JP2015009106A - Hemodialysis apparatus and hemodialysis apparatus operation method - Google Patents

Abstract

PROBLEM TO BE SOLVED: To improve the dialysis efficiency in a hemodialysis apparatus using a vessel which is capable of strictly controlling the supply volume and discharge volume of a dialysis fluid to the dialyzer.SOLUTION: A hemodialysis apparatus 1 has a control unit 15 which executes a dialysis fluid exchange process and a dialysis fluid supply process alternately to control at least any of a first fluid feed pump 82, a second fluid feed pump 52, on-off valves 83, 84, and on-off valves 60, 61 such that execution time T2 of the dialysis fluid supply process becomes longer than execution time T1 of the dialysis fluid exchange process in one cycle. In the dialysis fluid exchange process, the control unit 15 activates the first fluid feed pump 82 and opens a dialysis fluid exchange circuit 14 by the on-off valves 83, 84 for supplying a dialysis fluid to a first chamber 30 of a vessel 12 to cause a partition wall 32 to displace to the side of a second chamber 31, thereby discharging dialysis waste solution from the second chamber 31 to the outside. In the dialysis fluid supply process, the control unit 15 activates a second fluid feed pump 52 and opens a dialysis fluid supply circuit 13 by the on-off valves 60, 61 to cause the partition wall 32 to displace to the side of a first chamber 30, thereby supplying the dialysis fluid from the first chamber 30 to a dialyzer 10 and discharging the dialysis waste solution from the dialyzer 10 to the second chamber 31.

Description

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

  As a hemodialysis apparatus for strictly controlling the amount of water removed during dialysis, a device using a container (measuring container) having a displaceable partition that separates the interior into a first chamber and a second chamber has been proposed ( (See Patent Documents 1 to 4).

  The above hemodialysis apparatus normally supplies a new dialysate to the first chamber of the container and discharges the dialysate waste fluid of the second chamber to the outside, and a new dialysate of the first chamber. Is supplied to the dialyzer and the dialysate supply circuit for discharging the dialysate waste fluid from the dialyzer to the second chamber. A liquid feed pump and an on-off valve are provided.

  And in the above-mentioned hemodialysis apparatus, a dialysate exchange process and a dialysate supply process are performed alternately. In the dialysate exchange step, the on-off valve is opened in the dialysate exchange circuit, the dialysate is supplied to the first chamber of the container by the liquid feed pump, the partition wall of the container is pushed to the second chamber side, The dialysis waste liquid in chamber 2 is drained to the outside. In the dialysate supply process, the on-off valve is opened in the dialysate supply circuit, the dialysate in the first chamber of the container is supplied to the dialyzer by the liquid feed pump, and the partition wall of the container moves to the first chamber side. The dialysis waste liquid from the dialyzer is drained into the second chamber of the container. In this hemodialysis apparatus, in principle, the dialysate in the first chamber is supplied to the dialyzer and discharged from the dialyzer to the second chamber as much as the partition wall of the container moves. The supply amount and drainage amount can be strictly controlled. As a result, the patient's water removal amount can be strictly controlled.

JP-A-5-146506 JP 2000-126284 A JP 55-59816 A International Publication No. 2011/049196

  By the way, in the hemodialysis apparatus as described above, the dialysis fluid cannot be supplied to the dialyzer during the dialysis fluid exchange step, and the dialysis efficiency is lowered. Therefore, two dialysate exchange circuits and two dialysate supply circuits are provided. While one system performs the dialysate supply process, the other system performs the dialysate exchange process and continuously supplies the dialysate. Can be considered. However, in this case, the number of parts of the apparatus is greatly increased, and the apparatus cost is increased.

  The present invention has been made in view of the above points, and in a hemodialysis apparatus using a container capable of strictly controlling the amount of dialysis fluid supplied and the amount of drainage, a series of dialysis exchange circuits and dialysis fluid Even if it is the structure which uses a supply circuit, it aims at improving the dialysis efficiency by performing control which shortens the time when dialysate is not flowing into a dialyzer.

