JP2014097197A - Blood purification system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a blood purification system capable of grasping whether or not a predetermined process in a non-dialysis treatment process has been performed reliably and sufficiently.SOLUTION: In a blood purification system provided with a dialysis monitoring device 1 to which a dialyzer 17 is fitted and in which a predetermined non-dialysis treatment process is performed in a period of time when a dialysis treatment by the dialyzer 17 is not performed, and a dialysis fluid supply device 2 capable of supplying the dialysis monitoring device 1 with a dialysis fluid, a predetermined cleaning fluid or a chemical solution, or a predetermined fluid consisting of hot water for sterilization, in which the dialysis fluid is supplied to the dialysis monitoring device 1 from the dialysis fluid supply device 2 and the dialysis treatment is performed in the dialysis treatment process includes detection means 9 capable of detecting that the predetermined fluids have circulated in piping inside the dialysis monitoring device 1, and determination means 8 for determining whether or not it is detected by the detection means 9 that the predetermined fluids have circulated in the non-dialysis treatment process.

Description

  The present invention comprises a blood purification means to which a blood purifier for performing dialysis treatment on a patient is attached, and a liquid supply means capable of supplying dialysate, disinfectant, etc. to the blood purification means, and in the dialysis treatment step The present invention relates to a blood purification system in which dialysate is supplied from a liquid supply means to blood purification means to perform dialysis treatment.

  In general, a blood purification system has a RO water production device, a dissolution device, and a dialysate supply device installed in a machine room in a medical field such as a hospital, and is used for dialysis in a dialysis room (treatment room), which is a different place. A monitoring device is installed, and the dialysate supply device and the dialysis monitoring device are connected by a pipe. The dialysis fluid supply device creates dialysis fluid of a predetermined concentration from the dialysis fluid stock solution produced by the dissolution device, while multiple dialysis monitoring devices are installed corresponding to the number of patients undergoing dialysis treatment. Then, the dialysate prepared by the dialysate supply device is supplied to the blood purifier (dialyzer) of each dialysis monitoring device via a pipe.

  That is, the dialysis fluid supply device installed in the machine room is distributed to a plurality of dialysis monitoring devices installed in the dialysis chamber, and the dialysis fluid is sent, and the dialysis fluid is supplied to the dialyzer in each. It is. In this way, the blood purification system that distributes the dialysate produced in the machine room to each monitoring device for dialysis is usually referred to as a “central system for dialysis treatment”. What can be made is usually referred to as a “personal dialyzer”.

  However, conventionally, the dialysate supply device and each monitoring device for dialysis are electrically connected, and the dialysis treatment process performed at the time of dialysis treatment or the time zone when the dialysis treatment is not performed is performed. In the non-dialysis treatment process (pipe washing process or disinfection process), an electric signal (process signal) is transmitted from the dialysate supply device (supply means) to each dialysis monitoring device (blood purification means). Has been proposed (see, for example, Patent Document 1). Thus, when each dialysis monitoring device receives a predetermined electrical signal (process signal), an operation (such as driving a pump or opening / closing a solenoid valve) according to the signal is performed.

  Among these, in the non-dialysis treatment step, for example, a washing step and a chemical solution disinfection step for washing or disinfecting the piping of the monitoring device for dialysis are set, and a predetermined time zone (no dialysis treatment is performed). In the time zone), the dialysis fluid supply device supplies cleaning water, disinfectant solution, etc. to each dialysis monitoring device, and circulates in those pipes so that desired cleaning and disinfection are performed. .

JP 2004-16412 A

  However, in the conventional blood purification system, when the dialysis monitoring device is not linked to the dialysis fluid supply device, such as when the dialysis monitoring device is not turned on, the dialysis fluid supply device can Even if a process signal for the cleaning process or the chemical liquid disinfection process is transmitted to the monitoring device, the dialysis monitoring apparatus cannot be operated according to the process signal, and the cleaning and disinfection can be performed reliably. There was a possibility that it could not be performed sufficiently.

  That is, the conventional blood purification system unilaterally transmits process signals for cleaning and disinfection from the dialysate supply device to the monitoring device for dialysis. It is not known whether or not a predetermined liquid such as the liquid has circulated. However, it cannot be recognized that the state of washing and disinfection is insufficient, and there is a risk that the next dialysis treatment may be performed in that state, which may cause problems on hygiene. In addition, there is a possibility that such a problem may occur not only in the cleaning process and the chemical liquid disinfection process but also in other processes in the non-dialysis treatment process.

  The present invention has been made in view of such circumstances, and it is an object of the present invention to provide a blood purification system capable of grasping whether or not a predetermined process in a non-dialysis treatment process has been performed reliably and sufficiently.

  The invention according to claim 1 is a blood purification means in which a blood purifier for performing dialysis treatment on a patient is attached, and a predetermined non-dialysis treatment step is performed in a time zone when dialysis treatment by the blood purifier is not performed. And a liquid supply means capable of supplying the blood purification means with a predetermined liquid consisting of dialysate, predetermined washing liquid or chemical liquid, or hot water for disinfection, and from the liquid supply means in the dialysis treatment step In a blood purification system in which a predetermined liquid is supplied to the blood purification means and dialysis treatment is performed, a detection means capable of detecting that the predetermined liquid has flowed through a pipe inside the blood purification means, and the non-dialysis treatment And determining means for determining whether or not it has been detected that the predetermined liquid has been circulated by the detecting means during the process.

  According to a second aspect of the present invention, in the blood purification system according to the first aspect, the liquid supply means can transmit a process signal for causing the blood purification means to perform an arbitrary operation, and the liquid supply means The non-dialysis treatment process is discriminated based on the transmitted process signal.

