JP2012152286A - Extracorporeal blood circulation apparatus, and priming method - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an extracorporeal blood circulation apparatus which has an inexpensive and simple configuration, and furthermore achieves automatic priming processing.SOLUTION: The extracorporeal blood circulation apparatus 1 includes: a blood processor 10; a blood supply flow path 20 for supplying blood taken out from the inside of the body to the blood processor 10; a blood pump 30 provided in the blood supply flow path 20 and rotatable normally and reversely; a priming solution supply source 40 for supplying a priming solution to the blood supply flow path 20; a priming solution supply flow path 41 for connecting the priming solution supply source 40 to the blood supply flow path 20; a blood return flow path 50 for returning the blood processed in the blood processor 10 into the body; and a drip chamber 60 provided in the blood return flow path 50. The end part 20a of the blood supply flow path 20 and the end part 50a of the blood return flow path 50 are connected together, and the drip chamber 60 is provided with a discharge flow path 70 for discharging the priming solution and air to the outside.

Description

  The present invention relates to a blood extracorporeal circulation apparatus and a priming method.

  Currently, extracorporeal blood circulation therapy is adopted in which blood is taken out from a patient's body and subjected to a specific treatment and returned to the body. A blood extracorporeal circulation device used in such blood extracorporeal circulation therapy includes a blood circuit for circulating blood taken out from the body and returning it to the body, and a blood processing device such as a dialyzer for purifying the taken out blood. It is to be prepared.

  Before performing extracorporeal blood circulation therapy using such a blood extracorporeal circulation device, the inside of the blood circuit or blood processing device to be used is washed with a clean liquid such as physiological saline or dialysate and filled with the liquid. In general, a process called “priming” is performed (see, for example, Patent Document 1). In recent years, a priming process in which a wet type blood treatment device filled with an initial filling liquid is attached to a dry blood circuit, and a dry type blood treatment device not filled with an initial filling liquid is used as a dry blood circuit. A priming process that is installed and enforced has been put into practical use.

  In hemodialysis therapy, for example, a priming process of a hemodialyzer and a blood circuit (blood supply channel and blood return channel) is performed using a predetermined amount of electrolyte solution. At this time, it is necessary to discharge the air in the hemodialyzer and the blood circuit and fill the blood circuit with the electrolyte solution. This is because when blood is led from the body to the blood circuit through the arterial puncture needle connected to the tip of the blood supply channel at the start of hemodialysis treatment, the air that was in the blood circuit is added to the tip of the blood return channel. This is to prevent entry into the patient's body through the connected venipuncture needle.

  Such a priming process is relatively cumbersome and takes a long time, and conventionally, many people are required. For this reason, in recent years, various techniques for automatically performing the priming process have been proposed.

  For example, as shown in FIG. 6, a hemodialyzer 110 for purifying blood, a blood supply channel 120 for supplying blood taken from the body to the hemodialyzer 110, and a blood supply channel 120 A blood pump 130 provided for delivering blood to the hemodialyzer 110, an electrolyte solution supply source 140 for supplying an electrolyte solution to the blood supply channel 120, and a blood pump 130 in the direction of blood flow during hemodialysis treatment. An electrolyte solution supply channel 150 that connects the electrolyte solution supply source 140 to a site of the blood supply channel 120 located on the upstream side, and a blood return flow for returning the blood purified by the hemodialyzer 110 to the body The flow through the channel 160, the arterial drip chamber 170 for preventing air bubbles flowing through the blood supply channel 120 from flowing into the hemodialyzer 110, and the blood return channel 160. That a venous drip chamber 180 for air bubble is prevented from flowing into the body, in the hemodialysis apparatus 100 provided with an automatic priming by the following procedures are performed.

  First, a roller pump capable of forward and reverse rotation is adopted as the blood pump 130, and air discharge lines 171 and 181 for discharging air are provided in the arterial drip chamber 170 and the vein drip chamber 180, respectively. Then, the end 121 of the blood supply channel 120 opposite to the hemodialyzer 110 side and the end 161 of the blood return channel 160 opposite to the hemodialyzer 110 side are connected to loop the blood circuit. Shape. Thereafter, the air in the blood supply channel 120 downstream of the connecting portion 122 between the electrolyte solution supply channel 150 and the blood supply channel 120 in the blood flow direction during hemodialysis treatment is provided in the arterial drip chamber 170. The air is discharged through the air discharge line 171. On the other hand, in the blood flow direction during hemodialysis treatment, air in the blood supply flow channel 120 upstream of the connection portion 122 between the electrolyte solution supply flow channel 150 and the blood supply flow channel 120 is provided in the venous drip chamber 180. The air is discharged through the air discharge line 181.

Japanese Patent Laid-Open No. 2007-190068

  However, in the hemodialysis apparatus 100 capable of the automatic priming process as described above, as shown in FIG. 6, the air discharge lines (171 and 181) are provided on both the arterial drip chamber 170 side and the venous drip chamber 180 side. It is necessary to provide a mechanism (172, 182) for controlling the amount of air discharged through For this reason, the configuration of the apparatus is complicated, and the apparatus is expensive. In addition, there is a problem that the automatic priming process cannot be performed in the above-described procedure in the blood circuit in which the artery-side drip chamber is not provided.

  The present invention has been made in view of such circumstances, and has an inexpensive and simple configuration (for example, a configuration in which an arterial drip chamber is not provided) and can implement an automatic priming process. The purpose is to provide.

  To achieve the above object, an extracorporeal blood circulation apparatus according to the present invention is for purifying blood, comprising a blood flow path through which blood flows and a dialysate flow path through which dialysate flows through a blood purification membrane. A blood treatment device, a blood supply channel for supplying blood taken from the body to the blood treatment device, and a blood pump provided in the blood supply channel and capable of forward and reverse rotation for delivering blood to the blood treatment device A priming liquid supply source for supplying the priming liquid to the blood supply flow path, and a priming liquid supply flow for connecting the priming liquid supply source to a portion of the blood supply flow path located upstream of the blood pump in the blood flow direction. A blood return path for returning the blood processed by the blood treatment device into the body, and a drain provided in the blood return path for preventing bubbles flowing in the blood return path from flowing into the body. And an end of the blood supply channel opposite to the blood processor side and an end of the blood return channel opposite to the blood processor side are connected to each other. The drip chamber is provided with a discharge channel for discharging the priming liquid and / or air to the outside.

  When such a configuration is adopted, air on the downstream side of the blood pump in the blood flow direction can be moved to the upstream side of the blood pump by reverse rotation driving of the blood pump. Further, this air is replaced with a priming liquid supplied from the priming liquid supply source to the blood supply flow path via the priming liquid supply flow path, and is provided in the (venous side) drip chamber of the blood return flow path. It can be discharged to the outside from the discharge channel. Therefore, since it is not necessary to provide the arterial drip chamber, it is possible to perform the automatic priming process while realizing simplification and cost reduction of the configuration of the blood extracorporeal circulation device.

  The extracorporeal blood circulation apparatus according to the present invention may further include an air discharge end sensor that detects that a required amount of air has been discharged from the discharge flow path.

  The air discharge end sensor may be a priming liquid sensor that detects that the priming liquid has been discharged after the air from the discharge flow path.

  The air discharge end sensor may be a weight sensor that measures the weight of the priming liquid supply source and detects that the mass of the priming liquid having the same volume as the air to be discharged from the discharge flow path has decreased.

  A priming liquid supply pump provided in a priming liquid supply flow path for detecting that the air discharge end sensor has supplied a priming liquid having the same volume as the air to be discharged from the discharge flow path; And a control device for controlling.

  The air discharge end sensor may be a pressure measuring device for measuring the pressure in the drip chamber.

  In such a configuration, when the air is discharged from the discharge flow path, the measured value of the pressure in the drip chamber by the pressure measuring device is the atmospheric pressure, but the discharge of the air from the discharge flow path is finished and subsequently When the priming liquid starts to be discharged, the pressure measured in the drip chamber by the pressure measuring device is higher than the atmospheric pressure due to the flow resistance of the discharge channel. Therefore, in such a configuration, it is possible to detect that the discharge of a necessary amount of air from the discharge channel has been completed when the pressure in the drip chamber by the pressure measuring device has increased from atmospheric pressure to a higher level. .

  Further, in the extracorporeal blood circulation apparatus according to the present invention, an electromagnetic valve is provided in the discharge flow path, and the blood pump and the electromagnetic valve are interlocked when it is detected by the air discharge end sensor that the necessary amount of air has been discharged. It can be constituted as follows.

  By adopting such a configuration, when the air discharge end sensor detects that the required amount of air has been discharged from the discharge flow path, the blood pump and the electromagnetic valve can be interlocked. It becomes possible to shift to the next process efficiently.