  The present invention that achieves the above object provides a dialyzer, a container having a displaceable partition that divides the interior into a first chamber and a second chamber, and a dialysate to the first chamber, A dialysate exchange circuit for discharging the dialysate waste fluid of the second chamber to the outside, a first liquid feed pump for sending dialysate to the first chamber through the dialysate exchange circuit, and a first for opening and closing the dialysate exchange circuit. 1 switchgear, a dialysate supply circuit for supplying the dialysate in the first chamber to the dialyzer, and discharging dialysate waste fluid from the dialyzer to the second chamber, and the dialysate supply circuit A second liquid feeding pump for sending dialysis waste liquid to the second chamber through the second chamber, a second opening / closing device for opening and closing the dialysate supply circuit, and operating the first liquid feeding pump, The dialysate exchange circuit is opened by a device, and dialysate is supplied to the first chamber. The partition wall is displaced to the second chamber side, the dialysate exchange step for discharging the dialysis waste liquid from the second chamber to the outside, the second liquid feed pump is operated, and the second opening / closing device The dialysate supply circuit is opened, the partition wall is displaced toward the first chamber, the dialysate is supplied from the first chamber to the dialyzer, and the dialysate waste liquid is supplied from the dialyzer to the second chamber. The dialysate supply step for discharging the dialysis fluid alternately, and the execution time of the dialysate supply step in one cycle is longer than the execution time of the dialysate exchange step. And a control unit that controls at least one of the first opening / closing device and the second opening / closing device. The “dialyte supply process execution time” is the time during which the dialysate is flowing through the dialyzer, and the “dialyte exchange process execution time” is the time when dialysate flows into the first chamber of the container. It is time to do. Further, the “displacement” of the partition includes not only the movement of the entire partition but also the displacement due to the shape change caused by the operation of the partition itself.

  According to the present invention, since the execution time of the dialysate supply process in one cycle becomes long, the time during which the dialysate is supplied to the dialyzer with respect to the dialyzer becomes long, and the dialysis efficiency can be improved.

  The control unit sets the flow rate of the liquid fed by the first liquid feed pump in the dialysate exchange step to be higher than the flow rate of the liquid fed by the second liquid feed pump in the dialysate supply step. The opening time of the second opening / closing device in the supplying step may be longer than the opening time of the first opening / closing device in the dialysate exchange step. In such a case, by increasing the flow rate put into the first chamber of the container, the execution time of the dialysate exchange process can be shortened, and the execution time of the dialysate supply process can be increased accordingly. That is, the ratio in one cycle of the dialysate supply process in which the dialysate flows into the dialysate is increased, so that the dialysis efficiency can be suitably improved.

  The hemodialysis apparatus may further include a restoring force applying mechanism that applies a restoring force for returning the partition wall displaced toward the first chamber side or the second chamber side to the original position. When restoring force is applied to the first chamber side, normally, the speed at which the partition wall is displaced toward the first chamber side is greater than the speed at which the partition wall is displaced toward the second chamber side, and the dialysate exchange step The execution time of becomes longer. In this case, there is a great merit in increasing the dialysis efficiency by increasing the supply flow rate of the dialysate to the first chamber to shorten the execution time of the dialysate exchange process. On the other hand, when a restoring force is applied to the second chamber side, the dialysate supply flow rate to the first chamber side increases, and the execution time of the dialysate exchange step can be easily shortened.

  The hemodialysis apparatus further includes means for detecting completion of the displacement of the partition wall, and the control unit is configured to detect the first switching device or the second opening / closing device based on the detected completion of the displacement of the partition wall. At least one of the devices may be closed. If the completion timing of the displacement of the partition wall and the closing timing of the switchgear deviate, the container may expand due to the pump pressure and excessive liquid may enter the container. According to this method, excessive liquid can be prevented from entering each chamber of the container.

  According to another aspect of the present invention, there is provided a dialyzer, a container having a displaceable partition partitioning the interior into a first chamber and a second chamber, supplying dialysate to the first chamber, A dialysis fluid exchange circuit for discharging the dialysis waste fluid in the chamber to the outside, a first liquid feed pump for sending the dialysis fluid to the first chamber through the dialysate exchange circuit, and a first for opening and closing the dialysate exchange circuit. An opening and closing device, a dialysate supply circuit for supplying the dialysate from the first chamber to the dialyzer, and discharging dialysate waste fluid from the dialyzer to the second chamber, and through the dialysate supply circuit An operation method of a hemodialysis apparatus, comprising: a second liquid feed pump that sends dialysis waste liquid to the second chamber; and a second opening / closing device that opens and closes the dialysate supply circuit. A fluid pump is operated, and the dialysate exchange circuit is opened by the first switching device. A second dialysate exchange step of supplying dialysate to the first chamber, the partition wall being displaced toward the second chamber, and discharging dialysate waste fluid from the second chamber to the outside; And the second opening / closing device opens the dialysate supply circuit so that the partition wall is displaced toward the first chamber, and dialysate is transferred from the first chamber to the dialyzer. The dialysate supply step of supplying and discharging the dialysate waste solution from the dialyzer to the second chamber is alternately executed, and the execution time of the dialysate supply step in one cycle is longer than the execution time of the dialysate exchange step A hemodialysis apparatus in which a control unit for controlling at least one of the first liquid feeding pump, the second liquid feeding pump, the first opening / closing device and the second opening / closing device is operated so as to be longer This is the operation method.

