JP2012040445A - Peritoneal dialysis device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a peritoneal dialysis device which enables automatization of dialytic therapy by a patient himself or herself, has very clear operability, and enables cure under right condition and facile reaction regardless of trouble.SOLUTION: The peritoneal dialysis device has one dialysis solution vessel filled by dialysis solution, a dialysis circuit including at least one drainage vessel for reclaiming dialysis solution, a solution sending means from the dialysis solution vessel to the drainage vessel, and a display section 23 for displaying to inform conditions for dialysis, and provides the dialysis solution to the patient by the solution sending means and displays the operation procedure necessary for dialyzing by reclaiming the drainage with still pictures including characters or a motion picture together with voice guide on the display section 23.

Description

  The present invention relates to a peritoneal dialysis apparatus that can be performed by a patient at home (at home) or the like.

  Peritoneal dialysis (continuous ambulatory peritoneal dialysis, hereinafter also referred to as “CAPD”) is easy to return to society because patients can exchange dialysate containers (bags) at home or at work. ing.

  In this CAPD, a catheter tube (peritoneal catheter) is placed in the abdominal cavity of a patient, a transfer tube is connected to the outer end of the catheter tube, and a bag tube of a dialysate bag (injection bag) containing dialysate therein. The dialysate in the bag is injected into the abdominal cavity through each tube, and after dialyzing for a predetermined time, the dialysate drainage in the abdominal cavity is collected in the drainage bag through each tube. is there. The tubes are connected aseptically by fitting male and female connectors respectively attached to the ends of both tubes.

  By the way, in this CAPD, injecting dialysate into the peritoneum, the dialysate bag is placed about 1 m higher than the patient's abdomen, and the dialysate is transferred from the dialysate bag into the abdomen in the peritoneum by the drop. is doing. Moreover, the recovery of the dialysate drainage from the peritoneum is performed by placing the drainage bag at a position about 1 m below the patient's abdomen and transferring the dialysate from the peritoneum to the drainage bag.

  However, in such a dialysate injection and drainage method, for example, when the patient performs peritoneal dialysis while sleeping, the patient is put to bed at a high position of about 70 to 100 cm from the floor, and The dialysate bag needs to be set at a position about 1 m higher than the patient. For this reason, the height of the entire apparatus is as large as about 2 m, and it is difficult to handle and carry the apparatus, and there is a possibility that the apparatus may be overturned when a sleeping patient turns over. Furthermore, there is a drawback that the sleeping position (height) of the patient cannot be freely selected in order to ensure a head required for drainage.

  In order to make up for these drawbacks, a peritoneal dialysis apparatus has been proposed that automates injection and drainage and is not subject to the height restriction of the place where the dialysate and waste bag are installed. For example, Patent Document 1 proposes a peritoneal dialysis device in which a valve actuator is opened and closed so that the flow path of a disposable cassette is switched when selected. Patent Document 2 proposes a disposable cassette in which a pump part (diaphragm) for feeding peritoneal dialysate and a heating part are integrally formed. This cassette is heated from both sides, and is configured such that the heated peritoneal dialysis fluid is sent into the abdominal cavity of the patient by two pump parts (diaphragms).

Japanese Patent No. 3113887 JP 11-347115 A

  However, in order to perform peritoneal dialysis at home using such a peritoneal dialysis device, the patient himself / herself memorizes all procedures alone after receiving sufficient training for the use of the peritoneal dialysis device. However, it is a burden on the patient because it must be operated without a doubt.

  Further, for example, there is a problem that even if a slight trouble occurs in the operation procedure, it cannot be dealt with promptly.

  Therefore, the present invention has been made in view of the above-mentioned problems, and the object of the present invention is to enable automation of dialysis treatment by the patient himself, and the operability is extremely clear and easy to understand. It is to provide a peritoneal dialysis device capable of performing dialysis treatment under conditions.

  In order to solve the above-mentioned problems and achieve the object, according to the present invention, a dialysis fluid comprising at least one dialysis fluid container filled with dialysis fluid and at least one drainage container for collecting the dialysis fluid. A circuit, liquid supply means for supplying dialysate from the dialysate container as a starting point or the drainage container as an end point, and display means for informing conditions for displaying conditions related to dialysis. A peritoneal dialysis apparatus that performs dialysis by supplying dialysate to the patient side by liquid means and collecting the drainage liquid, and the operation procedure required for the dialysis is performed on the display unit of the display means It is characterized by being displayed as a still image or moving image including characters together with a voice guide.

  Further, a dialysate circuit including at least one dialysate container filled with dialysate and at least one drainage container for collecting dialysate, and starting from the dialysate container, or As an end point, it has a liquid feeding means for feeding dialysate, and a display means for informing the condition for displaying the conditions related to dialysis, and the dialysate is supplied to the patient by the liquid feeding means and the drainage liquid is collected. A peritoneal dialysis apparatus that performs dialysis by performing a dialysis on a background color that is displayed as a still image or a moving image including characters together with a voice guide in the display unit of the display means in order to notify an abnormal state of the dialysis. It is characterized by being different from the background color of the normal state.

  The still image or moving image is displayed in color.

  Further, a dialysate circuit including at least one dialysate container filled with dialysate and at least one drainage container for collecting dialysate, and starting from the dialysate container, or As an end point, it has a liquid feeding means for feeding dialysate, and a display means for informing the condition for displaying the conditions related to dialysis, and the dialysate is supplied to the patient by the liquid feeding means and the drainage liquid is collected. In the peritoneal dialysis apparatus for performing dialysis, the setting procedure including the liquid feeding required for the dialysis is performed by a still image that does not change the background color including characters together with the voice guide in the display unit of the display means. It is characterized by displaying.

  In addition, the display unit includes a liquid crystal touch panel on which a screen is pressed, and the patient can appropriately press the operation procedure, the operation for eliminating the abnormal state, and the setting procedure.

  The dialysis start button and end button are individually arranged at positions separated from the display unit, are displayed by color, and are provided with braille below each button.

