate from the dialyzer 1 (blood purifier), and a dialysate introduction line L1. The flow path on the downstream side of the dual pump 7 (pump means) and the flow path on the dialyzer 1 side from the connection with the replacement fluid line L3 and the flow path on the dialysate discharge line L2 upstream of the dual pump 7 (pump means). Open / close means (electromagnetic valves V1, V2 and V4 or electromagnetic valves V1, V2 and V3) that can be arbitrarily opened and closed, and the control means 10 supplies dialysate to the replacement fluid line L3 by the dual pump 7 (pump means). The flow of dialysate to the dialyzer 1 and the dialysate flow from the dialyzer 1 are stopped by keeping the opening / closing means closed while maintaining , It is possible to divert the solenoid valve or the like of the existing blood purification apparatus that is conventionally employed as a switching means.

  Further, the pump means includes a dual pump 7 disposed across the dialysate introduction line L1 and the dialysate discharge line L2, and has a bypass line L7 that bypasses the dual pump 7 in the dialysate discharge line L2. Since the dialysate is circulated through the bypass line L7, even when the dual pump 7 is used as the pump means, the opening / closing means (electromagnetic valve V1, With the V2 and V4 or solenoid valves V1, V2 and V3) closed, the flow of dialysate to the dialyzer 1 and the flow of dialysate from the dialyzer 1 can be easily and reliably stopped.

Next, a second embodiment of the present invention will be described.
As in the first embodiment, the blood purification apparatus according to the present embodiment is a hemodialysis apparatus (online HDF) in which pre-replacement fluid is supplied to the arterial blood circuit 2 side during the blood purification treatment process. As shown in FIG. 3, a blood circuit in which an arterial blood circuit 2 and a venous blood circuit 3 are connected to a dialyzer 1 as a blood purifier, a dialysate introduction line L1, and a dialysate discharge It mainly comprises a dialyzer body B having a line L2, a replacement fluid line L3, a replacement fluid pump 9 as a replacement fluid supply means, a control means 10 ', and a water removal pump 8'. In addition, the same code | symbol is attached | subjected to the component similar to 1st Embodiment, and those detailed description is abbreviate | omitted.

  The dewatering pump 8 ′ is disposed on the bypass line L4 and includes pump means for removing water from the blood of the patient flowing in the dialyzer 1. In the present embodiment, forward rotation or reverse rotation is possible. It is said that. The control means 10 ′ is pre-determined from the start of the supply of the dialysate to the arterial blood circuit 2 by the replacement fluid pump 9 (replacement fluid supply device) on the condition that the blood flowing through the dilution channel A is not diluted with the dialysate. Until the time elapses, the flow rate of the dialysate introduced into the dialyzer 1 and the flow rate of the dialysate discharged from the dialyzer 1 can be controlled to be substantially the same.

  Here, the control means 10 ′ according to the present embodiment causes the dialysate to be supplied from the replacement fluid line L3 while maintaining the flow of the dialysate to the dialyzer 1 and the flow of the dialysate from the dialyzer 1. . That is, the control means 10 ′ is predetermined from the start of the supply of the dialysate to the arterial blood circuit 2 by the replacement fluid pump 9 on the condition that the blood flowing through the dilution channel A is not diluted with the dialysate (replacement fluid). Until time (similar to the first embodiment) elapses, the solenoid valves V1, V2, and V6 are controlled to be opened and the solenoid valves V3, V4, and V5 are closed as shown in FIG. The

  In such a state, the control means 10 ′ maintains the supply of the dialysate (replacement fluid) to the replacement fluid line L3 by the dual pump 7 while supplying the dewatering pump 8 ′ to substantially the same flow rate as the dialysate for the replacement fluid line L3 (this embodiment). , The dialysate is circulated through the bypass line L4 by being driven in reverse so that the flow rate is substantially the same as the flow rate of the replacement fluid pump 9. However, since the flow rate of the water removal pump 8 ′ and the flow rate of the replacement fluid pump 9 are controlled to be substantially equal, the dialysate discharge line L2 forces the dialysate via the bypass line L4 that bypasses the duplex pump 7. Will be circulated.