  According to the present invention, dialysis efficiency can be improved in a hemodialysis apparatus using a container capable of strictly controlling the amount of dialysate supplied to the dialyzer and the amount of drainage.

It is a schematic diagram which shows the outline of a structure of the hemodialysis apparatus. It is a timing chart which shows operation | movement of an on-off valve. It is explanatory drawing which shows the state of supply to the container of the new dialysate of a hemodialysis apparatus, and the drainage of the dialysis waste liquid from a container. It is explanatory drawing which shows the state of supply to the dialyzer of the dialysate of a hemodialyzer, and the drainage of the dialysate waste liquid to the container. It is a schematic diagram which shows the outline of a structure of the hemodialysis apparatus at the time of providing a sensor. It is a timing chart which shows operation | movement of the on-off valve in the 3rd condition from the 1st condition of an Example.

  Hereinafter, preferred embodiments 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 according to the present embodiment.

  The hemodialysis apparatus 1 includes, for example, a dialyzer 10, a blood circulation circuit 11, a container 12, a dialysate supply circuit 13, a dialysate exchange circuit 14, and a control unit 15.

  The dialyzer 10 is, for example, a hollow fiber module incorporating a hollow fiber membrane. The dialyzer is passed through the secondary side 10b of the hollow fiber membrane while allowing the patient's blood to pass through the primary side 10a of the hollow fiber membrane. Waste or the like contained in the blood on the side 10a can be permeated to the secondary side 10b through the hollow fiber membrane to purify the blood.

  The blood circulation circuit 11 includes, for example, a first blood channel 21 connected from the needle portion 20 punctured by a patient to the inlet end 10c of the primary side 10a of the dialyzer 10, and the outlet end of the primary side 10a of the dialyzer 10. It has the 2nd blood flow path 23 connected to the other needle part 22 from 10d. The first blood circuit 21 is provided with a liquid feed pump 24.

  The container 12 is formed in a cylindrical shape made of, for example, a synthetic resin and, for example, a displaceable partition wall 32 that divides the inside into the first chamber 30 and the second chamber 31 in the axial direction, and allows the partition wall 32 to be displaced. The partition wall 32 includes a restoring force applying mechanism 33 that applies a restoring force toward the first chamber 30. That is, the container 12 has a so-called self-returning partition wall 32.

  The partition wall 32 is made of a diaphragm having elasticity, for example. The partition wall 32 is fixed near the center of the container 12 in the axial direction. The partition wall 32 may be, for example, a diaphragm made of a stretchable elastomer, and the stretchability itself becomes a restoring force. In addition, the partition wall 32 may be a diaphragm made of a glass fiber reinforced rubber material or a stainless concentric circular diaphragm, and may itself have a shape restoring force.

  The restoring force applying mechanism 33 includes, for example, a pressing member 40 that presses the partition wall 32 from the second chamber 31 side to the first chamber 30 side, a guide shaft 41 that guides the reciprocating movement of the pressing member 40 in the axial direction, A spring 42 is provided as an elastic body that urges the pressing member 40 toward the first chamber 30.

  The pressing member 40 is formed in a cylindrical shape, for example, and a guide insertion portion 40a is formed in the center of the surface on the second chamber 31 side. The guide shaft 41 is formed from the center of the inner wall surface 12a on the second chamber 31 side in the axial direction of the container 12 toward the axial direction on the first chamber 30 side. The guide shaft 41 is inserted into the guide insertion portion 40a of the pressing member 40, whereby the pressing member 40 can reciprocate in the axial direction. Note that there is no problem in operation even if the guide shaft 41 is not provided, as long as the pressing member 40 can be stably moved while the spring 42 expands and contracts.

  For example, a spring 42 is inserted into the guide shaft 41, and the spring 42 is interposed between the axial inner wall surface 12 a of the container 12 and the pressing member 40. The spring 42 biases the pressing member 40 and the partition wall 32 toward the first chamber 30, and a restoring force is generated when the partition wall 32 moves toward the second chamber 31. The position of the natural length of the spring 42 is set to the initial position when the partition wall 32 has finished moving to the first chamber 30 side.

