JP2012152289A - Blood purification device, and operation method of the same - Google Patents

Abstract

PROBLEM TO BE SOLVED: To stably measure a blood pressure by shortening the stop time of the flow of blood inside a blood supply flow path.SOLUTION: A hemodialysis apparatus 1 includes: a blood purifier 10; a blood supply flow path 12 for supplying blood from an arterial puncture needle 11 to the blood purifier 10; a blood return flow path 14 for returning the blood from the blood purifier 10 to a venipuncture needle 13; a blood pump 15 provided on the blood supply flow path 12 and capable of intermittently sending out the blood to the blood purifier 10; a pressure measuring device 16 for measuring a pressure in a position upstream from the blood pump 15 inside the blood supply flow path 12 while sending of the blood by the blood pump 15 is stopped; and a solenoid valve 17 for opening and closing between a pressure measuring position A by the pressure measuring device 16 in the blood supply flow path 12 and the blood pump 15.

Description

  The present invention relates to a blood purification apparatus and a method for operating the blood purification apparatus.

  For example, blood pressure can often suddenly drop during hemodialysis. Lowering blood pressure is undesirable for patients. In order to detect this decrease in blood pressure early, it is necessary to measure blood pressure frequently and ideally continuously during hemodialysis. The most commonly performed method is to measure the blood pressure intermittently but frequently by keeping the manchette wrapped around the upper limb with a sphygmomanometer using a manchette. Measurements by this method are limited to every 15 minutes at most, and if it is performed more frequently, the patient feels uncomfortable or the manchette causes congestion in the upper limbs. In addition, this method has a problem that the patient is uncomfortable with both upper limbs restrained because the manchette must be wound around the upper limb opposite to the shunt side where puncture for dialysis is performed.

Kazumi Kikuchi, et al., Pre-Post Hospital Care, 2003, 13, 43-53

  Therefore, as a method for measuring blood pressure during hemodialysis more frequently using the upper limb of the shunt side, blood in the blood supply flow path 122 connecting the arterial puncture needle 120 and the dialysis purifier 121 as shown in FIG. There is a method in which a pressure measuring device 124 is provided upstream of the pump 123, the blood pump 123 is intermittently stopped during hemodialysis, the pressure in the blood supply channel 122 is measured, and the blood pressure is thereby measured. Proposed. This method is based on the fact that the pressure in the blood supply channel 122 is equal to the shunt blood pressure in a state where blood is not circulating, and that the shunt blood pressure is proportional to the blood pressure. According to this method, since it is not necessary to wrap a manchette, blood pressure can be measured at any time without causing discomfort to the patient.

  However, in this method, it is necessary to stop the blood pump 123 and stop the blood flow during dialysis. However, if the time during which the blood pump 123 is stopped is too short, the blood supply flow path 122 generated when the pump is stopped Due to pulsation, expansion and contraction, vibration, pressure fluctuation in the blood supply channel 122, etc., the pressure in the blood supply channel 122 is not stable, and the blood pressure cannot be measured stably. On the other hand, if the time during which the blood pump 123 is stopped is too long, the blood may coagulate in the blood purifier 121 or the like, which is not preferable.

  The present invention has been made in view of the above points, and shortens the stop time of blood flow by a blood delivery device such as a blood pump to stabilize blood pressure while suppressing coagulation of blood in the blood purifier. An object of the present invention is to provide a blood purification device that can be measured and a method for operating the blood purification device.

  The present invention for achieving the above object is a blood purification apparatus, comprising a blood purification device for purifying blood, a blood supply channel for supplying blood to the blood purification device from an arterial puncture needle, and the blood A blood return channel for returning blood from the purifier to the venipuncture needle, a blood delivery device provided on the blood supply channel and capable of intermittently delivering blood to the blood purifier, and the blood delivery device A pressure measuring device that measures the pressure in the blood supply channel upstream of the blood delivery device while the blood delivery by the blood pressure is stopped, a pressure measurement position by the pressure measurement device, and the blood delivery device. And an opening / closing device that opens and closes the blood supply channel.