  According to the present invention, it is possible to automate dialysis treatment by the patient himself / herself, the operability is extremely clear and easy to understand, treatment can be performed under optimum conditions, and even if trouble occurs, it can be easily dealt with. A peritoneal dialysis apparatus capable of performing dialysis treatment under optimum conditions can be provided.

1 is an external perspective view showing a peritoneal dialysis device of the present invention together with a cassette 8. FIG. It is a figure which shows typically embodiment of the peritoneal dialysis apparatus of this invention. 3 is an external perspective view showing a flow path switching unit and a clamper 240 of the cassette 8. FIG. 3 is a three-dimensional exploded view of the cassette 8. FIG. It is a related figure of the heating circuit of the cassette 8, and a heater. (a) is a schematic diagram in which the dialysate is fed into the abdominal cavity, and (b) is a schematic diagram in which the drainage is in a liquid feed state. It is a block diagram of a dialysis machine body. , , , , , It is the figure which showed the display screen which changes sequentially in the display part.

  Below, the peritoneal dialysis apparatus of this invention is demonstrated in detail based on suitable embodiment shown to an accompanying drawing.

  First, FIG. 1 is an external perspective view showing the peritoneal dialysis apparatus of the present invention together with a disposable cassette (circuit for peritoneal dialysis) 8, and FIG. 2 is a schematic diagram showing the overall configuration.

  In both figures, the peritoneal dialysis apparatus 1 includes a dialysis apparatus main body 2 and a cassette 8 for the peritoneal dialysis apparatus that is detachably attached to the dialysis apparatus main body 2.

  Further, in FIG. 1, the dialysis machine main body 2 has a cassette mounting portion 21 having an opening 21 a shown by a two-dot chain line for mounting the cassette 8 from the front, and a state in which the cassette mounting portion 21 is closed and opened. The lid member 22, which is rotated with the gripping portion 22a at the position shown by the solid line and the broken line, the display unit 23, the operation unit 24a for performing the treatment start operation, and the operation for performing the treatment stop operation Part 24b.

  The shapes and colors of the operation unit 24a and the operation unit 24b are different from each other so that they can be easily distinguished from each other. The start operation unit (start button) 24a has one convex portion and a stop operation unit ( The stop button 24b has two convex portions.

  The display unit 23 is composed of, for example, a touch panel provided with a liquid crystal (LCD) panel or the like, and displays various information necessary for dialysis by pressing the touch panel and instructions for operating the apparatus from a speaker 400a shown in broken lines. Operate with the voice guide to ensure operability and convenience.

  Air bubbles are mixed in the sensor 16a for detecting the closed state of the lid member 22 as indicated by the solid line, the sensor 16b for detecting that the cassette 8 is loaded, and the connection tube 85 connected to the cassette 8. A bubble sensor 14a is provided at the position shown in the figure.

  Further, the cover of the main body 2 is provided with a hook portion 2a so as to be accommodated, and the liquid is reliably fed by hooking the tube to the hook portion 2a.

  On the other hand, the dialysis machine main body 2 has a main base portion 200 and a sub base portion 201 shown in broken lines as mounting base portions, each provided with a resin cover as shown, and the main base portion 200 and the sub base portion 201 being 1 It is made of an aluminum metal plate with a thickness of ˜2 mm, and the weight is reduced by drilling large holes everywhere. A lightweight resin cover is fixed to these bases. Further, for example, a memory card 204 having a storage capacity of 100 megabytes or more is provided so as to be able to be loaded into the card reader 203 shown by a broken line from the back of the apparatus. It is configured so that specification changes can be made quickly. In addition, patient data is recorded on the memory card 204, so that individual patients can be handled.

  Further, a shielding plate 202 is provided on the right side of the cassette mounting portion 21 shown in the two-dot chain line, so as to be movable in the direction of the arrow shown in the broken line, thereby preventing mechanical interference with the connection tube 85 of the cassette 8. By doing so, the cassette 8 can be set at the loading position.

  On the other hand, the cassette 8 includes a cassette main body 81 that is detachable from the cassette mounting portion 21 of the dialyzer main body 2, a lower main body frame 811 that is continuously formed from the cassette main body 81, and a gap 86 from the lower main body frame 811. And an upper main body frame 812 provided so as to face each other.

  Further, the cassette body 81 is integrally formed with a liquid feeding diaphragm 87, a heating unit 83, and a flow path switching unit as shown in the figure, and the diaphragm 87 is surrounded by a flange member 815. Has been.

  Next, in FIG. 2, the peritoneal dialysis device 1 includes a dialysate circuit unit 3, and the dialysate circuit unit 3 supplies dialysate to be injected (injected) into the peritoneum (intraperitoneal) of the patient K. A plurality of dialysate bags (dialysate containers) 4 to be accommodated (accommodated), an additional dialysate bag 5 to accommodate dialysate having different concentrations, and a drainage fluid for recovering dialysate drained from the peritoneum of patient K It is prepared to connect the tank (drainage container) 6 and a dialysis catheter (catheter tube) 7 placed in the peritoneum of the patient K.

  Here, the dialysate circuit unit 3 includes a liquid injection tube circuit 31, an additional liquid injection tube circuit 32, a liquid injection / drainage tube circuit 33, and a liquid discharge tube circuit 34. Furthermore, the dialysate circuit unit 3 includes a switching cassette circuit 82 provided in the cassette body 81 of the cassette 8, a heating cassette circuit 83, and a bypass circuit (patient side tube circuit) 84. The circuit 82 includes a liquid injection circuit 821, an additional liquid injection circuit 822, a liquid injection / drainage circuit 823, and a liquid discharge circuit 824.

  3 is an external perspective view showing the flow path switching unit and the clamper (clamp) 240 of the cassette 8 in FIG. 3. One end of the liquid injection circuit 821, one end of the additional liquid injection circuit 822, and other parts of the liquid injection / drainage circuit 823 Connection tubes 85a, 85b, 85c, and 85d are connected to the other end of the drainage circuit 824.