  The start of the control by the control means 10 'as described above is made on the condition that the blood flowing through the dilution flow path section A is not diluted with the replacement fluid (dialysate). For example, at the start of the replacement fluid (that is, the replacement fluid pump 9). When the blood concentration meter is disposed in the dilution flow path section A and it is determined that the blood concentration measured by the blood concentration meter is greater than a predetermined value, a pressure gauge is installed in the dilution flow path section A. When the fluid pressure of the blood flowing through the dilution channel A is measured and the fluid pressure is determined to be greater than a predetermined value, the blood pump 4 is in a predetermined amount while the replacement fluid pump 9 is stopped. When the blood pump 4 is driven for a predetermined flow rate or time in a state where the replacement fluid pump 9 is stopped when it is driven by (for example, the volume of the dilution flow passage portion A), the dilution flow passage portion A is Listed as undiluted conditions for blood That.

  According to the present embodiment, the control means 10 'maintains the dialysis fluid flow to the dialyzer 1 (blood purifier) and the dialysis fluid flow from the dialyzer 1 (blood purifier) while maintaining the dialysis from the replacement fluid line L3. Since the liquid is supplied, it is possible to prevent the filtering action from being performed while circulating the dialysate through the dialyzer 1 (blood purifier), and to prevent excessive concentration of the blood circulating extracorporeally when performing the pre-replacement fluid. Can do. In addition, according to this embodiment, since the compound pump 7 (pump means), the blood pump 4 and the replacement fluid pump 9 are continuously driven, the pre-replacement solution is performed without stopping the diffusion action in the dialyzer 1. In this case, excessive concentration of blood circulating outside the body can be prevented.

  Further, the control means 10 ′ maintains the supply of the dialysate to the replacement fluid line L3 by the duplex pump 7 and reversely drives the dewatering pump 9 to have substantially the same flow rate as the dialysate to the replacement fluid line L3. Since the dialysate is circulated through L4, the dialysate 1 (blood purifier) can be easily and reliably circulated through the dialysate to prevent filtration from being performed. Excessive concentration can be prevented.

  Although the present embodiment has been described above, the present invention is not limited to this. For example, as shown in FIG. 5, instead of the replacement fluid pump 9 disposed in the replacement fluid line L3, the dialysate introduction line L1 is used. You may apply to the hemodialysis apparatus provided with the throttle valve 11 (replacement fluid supply means) which can be arrange | positioned arbitrarily and can arrange | position the flow volume of the dialysate which is arrange | positioned and introduce | transduced into the dialyzer 1 (blood purifier). In this case, a flow meter 12 is disposed in the dialysate introduction line L1 in the vicinity of the throttle valve 11 so that the flow rate of the dialysate introduced into the dialyzer 1 and the flow rate flowing through the replacement fluid line L3 can be grasped. Is preferred.

  In the present embodiment, the dialysate is introduced and discharged by the compound pump 7, but other types (for example, a balancing chamber or the like) may be used instead. Alternatively, in place of the pump means disposed across the dialysate introduction line L1 and the dialysate discharge line L2, a separate pump is provided for each of the dialysate introduction line L1 and the dialysate discharge line L2. You may apply to things. In this case, it is preferable to provide a flow meter in the vicinity of each pump.

  Furthermore, although the hemodialysis apparatus according to the present embodiment is applied to online HDF, it may be applied to, for example, online HF. In this case, for example, in FIGS. 1 and 4, the electromagnetic valve V1 is closed to prevent the dialysate from flowing into the dialyzer 1, the electromagnetic valves V4 and V2 are opened, and filtration from the dialyzer 1 is performed while bypassing the dialysate. The action to be performed is performed. As described above, in the present embodiment, it can be applied to online HDF, online HF, or the like. However, instead of the one where one end of the replacement fluid line is connected to the replacement fluid introduction line L1, a replacement fluid bag containing a predetermined amount of replacement fluid is used. You may apply to the thing (form which is not online) connected to the replacement fluid source.

  On the condition that the blood flowing through the diluting flow path portion consisting of the flow path from the connection site with the replacement fluid line in the artery side blood circuit to the blood purifier is not diluted with dialysate, the artery side by the replacement fluid supply means Control means capable of controlling the flow rate of dialysate introduced into the blood purifier and the flow rate of dialysate discharged from the blood purifier to be substantially the same until a predetermined time has elapsed since the start of the supply of dialysate to the blood circuit As long as the blood purification device is provided with a blood purification device, it can also be applied to devices to which other functions are added.

