JP2017077383A - Blood purification device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a blood purification device capable of reliably filling a blood flow path and a dialysis fluid flow path of blood purification means with priming liquid, and dispensing with a reversing operation of the blood purification means by a medical worker at the start of blood purification treatment.SOLUTION: In a blood purification device, a dialyzer 2 is held in a state that a blood lead-out port 2b is directed upward when pouring priming liquid in priming. The priming liquid introduced from a blood introduction port 2a to a blood flow path 2e of the dialyzer 2 is filtered to a dialysis fluid flow path 2f through a blood purification membrane 2g, and led out from a dialysis fluid introduction port 2c so as to prime the dialysis fluid flow path 2f.SELECTED DRAWING: Figure 1

Description

  The present invention relates to a blood purification apparatus for purifying a patient's blood while circulating it outside the body.

  In general, a blood purification apparatus for performing dialysis treatment purifies blood circulating extracorporeally in an arterial blood circuit and a venous blood circuit that constitute a blood circuit for circulating a patient's blood extracorporeally. Blood purification means, and a device body on which various treatment means such as a blood pump for performing blood purification treatment by the blood circuit and the blood purification means are provided. Vascular access catheters or puncture needles (arterial puncture needles and venous side puncture needles) can be attached to the tips of the arterial blood circuit and the venous blood circuit, respectively.

  For example, after puncturing a patient with an arterial puncture needle and a venous side puncture needle, the blood of the patient flows through the arterial blood circuit and the venous blood circuit by driving the blood pump. The blood is purified by the blood purification means. In dialysis treatment, a dialysate introduction line for introducing dialysate into the blood purification means and a dialysate discharge line for discharging drainage from the blood purification means are respectively connected to the blood purification means. .

  In the blood purification apparatus as described above, it is necessary to prime the blood circuit and the blood purification means before blood purification treatment. Such priming is usually performed by driving a blood pump to supply a priming solution such as a physiological saline to the blood circuit. In the blood purification unit, a flow path for circulating blood in the blood circuit is provided. This is performed by filling the flow path (blood flow path) through which blood flows and the flow path (dialysis liquid flow path) through which dialysate flows with priming liquid. In addition, since this prior art is not related to the literature known invention, there is no prior art document information to be described.

The conventional blood purification apparatus has the following problems.
The blood purification means is set so that the flow direction of the dialysate in the dialysate flow channel faces the flow direction of the blood in the blood flow channel for reasons of dialysis efficiency. In addition, when bubbles remaining in the arterial blood circuit before blood purification treatment enter the blood purification means, the blood flow channel outlet (blood outlet port) is directed upward so that the bubbles can easily pass upward. The blood purification treatment was performed while holding the blood purification means.

  On the other hand, when the blood outlet port is directed upward as described above, the dialysate outlet (dialyte outlet port) is located below the dialysate inlet (dialyte inlet port), and during priming, the dialysate It will be difficult to remove bubbles remaining in the flow path. Therefore, at the time of priming, it is necessary to keep the blood outlet port facing downward, and at the start of blood purification treatment, it is necessary to invert the blood purification means so that the blood outlet port faces upward There was a problem that the reversal work by the medical staff would be necessary.

  The present invention has been made in view of such circumstances, and can reliably perform filling of the priming liquid into the blood flow path and the dialysate flow path of the blood purification means, and medical engagement at the start of blood purification treatment. An object of the present invention is to provide a blood purification apparatus that can eliminate the need for a person to reverse the blood purification means.