  A first priming method according to the present invention includes a blood processing device that processes blood in a specific manner and is not filled with an initial filling liquid, and a blood supply for supplying blood taken from the body to the blood processing device. A flow path, a blood pump provided in the blood supply flow path and capable of rotating in forward and reverse directions to send blood to the blood processing device, a priming liquid supply source for supplying the priming liquid to the blood supply flow path, and blood flow A priming fluid supply channel for connecting a priming fluid supply source to a portion of the blood supply channel located upstream of the blood pump in the direction, and a blood return channel for returning blood processed by the blood processing device to the body A drip chamber provided in the blood return channel for preventing bubbles flowing in the blood return channel from flowing into the body, and a priming solution and air from the drip chamber A priming method using an extracorporeal blood circulation device having a discharge channel for discharging to a part, and at the time of priming before treatment, an end of the blood supply channel opposite to the blood treatment device side The end of the blood return channel opposite to the blood processor side is connected to allow communication, the blood processor is placed with the blood inlet facing upward, and the blood pump is stopped. In this state, the priming liquid supplied from the priming liquid supply source through the priming liquid supply flow path to the blood supply flow path, between the connection between the blood supply flow path and the priming liquid supply flow path and the drip chamber. The blood flow path (blood supply flow path and blood return flow path) was filled, and air that was present in the blood flow path from the connection between the blood supply flow path and the priming liquid supply flow path to the drip chamber Discharge A first priming step for discharging the fluid from the channel to the outside, and a priming solution and drip chamber in the blood channel between the connection between the blood supply channel and the priming solution supply channel and the drip chamber by reversely rotating the blood pump The priming liquid existing in the blood flow is circulated upstream from the drip chamber in the blood flow direction, and the air downstream in the blood flow direction is connected to the priming liquid supply flow path in the blood supply flow path. A second priming step in which the priming liquid is moved from the priming liquid supply source to the blood supply flow path through the priming liquid supply flow path; A third plastic for discharging the air that has moved to the blood flow path between the drip chamber and the outside from the discharge flow path And a fourth priming step of discharging the priming solution supplied from the priming solution supply source to the blood supply channel through the priming solution supply channel to the outside from the discharge channel while rotating the blood pump forward or backward. And.

  A second priming method according to the present invention includes a blood processing device filled with an initial filling liquid for processing blood in a specific manner, and a blood supply flow for supplying blood taken from the body to the blood processing device. A blood pump provided in the blood supply channel and capable of rotating in forward and reverse directions for delivering blood to the blood treatment device, a priming fluid supply source for supplying priming fluid to the blood supply channel, and a blood flow direction A priming fluid supply channel that connects a priming fluid supply source to a portion of the blood supply channel that is located upstream of the blood pump, and a blood return channel that returns blood processed by the blood treatment device to the body. A drip chamber provided in the blood return channel to prevent bubbles flowing in the blood return channel from flowing into the body, and the priming liquid and air are discharged from the drip chamber to the outside. A priming method using an extracorporeal blood circulation device comprising: an end of the blood supply channel opposite to the blood treatment device side during priming before treatment; and blood return A state in which the end of the flow path opposite to the blood treatment device side is connected to allow communication, the blood treatment device is in a state where the blood introduction port faces upward, and the blood pump is stopped. In the priming liquid supplied from the priming liquid supply source through the priming liquid supply flow path to the blood supply flow path, the blood flow between the connection between the blood supply flow path and the priming liquid supply flow path to the drip chamber The air (the blood supply channel and the blood return channel) is filled, and the air present in the blood channel between the connection between the blood supply channel and the priming solution supply channel and the drip chamber is discharged. Out of the road A first priming step for discharging the blood pump, a second priming step for rotating the blood pump forward to lead the filling liquid filled in the blood treatment device from the blood outlet to the drip chamber, and a reverse rotation of the blood pump, The priming liquid in the blood flow path between the connection portion between the blood supply flow path and the priming liquid supply flow path and the drip chamber and the priming liquid existing in the drip chamber are circulated upstream of the drip chamber in the blood flow direction. And the third priming for moving the air downstream in the blood flow direction from the connection portion with the priming liquid supply flow channel in the blood supply flow channel to the blood flow channel and the drip chamber between the connection portion and the drip chamber. A priming solution from the priming solution supply source to the blood supply channel through the priming solution supply channel. A fourth priming step for discharging air that has moved to the blood flow path between the connection portion and the drip chamber to the outside from the discharge flow path, and a blood supply flow from the priming liquid supply source through the priming liquid supply flow path. And a fifth priming step of discharging the priming liquid supplied to the passage out of the discharge flow path while rotating the blood pump forward or backward.

  In the priming of the blood treatment device filled with the initial filling liquid, once the air flows into the blood treatment device filled with the filling liquid, the air that has flowed becomes an air embolism, and during hemodialysis therapy, Causes blood coagulation in the blood processor. However, in the second priming method (for the blood processing device filled with the initial filling liquid) according to the present invention, the priming liquid supplied from the priming liquid supply source to the blood supply flow path, the blood supply flow path and the priming After filling the blood flow circuit between the connection portion with the liquid supply flow path and the drip chamber, the blood pump is rotated in the forward direction so that a part of the filling liquid pre-filled with the blood treatment device is removed from the blood treatment device. The step of guiding the blood from the blood outlet to the drip chamber is added, so that the air between the blood treatment device and the drip chamber is discharged to the outside from the discharge channel provided in the drip chamber. With this process, in the present priming method, air can be effectively prevented from flowing into the blood processing apparatus that has been filled with the filling liquid in advance.

  In the fourth (fifth) priming step of the first (second) priming method according to the present invention, the priming solution supplied from the priming solution supply source to the blood supply channel through the priming solution supply channel is supplied to the blood pump. The blood flow can be discharged from the blood flow path to the dialysate flow path through the blood purification membrane while rotating in the forward or reverse direction.

  According to the present invention, it is possible to provide an extracorporeal blood circulation device capable of realizing an automatic priming process while having a low-cost and simple configuration (for example, a configuration in which an artery-side drip chamber is not provided).

It is a block diagram for demonstrating the structure of the hemodialysis apparatus (blood extracorporeal circulation apparatus) which concerns on 1st embodiment of this invention. It is a flowchart which shows the procedure of the automatic priming process using the hemodialysis apparatus (blood extracorporeal circulation apparatus) which concerns on 1st embodiment of this invention. It is a block diagram for demonstrating the structure of the hemodialysis apparatus (blood extracorporeal circulation apparatus) which concerns on 2nd embodiment of this invention. It is a block diagram for demonstrating the structure of the hemodialysis apparatus (blood extracorporeal circulation apparatus) which concerns on 3rd embodiment of this invention. It is a flowchart which shows the procedure of the automatic priming process using the hemodialysis apparatus (blood extracorporeal circulation apparatus) which concerns on 2nd and 3rd embodiment of this invention. It is a block diagram for demonstrating the structure of the conventional hemodialysis apparatus.

  Embodiments of the present invention will be described below with reference to the drawings. In the following embodiments, a hemodialysis apparatus will be described as an example of the extracorporeal blood circulation apparatus according to the present invention.

<First embodiment>
First, the first embodiment of the present invention will be described with reference to FIGS. 1 and 2.

  First, the configuration of the hemodialysis apparatus 1 according to the present embodiment will be described with reference to FIG. The hemodialysis apparatus 1 is provided in a hemodialyzer 10 for purifying blood, a blood supply channel 20 for supplying blood taken from the body to the hemodialyzer 10, and a blood supply channel 20. A blood pump 30 for delivering blood. The blood supply flow path 20 is located upstream of the blood pump 30 in the blood flow direction during hemodialysis and downstream of the blood pump 30 in the blood flow direction during hemodialysis. And a downstream blood supply channel 22 positioned there.

  In addition, the hemodialysis apparatus 1 has an electrolyte solution supply source (priming solution supply source) 40 via an electrolyte solution supply channel (priming solution supply channel) 41 from the blood pump 30 in the blood flow direction during hemodialysis treatment. Is also connected to a portion (connecting portion 21a) of the upstream blood supply channel 21 located on the upstream side. The blood pump 30 is a roller pump that can rotate forward and backward so that during priming, an electrolyte solution (priming solution) can be circulated both upstream and downstream in the blood flow direction during hemodialysis treatment. It has been adopted.