1 ... Dializer (blood purifier)
DESCRIPTION OF SYMBOLS 2 ... Arterial side blood circuit 3 ... Vein side blood circuit 4 ... Blood pump 5 ... Arterial side air trap chamber 6 ... Vein side air trap chamber 7 ... Duplex pump 8, 8 '... Dehydration pump 9 ... Replacement fluid pump (replacement fluid supply means) )
DESCRIPTION OF SYMBOLS 10, 10 '... Control means 11 ... Throttle valve 12 ... Flowmeter L1 ... Dialysate introduction line L2 ... Dialysate discharge line L3 ... Replacement fluid line A ... Dilution channel part

Claims (6)

A blood purifier that contains a blood purification membrane and purifies the blood with the blood purification membrane;
An arterial blood circuit in which a proximal end is connected to the blood purifier and a blood pump is disposed in the middle thereof;
A venous blood circuit having a proximal end connected to the blood purifier;
A dialysate introduction line for introducing dialysate into the blood purifier,
A dialysate discharge line for discharging dialysate from the blood purifier,
A fluid replacement line having one end connected to a fluid replacement source and the other end connected to the arterial blood circuit;
Fluid replacement means capable of supplying the fluid replacement fluid flowing into the fluid replacement line to the arterial blood circuit;
A blood purification apparatus comprising:
The replacement fluid supply means, provided that the blood flowing through the dilution flow path section consisting of the flow path between the connection site with the replacement fluid line in the artery side blood circuit and the blood purifier is not diluted with the replacement fluid. The flow rate of the dialysate introduced into the blood purifier and the flow rate of the dialysate discharged from the blood purifier are controlled to be substantially the same until a predetermined time has elapsed from the start of supplying the replacement fluid to the arterial blood circuit. A blood purification apparatus comprising a control means capable of performing the same.   The control means stops the flow of dialysate to the blood purifier and the flow of dialysate from the blood purifier, thereby discharging the flow of dialysate introduced into the blood purifier and the blood purifier. The blood purification apparatus according to claim 1, wherein the flow rate of the dialysate to be used is the same with zero flow rate.   The replacement fluid source is the dialysate introduction line to allow the dialysate as a replacement fluid to flow into the replacement fluid line, and the blood purifier, the supply of dialysate to the replacement fluid line, and the dialysis from the blood purifier Pump means for discharging the fluid, and the pump means in the dialysate introduction line downstream of the pump means in the dialysate introduction line and on the blood purifier side from the connection with the replacement fluid line, and the pump means in the dialysate discharge line And an opening / closing means capable of arbitrarily opening and closing a flow path on the upstream side, and the control means maintains the supply of dialysate to the replacement fluid line by the pump means while closing the opening / closing means. 3. The blood purification apparatus according to claim 2, wherein the flow of dialysate to the purifier and the flow of dialysate from the blood purifier are stopped.   The pump means includes a dual pump disposed across the dialysate introduction line and the dialysate discharge line, and has a bypass line that bypasses the dual pump in the dialysate discharge line. 4. The blood purification apparatus according to claim 3, wherein the dialysate is circulated through the blood.   The control means is configured to supply a replacement fluid from the replacement fluid line while maintaining a flow of dialysate to the blood purifier and a flow of dialysate from the blood purifier. 1. The blood purification apparatus according to 1.   The replacement fluid source is the dialysate introduction line, and the dialysate as a replacement fluid is allowed to flow into the replacement fluid line, and is disposed across the dialysate introduction line and the dialysate discharge line, and the blood purification And a bypass pump for supplying dialysate to the replacement fluid line and discharging the dialysate from the blood purifier, a bypass line for bypassing the dual pump in the dialysate discharge line, and a connection to the bypass line And a dewatering pump capable of normal rotation and reverse rotation, and the control means maintains the supply of the dialysate to the replacement fluid line by the dual pump and the drainage pump to the dialysate for the replacement fluid line. 6. The blood purification apparatus according to claim 5, wherein the dialysate is circulated through the bypass line by being reversely driven so as to have substantially the same flow rate.

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