  The dialysate supply circuit 13 includes, for example, a first dialysate supply channel 50 that communicates from the first chamber 30 of the container 12 to the dialyzer 10 and a second dialysate supply that communicates from the dialyzer 10 to the second chamber 31. A flow path 51 is provided. The second dialysate supply channel 51 is provided with a second liquid feed pump 52. The first dialysate supply channel 50 is provided with an on-off valve 60 that opens and closes the channel 50, and the second dialysate supply channel 51 has an on-off valve 61 that opens and closes the channel 51. Is provided. The on-off valve 61 is provided between the second liquid feeding pump 52 and the container 12. The liquid feeding pressure of the second liquid feeding pump 52 is determined in consideration of the pressure loss of the dialysate supply circuit 13 and the restoring force of the restoring force applying mechanism 33. In the present embodiment, the on-off valves 60 and 61 constitute the second opening / closing device of the present invention.

  The dialysate exchange circuit 14 includes, for example, a first dialysate exchange flow path 80 that communicates from the dialysate supply source 70 to the first chamber 30 of the container 12 and a second dialysate exchange path 80 that communicates from the second chamber 31 of the container 12 to the outside. A dialysate exchange channel 81 is provided. The first dialysate exchange flow path 80 is provided with a first liquid feed pump 82 that pumps the dialysate from the dialysate supply source 70 to the first chamber 30 and an open / close valve 83 that opens and closes the flow path 80. It has been. The second dialysate exchange channel 81 is provided with an on-off valve 84 that opens and closes the channel 81. The on-off valve 83 is provided between the container 12 and the first liquid feed pump 82. The liquid feeding pressure of the first liquid feeding pump 82 is determined in consideration of the pressure loss of the dialysate exchange circuit 14 and the restoring force of the restoring force applying mechanism 33. In the present embodiment, the open / close valves 83 and 84 constitute the first open / close device of the present invention.

  The second dialysate supply channel 51 is connected to a branch path 90 for adjusting the water removal amount. The dialysate waste fluid in the second dialysate supply channel 51 is drawn into the branch path 90. A liquid feed pump 91 is provided.

  The control unit 15 is a computer that controls the overall operation of the hemodialysis apparatus 1. For example, the control unit 15 controls the operation of the pumps 24, 52, 82, 91, the on-off valves 60, 61, 83, 84 and the like as described later. The hemodialysis apparatus 1 can be operated.

  Next, the operation of the hemodialysis apparatus 1 configured as described above will be described.

  On the patient side during hemodialysis, the needles 20 and 22 are punctured into the patient, and the patient's blood is supplied to the dialyzer 10 by the pump 24 through the first blood channel 21. The blood passes through the primary side 10a of the hollow fiber membrane of the dialyzer 10 and then returns to the patient through the second blood channel 23.

  On the other hand, on the container 12 side, the dialysate exchange process and the dialysate supply process are alternately repeated. As shown in FIG. 2, in the dialysate exchange process and the dialysate supply process, one cycle is performed at a predetermined set time T, in which the dialysate exchange process is executed time T1, the dialysate supply process is The execution time T2 is longer than the execution time T1. These times T, T1, and T2 are set based on the dialysate flow rate set in advance for each dialysis treatment. FIG. 2 also shows opening / closing timings of the on-off valves 60, 61, 83, 84.

  For example, in the dialysate exchange step, with the first liquid pump 82 activated in advance, the on-off valves 60 and 61 are closed and the on-off valves 83 and 84 are opened as shown in FIG. A new dialysate from the dialysate supply source 70 is supplied into the first chamber 30 of the container 12 by the pump 82. Due to the new dialysate supplied to the first chamber 30, the partition wall 32 and the pressing member 40 in the initial position are pushed against the restoring force of the spring 42 toward the second chamber 31, The volume of the chamber 30 increases. As a result, the volume of the second chamber 31 is reduced, and the dialysis waste liquid already filled in the second chamber 31 is pushed out by the partition wall 32 and the pressing member 40, and is externally passed through the second dialysate exchange channel 81. To be discharged. The partition wall 32 moves from the initial position to a predetermined second position on the second chamber 31 side. Thus, the dialysate is exchanged for the container 12. The first chamber 30 is filled with the dialysate whose volume is increased by moving the partition wall 32, and the dialysis waste liquid whose volume is decreased is discharged in the second chamber 31. The amount of dialysate and dialysis waste liquid are the same.