  In addition, the hemodialysis apparatus 1 has a blood return channel 50 for returning blood purified by the hemodialyzer 10 to the body, and air bubbles flowing through the blood return channel 50 are prevented from flowing into the body. Drip chamber 60. The blood return flow path 50 includes an upstream blood return flow path 51 located upstream of the drip chamber 60 in the blood flow direction during hemodialysis, and a downstream side of the drip chamber 60 in the blood flow direction during hemodialysis. And a downstream blood return flow path 52 which is positioned.

  In addition, the hemodialysis apparatus 1 is provided with an air / electrolyte solution discharge line (discharge channel) 70 for discharging the electrolyte solution and / or air from the drip chamber 60. The air / electrolyte solution discharge line 70 is provided with an electromagnetic valve 71 for opening and closing the air / electrolyte solution discharge line 70. On the downstream side of the air / electrolyte solution discharge line 70, an electrolyte solution sensor (priming solution sensor) 80 is installed via a drain receiver 72. The electrolyte solution sensor 80 functions as an air discharge end sensor in the present invention.

  The electrolyte solution sensor 80 in this embodiment includes a relatively small-capacity container 81, two electrodes 82a and 82b provided in the upper part of the container 81, and two electrodes 82a and 82b immersed in the electrolyte solution. When the liquid level of the electrolyte solution in the container 81 rises, the siphon system 83 discharges the electrolyte solution in the container 81 to the outside by the siphon principle. In the electrolyte solution sensor 80, when the electrolyte solution flowing out from the air / electrolyte solution discharge line 70 flows into the container 81, the liquid level rises, and eventually the two electrodes 82 a and 82 b are immersed in the electrolyte solution. Electricity flows between them, and at the same time, the electrolyte solution stored in the container 81 is discharged by the siphon system 83 so that it can be detected when the electrolyte solution flows next time. And the electrolyte solution sensor 80 is comprised so that it may interlock | cooperate with the blood pump 30, the solenoid valve 42, and the solenoid valve 71, and can transfer to the following process efficiently.

Next, with reference to the flowchart of FIG. 2, each step when the automatic priming process is performed in the hemodialysis apparatus 1 according to the present embodiment will be described. This priming process is a priming process for a blood circuit including a hemodialyzer 10 (so-called wet type) filled with an electrolyte solution.

In addition, when a part of the filling liquid in the hemodialyzer is replaced with air when performing the priming process of the hemodialyzer that has been prefilled with the filling liquid, the hemodialyzer is pushed by the air. No problem arises even if the filling solution that has come out of the container is returned to the hemodialyzer again. However, if all of the filling liquid in the hemodialyzer is replaced with air, the air bubbles are hemodialyzed when the filling liquid pushed out of the air and returned to the hemodialyzer is returned to the hemodialyzer. A phenomenon (so-called airlock) occurs that blocks the blood flow path in the vessel, and the hemodialyzer is no longer usable by the patient. For this reason, when performing the priming process of a hemodialyzer that has been prefilled with a filling solution, it is necessary to avoid the situation in which all of the filling solution in the hemodialyzer is replaced with air during each step. There is.

First, prior to the priming process, the artery side access connection portion 20a which is the end of the blood supply channel 20 opposite to the hemodialyzer 10 side, and the blood return channel 50 on the side opposite to the hemodialyzer 10 side. The vein side access connection part 50a which is an end part is connected using the connector 90 to make the blood circuit into a loop shape (closed circuit forming step: S1).

Next, in a state where the blood pump 30 is stopped and the electromagnetic valve 71 provided in the air / electrolyte discharge line 70 is opened, the electromagnetic valve 42 provided in the electrolyte supply channel 41 is opened. As a result, the electrolyte solution stored in the electrolyte solution supply source 40 naturally flows down the electrolyte solution supply channel 41 according to gravity and flows into the upstream blood supply channel 21. The electrolyte solution thus flowed in was present in the upstream blood supply channel 21 (the portion upstream of the connecting portion 21a between the electrolyte solution supply channel 41 and the upstream blood supply channel 21). The air and the air existing in the downstream blood return flow path 52 are discharged to the outside of the hemodialysis apparatus 1 through the air / electrolyte solution discharge line 70 provided in the drip chamber 60. When the air is discharged, the electrolyte solution that naturally flows down the electrolyte solution supply channel 41 from the electrolyte solution supply source 40 and flows into the upstream blood supply channel 21 flows into the upstream blood supply channel 21 and the air after the air. It flows through the downstream blood return channel 52 toward the drip chamber 60, passes through the air / electrolyte discharge line 70, is discharged to the outside of the hemodialysis apparatus 1, and passes through the drain receiver 72. It flows into the inside of the container 81. When the liquid level of the electrolyte solution rises inside the container 81 and both electrodes 82a and 82b are immersed in the electrolyte solution, a current flows between the two electrodes. A signal is sent to the electromagnetic valve 71. On the other hand, the electrolyte solution in the container 81 is discharged to the outside by the siphon system 83 based on the siphon principle (first natural flow step: S2).

In response to the signal sent from the electrolyte solution sensor 80 through the first natural flow step S2, the blood pump 30 starts to rotate forward with the electromagnetic valve 71 released. As a result, the electrolyte solution in the electrolyte solution supply source 40 is sent to the hemodialyzer 10 through the electrolyte solution supply channel 41 and the upstream blood supply channel 21, and in the downstream blood supply channel 22. The air that was present in the hemodialyzer 10 is pushed. Along with this, the filling liquid previously filled in the hemodialyzer 10 is pushed out to the upstream blood return flow path 51, and the air previously present in the upstream blood return flow path 51 is transferred to the drip chamber 60 and It is discharged to the outside of the hemodialysis apparatus 1 through the air / electrolyte discharge line 70, and at the same time, the upstream blood return channel 51 is filled with the filling liquid (first forward rotation step: S3). The blood pump 30 automatically stops when a slightly larger amount of filling liquid than the amount corresponding to the volume of the upstream blood return channel 51 is delivered, but this amount is larger than the capacity of the hemodialyzer 10. Therefore, only a part of the filling liquid filling the hemodialyzer 10 is pushed by the air and flows out into the upstream blood return channel 51, and all of the filling liquid in the hemodialyzer 10 is air. Will not be replaced.

  After the first positive rotation step S3, the air present in the upstream blood return flow path 51 is discharged to the outside of the hemodialysis apparatus 1 through the drip chamber 60 and the air / electrolyte discharge line 70. The step of moving the air present in the downstream blood supply flow path 22 and the hemodialyzer 10 downstream of the blood pump 30 to the upstream side of the blood pump 30 is performed. That is, in the first forward rotation step S3, when the blood pump 30 is rotated forward, the amount of filling liquid slightly larger than the amount corresponding to the volume of the upstream blood return channel 51 is finished, and then the air / electrolyte The electromagnetic valve 71 and the electromagnetic valve 42 on the liquid discharge line 70 are closed, and the blood pump 30 starts reverse rotation. As a result, a part of the air existing in the upstream portion and the downstream blood supply passage 22 of the hemodialyzer 10 is transferred to the upstream blood supply passage 21, the downstream blood return passage 52, and the drip chamber 60. It can be moved. At the same time, the electrolyte solution filling the upstream blood supply channel 21, the downstream blood return channel 52, and the drip chamber 60 flows into the upstream blood return channel 51, the hemodialyzer 10, and the downstream blood supply channel. Move to 22. The supply amount of the blood pump 30 is such that the volume in the upstream blood supply channel 21 from the connection portion 21a between the electrolyte solution supply channel 41 and the upstream blood supply channel 21 to the arterial access joint 20a, the connector 90 When the blood pump 30 reaches an amount corresponding to the sum of the volume in the downstream blood return flow path 52 from the venous access junction 50a to the drip chamber 60 and the volume of the drip chamber 60, the blood pump 30 The reverse rotation is automatically stopped (reverse rotation process: S4).

  When the reverse rotation step S4 is completed, a natural flow step is performed. That is, the electromagnetic valve 71 provided in the air / electrolyte solution discharge line 70 is opened, and then the electromagnetic valve 42 provided in the electrolyte solution supply channel 41 is opened. As a result, the electrolyte solution that naturally flows down the electrolyte solution supply channel 41 from the electrolyte solution supply source 40 according to gravity and flows into the upstream blood supply channel 21 flows into the upstream blood supply channel 21 and the downstream blood return channel. 52 and the air existing in the drip chamber 60 are discharged to the outside of the hemodialysis apparatus 1 through the air / electrolyte solution discharge line 70 provided in the drip chamber 60. When all the air is discharged and the electrolyte solution flows into the electrolyte solution sensor 80, a signal is sent from the electrolyte solution sensor 80 to the blood pump 30, the electromagnetic valve 71, and the electromagnetic valve 42 (second natural flow step: S5).