  According to a third aspect of the present invention, in the blood purification system according to the first aspect, the blood purification means discharges the dialysate from the dialysate introduction line for introducing the dialysate into the blood purifier and the blood purifier. A bypass state detecting means for detecting that the dialysate discharge line is in a bypass state in which the tip of the dialysate introduction line and the tip of the dialysate discharge line are connected; The non-dialysis treatment process is discriminated by detecting a bypass state.

  According to a fourth aspect of the present invention, in the blood purification system according to any one of the first to third aspects, the detection means includes a sensor disposed in the blood purification means, and the sensor is in a pipe. Concentration detection sensor for detecting the concentration of the liquid, pH detection sensor for detecting the pH of the liquid, temperature detection sensor for detecting the temperature of the liquid, liquid pressure detection sensor for detecting the pressure of the liquid, or circulation of the liquid It is characterized by comprising a distribution detection sensor for detecting the presence or absence.

  According to a fifth aspect of the present invention, in the blood purification system according to the fourth aspect of the invention, the detection means diverts a sensor for detecting a predetermined parameter relating to the liquid flowing through the piping of the blood purification means during dialysis treatment. It is characterized by that.

  According to a sixth aspect of the present invention, in the blood purification system according to any one of the first to fifth aspects, the predetermined liquid is circulated by the detection means during the non-dialysis treatment step by the determination means. It is characterized in that a notification means for performing a predetermined notification is provided on the condition that it has been determined that has not been detected.

  According to the first aspect of the present invention, the detection means that can detect that the predetermined liquid has flowed through the piping inside the blood purification means, and that the predetermined liquid has been circulated by the detection means in the non-dialysis treatment step. Determination means for determining whether or not is detected, it is possible to grasp whether or not a predetermined step in the non-dialysis treatment step has been performed reliably and sufficiently.

  According to the invention of claim 2, the liquid supply means can transmit a process signal for causing the blood purification means to perform an arbitrary operation, and the non-dialysis treatment process by the process signal transmitted from the liquid supply means. Therefore, in the blood purification system in which the blood purification means operates according to the process signal, a separate means for discriminating the non-dialysis treatment process can be dispensed with.

  According to the invention of claim 3, the blood purification means includes a dialysate introduction line for introducing dialysate into the blood purifier, a dialysate discharge line for discharging dialysate from the blood purifier, and the dialysate introduction line. And a bypass state detecting means for detecting that the tip of the dialysate discharge line is connected to the tip of the dialysate discharge line, and the bypass state detecting means detects the bypass state, whereby the non-dialysis treatment step is performed. Thus, in the blood purification system including the bypass state detection means, a separate means for determining the non-dialysis treatment process can be dispensed with.

  According to the invention of claim 4, the detection means is composed of a sensor disposed in the blood purification means, and the sensor is a concentration detection sensor for detecting the concentration of the liquid in the pipe, and a pH for detecting the pH of the liquid. Since it comprises a detection sensor, a temperature detection sensor that detects the temperature of the liquid, a liquid pressure detection sensor that detects the pressure of the liquid, or a flow detection sensor that detects the presence or absence of the flow of the liquid, piping inside the blood purification means It is possible to more easily and accurately detect that a predetermined liquid has circulated.

  According to the invention of claim 5, since the detecting means is a sensor for detecting a predetermined parameter relating to the liquid flowing through the piping of the blood purification means during dialysis treatment, a separate sensor is added as the detecting means. There is no need, and manufacturing costs and running costs can be suppressed.

  According to the sixth aspect of the present invention, the notification means for performing the predetermined notification on condition that the determination means has determined that the predetermined liquid has not been detected by the detection means during the non-dialysis treatment step. Therefore, it is possible for a medical worker or the like to easily grasp whether or not a predetermined process in the non-dialysis treatment process has been performed reliably and sufficiently.

1 is an overall schematic diagram showing a blood purification system according to an embodiment of the present invention. Schematic diagram showing a dialysis monitoring device in the blood purification system (before the coupler is attached to the coupler receiver) Schematic diagram showing the coupler receiver (state before the coupler is attached) in the monitoring device for dialysis Schematic diagram showing a dialysis monitoring device (coupler attached to a coupler receiver) in the blood purification system Schematic diagram showing the coupler receiver (with the coupler attached) in the monitoring device for dialysis Schematic diagram showing a blood purifier attached at the time of dialysis treatment in the monitoring device for dialysis in the blood purification system Schematic diagram showing a state where the coupler is connected in the monitoring device for dialysis Schematic showing piping of monitoring device for dialysis in the blood purification system Flow chart showing control contents in the blood purification system Overall schematic view showing a blood purification system according to another embodiment of the present invention.

Hereinafter, embodiments of the present invention will be specifically described with reference to the drawings.
The blood purification system according to the present embodiment prepares a dialysate with a liquid supply means, supplies the dialysate to the blood purification means to perform dialysis treatment, and as shown in FIG. A plurality of dialysis monitoring devices 1 (blood purification means) installed in a dialysis room (treatment room) in the field, and a dialysate supply device 2 installed in a machine room, which is a place different from the dialysis room in the medical field. And the RO water production device 3 and the dissolution device 4. Note that the dialysate supply device 2 and the RO water production device 3 according to the present embodiment constitute the liquid supply device of the present invention.