  In FIG. 2, a plurality of branch tube circuits 35 are branched and connected to one end side of the injection tube circuit 31, and one end of each branch tube circuit 35 is connected to the dialysate bag 4. The other end of the tube circuit 31 is connected to one end of the liquid injection circuit 821 via a connection tube 85a.

  One end of the additional tube circuit 32 is connected to the additional dialysate bag 5, and the other end of the additional tube circuit 32 is connected to one end of the additional liquid injection circuit 822 via the connection tube 85b.

  One end of the liquid injection / drainage tube circuit 33 is connected to the other end of the liquid injection / drainage circuit 823 via the connection tube 85c, and the other end of the liquid injection / drainage tube circuit 33 is dialyzed. The catheter 7 is connected via a transfer tube set 36. One end of the drainage tube circuit 34 is connected to the other end of the drainage circuit 824 via a connection tube 85 d, and the other end of the drainage tube circuit 34 is connected to the drainage tank 6.

  The liquid injection tube circuit 31, the additional liquid injection tube circuit 32, the liquid injection / drainage tube circuit 33, and the liquid discharge tube circuit 34 connected to the switching cassette circuit 82 forming the flow path switching unit are used for the cassette 8 to dialyze. When mounted on the main body 2, it is located on the front surface or the front side surface of the dialyzer main body 2.

  Each branch tube circuit 35, additional liquid injection tube circuit 32, liquid injection / drainage tube circuit 33, and liquid discharge tube circuit 34 are each provided with a clamp (channel opening / closing means) 37 that opens and closes the flow path. ing.

  Next, in the three-dimensional exploded view of the cassette 8 in FIG. 4, in the figure, components that have already been described are denoted by the same reference numerals and description thereof is omitted, and between the two divided heating cassette circuits 831 and 832 A gap 86 is formed, and when the cassette body 81 is mounted on the cassette mounting portion 21 of the dialyzer body 2, the heating means 9 is provided on both sides (upper surface and lower surface) of each of the divided heating cassette circuits 831 and 832. Heaters (heating units) are located, and each of the divided heating cassette circuits 831 and 832 is configured to be heated while being sandwiched by the corresponding heaters.

  The cassette body 81 is provided with the switching cassette circuit 82 shown in FIG. 1, and the switching cassette circuit 82 includes the liquid injection circuit 821, the additional liquid injection circuit 822, and the liquid injection / drainage shown in FIG. A circuit 823 and a drain circuit 824 are included. The other end of the additional liquid injection circuit 822 communicates with the liquid injection circuit 821, and one end of the liquid discharge circuit 824 communicates with the vicinity of the other end of the liquid injection circuit 821.

  Further, when the cassette body 81 is mounted on the cassette mounting portion 21 of the dialyzer body 2, the switching cassette circuit 82 switches between the injection circuit state and the drain circuit state due to the blockage by the clamper 240 of FIG. It is configured to be able to.

  Here, the liquid injection circuit state means that the liquid injection circuit 821 (or the additional liquid injection circuit 822) and the liquid injection / drainage circuit 823 communicate with each other so that the dialysate bag 4 (or the additional dialysate bag 5) is dialyzed. This refers to a state in which the catheter 7 is communicated, in other words, a state for injecting dialysate into the peritoneum of the patient K (a state in which injection is possible).

  Further, the drainage circuit state is a state in which the injection / drainage circuit 823 and the drainage circuit 824 communicate with each other so that the dialysis catheter 7 and the drainage tank 6 communicate with each other, in other words, dialysis from within the peritoneum of the patient K. This refers to a state for draining the liquid (a state where the liquid can be drained). Further, the cassette body 81 is provided with a heating cassette circuit 83 shown in FIG. The heating cassette circuit 83 includes two sheet-like divided heating cassette circuits 831 and 832 arranged to face each other.

  One end of the lower divided heating cassette circuit 831 communicates with the other end of the liquid injection circuit 821, and the other end of the lower divided heating cassette circuit 831 is connected to the upper divided heating cassette via the connection pipe 833. The circuit 832 communicates with one end. The other end of the upper divided heating cassette circuit 832 communicates with one end of the liquid injection / drainage circuit 823.

  Accordingly, the dialysate sequentially flows in the lower divided heating cassette circuit 831 and the upper divided heating cassette circuit 832 in this order.

  In the present invention, the dialysate may be divided and flow into the lower divided warming cassette circuit 831 and the upper divided warming cassette circuit 832 and then merged.

  As shown in the plan view of the cassette 8 in FIG. 5 and the rear view of the cassette 8 in FIG. 6, the flow path of each of the divided heating cassette circuits 831 and 832 has a meandering shape. It may be. Thus, by making it meander shape or spiral shape, the flow path of each division | segmentation cassette circuit 831 and 832 becomes long, and it can heat a dialysate reliably.

  Further, the cassette body 81 is provided with a diaphragm pump 87 which is kept airtight in a pump chamber which will be described later in order to pump the dialysate by contraction and expansion and to send the dialysate. It is connected in the middle of the circuit 821.

  The diaphragm pump 87 is accommodated in a sealed state by the flange member 815, so that the diaphragm pump 87 contracts when pressurized, and the diaphragm pump 87 expands when decompressed.

  The cassette body 81 is provided with the bypass circuit 84 as described above. One end of the bypass circuit 84 is connected to the upstream side of the heating cassette circuit 83, in the present embodiment, in the middle of the liquid injection circuit 821, and the other end of the bypass circuit 84 is connected to the downstream side of the heating cassette circuit 83, this embodiment. In the form, it is connected in the middle of the liquid injection / drainage circuit 823. The bypass circuit 84 connects the upstream side and the downstream side of the heating cassette circuit 83 to form a circulation circuit for cooling the dialysate.

  Further, in order to forcibly cool the dialysate in the bypass circuit 84, forcible cooling means such as a Peltier element may be provided to cool quickly and reliably.

  The switching cassette circuit 82, the heating cassette circuit 83, the bypass circuit 84, and the diaphragm pump 87 are arranged substantially in a plane. Thereby, the thickness of the cassette 8 can be made thinner.