The electromagnetic valve 71 and the electromagnetic valve 42 are closed by the signal sent from the electrolyte solution sensor 80 through the second natural flow step S5, and the blood pump 30 starts reverse rotation. As a result, a part of the air existing in the downstream blood supply channel 22 is moved to the upstream blood supply channel 21, the downstream blood return channel 52 and the drip chamber 60. At the same time, the electrolyte solution filling the upstream blood supply channel 21, the downstream blood return channel 52, and the drip chamber 60 flows into the upstream blood return channel 51, the hemodialyzer 10, and the downstream blood supply channel. Move to 22. The supply amount of the blood pump 30 is such that the volume in the upstream blood supply channel 21 from the connection portion 21a between the electrolyte solution supply channel 41 and the upstream blood supply channel 21 to the arterial access joint 20a, the connector 90 When the blood pump 30 reaches an amount corresponding to the sum of the volume in the downstream blood return flow path 52 from the venous access junction 50a to the drip chamber 60 and the volume of the drip chamber 60, the blood pump 30 The reverse rotation is automatically stopped (second reverse rotation step: S6).

  Following the reverse rotation step S6, the natural flow step is performed again. That is, the electromagnetic valve 71 provided in the air / electrolyte solution discharge line 70 is opened, and then the electromagnetic valve 42 provided in the electrolyte solution supply channel 41 is opened. As a result, the air that has been present in the upstream blood supply flow path 21 and the downstream blood return flow path 52 due to the electrolyte liquid naturally flowing from the electrolyte liquid supply source 40 is provided in the drip chamber 60. -It is discharged out of the hemodialysis machine 1 through the electrolyte solution discharge line 70. When all the air is discharged and the electrolyte solution flows into the electrolyte solution sensor 80, a signal is sent from the electrolyte solution sensor 80 to the blood pump 30, the electromagnetic valve 71, and the electromagnetic valve 42 (third natural flow step: S7).

These reverse rotation process and natural flow process are repeated until the air in the air / electrolyte solution discharge line 70 runs out. When there is no air in the air / electrolyte solution discharge line 70 and the electrolyte solution flows in, the electromagnetic valve 42 provided in the electrolyte solution supply channel 41 remains open, and the blood pump 30 continues to rapidly rotate forward. (Second forward rotation step: S8). As a result, a part of the electrolyte solution that naturally flows down the electrolyte solution supply channel 41 from the electrolyte solution supply source 40 according to gravity and flows into the upstream blood supply channel 21 is part of the upstream blood supply channel 21 and the downstream blood. The supply channel 22, hemodialyzer 10, upstream blood return channel 51, drip chamber 60, downstream blood return channel 52, and upstream blood supply channel 21 are circulated in this order, and the remaining portion is upstream blood. The supply flow path 21, the downstream blood supply flow path 22, the hemodialyzer 10, the upstream blood return flow path 51, the drip chamber 60, and the air / electrolyte discharge line 70 flow in this order and are discharged to the outside of the hemodialysis apparatus 1. Then, it is discarded through the electrolyte solution sensor 80. In the second forward rotation step S8, the hemodialyzer 10 is washed with the electrolyte solution.

When the electrolyte solution supply source 40 is emptied through the second forward rotation step S8, no more electrolyte solution flows into the electrolyte solution sensor 80, so that a current flows between the electrode 82a and the electrode 82b. Disappear. When this becomes a signal and is sent to the blood pump 30 and the electromagnetic valve 71, the blood pump 30 is stopped and the electromagnetic valve 71 is closed (pump stop / valve closing step: S9). The automatic priming process is completed through the above process group. Thereafter, the arterial access connecting portion 20a that is the end of the blood supply channel 20 opposite to the hemodialyzer 10 side, and the vein that is the end of the blood return channel 50 opposite to the hemodialyzer 10 side. The side access connection portion 50a is removed from the connector 90, and the arterial side puncture needle is attached to the arterial side access connection portion 20a, while the venous side puncture needle is attached to the venous side access connection portion 50a to puncture each shunt blood vessel of a dialysis patient. To do.

  In the hemodialysis apparatus 1 according to the embodiment described above, the air downstream of the blood pump 30 in the blood flow direction can be moved upstream of the blood pump 30 by the reverse rotation driving of the blood pump 30. Further, this air is replaced with an electrolyte solution supplied from the electrolyte solution supply source 40 to the blood supply channel 20 via the electrolyte solution supply channel 41, and is provided in the drip chamber 60 of the blood return channel 50. The air / electrolyte solution discharge line 70 can be discharged to the outside. Therefore, the automatic priming process can be performed with a low-cost and simple configuration in which the artery-side drip chamber is not provided.

  Further, in the hemodialysis apparatus 1 according to the embodiment described above, when the electrolyte solution sensor 80 detects that the necessary amount of air has been discharged from the air / electrolyte solution discharge line 70, the blood pump 30. Since the electromagnetic valve 71 and the electromagnetic valve 42 can be interlocked, it is possible to efficiently shift to the next step of the automatic priming process.

  In the hemodialysis apparatus 1 according to the embodiment described above, the air moved to the upstream side of the blood pump 30 in the blood flow direction is transferred to the blood supply channel 20 via the electrolyte solution supply channel 41. The electrolyte solution that naturally flows down due to gravity can be replaced and discharged to the outside from the air / electrolyte solution discharge line 70 provided in the drip chamber 60. Accordingly, since a special mechanism for supplying the electrolyte solution from the electrolyte solution supply source 40 to the blood supply channel 20 via the electrolyte solution supply channel 41 is not required, further simplification and cost reduction of the device are achieved. It becomes possible to do.

<Second embodiment>
Subsequently, a second embodiment of the present invention will be described with reference to FIGS. 3 and 5.

  First, the configuration of the hemodialysis apparatus 2 according to the present embodiment will be described with reference to FIG. The hemodialysis apparatus 2 employs a pressure measuring device 65 in place of the electrolyte solution sensor 80 of the hemodialysis apparatus 1 according to the first embodiment, and other configurations are substantially the same as those of the first embodiment. is there. For this reason, different configurations will be mainly described, and overlapping configurations will be denoted by the same reference numerals as those in the first embodiment, and detailed description thereof will be omitted.

  The hemodialyzer 2 includes a hemodialyzer 10, a blood supply channel 20 (upstream blood supply channel 21 and downstream blood supply channel 22), a blood pump 30, an electrolyte solution supply source 40, and an electrolyte solution supply channel 41. , A blood return channel 50 (upstream blood return channel 51 and downstream blood return channel 52), a drip chamber 60, an air / electrolyte solution discharge line 70, an electromagnetic valve 71, a drain receiver 72, and the like. In the hemodialysis apparatus 2, the inner diameter of the distal end portion 73 of the air / electrolyte solution discharge line 70 is thin in a spindle shape, and the drip chamber 60 further includes a pressure measuring device for monitoring the pressure in the drip chamber 60. 65 is provided.

  In such a configuration, when air exists in the drip chamber 60 and air is discharged from the air / electrolyte solution discharge line 70, the pressure in the drip chamber 60 is equal to the atmospheric pressure. However, when the electrolyte solution flows into the drip chamber 60 and further the electrolyte solution is discharged out of the hemodialysis apparatus 2 through the air / electrolyte solution discharge line 70, the tip 73 of the air / electrolyte solution discharge line 70 is removed. Since the inner diameter is reduced and the flow resistance is increased, the pressure in the drip chamber 60 rises to a level corresponding to the height of the electrolyte supply source 40 and the flow resistance of the air / electrolyte discharge line 70. . That is, the fact that the monitored value of the pressure measuring device 65 has increased from the atmospheric pressure to a predetermined value or more indicates that the discharge of air through the air / electrolyte solution discharge line 70 has ended, and therefore the tip is narrow. The pressure measuring device 65 that monitors the pressure in the air / electrolyte discharge line 70 and the drip chamber 60 with increased flow resistance functions as an air discharge end sensor in the present invention. And the pressure measuring device 65 is comprised so that it may interlock | cooperate with the blood pump 30, the solenoid valve 42, and the solenoid valve 71, and can transfer to the following process efficiently.

Next, with reference to the flowchart of FIG. 5, each step when the automatic priming process is performed in the hemodialysis apparatus 2 according to the present embodiment will be described. This priming process is a priming process for a blood circuit including a hemodialyzer 10 that is not filled with an electrolyte solution (so-called dry type).

First, prior to the priming process, the artery side access connection portion 20a which is the end of the blood supply channel 20 opposite to the hemodialyzer 10 side, and the blood return channel 50 on the side opposite to the hemodialyzer 10 side. The vein side access connection part 50a which is an end part is connected using the connector 90 to make the blood circuit into a loop shape (closed circuit forming step: S11).