  The dialysis monitoring device 1 (blood purification means) is provided with a dialyzer 17 (see FIGS. 6 and 8) as a blood purification device for performing hemodialysis treatment (dialysis treatment) on a patient and supplied from the dialysate supply device 2. The dialysis fluid is supplied to the dialyzer 17 to cause dialysis treatment, and a plurality of dialysis fluids are installed in the dialysis room. As shown in FIG. 6, the dialyzer 17 is formed with a blood inlet 17a, a blood outlet 17b, a dialysate inlet 17c, and a dialysate outlet 17d in the casing, and of these, the blood inlet 17a. Is connected to the proximal end portion of the arterial blood circuit α, and the blood outlet port 17b is connected to the proximal end portion of the venous blood circuit β. The dialysate introduction port 17c and the dialysate discharge port 17d are connected to the dialysate introduction line L1 and the dialysate discharge line L2 extending from the dialysis monitoring device 1 via the couplers C1 and C2, respectively.

  As shown in FIG. 6, the couplers C1 and C2 are each composed of a connector connected to the distal end of the dialysate introduction line L1 and the distal end of the dialysate discharge line L2, and these couplers C1 and C2 are introduced to the dialysate of the dialyzer 17, respectively. Each can be connected to the port 17c and the dialysate outlet port 17d. Further, in a state where dialysis treatment is not performed and the dialyzer 17 is not attached to the dialysis monitoring device 1, the couplers C1 and C2 are connected to each other as shown in FIG. Thus, a bypass state in which the tip of the dialysate introduction line L1 and the tip of the dialysate discharge line L2 are connected can be achieved.

  Here, as shown in FIGS. 2 and 4, the dialysis monitoring apparatus 1 according to the present embodiment includes a coupler receiver 11, a blood pump 12, a replacement fluid pump 13, a bubble detection sensor 14, and a display unit having a display screen. 15. It has warning light 16 etc. which consist of LED etc. The coupler receiver 11 includes a portion for mounting the couplers C1 and C2 in the bypass state as described above. As shown in FIG. 3, a bypass switch 10 as a bypass state detection unit is provided at the predetermined portion. Is formed.

  However, as shown in FIGS. 4 and 5, when the couplers C <b> 1 and C <b> 2 in the bypass state are placed on the coupler receiver 11, the bypass switch 10 is pressed and is electrically turned on. As shown in FIG. 1, the bypass switch 10 is connected to the control means 5 of the dialysate supply device 2 via an electrical wiring H2, and the dialysate supply device 2 uses the bypass switch in the dialysis monitoring device 1. 10 on / off states can be grasped. Thus, when the bypass switch 10 is turned on, it can be detected on the dialysate supply device 2 side that the couplers C1 and C2 are in the bypass state, and dialysis treatment is not performed (that is, , Dialyzer 17 is not connected).

  A plurality of hollow fiber membranes are accommodated in the dialyzer 17, and the hollow fiber membranes constitute a blood purification membrane for purifying blood. In such a hollow fiber membrane, the inside is a blood flow path and the outside (the flow path formed between the outer peripheral surface of the hollow fiber membrane and the inner peripheral surface of the case constituting the housing) is a dialysate flow path. Many hollows (pores) penetrating the outer peripheral surface and the inner peripheral surface of the hollow fiber membrane are formed.

  Thus, in the dialyzer 17, a blood flow path through which the patient's blood flows and a dialysate flow path through which the dialysate flows are formed through the hollow fiber membrane. The blood pump 12 (see FIG. 2) while the patient is punctured with the arterial puncture needle attached to the distal end of the arterial blood circuit α and the venous puncture needle attached to the distal end of the venous blood circuit β. By driving, the patient's blood circulates extracorporeally. In the extracorporeal circulation process, the blood flowing through the arterial blood circuit α passes through the blood flow path to reach the venous blood circuit β, and the dialysate flowing through the dialysate introduction line L1 It passes through the gas and reaches the dialysate discharge line L2, and impurities and the like in the blood can be purified by being filtered into the dialysate through the hollow fiber membrane.

  The dialysate introduction line L1 is connected to a pipe L (see FIG. 1) extending from the dialysate supply device 2, and the dialysate discharge line L2 is connected to a drain means (not shown). The dialysate supplied from the supply device 2 passes through the dialysate introduction line L1 and reaches the dialysate flow path of the dialyzer 17, and then is sent to the drainage means through the dialysate discharge line L2. In the dialysate introduction line L1 and the dialysate discharge line L2, as shown in FIG. 8, a dual pump 18 for feeding dialysate is disposed.

  In addition, two filtration filters 19 for purifying the dialysate are connected between the dual pump 18 (suction side) and the dialyzer 17 in the dialysate introduction line L1. A bypass line is connected to the liquid discharge line L2, and electromagnetic valves V3 and V4 capable of closing or opening the flow path are respectively disposed in the bypass line.

  Further, a bypass line that bypasses the duplex pump 18 (discharge side) is connected to the dialysate discharge line L2, and water is removed from the patient's blood flowing in the blood flow path of the dialyzer 17 to the bypass line. A dewatering pump 20 is provided for this purpose. Furthermore, solenoid valves V1 and V2 are respectively provided at one end side (the connection end side with the dialyzer 17) in the dialysate introduction line L1 and the dialysate discharge line L2, and are introduced into or discharged from the dialyzer 17. The flow path of the dialysate can be closed or opened. A bypass line is connected between the upstream side of the dialysate introduction line L1 and the downstream side of the dialysate discharge line L2, and an electromagnetic valve V5 is provided in the bypass line, and the dialysate discharge is performed. A solenoid valve V6 is disposed on the downstream side of the line L2 connected to the bypass line.