  In this dialysate exchange step, the dialysate feed flow rate by the first feed pump 82 is set higher than the dialysate feed rate by the second feed pump 52 in the dialysate supply step described later, Therefore, the dialysate is exchanged in a short time. When the execution time T1 has elapsed, the on-off valves 83 and 84 are closed, the supply of the dialysate to the first chamber 30 is stopped, and the dialysate exchange process is completed.

  For example, the dialysate supply process is started immediately after the dialysate exchange process is completed. In this dialysate supply step, the on-off valves 83 and 84 are closed and the on-off valves 60 and 61 are opened as shown in FIG. The partition wall 32 and the pressing member 40 are moved to the first chamber 30 side by the pumping pressure of the pump 52 and the restoring force of the spring 42 of the container 12, and the new dialysate in the first chamber 30 is moved to the first dialysis. It is supplied to the dialyzer 10 through the liquid supply channel 50. The dialysate flows through the secondary side 10b of the dialyzer 10, and at this time, the waste or the like that has passed through the hollow fiber membrane is taken into the dialysate from the blood of the patient flowing through the primary side 10a. Thereafter, the dialysis waste liquid containing the waste product of the dialyzer 10 is discharged to the second chamber 31 of the container 12 through the second dialysate supply channel 51. In the first chamber 30 of the container 12, the dialysate corresponding to the volume reduced by the partition wall 32 moving is sent out, and in the second chamber 31 dialysis waste fluid corresponding to the volume increased due to the partition wall 32 moving in. The amount of dialysate and dialysis waste liquid are the same. At this time, the partition wall 32 moves from the second position to the initial position.

  Further, in the dialysate supply process, the pump 91 is operated, and a part of the dialysate waste liquid passing through the second dialysate supply channel 51 is drawn into the branch channel 90 and discharged. Since the amounts of dialysate and dialysis waste fluid entering and exiting the container 12 coincide with each other, the amount of dialysis waste fluid discharged through this branch 90 is the amount of water removed from the patient's blood through the dialyzer 10.

  The dialysate feed flow rate by the second feed pump 52 in this dialysate supply step is lower than the dialysate feed rate by the first feed pump 82 in the dialysate exchange step described above, and is relatively long. The dialysate is supplied over time. When the execution time T2 elapses, the on-off valves 60 and 61 are closed, the supply of the dialysate to the dialyzer 10 is stopped, and the dialysate supply process ends.

  The dialysate exchange process and the dialysate supply process are repeated a predetermined number of times to complete the hemodialysis process.

  According to the present embodiment, by increasing the execution time T2 of the dialysate supply process for each cycle, the time during which the dialysate 10 is supplied to the dialyzer 10 in the entire hemodialysis process is increased. Since the time during which no dialysate is supplied is reduced, dialysis efficiency can be improved.

  Further, according to the present embodiment, the amount of dialysate supplied from the container 12 to the dialyzer 10 and the amount of dialysate waste fluid returned to the container 12 through the dialyzer 10 are accurately determined by a simple control method. At the same time, in the hemodialysis apparatus 1 having one container 12, the time during which the dialysate does not flow into the dialyzer 10 can be shortened to improve dialysis efficiency. As a result, it is possible to reduce the cost of components, reduce the size of the device by reducing the number of components, reduce the risk of failure by reducing the number of components, and further improve the safety of the device. Furthermore, since the structure is simplified, unitization of the dialysate circuit portion is facilitated, and maintenance can be easily and inexpensively performed by periodically exchanging the units.

  In the present embodiment, the flow rate of the first liquid pump 82 in the dialysate exchange step is set higher than the flow rate of the second liquid pump 52 in the dialysate supply step, so that the dialysate The opening time of the on-off valves 60 and 61 in the supply process is longer than the opening time of the on-off valves 83 and 84 in the dialysate exchange process. Thus, the dialysate exchange process execution time T1 can be shortened by increasing the flow rate of the dialysate entering the first chamber 30, and the dialysate supply process execution time T2 can be increased accordingly. Can be suitably improved.

  The hemodialysis apparatus 1 has a restoring force applying mechanism 33 that applies a restoring force for returning the partition wall 31 displaced to the second chamber 31 side to the original initial position on the first chamber 30 side. When the restoring force is applied to the second chamber 31 side, the speed at which the partition wall 32 is displaced toward the first chamber 30 side is larger than the speed at which the partition wall 32 is displaced toward the second chamber 31 side. The execution time T1 of the dialysate exchange process becomes long. Therefore, as in the present embodiment, the dialysate supply flow rate to the first chamber 30 is increased to shorten the dialysate exchange process execution time T1, and the dialysate supply process T2 execution time T2 is increased. The benefits of increasing dialysis efficiency are significant.