Next, with the blood pump 30 stopped, the electromagnetic valve 42 provided in the electrolyte solution supply channel 41 is opened. As a result, the electrolyte solution stored in the electrolyte solution supply source 40 naturally flows down the electrolyte solution supply channel 41 according to gravity and flows into the upstream blood supply channel 21. The electrolyte solution thus flowed into the upstream blood supply channel 21 (portion upstream of the connecting portion 21a between the electrolyte solution supply channel 41 and the upstream blood supply channel 21 in the blood flow direction). The air / electrolyte solution discharge line provided in the drip chamber 60 includes the air that was present, the air that was present in the downstream blood return flow path 52, and the air that was present in the drip chamber 60. 70 is discharged to the outside of the hemodialysis apparatus 1. As described above, the pressure measuring device 65 is monitoring while the air is discharged to the outside of the hemodialyzer 2 through the air / electrolyte discharge line 70 provided in the drip chamber 60. The pressure in the drip chamber 60 is equal to atmospheric pressure. When all of the air is exhausted, the electrolyte solution that naturally flows from the electrolyte solution supply source 40 through the electrolyte solution supply channel 41 and flows into the upstream blood supply channel 21 flows into the upstream blood supply channel 21 following the air. And it flows through the downstream blood return channel 52 toward the drip chamber 60, passes through the air / electrolyte solution discharge line 70, and is discharged to the outside of the hemodialyzer 2. Here, the pressure in the drip chamber 60 rises to a level corresponding to the height of the electrolyte solution supply source 40 and the flow resistance of the air / electrolyte solution discharge line 70. The pressure measuring device 65 monitoring the pressure in the drip chamber 60 indicates that the pressure in the drip chamber 60 has increased from atmospheric pressure to a predetermined level (that is, the electrolyte liquid is supplied from the electrolyte liquid supply source 40 to the electrolyte liquid supply flow). 41 flows naturally into the upstream blood supply channel 21, flows through the downstream blood return channel 52 toward the drip chamber 60, and reaches the air / electrolyte discharge line 70 to fill it. ) Is sent from the pressure measuring device 65 to the blood pump 30, the electromagnetic valve 71, and the electromagnetic valve 42 (first natural flow step: S12).

The electromagnetic valve 71 and the electromagnetic valve 42 are closed by a signal sent from the pressure measuring device 65 through the first natural flow step S12, and the blood pump 30 starts reverse rotation. As a result, a part of the air existing in the downstream blood supply flow path 22, the hemodialyzer 10, and the upstream blood return flow path 51 is moved to the upstream blood supply flow path 21 side. At the same time, the venous access joint is connected via the connector 90 and the upstream blood supply passage 21 from the connecting portion 21a between the electrolyte solution supply passage 41 and the upstream blood supply passage 21 to the arterial access joint 20a. The electrolyte solution filled in the downstream blood return channel 52 from the portion 50a to the drip chamber 60 and the drip chamber 60 is moved to the upstream blood return channel 51 side. The supply amount of the blood pump 30 is such that the volume in the upstream blood supply channel 21 from the connection portion 21a between the electrolyte solution supply channel 41 and the upstream blood supply channel 21 to the arterial access joint 20a, the connector 90 When the volume corresponding to the sum of the volume in the downstream blood return flow path 52 from the venous access junction 50a to the drip chamber 60 and the volume of the drip chamber 60 is reached via The reverse rotation is stopped (first reverse rotation step: S13).

  Following the first reverse rotation step S13, the natural flow step is performed again. That is, the electromagnetic valve 71 provided in the air / electrolyte solution discharge line 70 is opened, and then the electromagnetic valve 42 provided in the electrolyte solution supply channel 41 is opened. As a result, the electrolyte solution that naturally flows down the electrolyte solution supply channel 41 according to gravity from the electrolyte solution supply source 40 and flows into the upstream blood supply channel 21 flows upstream from the connection portion 21a to the arterial access joint 20a. The air present in the blood supply channel 21, the downstream blood return channel 52, and the drip chamber 60 is forced out of the hemodialyzer 2 through the air / electrolyte solution discharge line 70 provided in the drip chamber 60, Discharge. All of the air is exhausted, and the electrolyte solution flows naturally from the electrolyte solution supply source 40 through the electrolyte solution supply flow 41 and flows into the upstream blood supply channel 21, and the downstream blood return channel 52 flows toward the drip chamber 60. When the air reaches the air / electrolyte liquid discharge line 70 and fills it, the pressure measuring device 65 detects that the pressure in the drip chamber 60 has increased by a predetermined value from the atmospheric pressure. As a result, a signal is sent from the pressure measuring device 65 to the blood pump 30, the electromagnetic valve 71, and the electromagnetic valve 42 (second natural flow step: S14).

The electromagnetic valve 71 and the electromagnetic valve 42 are closed by the signal sent from the pressure measuring device 65 through the second natural flow step S14, and the blood pump 30 starts reverse rotation again. As a result, a part of the air remaining in the downstream blood supply flow path 22, the hemodialyzer 10, the upstream blood return flow path 51, etc. is moved to the upstream blood supply flow path 21 side. Along with this, the electrolyte solution that has filled the drip chamber 60 and the downstream blood return flow path 52 and the like becomes the upstream blood return flow path 51, the hemodialyzer 10, the downstream blood supply flow path 22, and the upstream blood supply. It moves in the direction of the flow path 21. The supply amount of the blood pump 30 is such that the volume in the upstream blood supply channel 21 from the connection portion 21a between the electrolyte solution supply channel 41 and the upstream blood supply channel 21 to the arterial access joint 20a, the connector 90 When the volume corresponding to the sum of the volume in the downstream blood return flow path 52 from the venous access junction 50a to the drip chamber 60 and the volume of the drip chamber 60 is reached via The reverse rotation is stopped (second reverse rotation step: S15).

  Following the second reverse rotation step S15, the natural flow step is performed again. That is, the electromagnetic valve 71 provided in the air / electrolyte solution discharge line 70 is opened, and then the electromagnetic valve 42 on the electrolyte solution supply channel 41 is opened. As a result, the air existing in the upstream blood supply channel 21, the downstream blood return channel 52, and the drip chamber 60 is provided in the drip chamber 60 by the electrolyte solution naturally flowing from the electrolyte solution supply source 40. The air / electrolyte solution discharge line 70 is discharged to the outside of the hemodialysis apparatus 2. When all the air is discharged and the air / electrolyte solution discharge line 70 is filled with the electrolyte solution, the pressure measuring device 65 detects that the pressure in the drip chamber 60 has increased from the atmospheric pressure by a predetermined value. As a result, a signal is sent from the pressure measuring device 65 to the blood pump 30 and the electromagnetic valve 71 (third natural flow step: S16).

The second reverse rotation step S15 and the third natural flow step S16 are repeated until the air in the air / electrolyte solution discharge line 70 runs out. When the pressure measuring device 65 detects that the pressure in the drip chamber 60 has not returned to atmospheric pressure, the blood pump 30 continues to rapidly rotate forward while the electromagnetic valve 42 on the electrolyte solution supply channel 41 remains open. (Normal rotation process: S17). A part of the electrolyte flowing into the upstream blood supply channel 21 from the electrolyte solution supply source 40 due to the forward rotation of the blood pump 30 is part of the upstream blood supply channel 21, the downstream blood supply channel 22, and the hemodialyzer. 10, the upstream blood return channel 51, the drip chamber 60, the downstream blood return channel 52, and the upstream blood supply channel 21 are circulated in this order, and the remaining portions are the upstream blood supply channel 21 and the downstream blood. The supply flow path 22, the hemodialyzer 10, the upstream blood return flow path 51, the drip chamber 60, and the air / electrolyte discharge line 70 flow in this order and are discharged to the outside of the hemodialysis apparatus 2. In the forward rotation step S17, the hemodialyzer 10 is washed with the electrolyte solution.