  According to the present invention, when the blood delivery by the blood delivery device is stopped for pressure measurement, the gap between the pressure measurement position of the blood supply channel and the blood delivery device can be closed by the opening / closing device. The blood supply flow path around the position and the internal behavior converge in a short time. Thereby, the pressure in the blood supply channel is stabilized in a short time, and the pressure measurement by the pressure measuring device can be performed immediately. As a result, a stable pressure measurement can be performed while shortening the stop time of blood flow in the blood supply channel and suppressing coagulation of blood in the blood purifier.

  The blood purification device closes the blood supply channel by the opening / closing device and intermittently measures the pressure of the blood supply channel by the pressure measuring device when blood delivery by the blood delivery device is intermittently stopped You may have a control apparatus. Thereby, intermittent measurement of the pressure of the blood supply channel during blood purification is stably and automatically performed.

  The control device may control the intermittent stop time of the blood delivery within 4 seconds or more and 15 seconds or less. If the intermittent stop time of the blood delivery is 4 seconds or more, the pressure can be measured after the pressure in the blood supply channel is reliably stabilized, while the intermittent blood delivery is If the stop time is within 15 seconds, the pressure in the blood supply channel can be measured while reliably suppressing the coagulation of blood in the blood purifier.

  The pressure measurement device may include a pressure detection unit, and a pressure detection channel that communicates the pressure detection unit and the blood supply channel.

  The control device may include another opening / closing device that opens and closes the pressure detection flow path. In such a case, even when the pressure in the blood supply channel upstream of the blood delivery device is negative when the blood delivery device during blood purification is delivering blood, the pressure is Air in the detection channel is prevented from entering the blood supply channel.

  The inner diameter of the pressure detection channel may be 2 mm or less.

  The blood supply flow channel side in the pressure detection flow channel is filled with liquid, the pressure detection unit side is filled with air, and a boundary surface between the liquid and air exists in the pressure detection flow channel. Also good. In such a case, the liquid in the pressure detection flow path connected to the blood in the blood supply flow path is in contact with the pressure detection section, thereby effectively preventing the risk of blood being contaminated by bacteria or the like. .

  The blood purification apparatus may further include a height maintaining mechanism that maintains a boundary surface between the liquid and air in the pressure detection flow path at a constant height. In such a case, the height of the boundary surface between the liquid and the air in the pressure detection flow path does not change even when the air in the pressure detection flow path contracts or expands due to the pressure fluctuation. The pressure measurement by the pressure measuring device is accurately performed.

  The height maintaining mechanism may be an air chamber provided in the pressure detection flow path.

  The height maintaining mechanism may be a mechanism that maintains a region of the pressure detection flow path where a boundary surface between the liquid and air exists at a certain height. In such a case, even if the boundary surface between the liquid and air in the pressure detection flow path moves in the pressure detection flow path due to the compression and expansion of air due to pressure fluctuation, Pressure measurement is not affected.

  The blood purification apparatus may have a function of correcting a measurement value measured by the pressure detection unit based on a height of a boundary surface between the liquid and air in the pressure detection channel with respect to a shunt blood vessel. Good. In such a case, the measurement value measured by the pressure detection unit, which has been underestimated by the height of the boundary surface between the liquid and air in the pressure detection channel with respect to the shunt blood vessel, is proportional to the blood pressure. The pressure value of the blood supply channel at the same height as the blood vessel can be corrected.

  The blood purification apparatus closes the pressure detection flow path leading to the blood supply flow path and releases the pressure detection section to the atmosphere when the blood pressure during the blood purification process is not measured in the pressure measurement apparatus. By adjusting the zero point correction and / or the pressure detector to an electrolyte solution bag whose height is known in advance, the pressure is adjusted with a hydrostatic pressure corresponding to the height difference from the liquid level in the electrolyte solution bag. You may make it do.

  The blood purification apparatus uses the ratio between the actually measured blood pressure input and the pressure in the blood supply channel measured by the pressure measuring apparatus at the time of the actual measurement, and is subsequently measured by the pressure measuring apparatus. You may have the calculating part which calculates a blood pressure from the pressure of the said blood supply flow path. In this case, in the state where the blood does not flow through the blood supply channel, the pressure in the blood supply channel is equal to the shunt blood pressure, and the shunt blood pressure is proportional to the blood pressure. If the blood pressure is measured only once immediately after the start, the ratio between the measured blood pressure and the pressure in the blood supply channel measured by the pressure measuring device is used, and then the pressure measuring device measures the blood pressure. The blood pressure can be calculated from the pressure in the blood supply channel.