  Thus, the electromagnetic valves V1 to V6 constitute valve means that can arbitrarily close or open the flow path at the predetermined location by opening and closing operations, and the opening and closing operations are control means comprising a microcomputer or the like. 7 (see FIG. 1). The control means 7 is electrically connected to the drive control means of the blood pump 12 and the duplex pump 18, respectively, and can control the drive of the blood pump 12 and the duplex pump 18. By such a control means 7, necessary control can be performed on arbitrary components during dialysis treatment or non-dialysis treatment.

  The RO water production apparatus 3 (liquid supply means) includes a module (purification filter) having a filter membrane and the like, and purifies raw water to obtain clean water (RO water). As shown, it is connected to the dialysate supply device 2 via a pipe so that clean water can be supplied to the dialysate supply device 2. The clean water obtained by the RO water production apparatus 3 is used when the dialysate supply apparatus 2 prepares the dialysate, or the dialysate supply apparatus 2 and the dialysis monitoring apparatus 1 are cleaned. It is also used as cleaning water. Note that the RO water production apparatus 3 may be connected to a personal dialysis apparatus as shown in FIG. 10 so that clean water is supplied to the personal dialysis apparatus.

  For example, a predetermined amount of the powder drug for dialysis is charged into the dissolution apparatus 4, and the powder drug for dialysis and clean water (for example, clean water supplied from the RO water production apparatus 3) are mixed (mixed). Thus, a dialysate stock solution having a predetermined concentration is prepared, and is connected to the dialysate supply device 2 through a pipe. Such pipes are provided with pumps P2 and P3. By driving the pumps P2 and P3 at an arbitrary timing, the prepared dialysate stock solutions (for example, A stock solution and B stock solution) are respectively supplied to the dialysate supply device. 2 is configured to be supplied.

  The dialysate supply device 2 (liquid supply means) can prepare dialysate having a predetermined concentration using the clean water obtained by the RO water production device 3 and the dialysate stock solution prepared by the dissolution device 4, and each dialysis solution Can be supplied to the monitoring device 1 (blood purification means). In addition, the dialysis fluid supply apparatus 2 has a disinfecting chemical solution introduction part a capable of introducing hypochlorous acid for disinfecting the piping, and an acid capable of introducing acetic acid for dissolving the carbonate precipitated in the piping. In the cleaning / disinfecting process that is performed during a time period when dialysis treatment is not performed, a necessary chemical agent is optionally placed in the pipe. It can be introduced.

  In the present embodiment, hypochlorous acid is introduced from the disinfecting chemical solution introduction section a, but other disinfecting agents and liquids may be introduced. Further, for example, clean water supplied from the RO water production apparatus 3 is heated by a heater (not shown) in the dialysate supply apparatus 2 or hot water is directly supplied from the RO water production apparatus 3 for disinfection. The hot water may be supplied to each dialysis monitoring device 1. When disinfecting with hot water, citric acid may be introduced from the disinfecting chemical solution introduction part a or the acid cleaning chemical solution introduction part b, and the citric acid may be mixed into the hot water for disinfection. Moreover, it is good also as a thing different from an acetic acid as a chemical | medical solution for the acid cleaning introduced from the chemical | medical solution introduction part b for acid cleaning.

  The dialysis fluid supply device 2 is connected to each of a plurality of dialysis monitoring devices 1 via a pipe L, and the dialysis fluid (dialysis fluid supply device 2 is connected to each of the dialysis monitoring devices 1 via the piping L. Dialysis fluid prepared in step 2), a predetermined cleaning liquid (for example, clean water prepared by the RO manufacturing apparatus 3), and a chemical solution required for disinfection (for example, the disinfecting chemical solution introducing portion a or the acid cleaning chemical solution introducing portion b). A predetermined liquid such as an introduced chemical liquid) can be supplied. In addition, the dialysate supply device 2 is provided with a touch panel capable of giving instructions and predetermined display of control contents related to dialysate supply, cleaning, or disinfection.

  Furthermore, the dialysate supply device 2 is provided with a control means 5 composed of a microcomputer or the like, and the control means 5 makes necessary control for any component (dialysis produced by the dissolving device 4). Control for supplying the liquid stock solution or control for introducing a chemical solution or the like from the disinfecting chemical solution introduction part a or the acid cleaning chemical solution introduction part b) can be performed. Further, the control means 5 is electrically connected to the control means 7 disposed in each dialysis monitoring device 1 via the wiring H1, and the process signal is transmitted to each dialysis monitoring device 1 via the wiring H1. In addition, the dialysis monitoring device 1 is caused to perform an arbitrary operation (operation corresponding to the received process signal) by the process signal.

  The process signal consists of a signal output in accordance with a program preset in the control means 5, and as shown in FIG. 9, dialysis treatment by the dialyzer 17 is performed in addition to the dialysis treatment step Sc for performing dialysis treatment, blood return, and the like. It consists of a signal for performing a predetermined non-dialysis treatment step Sa performed in a non-performed time zone. In the non-dialysis treatment process Sa, a water washing process (S1, S3, S5) for washing the pipe with clean water produced by the RO water production apparatus 3, a chemical solution introduced from the disinfecting chemical solution introduction part a (this implementation) Chemical liquid disinfection step S2 for disinfecting the pipe with hypochlorous acid in the form, and acid cleaning step S4 for acid cleaning the pipe with the chemical liquid (acetic acid in the present embodiment) introduced from the acid cleaning chemical introduction section b In addition to the cleaning / disinfecting step Sb, a preset step S6 that is set in a standby state, a liquid replacement step S7 that replaces the liquid in the pipe with a dialysate, and a dialysis preparation step S8 that is a preparation step for performing dialysis treatment are set. The