When the electrolyte solution supply source 40 is emptied through the forward rotation step S17, the electrolyte solution in the blood circuit and the hemodialyzer 10 flows into the upstream blood supply channel 21, the downstream blood supply channel 22, and the hemodialysis. The circulation continues in the order of the vessel 10, the upstream blood return channel 51, the drip chamber 60, the downstream blood return channel 52, and the upstream blood supply channel 21, while the electrolyte solution from the air / electrolyte discharge line 70 Discharge stops. While the electrolyte solution is being discharged out of the hemodialysis apparatus 2 through the air / electrolyte solution discharge line 70, the pressure in the drip chamber 60 monitored by the pressure measuring device 65 depends on the height of the electrolyte solution supply source 40 and the air / electrolyte. Although the pressure rises to a level corresponding to the flow resistance of the liquid discharge line 70, when the discharge of the electrolyte liquid from the air / electrolyte liquid discharge line 70 stops, the pressure in the drip chamber 60 monitored by the pressure measuring device 65 is large. Return to atmospheric pressure. Therefore, after detecting that the pressure in the drip chamber 60 monitored by the pressure measuring device 65 has decreased by a predetermined value after the start of the forward rotation step S17, the blood pump 30 is stopped and the electromagnetic valve 71 is closed. (Pump stop / valve closing step S18). The automatic priming process is completed through the above process group. Thereafter, the arterial access connecting portion 20a that is the end of the blood supply channel 20 opposite to the hemodialyzer 10 side, and the vein that is the end of the blood return channel 50 opposite to the hemodialyzer 10 side. The side access connection portion 50a is removed from the connector 90, and the arterial side puncture needle is attached to the arterial side access connection portion 20a, while the venous side puncture needle is attached to the venous side access connection portion 50a to puncture each shunt blood vessel of a dialysis patient. To do.

  In the hemodialysis apparatus 2 according to the embodiment described above, the air on the downstream side of the blood pump 30 in the blood flow direction can be moved to the upstream side of the blood pump 30 by the reverse rotation driving of the blood pump 30. Further, the air is replaced with the electrolyte solution supplied by natural fall from the electrolyte solution supply source 40 to the blood supply channel 20 via the electrolyte solution supply channel 41, and the drip chamber 60 of the blood return channel 50 is replaced. Can be discharged to the outside from an air / electrolyte discharge line 70 provided on the outside. Therefore, the automatic priming process can be performed with a low-cost and simple configuration in which the artery-side drip chamber is not provided.

  In the hemodialysis apparatus 2 according to the embodiment described above, when the pressure measuring device 65 detects that the necessary amount of air has been discharged from the air / electrolyte solution discharge line 70, the blood pump 30. Since the electromagnetic valve 71 and the electromagnetic valve 42 can be interlocked, it is possible to efficiently shift to the next step of the automatic priming process.

  Further, in the hemodialysis apparatus 2 according to the embodiment described above, the air moved to the upstream side of the blood pump 30 in the blood flow direction is transferred to the blood supply channel 20 via the electrolyte solution supply channel 41. The electrolyte solution that naturally flows down due to gravity can be replaced and discharged to the outside from the air / electrolyte solution discharge line 70 provided in the drip chamber 60. Accordingly, since a special mechanism for supplying the electrolyte solution from the electrolyte solution supply source 40 to the blood supply channel 20 via the electrolyte solution supply channel 41 is not required, further simplification and cost reduction of the device are achieved. It becomes possible to do.

  In the hemodialysis apparatus 2 according to the present embodiment, if the dialysate flow path of the hemodialyzer 10 is opened to the atmosphere in the forward rotation step S17, the electrolyte solution is not only the air / electrolyte discharge line 70 but also blood. It is also discharged to the dialysate flow path through the dialysis membrane of the dialyzer 10. If it does in this way, the time required for forward rotation process S17 can be shortened.

<Third embodiment>
Subsequently, a third embodiment of the present invention will be described with reference to FIGS. 4 and 5.

  First, the configuration of the hemodialysis apparatus 3 according to the present embodiment will be described with reference to FIG. The hemodialysis apparatus 3 employs an electrolyte solution supply source weight monitor 43 instead of the pressure measurement device 65 of the hemodialysis apparatus 2 according to the second embodiment, and other configurations are substantially the same as those of the second embodiment. Are identical. For this reason, different configurations will be mainly described, and overlapping configurations will be denoted by the same reference numerals as those in the second embodiment, and detailed description thereof will be omitted.

  The hemodialyzer 3 includes a hemodialyzer 10, a blood supply channel 20 (upstream blood supply channel 21 and downstream blood supply channel 22), a blood pump 30, an electrolyte solution supply source 40, and an electrolyte solution supply channel 41. , A blood return channel 50 (upstream blood return channel 51 and downstream blood return channel 52), a drip chamber 60, an air / electrolyte solution discharge line 70, an electromagnetic valve 71, a drain receiver 72, and the like. Further, the hemodialysis apparatus 3 includes an electrolyte solution supply source weight monitor (weight sensor) 43 that monitors the weight of the electrolyte solution supply source 40. The electrolyte solution supply source weight monitor 43 measures the weight of the electrolyte solution supply source 40 and detects that the mass of the electrolyte solution having the same volume as the air to be discharged from the air / electrolyte solution discharge line 70 has decreased. It functions as an air discharge end sensor in the present invention. The electrolyte solution supply source weight monitor 43 is configured to be interlocked with the blood pump 30, the electromagnetic valve 42, and the electromagnetic valve 71, and can move to the next process efficiently.

  Next, with reference to the flowchart of FIG. 5, each step when the automatic priming process is performed in the hemodialysis apparatus 3 according to the present embodiment will be described. This priming process is a priming process for a blood circuit including a hemodialyzer 10 that is not filled with an electrolyte solution (so-called dry type).

  First, prior to the priming process, the artery side access connection portion 20a which is the end of the blood supply channel 20 opposite to the hemodialyzer 10 side, and the blood return channel 50 on the side opposite to the hemodialyzer 10 side. The vein side access connection part 50a which is an end part is connected using the connector 90 to make the blood circuit into a loop shape (closed circuit forming step: S11).

  Next, in a state where the blood pump 30 is stopped and the electromagnetic valve 71 provided in the air / electrolyte discharge line 70 is opened, the electromagnetic valve 42 provided in the electrolyte supply channel 41 is opened. As a result, the electrolyte solution stored in the electrolyte solution supply source 40 naturally flows down the electrolyte solution supply channel 41 according to gravity and flows into the upstream blood supply channel 21. The electrolyte solution thus flowed into the upstream blood supply channel 21 (portion upstream of the connecting portion 21a between the electrolyte solution supply channel 41 and the upstream blood supply channel 21 in the blood flow direction). The air / electrolyte solution discharge line provided in the drip chamber 60 includes the air that was present, the air that was present in the downstream blood return flow path 52, and the air that was present in the drip chamber 60. 70 is discharged to the outside of the hemodialysis apparatus 3. When the air is discharged, the electrolyte solution that naturally flows down the electrolyte solution supply channel 41 from the electrolyte solution supply source 40 and flows into the upstream blood supply channel 21 flows into the upstream blood supply channel 21 and the air after the air. It flows through the downstream blood return channel 52 toward the drip chamber 60, passes through the air / electrolyte discharge line 70, and is discharged to the outside of the hemodialyzer 3. Here, the electrolyte liquid supply source weight monitor 43 that monitors the weight of the electrolyte liquid supply source 40 is configured so that the weight of the electrolyte liquid supply source 40 is the same volume as the air to be discharged from the air / electrolyte liquid discharge line 70. (That is, the electrolyte solution naturally flows down the electrolyte solution supply flow 41 from the electrolyte solution supply source 40 and flows into the upstream blood supply channel 21, and the downstream blood return channel 52. , And then reaches the air / electrolyte liquid discharge line 70 and satisfies this condition), the blood pump 30, the electromagnetic valve 71, and the electromagnetic valve from the electrolyte liquid supply source weight monitor 43 are detected. A signal is sent to 42 (first natural flow step: S12).

  The electromagnetic valve 71 and the electromagnetic valve 42 are closed by the signal sent from the electrolyte solution supply source weight monitor 43 through the first natural flow step S12, and the blood pump 30 starts reverse rotation. As a result, a part of the air existing in the downstream blood supply flow path 22, the hemodialyzer 10, and the upstream blood return flow path 51 is moved to the upstream blood supply flow path 21 side. At the same time, the venous access joint is connected via the connector 90 and the upstream blood supply passage 21 from the connecting portion 21a between the electrolyte solution supply passage 41 and the upstream blood supply passage 21 to the arterial access joint 20a. The electrolyte solution filled in the downstream blood return channel 52 from the portion 50a to the drip chamber 60 and the drip chamber 60 is moved to the upstream blood return channel 51 side. The supply amount of the blood pump 30 is such that the volume in the upstream blood supply channel 21 from the connection portion 21a between the electrolyte solution supply channel 41 and the upstream blood supply channel 21 to the arterial access joint 20a, the connector 90 When the volume corresponding to the sum of the volume in the downstream blood return flow path 52 from the venous access junction 50a to the drip chamber 60 and the volume of the drip chamber 60 is reached via The reverse rotation is stopped (first reverse rotation step: S13).