  The blood purification apparatus may include a display unit that displays the blood pressure calculated by the calculation unit.

  Another aspect of the present invention is a method for operating a blood purification apparatus, the blood purification apparatus comprising: a blood purification device for purifying blood; and a blood supply for supplying blood to the blood purification device from an arterial puncture needle A blood delivery device provided on the blood supply channel and intermittently delivering blood to the blood purification device, the blood return channel for returning blood from the blood purification device to the venipuncture needle A pressure measuring device that measures the pressure in the blood supply channel upstream of the blood delivery device while blood delivery by the blood delivery device is stopped, and a pressure measurement position by the pressure measurement device, An open / close device that opens and closes the blood supply channel with the blood delivery device, intermittently stops the blood delivery by the blood delivery device, and on the upstream side of the blood delivery device, Blood delivery By the opening and closing device with location of stop to close the blood supply passage, the control device is operated to measure the pressure of the blood supply channel by the pressure measuring device.

  The control device may control the intermittent stop time of the blood delivery within 4 seconds or more and 15 seconds or less.

  The control device is configured to measure the pressure of the blood supply channel measured by the pressure measurement device based on a ratio between the actually measured blood pressure and the pressure of the blood supply channel measured by the pressure measurement device at the time of the actual measurement. The blood pressure may be calculated from the above.

  The pressure measuring device includes a pressure detection unit, and a pressure detection channel that communicates the pressure detection unit and the blood supply channel, and the blood purification device opens and closes the pressure detection channel. The control device further includes another opening / closing device, and when the blood delivery is stopped, the control device opens the pressure detection flow path by the other opening / closing device, and at the time of the blood delivery, the other opening / closing device The pressure detection flow path may be closed.

  According to the present invention, blood pressure can be measured frequently and stably using a blood purification apparatus.

It is explanatory drawing which shows the outline of a structure of the hemodialysis apparatus. It is explanatory drawing which shows the interface of the liquid and air in the flow path for pressure detection. It is explanatory drawing which shows the state of the hemodialysis apparatus at the time of pressure measurement. It is explanatory drawing which shows the flow path for pressure detection with an air chamber. It is a graph which shows the result of the shunt blood pressure measurement of the evaluation case 1. It is a graph which shows the result of the shunt blood pressure measurement of the evaluation case 2. It is explanatory drawing which shows the structure of the hemodialysis apparatus before improvement.

  Hereinafter, an example of an embodiment of the present invention will be described with reference to the drawings. FIG. 1 is an explanatory diagram showing an outline of the configuration of a hemodialysis apparatus 1 as a blood purification apparatus according to the present embodiment.

  The hemodialysis apparatus 1 includes a blood purifier 10 for purifying blood, a blood supply channel 12 for supplying blood from the arterial puncture needle 11 to the blood purifier 10, and blood from the blood purifier 10 to the vein puncture needle 13. A blood return channel 14 for returning the blood, a blood pump 15 provided on the blood supply channel 12 and serving as a blood delivery device for delivering blood to the blood purifier 10, A pressure measuring device 16 that measures the pressure upstream of the blood pump 15, and an electromagnetic valve 17 as an opening / closing device that opens and closes between the blood pump 15 and the pressure measurement position A by the pressure measuring device 16 in the blood supply channel 12. Etc.

  The blood purifier 10 is, for example, a hollow fiber module that incorporates a hollow fiber membrane 18. Blood is passed through the primary side 10 a of the membrane 18, dialysate is passed through the secondary side 10 b, and unnecessary in the blood on the primary side 10 a. The substance can be taken into the dialysate on the secondary side 10b through the membrane 18 to dialyze the blood.

  For example, soft tubes are used for the blood supply channel 12 and the blood return channel 14. The blood pump 15 is, for example, a tube pump, and can handle the tube of the blood supply flow path 12 to pump blood to the blood purifier 10 side.

  A drip chamber 30 is provided between the blood pump 15 in the blood supply channel 12 and the blood purifier 10. The blood return flow path 14 is provided with a drip chamber 31, and the drip chamber 31 is provided with a venous pressure sensor 32.