  Here, in the dialysis monitoring apparatus 1 according to the present embodiment, as shown in FIG. 1, detection means 9 that can detect that a predetermined liquid has passed through the internal piping is disposed. The detection means 9 includes a sensor disposed in the dialysis monitoring device 1 (blood purification means), and the sensor detects a concentration of liquid in the pipe (A1) as shown in FIG. A5, A6), pH detection sensor A2 for detecting the pH of the liquid, temperature detection sensor A3 for detecting the temperature of the liquid, liquid pressure detection sensor A4 for detecting the pressure of the liquid, or presence / absence of circulation of the liquid It consists of a distribution detection sensor (not shown) that detects

  The detection means 9 according to the present embodiment is configured by diverting a sensor for detecting a predetermined parameter relating to a liquid (dialysis solution or the like) flowing through the piping of the dialysis monitoring device 1 during dialysis treatment, and the concentration detection sensor A1. Is capable of detecting the electrical conductivity (concentration) of the dialysate supplied during dialysis treatment and capable of detecting the concentration of a predetermined liquid flowing through the pipe during non-dialysis treatment. The concentration detection sensor A5 is composed of a sensor that detects blood leakage by irradiating the liquid in the pipe with light during dialysis treatment, and the concentration detection sensor A6 irradiates the liquid in the pipe with ultraviolet light during dialysis treatment. The sensor comprises a sensor for detecting the urea concentration, and in any case during non-dialysis treatment, the predetermined liquid is circulated in the pipe by detecting the concentration of the predetermined liquid flowing through the pipe of the dialysis monitoring device 1. This can be detected.

  The pH detection sensor A2 can detect the pH of the liquid supplied during dialysis treatment and can detect the pH of a predetermined liquid flowing through the piping of the dialysis monitoring device 1 during non-dialysis treatment. is there. In particular, at the time of non-dialysis treatment, if acid is detected by the pH detection sensor A2, acetic acid or citric acid is circulated in the pipe, and if alkali is detected, hypochlorous acid is circulated. If neutrality is detected, it will be understood that washing water (clean water) is circulating. Therefore, according to the pH detection sensor A2, it is possible to detect that a predetermined liquid is circulating in the pipe during non-dialysis treatment.

  The temperature detection sensor A3 can detect the temperature of a dialysate or the like supplied during dialysis treatment, and can detect the temperature of a predetermined liquid flowing through the piping of the dialysis monitoring device 1 during non-dialysis treatment. Is. In particular, when a liquid having a predetermined temperature or higher is detected during non-dialysis treatment, it can be detected that hot water for disinfection (including hot water mixed with citric acid) is circulating in the pipe. . The temperature detection sensor A3 may be one that can detect the temperature and circulation time of the fluid in addition to the one that detects the circulation of the liquid at a predetermined temperature or higher.

  The hydraulic pressure detection sensor A4 is capable of detecting the pressure (hydraulic pressure) of a liquid such as dialysate supplied at the time of dialysis treatment, and at the time of non-dialysis treatment, a predetermined pressure flowing through the piping of the dialysis monitoring apparatus 1 The liquid pressure of the liquid can be detected. However, since the liquid pressure detected by the liquid pressure detection sensor A4 varies with changes in the viscosity and temperature of the liquid flowing in the pipe, it is estimated which is the predetermined liquid flowing in the pipe. be able to.

  The flow detection sensor for detecting the presence or absence of the flow of the liquid is upstream of the solenoid valves (V1 to V6) and pumps (such as the duplex pump 18 or the dewatering pump 20) connected to or disposed in the piping in the dialysis monitoring device 1. Oscillation electrode and reception electrode are arranged on the side and downstream, respectively, and it is possible to detect opening / closing and driving of the solenoid valve and pump according to the presence / absence of conduction during liquid flow (pump is operating or solenoid valve is open) It is a thing. With such a flow detection sensor, it is possible to detect that a predetermined liquid is flowing during non-dialysis treatment.

  Further, the control means 7 included in the dialysis monitoring apparatus 1 according to the present embodiment includes a determination means for determining whether or not the detection means 9 detects that a predetermined liquid has been circulated in the non-dialysis treatment step. 8 is formed. In the present embodiment, the determination of whether or not it is a non-dialysis treatment process is configured to be performed based on a process signal transmitted from the dialysate supply device 2. That is, the process signal transmitted from the control means 5 of the dialysate supply apparatus 2 to each dialysis monitoring apparatus 1 is a cleaning / disinfecting process such as a water cleaning process or a chemical liquid disinfecting process, a liquid replacement process, a dialysis preparation process, or a preset process. If it is, it is determined that it is a non-dialysis treatment process other than the dialysis treatment process. In addition, as described above, the non-dialysis treatment process is determined by the process signal transmitted from the dialysate supply device 2, and the bypass switch 10 (bypass state detection means) detects that the bypass state is not detected. The dialysis treatment process may be determined.

  Thus, it is determined by the determination means 8 that it is a non-dialysis treatment step, and it is determined by the detection means 9 that the flow of a predetermined liquid (predetermined cleaning liquid or chemical liquid or hot water for disinfection) is detected. Thus, it is possible to grasp that a necessary liquid (predetermined cleaning solution or chemical solution, or hot water for disinfection) circulates in the piping of the dialysis monitoring device 1 during the non-dialysis treatment process. The determination unit 8 according to the present embodiment determines whether or not the predetermined liquid is necessary and determines whether or not the predetermined liquid is a necessary liquid by identifying based on the concentration, pH, or temperature. However, only the presence or absence of a predetermined liquid may be determined.