  Following the first reverse rotation step S13, the natural flow step is performed again. That is, the electromagnetic valve 71 provided in the air / electrolyte solution discharge line 70 is opened, and then the electromagnetic valve 42 provided in the electrolyte solution supply channel 41 is opened. As a result, the electrolyte solution that naturally flows down the electrolyte solution supply channel 41 from the electrolyte solution supply source 40 according to gravity and flows into the upstream blood supply channel 21 is removed from the air present in the downstream blood return channel 52. Then, it is swept away in the direction of the drip chamber 60 and discharged out of the hemodialysis apparatus 3 through the air / electrolyte solution discharge line 70 provided in the drip chamber 60. All of the air is exhausted, and the electrolyte solution flows naturally from the electrolyte solution supply source 40 through the electrolyte solution supply flow 41 and flows into the upstream blood supply channel 21, and the downstream blood return channel 52 flows toward the drip chamber 60. When the refrigerant reaches the air / electrolyte solution discharge line 70 and fills it, the electrolyte solution supply source weight monitor 43 determines that the weight of the electrolyte solution supply source 40 is the air to be discharged from the air / electrolyte solution discharge line 70. A decrease in the weight of the same volume of electrolyte is detected. As a result, a signal is sent from the electrolyte solution supply source weight monitor 43 to the blood pump 30, the electromagnetic valve 71, and the electromagnetic valve 42 (second natural flow step: S14).

  The electromagnetic valve 71 and the electromagnetic valve 42 are closed by the signal sent from the electrolyte solution supply source weight monitor 43 through the second natural flow step S14, and the blood pump 30 starts reverse rotation again. As a result, a part of the remaining air existing in the downstream blood supply flow path 22, the hemodialyzer 10, the upstream blood return flow path 51 and the like is moved to the upstream blood supply flow path 21 side. Along with this, the electrolyte solution that has filled the drip chamber 60 and the downstream blood return flow path 52 and the like becomes the upstream blood return flow path 51, the hemodialyzer 10, the downstream blood supply flow path 22, and the upstream blood supply. It moves in the direction of the flow path 21. The supply amount of the blood pump 30 is such that the volume in the upstream blood supply channel 21 from the connection portion 21a between the electrolyte solution supply channel 41 and the upstream blood supply channel 21 to the arterial access joint 20a, the connector 90 When the volume corresponding to the sum of the volume in the downstream blood return flow path 52 from the venous access junction 50a to the drip chamber 60 and the volume of the drip chamber 60 is reached via The reverse rotation is stopped (second reverse rotation step: S15).

  Following the second reverse rotation step S15, the natural flow step is performed again. That is, the electromagnetic valve 71 provided in the air / electrolyte solution discharge line 70 is opened, and then the electromagnetic valve 42 on the electrolyte solution supply channel 41 is opened. As a result, the air that has been present in the upstream blood supply flow path 21 and the downstream blood return flow path 52 due to the electrolyte liquid naturally flowing from the electrolyte liquid supply source 40 is provided in the drip chamber 60. -It is discharged to the outside of the hemodialyzer 3 through the electrolyte solution discharge line 70. When all the air is discharged and the air / electrolyte solution discharge line 70 is filled with the electrolyte solution, the electrolyte solution supply source weight monitor 43 should discharge the weight of the electrolyte solution supply source 40 from the air / electrolyte solution discharge line 70. A decrease in the weight of the electrolyte solution having the same volume as the air is detected. As a result, a signal is sent from the electrolyte solution supply source weight monitor 43 to the blood pump 30, the electromagnetic valve 71, and the electromagnetic valve 42 (third natural flow step: S6).

  The second reverse rotation step S15 and the third natural flow step S16 are repeated until the air in the air / electrolyte solution discharge line 70 runs out. The electrolyte liquid source weight monitor 43 is configured so that the weight of the electrolyte liquid source 40 is the volume of the blood supply channel 20, the volume of the hemodialyzer 10, the volume of the blood return channel 50, the volume of the drip chamber 60, When it is detected that the weight corresponding to the sum of the two is further reduced by a weight obtained by adding a predetermined weight, the blood pump 30 continues to rapidly rotate forward while the electromagnetic valve 42 on the electrolyte solution supply channel 41 remains open. (Normal rotation process: S17). As a result, a part of the electrolyte solution that naturally flows down the electrolyte solution supply channel 41 from the electrolyte solution supply source 40 according to gravity and flows into the upstream blood supply channel 21 is part of the upstream blood supply channel 21 and the downstream blood. The supply channel 22, hemodialyzer 10, upstream blood return channel 51, drip chamber 60, downstream blood return channel 52, and upstream blood supply channel 21 are circulated in this order, and the remaining portion is upstream blood. The supply flow path 21, the downstream blood supply flow path 22, the hemodialyzer 10, the upstream blood return flow path 51, the drip chamber 60, and the air / electrolyte discharge line 70 flow in this order and are discharged to the outside of the hemodialysis apparatus 1. Is done. In the forward rotation step S17, the hemodialyzer 10 is washed with the electrolyte solution.

  When the electrolyte solution supply source 40 is emptied through the forward rotation step S17, the electrolyte solution supply source weight monitor 43 detects this and sends a signal to the blood pump 30 and the electromagnetic valve 71. Thereby, the blood pump 30 is stopped and the electromagnetic valve 71 is closed (pump stop / valve closing step: S18). The automatic priming process is completed through the above process group. Thereafter, the arterial access connecting portion 20a that is the end of the blood supply channel 20 opposite to the hemodialyzer 10 side, and the vein that is the end of the blood return channel 50 opposite to the hemodialyzer 10 side. The side access connection portion 50a is removed from the connector 90, and the arterial side puncture needle is attached to the arterial side access connection portion 20a, while the venous side puncture needle is attached to the venous side access connection portion 50a to puncture each shunt blood vessel of a dialysis patient. To do.

  In each of the above embodiments, by supplying the electrolyte solution from the electrolyte solution supply source 40 to the blood supply channel 20 via the electrolyte solution supply channel 41 by natural flow due to gravity, blood in the blood circulation direction is supplied. Although the example in which the air moved to the upstream side of the pump 30 is discharged to the outside from the air / electrolyte solution discharge line 70 is shown, an electrolyte solution supply pump (priming solution supply pump) is provided in the electrolyte solution supply channel 41, By supplying the electrolyte solution from the electrolyte solution supply source 40 to the blood supply channel 20 via the electrolyte solution supply channel 41 by the electrolyte solution supply pump, the electrolyte solution is moved to the upstream side of the blood pump 30 in the blood circulation direction. It is also possible to discharge the air from the air / electrolyte solution discharge line 70 to the outside.

  When such a configuration is adopted, the air moved to the upstream side of the blood pump 30 in the blood flow direction is replaced with the electrolyte solution that is forcibly supplied by the electrolyte solution supply pump, and is provided in the drip chamber 60. The air / electrolyte solution discharge line 70 can be discharged to the outside. Therefore, priming can be performed even when the electrolyte solution supply source 40 is at a low position, and the dialysate flowing in the dialysate flow path can be used as the priming solution.

  Also, a control device that stops the electrolyte solution supply pump when an electrolyte solution having the same volume as the air to be discharged from the air / electrolyte solution discharge line 70 is discharged may be employed. By adopting such a configuration, it is possible to know that the discharge of a necessary amount of air from the air / electrolyte solution discharge line 70 is completed by stopping the electrolyte solution supply pump. The electrolyte solution supply pump and the control device in such a case constitute the air discharge end sensor in the present invention.

  Further, it is also possible to adopt a configuration in which the electrolyte solution supply pump is interlocked when it is detected by the air discharge end sensor (the electrolyte solution sensor 80 or the pressure measuring device 65) that the discharge of a necessary amount of air has ended. . By adopting such a configuration, when the air discharge end sensor detects that the required amount of air has been discharged from the air / electrolyte solution discharge line 70, the electrolyte solution supply pump can be interlocked. It is possible to efficiently shift to the next step of the automatic priming process.

  In each of the above embodiments, an example in which automatic priming processing is performed in a hemodialysis apparatus that does not have an arterial drip chamber has been shown. However, even when an arterial drip chamber is provided, automatic priming processing is performed in the same procedure. Can be implemented.

  Further, in each of the above embodiments, an example in which the present invention is applied to a hemodialysis apparatus has been shown. However, the same configuration (blood treatment device, blood supply flow path, blood pump capable of forward and reverse rotation, priming liquid supply source) The present invention can also be applied to other blood extracorporeal circulation devices having a priming fluid supply channel, a blood return channel, a drip chamber, and the like. For example, the present invention is applied to a blood purification apparatus used for simple plasma exchange therapy (PE), double filtration plasmapheresis (DFPP), continuous hemofiltration (CHF), and the like. It can also be applied.