  As in the present embodiment, it is desirable to increase the amount of liquid delivery by switching the dialysate exchange process and the dialysate supply process by the on-off valves 60, 61, 83, and 84 instantaneously without any gap. . On the other hand, when considering the stability of the operation of the partition wall 32, a standby time is provided for temporarily closing all the on-off valves 60, 61, 83, 84 when the dialysate exchange process and the dialysate supply process are switched. It is also effective.

  Further, the restoring force applying mechanism 33 may be one in which a restoring force is applied to the second chamber 31 side. In such a case, the speed at which the partition wall 32 is displaced to the second chamber 31 side is the first speed. The rate of displacement toward the chamber 30 side is greater, and the execution time T1 of the dialysate exchange step can be easily shortened. As a result, the dialysis efficiency can be improved by extending the execution time T2 of the dialysate supply process.

  Further, in the present embodiment, the restoring force imparting mechanism 33 is not necessarily required. In this case, the partition wall 32 is moved by using the liquid feeding pressure of the second liquid feeding pump 52 described later, and the container 12 is moved. The dialysate can be sent from the first chamber 30 to the dialyzer 10 and the dialysate waste solution can be sent from the dialyzer 10 to the second chamber 31 appropriately.

  In the above embodiment, when the displacement of the partition wall 32 to the initial position on the first chamber 30 side is completed or immediately after that, the dialysate supply circuit 13 may be closed by the on-off valves 60 and 61, The dialysate exchange circuit 14 may be closed by the on-off valves 83 and 84 when the displacement of the partition wall 32 to the second position on the second chamber 31 side is completed or immediately thereafter. More preferably, the dialysate supply circuit 13 may be closed by the on-off valves 60 and 61 within 0.5 sec from the completion of the displacement of the partition wall 32 toward the first chamber 30, The dialysate supply circuit 14 may be closed by the on-off valves 83 and 84 within 0.5 sec from the completion of the displacement of the second chamber 31 to the chamber 31 side. By doing so, the on-off valves 60 and 61 are opened for a long time after the movement of the partition wall 32 is completed, the pump pressure is applied to the second chamber 31, the second chamber 31 expands, and excess dialysis waste liquid is discharged. The entry into the second chamber 31 can be suppressed. In addition, the on-off valves 83 and 84 are opened for a long time after the partition wall 32 is moved, the pump pressure is applied to the first chamber 30, the first chamber 30 expands, and excess dialysate enters the first chamber 30. Intrusion can be suppressed.

  The hemodialysis apparatus 1 may have a means for detecting the completion of the displacement of the partition wall 32. In such a case, for example, as shown in FIG. 5, a sensor 100 that detects the position of the partition wall 32 is provided in the container 12. The detection result of the sensor 100 is output to the control unit 15. Then, for example, the sensor 100 accurately grasps the timing when the partition wall 32 has finished moving, and the control unit 15 receives it and immediately closes the on-off valves 60, 61 or the on-off valves 83, 84. Can do. As a result, it is possible to reliably prevent the dialysis waste liquid from being fed into the second chamber 31 or the dialysate from being fed into the first chamber 30 after the movement of the partition wall 32 is completed. The sensor 100 may detect both the completion timing of the movement of the partition wall 32 toward the first chamber 30 and the completion timing of the movement of the partition wall 32 toward the second chamber 32, or one of them may be detected. You may do.

  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 partition wall 32 of the container 12 may be a piston type structure instead of a diaphragm type structure.

  Examples are shown below. Using the hemodialyzer 1 having the configuration shown in FIG. 1, the discharge pressures of the first liquid pump 82 of the dialysate exchange circuit 14 and the second liquid pump 52 of the dialysate supply circuit 13 are changed, or dialysis is performed. Execution ratio of dialysate supply process when the opening / closing timings of the on / off valves 83 and 84 of the liquid exchange circuit 14 and the on / off valves 60 and 61 of the dialysate supply circuit 13 are changed (the dialysate is flowing into the dialyzer 10). Time ratio) was measured. FIG. 6 shows a timing chart of opening / closing of the on-off valve under the following first to third conditions.