  The pressure measurement device 16 includes, for example, a pressure detection unit 40 and a pressure detection channel 41 that connects the pressure detection unit 40 and the pressure measurement position A of the blood supply channel 12. The pressure detection unit 40 is, for example, an atmospheric pressure sensor. The pressure detection channel 41 is formed of a tube having an inner diameter of 2 mm or less, which is smaller than the blood supply channel 12. The blood supply channel 12 side in the pressure detection channel 41 is filled with liquid, and the pressure detection unit 40 side is filled with air. The boundary surface is formed. Therefore, the pressure measuring device 16 can measure the pressure in the blood supply channel 12 by converting the fluid pressure into the atmospheric pressure.

  FIG. 2 shows a boundary surface 44 between the liquid and air in the pressure detection channel 41. When the pressure detection channel 41 is formed of a tube having an inner diameter of 2 mm or less, a boundary surface 44 between the liquid and air is formed at a right angle to the direction of the pressure detection channel 41.

  The region of the pressure detection flow path 41 where the boundary surface 44 between the liquid and air exists is spirally wound, for example, as shown in FIG. 1 to form a spiral pressure detection flow path portion 41a. And even if the boundary surface 44 between the liquid and air moves in the spiral pressure detection flow path 41a with the compression or expansion of the air due to the pressure fluctuation, the height of the boundary surface 44 does not change. As described above, the spiral pressure detection flow path portion 41a is fixed so that the spiral surface is horizontal. In the present embodiment, the spiral pressure detection flow path portion 41a constitutes a height maintaining mechanism that maintains the boundary surface 44 at a constant height.

  An electromagnetic valve 42 as another opening / closing device is provided in the vicinity of the blood supply channel 12 of the pressure detection channel 41.

The pressure information detected by the pressure detection unit 40 is output to the control device 50. The control device 50 is, for example, a general-purpose computer, and includes a storage unit 51, a calculation unit 52, a display unit 53, and the like. The storage unit 51 stores, for example, the detected pressure information of the blood supply channel 12, and the calculation unit 52 can calculate the blood pressure of the patient from the pressure information. The blood pressure is calculated by, for example, the blood supply flow path corrected by the blood pressure of the patient stored in the storage unit 51 and the height of the boundary surface between the liquid and air in the pressure detection flow path 41 with respect to the shunt blood vessel. This is done using a ratio of 12 pressures. Hereinafter, it is assumed that “the pressure of the blood supply channel 12” is corrected by the height of the boundary surface between the liquid and the air in the pressure detection channel 41 with respect to the shunt blood vessel. For example, the ratio R (R) of the blood pressure B of the patient measured and input immediately before the start of hemodialysis and the pressure C of the blood supply channel 12 measured using the pressure measuring device 16 at the time of the actual measurement. = B / C) is used. Therefore, the blood pressure (mmHg) at the time of hemodialysis is, for example, the mercury column pressure (mmHg) detected by the pressure detection unit 40 and the height of the boundary surface between the liquid and air in the pressure detection channel 41 with respect to the shunt blood vessel. The mercury column pressure (mmHg) converted from the water column pressure (cmH ₂₀ ) corresponding to the thickness is added, and this value is multiplied by the ratio R. The peak value and the bottom value of the pressure wave in the blood supply channel 12 correspond to the systolic blood pressure and the diastolic blood pressure, respectively.

  The display unit 53 can display the calculated blood pressure of the patient in real time. Further, the display unit 53 may display the temporal change of the calculated blood pressure of the patient.

  The control device 50 also controls the operation of the entire hemodialysis device 1. The control device 50 can control the operation of the blood pump 15, the electromagnetic valve 17, the pressure measuring device 16, the electromagnetic valve 42, etc., and can perform hemodialysis processing and blood pressure measurement of the patient during the hemodialysis processing.

  Next, an operation method of the hemodialysis apparatus 1 configured as described above will be described together with a hemodialysis process.

  As shown in FIG. 1, with the electromagnetic valve 42 closed and the electromagnetic valve 17 opened, the blood pump 15 is operated, and the blood of the patient passes from the arterial puncture needle 11 through the blood supply flow path 12 to the blood purifier. 10 is sent. In blood purifier 10, unnecessary substances in the blood are removed. The blood purified through the blood purifier 10 is returned to the patient from the venipuncture needle 13 through the blood return channel 14.