  When the cassette body 81 is mounted on the cassette mounting portion 21 of the dialyzer body 2, the outlet side (downstream side) of the heating cassette circuit 83 can be switched between the final injection circuit state and the return circuit state. It is configured. Here, the final liquid injection circuit state means a state in which the outlet side of the heating cassette circuit 83 communicates with the liquid injection / drainage circuit 823 and does not communicate with the bypass circuit 84. The return circuit state refers to a state in which the outlet side of the heating cassette circuit 83 communicates with the bypass circuit 84 and does not communicate with the liquid injection / drainage circuit 823.

  Furthermore, as shown in the three-dimensional exploded view of the cassette 8 in FIG. 4, first to eighth support protrusions 881 to 888 that form a flow path switching unit at positions corresponding to the switching cassette circuit 82 of the lower body frame 811. Is formed. The first support protrusion 881 supports the vicinity of one end of the liquid injection circuit 821, the second support protrusion 882 supports the additional liquid injection circuit 822, and the third support protrusion 883 is an injection liquid. The fourth support protrusion 884 supports between the diaphragm pump 87 and one end of the bypass circuit 84 in the liquid circuit 821, and supports between the diaphragm pump 87 and one end of the heating cassette circuit 83 in the liquid injection circuit 821. To do. Similarly, the fifth support protrusion 885 supports the drain circuit 824, and the sixth support protrusion 886 is connected to the other end of the heating cassette circuit 83 and the bypass circuit 84 in the liquid injection / drain circuit 823. The seventh support protrusion 887 supports the vicinity of the other end of the liquid injection / drainage circuit 823, and the eighth support protrusion 888 supports the bypass circuit 84. To do.

  The switching cassette circuit 82, the bypass circuit 84, and the diaphragm pump 87 are integrally formed by blow molding. Thereby, joining with another component can be reduced, the quality of the cassette 8 can be improved, and the cost can be reduced.

  Further, each of the divided heating cassette circuits 831 and 832 of the heating cassette circuit 83 is formed by sheet molding. Thereby, manufacture of each division | segmentation heating cassette circuit 831 and 832 becomes easy, and cost can be reduced.

  The switching cassette circuit 82, the bypass circuit 84, and the diaphragm pump 87 are joined to the divided heating cassette circuits 831 and 832 by high-frequency fusion (high-frequency welding) and adhesion.

  Here, in order to form the division heating cassette circuits 831 and 832 by sheet molding, for example, two resin sheets are overlapped, and these are fused in a predetermined pattern. In addition, the part which was not melt | fused forms a flow path.

  The switching cassette circuit 82, the heating cassette circuit 83, the bypass circuit 84, and the diaphragm pump 87 are composed of soft resins such as polyethylene, polypropylene, ethylene-propylene copolymer, and ethylene-vinyl acetate copolymer, respectively. Polyolefins such as coalescence (EVA), polyvinyl chloride, polyvinylidene chloride, polystyrene, polyamide, polyimide, poly- (4-methylpentene-1), ionomer, acrylic resin, polyethylene terephthalate (PET), polybutylene terephthalate (PBT) ) Polyester, styrene, polyolefin, polyvinyl chloride, polyurethane, polyester, polyamide and other thermoplastic elastomers, silicone resin, polyurethane, etc. Polymers, blends, polymer alloys and the like, can be used singly or in combination of two or more of these (e.g., a laminate of two or more layers).

  Further, positioning holes 8a and 8a are formed in the cassette body 81 so that positioning is performed by the positioning pins of the sub base 201. Further, an opening 81b that forms part of the flow path switching portion is formed opposite to the first to eighth support protrusions, and the clamper can enter the opening 81b so as to be closed. ing.

  On the other hand, as shown in the heater configuration diagram of FIG. 5, a heating means 9 for heating the heating cassette circuit 83 of the cassette 8 is provided in the dialysis apparatus main body 2. (Layered) lower surface heater 91, plate-shaped (layered) upper surface heater 92, and plate-shaped (layered) intermediate surface heater 93.

  Here, the lower surface heater 91 heats the lower surface of the lower divided heating cassette circuit 831 from below through an aluminum plate 94a as a heat transfer member, and the upper surface heater 92 The upper surface of the divided heating cassette circuit 832 is heated from above via an aluminum plate 94d as a heat transfer member. The intermediate surface heater 93 is located in the gap 86 and heats the upper surface of the lower divided heating cassette circuit 831 from above through an aluminum plate 94b as a heat transfer member, and also performs upper divided heating. The lower surface of the temperature cassette circuit 832 is heated from below through an aluminum plate 94c as a heat transfer member.

  Accordingly, the dialysate inside the lower divided heating cassette circuit 831 is heated while being sandwiched between the lower surface heater 91 and the intermediate surface heater 93, and the dialysis solution inside the upper divided heating cassette circuit 832. The liquid is heated while being sandwiched between the upper surface heater 92 and the intermediate surface heater 93. Therefore, the heating efficiency of the dialysate inside the heating cassette circuit 83 by the heating means 9 is improved, which is advantageous for downsizing and weight reduction of the dialyzer body 2 and the cassette 8.

  The clamp means 11 shown in FIG. 3 switches the switching cassette circuit 82 of the cassette 8 to one of a liquid injection circuit state and a liquid discharge circuit state, and the outlet side of the heating cassette circuit 83 is in a final liquid injection circuit state. Or the drain circuit state, or assists the pumping operation of the diaphragm pump 87.

  That is, first to eighth clamps 111 to 118 indicated by arrows are provided in the dialyzer main body 2, and the first clamp 111 cooperates with the first support protrusion 881 of the liquid injection circuit 821. Clamp so that the channel closes near one end. The second clamp 112 cooperates with the second support protrusion 882 to clamp the additional liquid injection circuit 822 so that the flow path is closed. The third clamp 113 cooperates with the third support protrusion 883 to clamp one end of the diaphragm pump 87 and the bypass circuit 84 in the liquid injection circuit 821 so that the flow path is closed. The fourth clamp (pumping control clamp) 114 cooperates with the fourth support protrusion 884 to clamp the diaphragm pump 87 and one end of the heating cassette circuit 83 in the liquid injection circuit 821 so that the flow path is closed. .