  Furthermore, the notification means 6 is electrically connected to the control means 5 of the dialysate supply apparatus 2 according to the present embodiment. The notification means 6 makes the predetermined notification on condition that the determination means 8 has determined that the predetermined liquid has not been detected by the detection means 9 during the non-dialysis treatment step. For example, it is composed of a display monitor for warning display or lighting, a warning light, or a speaker for outputting an alarm.

  In addition, although the alerting | reporting means 6 which concerns on this embodiment is arrange | positioned in the dialysate supply apparatus 2, what is arrange | positioned in each of the monitoring apparatus 1 for dialysis (for example, the display means 15 of the monitoring apparatus 1 for dialysis). Display or warning light 16 may be turned on or blinked). In this case, only the dialysis monitoring device 1 determined by the determination means 8 that the detection means 9 has not detected that the predetermined liquid has been detected during the non-dialysis treatment step is displayed on the display means 15 or the warning lamp 16. It is preferable to display a warning.

Next, the control contents in the blood purification system according to the present embodiment will be described based on the flowchart of FIG.
When the dialysis treatment is completed, a process signal is transmitted from the dialysate supply device 2, and the non-dialysis treatment step Sa is performed in each dialysis monitoring device 1. In this non-dialysis treatment process Sa, first, the clean water produced by the RO water production device 3 is sent to each dialysis monitoring device 1 through the pipe L and is circulated through the piping in each dialysis monitoring device 1. (Water washing step S1). At this time, the determination means 8 determines whether or not the detection means 9 detects that a predetermined liquid (in this case, clean water for cleaning) has been circulated.

  Thereafter, hypochlorous acid (raw solution) is introduced from the disinfecting chemical solution introduction section a, and the hypochlorous acid is mixed with diluted clean water supplied from the RO water production apparatus 3 and diluted through the pipe L. It sends to each monitoring apparatus 1 for dialysis (chemical solution disinfection process S2). Thereby, hypochlorous acid as a disinfectant can be circulated through the piping in each dialysis monitoring device 1 for disinfection. At this time, the determination means 8 determines whether or not the detection means 9 has detected that a predetermined liquid (in this case, hypochlorous acid) has been circulated. In addition, not only the presence or absence of circulation of hypochlorous acid, for example, the concentration and the circulation time may be detected, and the determination unit 8 may determine whether or not the normal concentration and the circulation time have been maintained. .

  And after chemical | medical solution disinfection process S2, the clean water produced with the RO water manufacturing apparatus 3 is again sent to each dialysis monitoring apparatus 1 via the piping L, and is distribute | circulated by the piping in each dialysis monitoring apparatus 1. (Water washing step S3). Thereby, hypochlorous acid as a disinfectant is replaced with cleaning water (clean water). At this time, the determination means 8 determines whether or not the detection means 9 detects that a predetermined liquid (in this case, clean water for cleaning) has been circulated.

  At this time, in addition to determining that the flow of clean water has been detected, the determination unit 8 does not detect the predetermined liquid (hypochlorous acid) circulated in the chemical liquid disinfection step S2. You may make it determine. This makes it possible to determine whether or not cleaning water has been circulated in the water cleaning step S3 and to detect that hypochlorous acid circulated in the chemical solution disinfection step S2 remains in the water cleaning step S3. it can.

  Thereafter, acetic acid (raw solution) is introduced from the acid cleaning chemical solution introducing section b, and each dialysis monitoring device is connected via the pipe L while diluting by mixing the acetic acid with clean water supplied from the RO water production device 3. 1 (acid cleaning step S4). Thereby, the acetic acid as an acid washing | cleaning liquid can be distribute | circulated by piping in each monitoring apparatus 1 for dialysis, and a precipitate can be melt | dissolved. At this time, the determination means 8 determines whether or not the detection means 9 detects that a predetermined liquid (in this case, acetic acid) has been circulated. Note that not only the presence / absence of the distribution of acetic acid but also the concentration and distribution time thereof may be detected, for example, and the determination unit 8 may determine whether or not the normal concentration and distribution time have been maintained.

  Then, after the acid washing step S4, the clean water produced by the RO water production device 3 is again sent to each dialysis monitoring device 1 via the pipe L and is circulated through the piping in each dialysis monitoring device 1. (Water washing step S5). As a result, acetic acid as the acid cleaning liquid is replaced with cleaning water (clean water). At this time, the determination means 8 determines whether or not the detection means 9 detects that a predetermined liquid (in this case, clean water for cleaning) has been circulated.

  At this time, the determination means 8 determines that the predetermined liquid (acetic acid) circulated in the acid cleaning step S4 is no longer detected by the detection means 9 in addition to determining that the flow of clean water has been detected. You may make it determine. Accordingly, it can be determined whether or not the cleaning water has been circulated in the water cleaning step S5, and it can be detected that the acetic acid circulated in the acid cleaning step S4 remains in the water cleaning step S5.

  When the series of cleaning and disinfecting steps Sb described above is completed, the process proceeds to a preset step S6, and the standby state is maintained until the liquid replacement step S7 that is the next step is started. Then, in the liquid replacement step S7, the liquid in the pipe of the dialysis monitoring device 1 is replaced with a dialysis solution, and a dialysis treatment is performed in the dialysis preparation step S8. Accordingly, in each of the non-dialysis treatment steps Sa, it is determined whether or not it has been detected by the detection means 9 that the predetermined liquid has been circulated. If it is determined that the predetermined liquid has not been detected, disinfection or acid cleaning in the pipe or The notification means 6 performs notification that there is a possibility that the water cleaning is insufficient.