During this hemodialysis treatment, the patient's blood pressure is measured intermittently, for example, once every 5 minutes.
The blood pressure measurement of a patient is performed as follows, for example. First, as shown in FIG. 3, the blood pump 15 is stopped and the delivery of blood in the blood supply channel 12 is stopped. This stops blood flow. At the same time, the electromagnetic valve 17 is closed, and the upstream side of the blood pump 15 in the blood supply channel 12 is closed. Further, the electromagnetic valve 42 is opened, and the pressure detection flow path 41 is opened. Thereafter, the pressure detection unit 40 detects the pressure at the pressure measurement position A in the blood supply channel 12, and the pressure information is output to the control device 50. The calculation unit 52 of the control device 50 calculates the patient's blood pressure from the pressure information based on the ratio R between the patient's blood pressure and the pressure in the blood supply channel 12 stored in advance in the storage unit 51. At this time, the peak value and the bottom value of the pressure wave in the blood supply channel 12 become the systolic blood pressure and the diastolic blood pressure, respectively. The calculated patient pressure is displayed on the display unit 53 in real time.

  The blood delivery stop time for pressure measurement is controlled within 4 seconds to 15 seconds, for example. After a certain stop time elapses, the solenoid valve 42 is closed, the solenoid valve 17 is opened, and then the blood pump 15 is restarted to resume blood delivery.

  According to the present embodiment, the blood pump 15 can be closed on the upstream side of the blood pump 15 in the blood supply channel 12 by the electromagnetic valve 17 when the blood pump 15 stops sending blood for pressure measurement. The pressure change in the blood supply channel 12 and the vibration of the blood supply channel 12 itself, etc. caused by the stoppage of the blood supply channel 12 are cut off there, and the behavior of the blood supply channel 12 around the pressure measurement position A and its interior can be shortened. Converge. Thereby, the pressure in the blood supply channel 12 is stabilized in a short time, and the pressure measurement by the pressure measuring device 16 can be performed immediately. As a result, it is possible to perform a stable pressure measurement while shortening the stop time of blood flow in the blood supply channel 12 and suppressing blood coagulation in the blood purifier 10 or the like.

  Since the pressure measurement device 16 includes the pressure detection unit 40 and the pressure detection flow channel 41, it is possible to appropriately measure the pressure without disturbing the blood flow in the blood supply flow channel 12.

  Since the hemodialysis apparatus 1 includes the electromagnetic valve 42 that opens and closes the pressure detection channel 41, for example, when the blood pump 15 is in operation during hemodialysis, the blood supply channel upstream of the blood pump 15 is used. Even when the pressure in the pressure 12 is equal to or lower than the atmospheric pressure, the air in the pressure detection channel 41 can be prevented from entering the blood supply channel 12.

  In the hemodialysis apparatus 1, since the inner diameter of the pressure detection channel 41 is 2 mm or less, the behavior of the pressure detection channel 41 when the blood pump 15 is stopped is also stabilized in a short time. For this reason, the pressure measurement can be started immediately after the blood delivery is stopped. Furthermore, when the inner diameter of the pressure detection channel 41 is 2 mm or less, the liquid and air in the pressure detection channel 41 form a boundary surface 44 perpendicular to the pressure detection channel. That is, an air layer is not formed in the upper part in the cross section of the pressure detection channel 41, and a liquid layer is not formed in the lower part. Accordingly, no liquid flows into the pressure measuring device 16.

  The control device 50 intermittently stops the blood delivery by the blood pump 15, closes the blood supply channel 12 using the electromagnetic valve 17 when the control stops, and causes the pressure measuring device 16 to measure the pressure of the blood supply channel 12. Therefore, the pressure measurement process can be performed automatically and appropriately.

  Since the control device 50 controls the intermittent stop time of the blood delivery within 4 seconds or more and 15 seconds or less, the pressure in the blood supply channel 12 is surely stabilized and reliably in the blood purifier 10 or the like. The pressure in the blood supply channel 12 can be measured while suppressing blood coagulation.

  The control device 50 determines the blood supply flow measured by the pressure measuring device 16 based on the ratio R between the actually measured blood pressure inputted and the pressure of the blood supply channel 12 measured by the pressure measuring device 16 at the time of the actual measurement. It has the calculating part 52 which calculates a blood pressure from the pressure of the path | route 12. Thereby, blood pressure can be calculated easily and accurately.