1 ・ 2 ・ 3 ・ ・ ・ Hemodialysis machine
10 ... hemodialyzer (blood treatment device)
20 ... Blood supply channel 20a ... Arterial side access connection (end of blood supply channel opposite to blood treatment device side)
30 ... Blood pump 40 ... Electrolyte solution supply source (priming solution supply source)
41 ... Electrolyte solution supply channel (priming solution supply channel)
43 ... Electrolyte supply source weight monitor (weight sensor, air discharge end sensor)
50 ... Blood return channel 50a ... Vein side access connection (end of blood return channel opposite to blood treatment device side)
60 ... Drip chamber 65 Pressure measuring device (Air discharge end sensor)
70: Air / electrolyte discharge line (discharge flow path)
71 ... Solenoid valve 80 ... Electrolyte solution sensor (priming solution sensor, air discharge end sensor)

Claims (11)

A blood treatment device for purifying blood, comprising a blood passage through which blood flows and a dialysate passage through which dialysate flows through a blood purification membrane, and blood taken from the body into the blood treatment device A blood supply channel for supplying, a blood pump provided in the blood supply channel and capable of rotating in the forward and reverse directions for delivering blood to the blood processor, and a priming solution for supplying the blood supply channel The priming fluid supply source, a priming fluid supply channel connecting the priming fluid supply source to a portion of the blood supply channel located upstream of the blood pump in the blood flow direction, and the blood processing device. A blood return channel for returning the blood to the body, a drip chamber provided in the blood return channel for preventing bubbles flowing through the blood return channel from flowing into the body, A blood extracorporeal circulation apparatus comprising,
The drip chamber is configured such that an end portion of the blood supply channel opposite to the blood processor side and an end portion of the blood return channel opposite to the blood processor side are connected. Is provided with a discharge channel for discharging the priming liquid and / or air to the outside.
Blood extracorporeal circulation device. An air discharge end sensor for detecting that a required amount of air has been discharged from the discharge flow path;
The blood extracorporeal circulation apparatus according to claim 1. The air discharge end sensor is a priming liquid sensor that detects that priming liquid has been discharged after air from the discharge flow path.
The blood extracorporeal circulation apparatus according to claim 2. The air discharge end sensor is a weight sensor that measures the weight of the priming liquid supply source and detects that the mass of the priming liquid having the same volume as the air to be discharged from the discharge flow path has decreased.
The blood extracorporeal circulation apparatus according to claim 2. A priming liquid supply pump provided in the priming liquid supply flow path for detecting that the air discharge end sensor has supplied a priming liquid having the same volume as the air to be discharged from the discharge flow path; A control device for controlling the pump,
The blood extracorporeal circulation apparatus according to claim 2. The air discharge end sensor is a pressure measuring device for measuring a pressure in the drip chamber;
The blood extracorporeal circulation apparatus according to claim 2. A solenoid valve provided in the discharge flow path;
The blood pump and the solenoid valve are configured to work together when it is detected by the air discharge end sensor that the required amount of air has been discharged.
The blood extracorporeal circulation apparatus according to any one of claims 2 to 6. A blood processing unit that is not filled with an initial filling liquid, which processes blood in a specific manner, a blood supply channel for supplying blood taken from the body to the blood processing unit, and a blood supply channel A blood pump that is provided to send blood to the blood processor and can rotate forward and backward, a priming liquid supply source for supplying priming liquid to the blood supply channel, and upstream of the blood pump in the blood flow direction. A priming liquid supply flow path for connecting the priming liquid supply source to a site of the blood supply flow path located on the side, a blood return flow path for returning blood treated by the blood treatment device, A drip chamber provided in the blood return channel for preventing bubbles flowing through the blood return channel from flowing into the body, and a priming solution and air from the drip chamber A priming method using a discharge passage for discharging to the outside the by which blood extracorporeal circulation apparatus comprising a,
During priming before treatment, the end of the blood supply channel opposite to the blood processor side is connected to the end of the blood return channel opposite to the blood processor side for communication. The blood treatment device is placed in a state where the blood introduction port faces upward, and the blood pump is stopped, and the blood is passed from the priming solution supply source through the priming solution supply channel. The priming liquid supplied to the supply flow path fills the blood flow path from the connection between the blood supply flow path and the priming liquid supply flow path to the drip chamber, and the blood supply flow path and the A first priming step of discharging the air that was present in the blood flow path between the connection portion with the priming liquid supply flow path to the drip chamber from the discharge flow path;
Priming liquid in the blood channel between the connection part of the blood supply channel and the priming solution supply channel and the drip chamber by rotating the blood pump in reverse, and a priming solution existing in the drip chamber In the blood flow direction upstream of the drip chamber, and the air that is downstream of the blood supply channel in the blood flow direction with respect to the connection portion with the priming liquid supply channel. A second priming step for moving the blood flow path between the drip chamber and the drip chamber;
By supplying priming liquid from the priming liquid supply source to the blood supply flow path through the priming liquid supply flow path, the air that has moved to the blood flow path between the connecting portion and the drip chamber is discharged. A third priming step for discharging from the road to the outside;
A fourth priming that discharges the priming liquid supplied from the priming liquid supply source to the blood supply flow path through the priming liquid supply flow path from the discharge flow path while rotating the blood pump forward or backward. Including a process,
Priming method. The blood treatment device is formed by forming a blood flow path through which blood flows and a dialysate flow path through which dialysate flows through a blood purification membrane,
In the fourth priming step, the priming liquid supplied from the priming liquid supply source to the blood supply flow path through the priming liquid supply flow path is rotated from the blood processor while rotating the blood pump forward or backward. Discharging from the blood flow path to the dialysate flow path through the blood purification membrane,
The priming method according to claim 8. A blood processing device filled with an initial filling liquid for processing blood in a specific manner, a blood supply channel for supplying blood taken from the body to the blood processing device, and a blood supply channel A blood pump capable of rotating forward and reverse for delivering the blood to the blood processor, a priming liquid supply source for supplying a priming liquid to the blood supply flow path, and an upstream side of the blood pump in the blood flow direction A priming fluid supply channel that connects the priming fluid supply source to a portion of the blood supply channel that is located in a blood supply channel, a blood return channel for returning blood treated by the blood processor, and the blood A drip chamber provided in the return flow path for preventing bubbles flowing through the blood return flow path from flowing into the body, and a priming solution and air from the drip chamber to the outside A discharge passage for discharging, a priming method using it are blood extracorporeal circulation apparatus comprising a,
During priming before treatment, the end of the blood supply channel opposite to the blood processor side is connected to the end of the blood return channel opposite to the blood processor side for communication. The blood treatment device is placed in a state where the blood introduction port faces upward, and the blood pump is stopped, and the blood is passed from the priming solution supply source through the priming solution supply channel. The priming liquid supplied to the supply flow path fills the blood flow path from the connection between the blood supply flow path and the priming liquid supply flow path to the drip chamber, and the blood supply flow path and the A first priming step of discharging the air that was present in the blood flow path between the connection portion with the priming liquid supply flow path to the drip chamber from the discharge flow path;
A second priming step in which the blood pump is rotated forward to guide the filling liquid filling the blood processing device from the blood outlet to the drip chamber;
The blood pump is rotated in the reverse direction so that the priming liquid in the blood flow path between the connection part of the blood supply flow path and the priming liquid supply flow path and the drip chamber and the priming liquid existing in the drip chamber are removed. Circulates upstream of the drip chamber in the blood flow direction, and air on the downstream side of the blood supply channel in the blood flow direction with respect to the connection portion with the priming liquid supply channel. A third priming step for moving the blood flow path between the drip chamber and the drip chamber;
By supplying priming liquid from the priming liquid supply source to the blood supply flow path through the priming liquid supply flow path, the air that has moved to the blood flow path between the connecting portion and the drip chamber is discharged. A fourth priming step for discharging from the road to the outside;
Fifth priming for discharging the priming liquid supplied from the priming liquid supply source to the blood supply flow path through the priming liquid supply flow path from the discharge flow path while rotating the blood pump forward or backward. Including a process,
Priming method. The blood treatment device is formed by forming a blood flow path through which blood flows and a dialysate flow path through which dialysate flows through a blood purification membrane,
In the fifth priming step, the priming liquid supplied from the priming liquid supply source to the blood supply flow path through the priming liquid supply flow path is rotated from the blood processor while rotating the blood pump forward or backward. Discharging from the blood flow path to the dialysate flow path through the blood purification membrane,
The priming method according to claim 10.

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