  Similarly, the fifth clamp 115 cooperates with the fifth support protrusion 885 to clamp the drain circuit 824 so that the flow path is closed. The sixth clamp 116 cooperates with the sixth support protrusion 886 to clamp the flow path between the other end of the heating cassette circuit 83 and the other end of the bypass circuit 84 in the liquid injection / drainage circuit 823. To do. The seventh clamp 117 cooperates with the seventh support protrusion 887 to clamp the vicinity of the other end of the liquid injection / drainage circuit 823 so that the flow path is closed. The eighth clamp 118 cooperates with the eighth support protrusion 888 to clamp the bypass circuit 84 so that the flow path is closed. Therefore, when the switching cassette circuit 82 is switched to the liquid injection circuit state, the first clamp 111 (or the second clamp 112), the fourth clamp (pumping control clamp) 114, the sixth clamp 116, and the seventh clamp 117 are respectively In addition to switching to the unclamped state, the second clamp 112 (or the first clamp 111), the fifth clamp 115, and the eighth clamp 118 are each switched to the clamped state. When the inside of the chamber 814 is pressurized by the pumping operation means 10, the fourth clamp 114 is switched to the unclamped state and the third clamp 113 is switched to the clamped state. Further, when the pressure in the chamber 814 is reduced by the pumping operation means 10, the fourth clamp 114 is switched to the clamped state and the third clamp 113 is switched to the unclamped state. As a result, the dialysate can be sent from the dialysate bag 4 (or the additional dialysate bag 5) toward the dialysis catheter 7, that is, injected, so that the peritoneal cavity of the dialysate shown in FIG. The liquid can be fed into the inside.

  In addition, when the switching cassette circuit 82 is switched to the drain circuit state and switched, the seventh clamp 117 and the eighth clamp 118 are switched to the unclamped state, and the first clamp 111, the second clamp 112, and the fourth clamp. By switching the 114 and sixth clamps 116 to the clamped state, the waste liquid can be recovered as shown in FIG.

  Further, when the pressure in the pump chamber is reduced by the pumping operation means, the third clamp 113 is switched to the unclamped state and the fifth clamp 115 is switched to the clamped state. Further, when the inside of the chamber 814 is pressurized by the pumping operation means, the third clamp 113 is switched to the clamped state, and the fifth clamp 115 is switched to the unclamped state, whereby dialysis is performed from the dialysis catheter 7 toward the drainage tank 6. The liquid can be drained.

  The diaphragm pump 87, the third clamp 113, the fourth clamp 114, the fifth clamp 115, and the pumping operation means constitute a liquid feeding means for feeding dialysate.

  Further, when the switching cassette circuit 82 is in the liquid injection circuit state and the outlet side of the heating cassette circuit 83 is in the final liquid injection circuit state, the seventh clamp 117 is in the unclamped state and the eighth clamp 118 is in the clamped state. It has become.

  When the outlet side of the heating cassette circuit 83 is switched to the return circuit state, the first clamp 111, the second clamp 112, and the seventh clamp 117 are switched to the clamped state, and the eighth clamp 118 is switched to the unclamped state. As a result, the dialysate does not flow from the outlet side of the heating cassette circuit 83 toward the dialysis catheter 7 but flows through the bypass circuit 84 toward the diaphragm pump 87. That is, the dialysate circulates between the bypass circuit 87 and the heating cassette circuit 83.

  The seventh clamp 117 and the eighth clamp 118 constitute liquid injection return circuit switching means for switching the outlet side of the heating cassette circuit 83 between the final liquid injection circuit state and the return circuit state.

  Here, when the dialysate is drained, the drainage is collected in the drainage tank 6 via the bypass circuit 84. Thereby, the structure of a flow path can be simplified.

  As described above, by providing the cassette body 81 with the switching cassette circuit 82, the heating cassette circuit 83, the bypass circuit 84, and the diaphragm pump 87, the peritoneal dialysis device 1 can be reduced in size and weight. Therefore, handling such as transportation of the peritoneal dialysis device 1 is facilitated, and a smooth medical practice can be performed.

  In particular, since the dialysate flowing through each of the divided heating cassette circuits 831 and 832 is heated while being sandwiched between the corresponding heaters, the heating efficiency of the dialysate is improved. 1 can be further reduced in size and weight.

  On the other hand, as shown in FIG. 2, the peritoneal dialysis device 1 includes various sensors for temperature control of the dialysate and the like.

  That is, on the downstream side of the heating cassette circuit 83 of the dialyzer main body 2, an outlet for measuring (detecting) the temperature (outlet liquid temperature) of the dialysate flowing on the outlet side (downstream side) of the heating cassette circuit 83. A temperature sensor 12A for liquid temperature is installed, and the temperature (inlet liquid temperature) of the dialysate flowing on the inlet side (upstream side) of the heating cassette circuit 83 is measured (detected) on the upstream side of the heating cassette circuit 83. An inlet liquid temperature sensor 12B is installed.

  Here, as the outlet liquid temperature sensor 12A and the inlet liquid temperature sensor 12B, it is preferable to use a thermopile type infrared sensor (non-contact type temperature sensor) having a very fast response speed. Thereby, the temperature of each surface heater 91,92,93 can be controlled with high precision.

  Further, as shown in FIG. 5, each surface heater 91, 92, 93 is provided with a heater temperature sensor 13 such as a thermistor for measuring (detecting) the temperature. Further, the dialyzer main body 2 is provided with bubble sensors 14 for detecting bubbles on the inlet side and the outlet side of the switching cassette circuit 82, respectively. The peritoneal permeation device 1 includes an occlusion sensor that detects occlusion of the circuit and other various sensors (various sensors 16).

  Furthermore, as shown in the block diagram of FIG. 7, the peritoneal dialysis apparatus 1 includes a control system (control means) 15 that performs control of injection and drainage of dialysate.