  The control device 50 includes a display unit 53 that displays the calculated blood pressure. Thereby, a patient's blood-pressure state can be confirmed timely.

  Since the spiral pressure detection flow path portion 41a is formed to maintain the area of the pressure detection flow path 41 where the boundary surface 44 between the liquid and air exists at a constant height, the height of the boundary surface 44 is The pressure detection by the pressure detector 40 can be performed stably and accurately without fluctuation.

  The height maintaining mechanism for maintaining the boundary surface 44 between the liquid and air in the pressure detection channel 41 at a constant height is an air chamber provided in the pressure detection channel 41 as shown in FIG. 60 may be sufficient. In such a case, by fixing the air chamber 60 to the outer wall or the like of the hemodialysis apparatus 1, the boundary surface 44 between the liquid and the air in the detection flow channel 41 can be maintained at a constant height.

  In the above embodiment, the detected pressure of the pressure measuring device 16 is corrected based on the height of the boundary surface 44 between the liquid and air in the pressure detection flow channel 41 with respect to the shunt blood vessel. That is, by adding a hydrostatic pressure corresponding to the height of the boundary surface 44 between the liquid and air in the pressure detection flow channel 41 with respect to the shunt blood vessel stored in the storage unit 51 to the detection pressure of the pressure measuring device 16, The pressure of the blood supply channel 12 at the same height as the shunt blood vessel can be measured more accurately.

  In the above-described embodiment, when the pressure detection flow channel 41 is closed with respect to the blood supply flow channel 12 when the blood pressure is not measured during the hemodialysis process, the pressure detection unit 40 is released to the atmosphere. The zero point may be adjusted by doing so. As a result, abnormal pressure detection due to long-term use can be prevented. Further, by connecting the pressure detection channel 41 via the electrolyte solution back and the electrolyte solution supply channel whose height is known in advance, the difference in level between the pressure detection channel 41 and the electrolyte solution bag is caused. The detection value of the pressure detector 40 may be corrected with the hydrostatic pressure. Further, both of these corrections may be performed, and the pressure correction accuracy can be further improved by the two-point correction. The electrolyte solution bag can be used when supplying the electrolyte solution to the blood supply channel 12 at the time of blood collection at the end of hemodialysis.

  The preferred embodiments of the present invention have been described above with reference to the accompanying drawings, but the present invention is not limited to such examples. It is obvious for those skilled in the art that various modifications or modifications can be conceived within the scope of the idea described in the claims, and these naturally belong to the technical scope of the present invention. It is understood. For example, the opening / closing device is not limited to a solenoid valve. Further, the mechanism for maintaining the pressure detection flow path in the region where the boundary surface between the liquid and air exists at the same height is not limited to the spiral pressure detection flow path portion 41 a or the air chamber 60. Furthermore, the present invention can be applied to blood purification apparatuses other than hemodialysis apparatuses.

(Experiment 1)
As a comparative example, an air chamber is provided in the pressure detection flow path 41, the inner diameter of the pressure detection flow path 41 is 4.7 mm, and the blood supply flow path 12 does not include the electromagnetic valve 17. A dialysis device (hereinafter referred to as “comparative hemodialysis device 100”) was produced. As the hemodialysis apparatus 1 according to the present invention, an air chamber 60 is provided in the pressure detection channel 41, the inner diameter of the pressure detection channel 41 is 1 mm, and the blood supply flow is stopped when the blood pump 15 is stopped. The thing which the solenoid valve 17 of the path | route 12 closes was used. Blood purification therapy was performed on 6 terminal maintenance dialysis patients using the hemodialysis apparatus 1 of the present invention and the comparative hemodialysis apparatus 100, respectively. Then, after the blood pump 15 is stopped during the blood purification process, the pressure of the blood supply channel 12 is measured by the pressure detection unit 40, and the blood monitored by the pressure detection unit 40 from the time when the blood pump 15 is stopped. The time until the pressure of the supply flow path 12 was stabilized was measured.