First condition: The discharge pressures of the first liquid pump 82 and the second liquid pump 52 are adjusted to 100 kPa and 100 kPa, respectively, and the on-off valves 60 and 61 and the on-off valves 83 and 84 are set to 1.2 seconds and 2 respectively. It was opened and closed alternately every second. That is, the on-off valves 60 and 61 are closed and the on-off valves 83 and 84 are maintained for 2 seconds, and then the on-off valves 60 and 61 are opened and the on-off valves 83 and 84 are maintained for 1.2 seconds. Thereafter, the on-off valves 60 and 61 were closed again and the on-off valves 83 and 84 were opened again. At this time, the partition wall 32 moves to the initial position on the first chamber 30 side in the same time as the opening time of the on-off valves 60, 61, and has no time (standby time) to remain in that state. It was confirmed that it moved to the second position on the second chamber 31 side in the same time as 84 opening time. That is, the timing when the partition wall 32 finishes moving coincides with the closing timing of the on-off valves 60, 61, 83, and 84. Note that the partition wall 32 moves to the initial position on the first chamber 30 side even though the time for opening the on-off valves 60 and 61 is short, because the restoring force applying mechanism 33 in the container 12 is the partition wall 32. Because it helps to move. In this case, the opening time of the on-off valves 60 and 61 is equal to the execution time T2 of the dialysate supply process, the opening time of the on-off valves 83 and 84 is equal to the execution time T1 of the dialysate exchange process, and the execution time of the dialysate supply process T2 became shorter than the execution time T1 of the dialysate exchange step, and the ratio of the time during which the dialysate flows in the dialyzer 10 was as low as about 38%.

Second Condition The discharge pressure of the second liquid feed pump 52 was lowered with respect to the “first condition”, with the discharge pressures of the first liquid feed pump 82 and the second liquid feed pump 52 being 100 kPa and 60 kPa, respectively. At this time, unlike the case of the “first condition”, the on-off valves 60 and 61 and the on-off valves 83 and 84 are alternately opened and closed in 1.6 seconds and 2 seconds, respectively, so that the partition wall 32 is in a predetermined position ( It moved to the initial position and the second position), and almost no standby time was observed. Therefore, the opening time of the on-off valves 60 and 61 is equal to the execution time T2 of the dialysate supply process, the opening time of the on-off valves 83 and 84 is equal to the execution time T1 of the dialysate exchange process, and the execution time T2 of the dialysate supply process Becomes shorter than the execution time T1 of the dialysate exchange process. In this case, the ratio of the time during which the dialysate flows in the dialyzer 10 is about 44%, and the ratio at which the dialysate flows is higher than the “first condition”. However, since the time required for one cycle in which the container 12 performs liquid feeding is 3.6 seconds, which is increased from 3.2 seconds in the “first condition”, the amount of liquid that can be delivered per unit time Decreased.

Third condition Next, the discharge pressures of the first liquid feeding pump 82 and the second liquid feeding pump 52 were adjusted to 150 kPa and 40 kPa, respectively. In this case, the opening time of the on-off valves 60 and 61 (= the closing time of the on-off valves 83 and 84) is 2 seconds, and the opening time of the on-off valves 83 and 84 (= the closing time of the on-off valves 60 and 61 is 1.2 seconds). As a result, the partition wall 32 moves to a predetermined position (initial position and second position), and the waiting time is hardly observed.In this case, the opening time of the on-off valves 60 and 61 is dialysate supply. The opening time of the on-off valves 83 and 84 is equal to the execution time T1 of the dialysate exchange process, and the execution time T2 of the dialysate supply process is shorter than the execution time T1 of the dialysate exchange process. As a result, the ratio of the time during which the dialysate flows through the dialyzer 10 is approximately 63%, and the time during which the dialysate flows through the dialyzer 11 is nearly 1.7 times longer than that of the “first condition”. In addition, it takes one cycle for the container 12 to feed the liquid. Time is the same time as a 3.2 seconds "first condition", thus feeding amount per unit time is the same as the "first condition".

Table 1 summarizes the results of the above first to third conditions.

  It should be noted that values such as pump discharge pressure and opening / closing time of the on-off valve shown in Table 1 are appropriate values depending on the pressure loss of the dialysate supply circuit 13 and dialysate exchange circuit 14, the degree of restoring force of the restoring force applying mechanism 33, and the like. It is set, and the above value is not always the optimum value.

  INDUSTRIAL APPLICABILITY The present invention is useful for improving dialysis efficiency in a hemodialysis apparatus using a container capable of strictly controlling the amount of dialysate supplied to the dialyzer and the amount of drainage.