  That is, the control system 15 includes a CPU 151 and a storage unit 152. The CPU 151 controls the temperature of the clamp control block 153 that controls the plurality of clamps 111 to 118 and the plurality of surface heaters 91, 92, and 93. A heater control unit 154 for controlling the pumping operation means 10 and a pumping operation control unit 155 for controlling the pumping operation means 10 are electrically connected to each other. The CPU 151 includes an outlet liquid temperature sensor 12A, an inlet liquid temperature sensor 12B, each heater temperature sensor 13, each bubble sensor 14, a display unit 23, and operation units 24a and 24b, respectively. Connected. The CPU 151 is electrically connected to a power supply circuit 156, a battery circuit 157, a sound generation circuit 400, and a cassette loading control unit 301 that controls the cassette loading unit 300. The display unit 23 is electrically connected to a card reader 203 that can be loaded with the memory card.

  When the temperature measured by the outlet liquid temperature sensor 12A becomes equal to or higher than a predetermined temperature (39 ° C. in the present embodiment), the control system 15 causes the clamp controller 153 to execute the seventh clamp 117. Is switched to the clamped state, the eighth clamp 118 is controlled to switch to the unclamped state, and the heater control unit 154 switches to the off state in which the driving of the plurality of surface heaters 91, 92, 93 is stopped.

  The outputs (output values) of the surface heaters 91, 92, and 93 are selected based on the temperature control flow of the dialysate and the temperature of the dialysate. That is, the control system 15 determines the temperature of the dialysate to be injected based on the temperature measured by the outlet liquid temperature sensor 12A and the temperature measured by the inlet liquid temperature sensor 12B. The outputs (drives) of the plurality of surface heaters 91, 92, and 93 are controlled so as to be within the temperature range. Then, the clamp control unit 153 controls the first clamp 111 (or the second clamp 112), the fourth clamp 114, the sixth clamp 116, and the seventh clamp 117 to switch to the unclamped state, and the second clamp 112 ( Alternatively, the first clamp 111), the fifth clamp 115, and the eighth clamp 118 are controlled to switch to the clamped state. Thereby, the switching cassette circuit 82 can be switched to the liquid injection circuit state. In addition, the heater control unit 154 performs control so that electric power (output) is supplied to the plurality of surface heaters 91, 92, and 93. Thereby, the heating process which heats the dialysate which flows through the heating cassette circuit 83, in other words, the temperature control flow of the dialysate enters the preheating process.

  When the time T1 has elapsed since the start of power supply to the plurality of surface heaters 91, 92, 93, the preheating process is completed. When this preheating process is completed, the pumping operation control unit 155 controls the pumping operation means 10 to alternately pressurize and depressurize the pump chamber. In addition, the clamp control unit 153 controls the fourth clamp 114 to switch between the clamped state and the unclamped state alternately according to the pressurization and decompression in the chamber 814, and also controls the third clamp 113 to perform the clamp. Switching between the state and the unclamped state is repeated alternately according to the pressurization and decompression in the chamber 814. As a result, the diaphragm pump 87 is pumped (contracted and expanded), and the dialysate is sent from the dialysate bag 4 toward the dialysis catheter 7 and injected.

  When the preheating step is completed, the temperature control flow of the dialysate enters the initial heating step. When the initial warming process ends, the temperature control flow of the dialysate normally enters the warming process. In the normal warming process, the output control of the plurality of surface heaters 91, 92, 93 is the heater output value by P control when the temperature measured by the outlet liquid temperature sensor 12A is less than 33 ° C. Is output to the plurality of surface heaters 91, 92, 93.

  On the other hand, when the temperature measured by the outlet liquid temperature sensor 12A is 33 ° C. or higher and lower than 39 ° C., the output value of the heater by PI control is output to the plurality of surface heaters 91, 92, 93.

  Thereby, output control of the several surface heaters 91, 92, and 93 can be performed with high precision. In the initial heating process or the normal heating process, when the temperature measured by the outlet liquid temperature sensor 12A is 39 ° C. or higher, the clamp controller 153 controls the seventh clamp 117 to switch to the clamped state. At the same time, the eighth clamp 118 is controlled to switch to the unclamped state. Further, the heater control unit 154 stops the supply of electric power to the plurality of surface heaters 91, 92, 93, in other words, turns off the plurality of surface heaters 91, 92, 93. Thereby, the outlet side of the heating cassette circuit 83 can be switched to the return circuit state, and the dialysate flows from the heating cassette circuit 83 toward the bypass circuit 84 without flowing toward the dialysis catheter 7. It returns to the upstream side of the heating cassette circuit 83 through the bypass circuit 84, circulates between the bypass circuit 84 and the heating cassette circuit 83, and the temperature decreases (cools) during that time. That is, the dialysate heating control flow shifts to the cooling step (step 12). Therefore, a dialysis solution having a temperature considerably higher than the body temperature of the patient K (a temperature of 39 ° C. or higher) is not injected into the patient K, and a safe dialysis treatment can be performed.

  When the temperature measured by the outlet liquid temperature sensor 12A is less than 39 ° C., the clamp controller 153 controls the seventh clamp 117 to switch to the unclamped state, and controls the eighth clamp 118. Switch to the clamped state. Further, the plurality of surface heaters 91, 92, 93 are switched on. Thereby, the exit side of the heating cassette circuit 83 can be returned to the final liquid injection circuit state, and the process proceeds to the initial heating process or the normal heating process again. When a predetermined amount of dialysate is injected (injected) into the peritoneum of patient K, the injection of dialysate is completed.

  After the injection of the dialysate is completed, the clamp controller 154 controls the seventh clamp 117 and the eighth clamp 118 to switch to the unclamped state, and controls the fourth clamp 114 and the sixth clamp 116 to perform the clamp. Switch to state. Thereby, the switching cassette circuit 82 can be switched to the drain circuit state.

  Then, the pumping operation control unit 155 controls the pumping operation means 10 to alternately repeat the depressurization and pressurization of the chamber 814. In addition, the clamp control unit controls the third clamp 113 to alternately switch between the unclamped state and the clamped state according to the decompression and pressurization of the chamber 814, and also controls the fifth clamp 115 to perform the clamping. Switching between the state and the unclamped state is repeated alternately according to the pressure reduction and pressurization in the chamber 814. Thereby, the diaphragm pump 87 is pumped, and the dialysate in the peritoneum can be sent from the dialysis catheter 7 toward the drainage tank 6 to be drained.