  When supplying hot water for disinfection (including one mixed with citric acid) to each dialysis monitoring device 1 instead of the chemical solution disinfection step S2 and the acid washing step S4, It is preferable that the determination unit 8 determines whether or not the liquid having the predetermined temperature is continuously detected for a predetermined time by the detection sensor A3. Thereby, it can be grasped | ascertained whether the hot water of the temperature which has a disinfection effect was distribute | circulated reliably in piping of the monitoring apparatus 1 for dialysis. Further, the preset step S6 may be performed between the acid cleaning step S4 and the water cleaning step S5 in the cleaning / disinfecting step Sb to secure a time for sufficiently obtaining the acid cleaning effect.

  According to the above embodiment, the detection means 9 that can detect that a predetermined liquid has flowed through the piping inside the dialysis monitoring device 1 (blood purification means), and the detection means 9 in the non-dialysis treatment step Determination means 8 for determining whether or not it has been detected that the liquid has been circulated, so that predetermined steps in the non-dialysis treatment step (water washing steps S1, S3, S5, chemical disinfection step S2, acid washing step) It is possible to grasp whether or not S4 etc. has been performed reliably and sufficiently.

  In addition, the dialysate supply device 2 (liquid supply means) according to the present embodiment can transmit a process signal for causing the dialysis monitoring device 1 (blood purification means) to perform an arbitrary operation, and supply the dialysate supply device. Since the non-dialysis treatment process is discriminated by the process signal transmitted from the apparatus 2 (liquid supply means), the non-dialysis treatment process is discriminated in the blood purification system in which the dialysis monitoring device 1 operates according to the process signal. A separate means for this can be dispensed with.

  Further, the monitoring device for dialysis 1 includes a dialysate introduction line L1 for introducing dialysate into the dialyzer 17, a dialysate discharge line L2 for discharging dialysate from the dialyzer 17, and the distal end of the dialysate introduction line L1. Since it has a bypass switch 10 (bypass state detecting means) that detects that it is in a bypass state connected to the tip of the liquid discharge line L2, the bypass switch 10 detects that the bypass state is not detected. If the dialysis treatment process is to be discriminated, a separate means for discriminating the non-dialysis treatment process can be dispensed with in the blood purification system including the bypass state detection means such as the bypass switch 10.

  Furthermore, the detection means 9 according to the present embodiment is composed of a sensor disposed in the dialysis monitoring device 1, and includes concentration detection sensors (A1, A5, A6) for detecting the concentration of the liquid in the pipe, Since it comprises a pH detection sensor A2 for detecting pH, a temperature detection sensor A3 for detecting the temperature of the liquid, a hydraulic pressure detection sensor A4 for detecting the pressure of the liquid, or a flow detection sensor for detecting the presence or absence of the flow of the liquid. In addition, it is possible to more easily and accurately detect that a predetermined liquid has flowed through the piping inside the dialysis monitoring device 1.

  In particular, the detection means 9 according to the present embodiment uses a sensor for detecting a predetermined parameter relating to the liquid flowing through the piping of the dialysis monitoring device 1 during dialysis treatment, so that a separate sensor is used as the detection means 9. There is no need to add, and manufacturing costs, running costs, and the like can be suppressed. The detecting means 9 is not limited to a sensor for detecting a predetermined parameter relating to the fluid flowing through the piping of the dialysis monitoring device 1 during dialysis treatment, and a sensor exclusively used during non-dialysis treatment is newly added. You may make it arrange | position to.

  In addition, according to the present embodiment, the determination unit 8 performs a predetermined notification on the condition that the detection unit 9 determines that the predetermined liquid has not been detected in the non-dialysis treatment step. Since the notification means 6 is provided, it is possible for a medical worker or the like to easily grasp whether or not a predetermined process in the non-dialysis treatment process has been performed reliably and sufficiently. The notification by the notification means 6 may be performed at a predetermined step in the non-dialysis treatment step, or a history may be left as a log.

  The blood purification system according to the present embodiment has been described above, but the present invention is not limited to this, and for example, a process signal is transmitted from the dialysate supply device 2 to each dialysis monitoring device 1, Instead of the one that performs the operation according to the process signal, the present invention may be applied to the one in which the process signal is not transmitted and the dialysis treatment process and the non-dialysis treatment process are performed. In the present embodiment, the process signal is transmitted from the control means 5 to each dialysis monitoring device 1 via the wiring H1, and the electrical signal of the bypass switch 10 is transmitted to the dialysate supply device 2 via the wiring H2. Although it is configured to be transmitted to the control means 5, the control means 5 and 7 and the bypass switch 10 may be electrically connected via a wiring (for example, a LAN) capable of transmitting and receiving signals bidirectionally. Good.

  Further, instead of the central system as in the above embodiment, as shown in FIG. 10, it is composed of an RO water production apparatus 3 as a liquid supply means and a personal dialyzer 21 as a blood purification means. It may be a blood purification system. The personal dialysis device 21 is supplied with clean water produced by the RO water production device 3 through the pipe N, and mixes the pure water for dialysate (A stock solution and B stock solution) with a predetermined concentration. Dialysis solution can be prepared and dialysis treatment can be performed.

  That is, the personal dialysis device 21 is attached with a dialyzer 17 (see FIG. 6) as a blood purifier for performing dialysis treatment on a patient, as in the dialysis monitoring device 1 of the above embodiment. A dialysis treatment can be performed by supplying the dialysis solution prepared in this manner, and a predetermined non-dialysis treatment step (a step similar to the above embodiment) is performed in a time zone when the dialysis treatment by the dialyzer 17 is not performed. Has been.