As a result, in the comparative hemodialysis apparatus 100, the time from when the blood pump 15 is stopped until the pressure of the blood supply channel 12 monitored by the pressure detection unit 40 is stabilized is 17.7 ± 3. It was 4 seconds. In contrast, in the hemodialysis apparatus 1 according to the present invention, the time from when the blood pump 15 is stopped until the pressure of the blood supply flow path 12 monitored by the pressure detection unit 40 is stabilized is 5.5. ± 1.1 seconds. There was a significant difference between the two when P (probability) (established that there was a difference between the two groups) <0.001. That is, shortening of the relaxation time due to factors such as pulsation, expansion / contraction, and vibration of the blood supply channel 12 has been clarified, and highly accurate measurement can be performed in a short time. As a result, in the present invention, the time during which the blood pump 15 is stopped can be shortened, so that the blood can be effectively prevented from coagulating in the blood purifier 10 and the like. It shows that a more obvious pressure change curve can be obtained.
(Evaluation case 1)
In patients with end-stage renal failure hemodialysis (female, 74 years old, dialysis history 4 years), a manchette is wrapped around the upper arm of the arm opposite to the shunt limb, and intermittent systolic and diastolic blood pressure during blood purification treatment The mean blood pressure was calculated from these blood pressures using the following formula (1). This calculated value is taken as the actual average blood pressure.

Actual mean blood pressure = (systolic blood pressure−diastolic blood pressure) / 3 + diastolic blood pressure (1)
Simultaneously with the blood pressure measurement, in the hemodialysis apparatus 1 shown in FIG. 1, the average of the blood supply flow path 12 corrected by the height of the boundary surface between the liquid and air in the pressure detection flow path 41 with respect to the shunt blood vessel. The pressure was measured. Hereinafter, the “average pressure in the blood supply channel 12” is corrected by the height of the boundary surface between the liquid and air in the pressure detection channel 41 with respect to the shunt blood vessel. Using the ratio R1 of the measured average blood pressure to the average pressure of the blood supply channel 12 at the first measurement (measured average blood pressure at the first measurement ÷ average pressure of the blood supply channel at the first measurement), the equation (2) The measured average blood pressure was calculated by converting the average pressure of the blood supply channel 12 measured thereafter to the average blood pressure. Measurement average blood pressure = R1 × corrected blood supply channel average pressure (2)
However, R1 is the ratio of the measured average blood pressure to the average pressure of the blood supply channel 12 at the time of the first measurement.

As shown in FIG. 5, the measured average blood pressure coincided with the actually measured average blood pressure.
(Evaluation case 2)
In patients with end-stage renal failure hemodialysis (female, 66 years old, 6 years of dialysis), a manchette is wrapped around the upper arm of the arm opposite the shunt limb, and intermittent systolic and diastolic blood pressure during blood purification treatment Measured mean blood pressure was calculated from these blood pressures using the above equation (1).

  Simultaneously with the blood pressure measurement, in the hemodialysis apparatus 1 shown in FIG. 1, the average pressure in the blood supply channel 12 is measured, and the measured average blood pressure is calculated from the average pressure in the blood supply channel 12 by the above equation (2). Calculated.

  As shown in FIG. 6, the estimated mean blood pressure also coincided with the actually measured mean blood pressure in this patient. Thus, according to this invention, it was confirmed that the change of a blood pressure can be grasped | ascertained without a patient's burden.

DESCRIPTION OF SYMBOLS 1 Hemodialysis apparatus 10 Blood purifier 11 Arterial puncture needle 12 Blood supply circuit 13 Venous puncture needle 14 Blood return circuit 15 Blood pump 16 Pressure measuring device 17 Electromagnetic valve 40 Pressure detection part 41 Pressure detection flow path 41a For spiral pressure detection Flow path part 42 Solenoid valve 44 Interface 50 Control device 51 Storage part 52 Calculation part 53 Display part A Pressure measurement position

Claims (18)