  8 to 13 are diagrams showing display screens that sequentially change in the display unit 23 shown in FIG.

  In the block diagrams of FIGS. 7 and 8, when the power of the device 2 is turned on and the operation unit 24a is pressed, the initial screen 500 of the device manufacturer name is displayed and the nurse and sheep (character image) serving as a guide are displayed. The screen moves to the screen 501 displayed in color, and the storage unit 152 is initialized by moving and displaying an arrow on the screen 502, and at the same time, “Please treat in a bright and clean place. Always wash your hands.” Is generated from the speaker 400a by electronic voice. Following this, the screen is automatically switched to the screen 503. In this screen, treatment pattern, initial drainage volume, injection volume, intraperitoneal retention time, number of cycles, final injection volume, final concentration change, dialysis time, scheduled dialysis end time, total dialysate volume, etc. Parameters required for peritoneal dialysis are displayed as previous data. If this is acceptable, the “next” touch key 506 is pressed to advance to the screen of FIG.

  On the screen 507 in FIG. 9, the cassette 8 is displayed with a voice guide so as to be set in the mounting portion of the apparatus. In addition, on the screen 507, a “setting confirmation” touch key 508 appears simultaneously. When the touch key 508 is pressed, the screen moves to a screen 523 in FIG. On the screen 509 after the screen 507, a voice guide “The procedure for inserting my home piko” composed of the cassette 8 and the piping shown in FIG. 6 is generated, and before and after this, images of the nurse and the cassette are displayed. It is displayed as a replacement. Therefore, when the patient touches the “Next” touch key 510, the screen changes to a screen 511, and the letters “Please close all clamps” and the operation procedure are displayed together with a voice guide and a color still image. When the “Next” touch key 512 on the screen 511 is pressed, the screen is displayed so that the lid member 22 is opened on the front side on the screen 513, voice guidance is performed, and the screen is automatically switched to the screen 514. On this screen 514, the state in which the cassette 8 is inserted from above the lid member of the apparatus is displayed as a moving image in color. Following this, a screen for closing the lid member after loading the cassette is displayed on the screen 515 together with a voice guide, and the screen changes to the screen 516 in FIG. 10 and waits until the cassette is moved to the state of being sandwiched by the three layers of heaters. Following this, on the screen 517, a moving image is displayed together with the voice guide so as to set the connection tube on the hook 2a of the main body, and the screen moves to the screen 518.

  On this screen 518, “Connect a dialysis bag to Pico Set (trademark of Terumo Co., Ltd.) 8” is displayed together with a voice guide, and when “Next” is touched, the screen changes to screen 519 and shows the state of the connection. At the same time, a voice guide is generated. An operation for a necessary connection is instructed by automatically switching to this transition and screens 520, 521, and 522. The screen of FIG. 11 is a screen that is sequentially displayed when the “Setting Confirmation” touch key 508 on the screens 507 and 508 of FIG. 9 is touched. On the screen 523, a message for confirming connection is displayed together with a voice guide. After the connection is completed, after touching the “Next” touch key 524, the standby screen display of the screen 525 is performed, and after the connection is displayed on the screen 526 and other voices are displayed and voice guidance is given. Then, touch the “setting” touch key on the screen 528 to prepare for dialysis, and press the operation unit 24a to start dialysis. Further, on this screen 528, when the touch key 530 of “up / down arrow” is touched, the items 1 to 5 on the screen are displayed in reverse, and the touch can be confirmed by touching the return touch key. Further, on the screen 526, an item that the patient needs to explain can be selected with the touch key 530.

  On the other hand, when the “change” touch key 504 on the screen 503 in FIG. 8 is touched, the screen is changed to the screen 531 in FIG. 12, and the “up / down arrow” touch key 533 is touched to set the dialog with the screens 534 to 541. do. Since the display color of these screens 534 to 541 is a single color and the background color does not change, it can be seen that the patient is changing the setting.

  Discharge line blockage, injection line blockage, injection failure, drainage failure, insufficient drainage volume, additional injection line blockage, battery voltage drop, outside temperature drop, peritoneal line blockage, bubble detection, power failure, etc. The contents and the operation procedures corresponding to them are stored in the storage unit 152 in advance. When an abnormality is detected by the bubble sensor 14 and the various sensors 16, the screen automatically displays an abnormal state, and what kind of abnormality has occurred is sequentially displayed on the screen. (Patient) can confirm the response.

  FIG. 13 shows an example of an abnormal state of dialysis when the drainage line is blocked. In order to notify the abnormal state, on the screens 550 to 554, a voice image and a still image or a moving image including characters are displayed, and the background color is displayed as a conspicuous predetermined color such as yellow or orange indicated by hatching in the drawing. In this way, the patient is informed of an abnormal condition.

  On screen 550, the text “Please press the stop switch to stop the alarm sound” is displayed on the alarm (alarm) / instruction screen. Done.

  When the operation unit (stop button) 24b is pressed in accordance with this instruction, a question-type screen is displayed as shown in a screen 551, and one of the obstruction locations (patterns) stored in advance in the storage unit 152 is peritoneal dialysis. It is indicated by an arrow 551a and a circular dot mark 551b of a predetermined color (red) together with a schematic diagram of the line, and a question as to whether or not “pink clamp is closed” is made by voice together with character display.

  If “No” is clicked on the screen 551, the screen shifts to the screen 552, but if “Yes” is clicked, the screen 555 is displayed, and the procedure to be handled is instructed by characters and voices “please open the pink clamp”. When the procedure according to this instruction is executed and “Next” is clicked, the screen shifts to a screen 552.

  If you click "No" on screen 552, the screen will move to screen 554, but if you click "Yes", screen 555 will be displayed, and the procedure to be taken is the text and sound "Please fix the tube crushing and twisting". Indicated by When the procedure according to this instruction is executed and “Next” is clicked, the screen shifts to a screen 554.