DESCRIPTION OF SYMBOLS 1 Hemodialysis apparatus 10 Dialyzer 10a Primary side 10b Secondary side 10c Inlet end 10d Outlet end 11 Blood circulation circuit 12 Container 12a Inner wall surface 13 Dialysate supply circuit 14 Dialysate exchange circuit 15 Control part 20 Arterial side needle part 21 1st Blood channel 22 Venous needle 23 Second blood channel 30 First chamber 31 Second chamber 32 Partition 33 Restoring force applying mechanism 40 Pressing member 40a Guide insertion portion 41 Guide shaft 42 Spring 50 First dialysis Liquid supply flow path 51 Second dialysate supply flow path 52 Second liquid feed pump 60 Open / close valve 61 Open / close valve 70 Dialysate supply source 80 First dialysate exchange flow path 81 Second dialysate exchange flow path 82 First liquid feed pump 83 On-off valve 84 On-off valve 90 Branch path 91 Pump

Claims (5)

A dialyzer,
A container having a displaceable partition that separates the interior into a first chamber and a second chamber;
A dialysate exchange circuit for supplying dialysate to the first chamber and discharging the dialysate waste fluid of the second chamber to the outside;
A first liquid pump for sending dialysate to the first chamber through the dialysate exchange circuit;
A first switch for opening and closing the dialysate exchange circuit;
A dialysis fluid supply circuit for supplying the dialysis fluid from the first chamber to the dialyzer and discharging dialysis waste fluid from the dialyzer to the second chamber;
A second liquid feed pump for sending dialysis waste liquid to the second chamber through the dialysate supply circuit;
A second opening / closing device for opening and closing the dialysate supply circuit;
The first liquid supply pump is operated, the dialysate exchange circuit is opened by the first opening and closing device, dialysate is supplied to the first chamber, and the partition wall is located on the second chamber side. Displacement, dialysate exchange process for discharging dialysis waste liquid from the second chamber to the outside, operating the second liquid feed pump, opening the dialysate supply circuit by the second opening and closing device, The partition wall is displaced to the first chamber side, and the dialysate supply step of supplying dialysate from the first chamber to the dialyzer and discharging dialysate waste fluid from the dialyzer to the second chamber is alternately performed. And the first liquid feed pump, the second liquid feed pump, the first liquid feed pump, the first liquid feed pump, the first liquid feed pump, the first liquid feed pump, and the first liquid feed pump, A control unit that controls at least one of the switchgear and the second switchgear. That hemodialysis apparatus.   The control unit sets the flow rate of the liquid fed by the first liquid feed pump in the dialysate exchange step to be higher than the flow rate of the liquid fed by the second liquid feed pump in the dialysate supply step. The hemodialysis apparatus according to claim 1, wherein an opening time of the second opening / closing device in the supplying step is made longer than an opening time of the first opening / closing device in the dialysate exchange step.   The hemodialysis apparatus according to claim 1 or 2, further comprising a restoring force applying mechanism that applies a restoring force for returning the partition wall displaced toward the first chamber side or the second chamber side to an original position. . Means for detecting completion of the displacement of the partition;
The hemodialysis according to any one of claims 1 to 3, wherein the controller closes at least one of the first opening / closing device and the second opening / closing device based on completion of the detected displacement of the partition wall. apparatus. A dialyzer,
A container having a displaceable partition that separates the interior into a first chamber and a second chamber;
A dialysate exchange circuit for supplying dialysate to the first chamber and discharging the dialysate waste fluid of the second chamber to the outside;
A first liquid pump for sending dialysate to the first chamber through the dialysate exchange circuit;
A first switch for opening and closing the dialysate exchange circuit;
A dialysis fluid supply circuit for supplying the dialysis fluid from the first chamber to the dialyzer and discharging dialysis waste fluid from the dialyzer to the second chamber;
A second liquid feed pump for sending dialysis waste liquid to the second chamber through the dialysate supply circuit;
A second opening / closing device that opens and closes the dialysate supply circuit;
The first liquid supply pump is operated, the dialysate exchange circuit is opened by the first opening and closing device, dialysate is supplied to the first chamber, and the partition wall is located on the second chamber side. Displacement, dialysate exchange process for discharging dialysis waste liquid from the second chamber to the outside, operating the second liquid feed pump, opening the dialysate supply circuit by the second opening and closing device, The partition wall is displaced to the first chamber side, and the dialysate supply step of supplying dialysate from the first chamber to the dialyzer and discharging dialysate waste fluid from the dialyzer to the second chamber is alternately performed. And the first liquid feed pump, the second liquid feed pump, the first liquid feed pump, the first liquid feed pump, the first liquid feed pump, the first liquid feed pump, and the first liquid feed pump, A control unit that controls at least one of the switchgear and the second switchgear operates. , Method of operation of the hemodialysis apparatus.

Images