A blood purification device,
A blood purifier that purifies the blood;
A blood supply flow path for supplying blood from the arterial puncture needle to the blood purifier;
A blood return channel for returning blood from the blood purifier to the venipuncture needle;
A blood delivery device provided on the blood supply flow path and capable of intermittently delivering blood to the blood purifier;
A pressure measuring device for measuring the pressure in the blood supply channel upstream of the blood delivery device while the blood delivery by the blood delivery device is stopped;
A blood purification device comprising: an opening / closing device that opens and closes the blood supply channel between a pressure measurement position by the pressure measurement device and the blood delivery device.   And a controller that closes the blood supply channel using the opening / closing device and further measures the pressure of the blood supply channel using the pressure measuring device when blood delivery is intermittently stopped by the blood delivery device. Item 2. The blood purification apparatus according to Item 1.   The blood purification apparatus according to claim 2, wherein the control device controls the intermittent stop time of the blood delivery within 4 seconds or more and 15 seconds or less.   The blood purification apparatus according to claim 1, wherein the pressure measuring device includes a pressure detection unit, and a pressure detection channel that communicates the pressure detection unit with the blood supply channel.   The blood purification apparatus according to claim 4, further comprising another opening / closing device that opens and closes the pressure detection flow path.   The blood purification apparatus according to claim 4 or 5, wherein an inner diameter of the pressure detection channel is 2 mm or less.   The blood supply flow channel side in the pressure detection flow channel is filled with liquid, the pressure detection unit side is filled with air, and a boundary surface between the liquid and air exists in the pressure detection flow channel. The blood purification apparatus according to any one of claims 4 to 6.   The blood purification apparatus according to claim 7, further comprising a height maintaining mechanism for maintaining a boundary surface between the liquid and air in the pressure detection flow path at a constant height.   The blood purification apparatus according to claim 8, wherein the height maintaining mechanism is an air chamber provided in the pressure detection flow path.   The blood purification apparatus according to claim 8, wherein the height maintaining mechanism is a mechanism that maintains a region of the pressure detection flow path where a boundary surface between the liquid and air exists at a constant height.   The measurement value measured by the pressure detection unit has a function of correcting the measurement value by the height of the boundary surface between the liquid and air in the pressure detection flow path with respect to the shunt blood vessel. The blood purification apparatus as described.   In the pressure measuring device, when the blood pressure during the blood purification process is not measured, the pressure detection flow path leading to the blood supply flow path is closed, and the pressure detection unit is released to the atmosphere. Alternatively, the pressure is adjusted by a hydrostatic pressure corresponding to a difference in height from the liquid level in the electrolyte liquid bag by communicating the pressure detection unit with an electrolyte liquid bag whose height is known in advance. The blood purification apparatus according to any one of 11.   Using the ratio between the actually measured blood pressure input and the pressure in the blood supply channel measured by the pressure measuring device at the time of the actual measurement, the blood supply channel measured later by the pressure measuring device The blood purification apparatus according to claim 1, further comprising an arithmetic unit that calculates blood pressure from pressure.   The blood purification apparatus according to claim 13, further comprising a display unit that displays the blood pressure calculated by the calculation unit. A method of operating a blood purification device,
The blood purification device comprises:
A blood purifier that purifies the blood;
A blood supply flow path for supplying blood from the arterial puncture needle to the blood purifier;
A blood return channel for returning blood from the blood purifier to the venipuncture needle;
A blood delivery device provided on the blood supply flow path and capable of intermittently delivering blood to the blood purifier;
A pressure measuring device for measuring the pressure in the blood supply channel upstream of the blood delivery device while the blood delivery by the blood delivery device is stopped;
An open / close device that opens and closes the blood supply channel between a pressure measurement position by the pressure measurement device and the blood delivery device,
The blood delivery by the blood delivery device is intermittently stopped, and at the upstream side of the blood delivery device, the blood supply channel is closed by the opening / closing device together with the stop of the blood delivery device, and the pressure measuring device A method for operating a blood purification apparatus, wherein a control device for measuring the pressure of a blood supply channel is operated.   The operation method of the blood purification apparatus according to claim 15, wherein the control device controls an intermittent stop time of the blood delivery within 4 seconds or more and 15 seconds or less.   The control device is configured to measure the pressure of the blood supply channel measured by the pressure measurement device based on a ratio between the actually measured blood pressure and the pressure of the blood supply channel measured by the pressure measurement device at the time of the actual measurement. The blood pressure is calculated from the blood purification apparatus according to claim 15 or 16. The pressure measuring device includes a pressure detection unit, and a pressure detection channel that communicates the pressure detection unit and the blood supply channel,
The blood purification device further includes another opening / closing device that opens and closes the pressure detection flow path,
The control device opens the pressure detection flow channel by the other switching device when the blood delivery is stopped, and closes the pressure detection flow channel by the other switching device when the blood is delivered. The operating method of the blood purification apparatus in any one of Claims 15-17.

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