  On the screen 554, the user is instructed by characters and voices such as “Please press the start switch.

  In this way, the abnormal content / location is assumed in advance and stored in the storage unit 152 so that it can be sequentially confirmed.

  In each screen, the user can return to the original operation by pressing the operation unit 24a.

  In addition to the blockage of the drainage line shown in FIG. 13, this abnormal state includes the blockage of the injection line during treatment and priming, poor liquid injection, poor drainage and shortage, air bubbles, and additional injection during treatment and priming. There are liquid line blockage, battery backup due to power failure, and outside air temperature drop, and when these abnormalities occur, all of them become background colors with conspicuous colors such as yellow and orange, and at the same time, the abnormality is notified by voice guidance, so there is a trouble. Even if it occurs, it can be easily handled, so it can be used with confidence.

DESCRIPTION OF SYMBOLS 1 Peritoneal dialyzer 2 Dialyzer main body 21 Cassette mounting part 22 Lid member 23 Display part 24a, 24b Operation part 3 Dialysate unit 31 Injection tube circuit 32 Additional injection tube circuit 33 Injection / drain tube circuit 34 Drain tube Circuit 35 Branch tube circuit 36 Transfer tube set 37 Clemme 4 Dialysate bag 5 Additional dialysate bag 6 Drain tank 7 Dialysis catheter 8 Cassette 81 Cassette body 811 Lower body frame 812 Upper body frame 82 Switching cassette circuit 821 Injection circuit 822 Addition Injection circuit 823 Injection / drain circuit 824 Drain circuit 83 Heating cassette circuit 831 Division heating cassette circuit 832 Division heating cassette circuit 833 Connection pipe 84 Bypass circuit 85a-85d Connection tube 86 Gap 87 Diaphragm pump 881 1st Support protrusion 82 second support protrusion 883 third support protrusion 884 fourth support protrusion 885 fifth support protrusion 886 sixth support protrusion 887 seventh support protrusion 888 eighth support protrusion 9 heating means 91 lower surface heater 92 upper surface heater 93 intermediate heater 94a to 94d Aluminum plate 10 Pumping operation means 101 Air circuit 102 Branch air circuit 103 Branch air circuit 104 Air pressure generator 105 Vacuum pressure generator 106 Switching valve 11 clamp means 111 First clamp 112 Second clamp 113 Third clamp 114 Fourth Clamp 115 Fifth Clamp 116 Sixth Clamp 117 Seventh Clamp 118 Eighth Clamp 12A Outlet Liquid Temperature Sensor 12B Inlet Liquid Temperature Sensor 13 Heater Temperature Sensor 14 Bubble Sensor 15 Control System 151 CPU
152 Storage Unit 153 Clamp Control Unit 154 Heater Control Unit 155 Pumping Operation Control Unit 156 Power Supply Circuit 157 Battery Circuit 16 Various Sensors 200 Main Base 201 Sub Base 202 Shield Plate 203 Card Reader 204 Memory Cards 500 to 554 Screen

  In order to solve one or more problems described above, the peritoneal dialysis apparatus of the present invention has the following configuration. That is, it has a liquid feeding means for feeding the dialysate using a diaphragm pump from the dialysate container as the starting point, and supplying the dialysate to the patient side and collecting the drained fluid for dialysis. In the peritoneal dialysis apparatus to be performed, a start button for receiving a dialysis start instruction, a stop button for receiving a dialysis stop instruction, a display means for graphically displaying an operation procedure necessary for dialysis, and a dialysis Detecting means for detecting an abnormal state according to the present invention, wherein the display means displays a background color of a color different from the background color in a normal state when the detecting means detects an abnormal state of dialysis. The operation procedure performed by the user in response to the detected abnormal state is displayed in a question format.

Claims (6)

  A dialysate circuit including at least one dialysate container filled with dialysate and at least one drainage container for collecting dialysate, and starting from the dialysate container, or starting from the drainage container , Having a liquid feeding means for feeding dialysate, and a display means for informing a condition for displaying a condition related to dialysis, and supplying the dialysate to the patient side by the liquid feeding means and collecting the drainage liquid A peritoneal dialysis apparatus for performing dialysis with a peritoneum, wherein operation procedures necessary for the dialysis are displayed as a still image or a moving image including characters together with a voice guide on a display unit of the display means Dialysis machine.   A dialysate circuit including at least one dialysate container filled with dialysate and at least one drainage container for collecting dialysate, and starting from the dialysate container, or starting from the drainage container , Having a liquid feeding means for feeding dialysate, and a display means for informing a condition for displaying a condition related to dialysis, and supplying the dialysate to the patient side by the liquid feeding means and collecting the drainage liquid In order to notify the abnormal state of dialysis, a background color displayed as a still image or a moving image including characters together with a voice guide in the display unit of the display means is displayed in order to notify the abnormal state of the dialysis. A peritoneal dialysis device characterized by being different from the background color of the state.   The peritoneal dialysis apparatus according to claim 1 or 2, wherein the still image or moving image is displayed in color.   A dialysate circuit including at least one dialysate container filled with dialysate and at least one drainage container for collecting dialysate, and starting from the dialysate container, or starting from the drainage container , Having a liquid feeding means for feeding dialysate, and a display means for informing a condition for displaying a condition related to dialysis, and supplying the dialysate to the patient side by the liquid feeding means and collecting the drainage liquid In the peritoneal dialysis apparatus that performs dialysis in the above-described manner, the setting procedure including the liquid feeding required for the dialysis is displayed on the display unit of the display unit as a still image that does not change the background color including characters together with the voice guide. A peritoneal dialysis device.   5. The display unit according to claim 1, wherein the display unit includes a liquid crystal touch panel on which a screen is pressed, and the patient can appropriately press the operation procedure, the operation for eliminating the abnormal state, and the setting procedure. The peritoneal dialysis apparatus according to any one of the above.   6. The dialysis start button and end button are individually arranged at positions separated from the display unit, are displayed by color, and braille is provided below each button. The peritoneal dialysis apparatus according to any one of the above.

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