  In addition, the personal dialyzer 21 is formed with a disinfecting chemical solution introduction part a that introduces hypochlorous acid for disinfection, for example, and an acid cleaning chemical solution introduction part b that introduces acetic acid for acid cleaning, for example. Has been. Then, hypochlorous acid, acetic acid and the like introduced from the disinfecting chemical solution introduction part a or the acid cleaning chemical solution introduction part b are mixed with the clean water supplied from the RO water production apparatus 3 and diluted, and used for personal use. Disinfection and acid cleaning are performed by circulating the pipes in the dialyzer 21. Similar to the above embodiment, other disinfecting chemicals and liquids may be introduced instead of the predetermined cleaning liquid and chemical liquid for disinfection. Furthermore, for example, the clean water supplied from the RO water production apparatus 3 may be heated by a heater (not shown) in the personal dialysis apparatus 21, or hot water may be supplied directly from the RO water production apparatus 3. When disinfecting with hot water, citric acid may be introduced from the disinfecting chemical solution introduction part a or the acid cleaning chemical solution introduction part b, and the citric acid may be mixed into the hot water for disinfection. Moreover, it is good also as a thing different from an acetic acid as a chemical | medical solution for the acid cleaning introduced from the chemical | medical solution introduction part b for acid cleaning.

  However, each personal dialysis machine 21 is provided with a detection means 9 and a bypass switch 10 having the same functions as those in the above embodiment, and is electrically connected to the determination means 8 formed in the control means 7. ing. In this case, the determination means 8 determines whether or not a predetermined liquid has been detected by the detection means 9 during the non-dialysis treatment step, as in the above embodiment. The non-dialysis treatment process is discriminated when the state detecting means) detects the bypass state.

  Then, it is determined by the determination means 8 that it is a non-dialysis treatment step, and it is determined by the detection means 9 that the flow of a predetermined liquid (predetermined cleaning liquid or chemical liquid or hot water for disinfection) is detected. For example, at the time of the non-dialysis treatment process, it can be grasped that a necessary liquid (predetermined cleaning solution or chemical solution, or hot water for disinfection) circulated in the pipe of the personal dialysis device 21.

  Furthermore, the notification means 6 is electrically connected to the control means 7 according to the present embodiment. The notification means 6 has the same function as that of the above embodiment, and it is determined by the determination means 8 that the detection means 9 has not detected that the predetermined liquid has been circulated during the non-dialysis treatment step. As a condition, predetermined notification is performed. As the notification means 6, for example, a display monitor for performing notification display or lighting, a warning light, a speaker for outputting an alarm, or the like can be used.

  A detection unit that can detect that a predetermined liquid has flowed through the piping inside the blood purification unit, and a determination that determines whether or not the detection unit has detected that the predetermined liquid has flowed during a non-dialysis treatment step If it is a blood purification system provided with a means, it can apply also to what added the other function.

1 Dialysis monitoring device (blood purification means)
2 Dialysate supply device (liquid supply means)
3 RO water production apparatus 4 Dissolution apparatus 5 Control means 6 Notification means 7 Control means 8 Determination means 9 Detection means 10 Bypass switch (bypass state detection means)
DESCRIPTION OF SYMBOLS 11 Coupler receptacle 12 Blood pump 13 Fluid replacement pump 14 Bubble detection sensor 15 Display means 16 Warning lamp 17 Dialyzer (blood purifier)
18 Duplex pump 19 Filtration filter 20 Water removal pump

Claims (6)

A blood purification means for performing dialysis treatment on a patient, and blood purification means for performing a predetermined non-dialysis treatment step in a time zone when dialysis treatment by the blood purification device is not performed;
A liquid supply means capable of supplying a predetermined liquid made of dialysate, predetermined washing liquid or chemical liquid, or hot water for disinfection to the blood purification means;
A blood purification system in which a predetermined liquid is supplied from the liquid supply means to the blood purification means in a dialysis treatment step to perform dialysis treatment,
Detection means capable of detecting that the predetermined liquid has circulated through the piping inside the blood purification means;
In the non-dialysis treatment step, determination means for determining whether or not the detection means has detected that the predetermined liquid has circulated,
A blood purification system comprising:   The liquid supply means can transmit a process signal for causing the blood purification means to perform an arbitrary operation, and the non-dialysis treatment process is determined based on the process signal transmitted from the liquid supply means. The blood purification system according to claim 1, wherein:   The blood purification means includes a dialysate introduction line for introducing dialysate into the blood purifier, a dialysate discharge line for discharging dialysate from the blood purifier, a tip of the dialysate introduction line, and a dialysate discharge line A bypass state detecting means for detecting that the tip is connected to a bypass state, and the non-dialysis treatment step is determined by detecting the bypass state by the bypass state detecting means. The blood purification system according to claim 1, wherein:   The detection means includes a sensor disposed in the blood purification means, and the sensor includes a concentration detection sensor that detects the concentration of the liquid in the pipe, a pH detection sensor that detects the pH of the liquid, and the temperature of the liquid. A temperature detection sensor for detecting a fluid, a liquid pressure detection sensor for detecting the pressure of the liquid, or a flow detection sensor for detecting the presence or absence of the flow of the liquid. The blood purification system described.   5. The blood purification system according to claim 4, wherein the detection means is a sensor for detecting a predetermined parameter relating to a liquid flowing through the piping of the blood purification means during dialysis treatment.   Provided with a notification means for performing a predetermined notification on the condition that the determination means determines that the predetermined liquid has not been circulated by the detection means during the non-dialysis treatment step. The blood purification system according to any one of claims 1 to 5, characterized in that:

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