  The invention described in claim 1 includes a blood introduction port through which blood can be introduced, a blood delivery port from which blood can be derived, and a blood flow extending through the blood introduction port and the blood delivery port so that blood can flow. A dialysis fluid introduction port capable of introducing a dialysis fluid, a dialysis fluid derivation port capable of deriving a dialysis fluid, and the dialysis fluid introduction port and the dialysis fluid derivation port. A blood purification system capable of purifying blood flowing through the blood flow path by interposing between the blood flow path and the dialysate flow path, and a dialysate flow path capable of flowing dialysate in a direction facing the circulating blood A blood purification means having a membrane, an arterial blood circuit connected to a blood introduction port of the blood purification means, a venous blood circuit connected to the blood outlet port, and the arterial blood circuit From the tip of the venous blood circuit A blood circuit capable of extracorporeally circulating the patient's blood to the end, a dialysate introduction line connected to the dialysate introduction port of the blood purification means and capable of introducing dialysate into the blood purification means, and dialysis of the blood purification means A dialysate drainage line connected to the fluid outlet port and capable of draining drainage from the blood purification means; and disposed in the arterial blood circuit, from the arterial blood circuit toward the venous blood circuit. And a blood pump that can circulate blood extracorporeally, and in the blood purification device that can be primed by supplying the priming liquid to the blood circuit by driving the blood pump, filling the priming liquid in priming The blood purification means is held with the blood outlet port facing upward, and the blood is introduced from the blood introduction port. The priming liquid introduced into the blood flow path of the purifying means is filtered through the blood purification membrane into the dialysate flow path, and the dialysis liquid flow path can be primed by being led out from the dialysate introduction port. It is characterized by that.

  According to a second aspect of the present invention, in the blood purification apparatus according to the first aspect, the priming fluid is stored in a priming fluid at least at a distal end portion of the arterial blood circuit of the arterial blood circuit and the venous blood circuit. A bag is connectable, and the priming liquid in the priming liquid storage bag can be supplied to the blood circuit when the priming liquid is filled during priming.

  According to a third aspect of the present invention, in the blood purification apparatus according to the first or second aspect of the present invention, the blood purification apparatus includes a replacement fluid line capable of communicating a predetermined portion of the venous blood circuit with a dialysate introduction line, and the priming in priming The gas discharged from the dialysate introduction port of the blood purification means can be discharged to the venous blood circuit through the replacement fluid line when the liquid is filled.

  According to a fourth aspect of the present invention, in the blood purification apparatus according to the third aspect of the present invention, the blood purification apparatus further comprises a replacement fluid pump disposed in the replacement fluid line and capable of feeding dialysate from the dialysate introduction line to the venous blood circuit. When filling the priming solution in priming, the flow rate from the replacement fluid pump is set to be equal to or lower than the flow rate from the blood pump, thereby allowing the gas discharged from the dialysate introduction port of the blood purification means to pass through the replacement fluid line. It is possible to drain into the venous blood circuit.

  According to a fifth aspect of the present invention, in the blood purification device according to the third aspect, the blood purification device is disposed between the blood purification means in the venous blood circuit and a connection portion of the replacement fluid line, and the flow path is arbitrarily opened and closed. And opening and closing means, and closing the flow path by closing the opening and closing means when filling the priming liquid in priming, thereby allowing the gas discharged from the dialysate introduction port of the blood purification means to flow into the replacement fluid line Through the venous blood circuit.

  According to a sixth aspect of the present invention, in the blood purification apparatus according to any one of the third to fifth aspects, the gas discharged to the venous blood circuit when the priming liquid is filled in priming is supplied to the venous blood. It is possible to collect in a collection container connected to the tip of the circuit.

  According to a seventh aspect of the present invention, in the blood purification apparatus according to any one of the third to fifth aspects, the blood circuit side air trap chamber disposed at a connection portion of the venous side blood circuit with the replacement fluid line. An air discharge line extending from the upper part of the blood circuit side air trap chamber and capable of discharging air in the blood circuit side air trap chamber; and air in the blood circuit side air trap chamber Air discharging means that can be discharged to the outside through the gas, and when the priming liquid is filled in priming, the gas discharged to the venous blood circuit is collected in the blood circuit side air trap chamber, It is characterized in that the air discharge means can be operated to discharge outside through the air discharge line.

  According to an eighth aspect of the present invention, in the blood purification apparatus according to the seventh aspect of the present invention, the blood purification device further includes a liquid level detecting unit capable of detecting a liquid level of the blood circuit side air trap chamber. On the condition that the liquid level is detected, the discharge of gas by the air discharge means is stopped.

  The invention according to claim 9 is the blood purification apparatus according to any one of claims 1 to 8, wherein the blood purification apparatus is connected to a distal end portion of the dialysate introduction line and accommodates a dialysate introduced into the blood purification means. A dialysate storage bag, a drainage storage bag connected to the distal end of the dialysate discharge line and capable of storing drainage discharged from the blood purification means, and disposed in the dialysate introduction line; A dialysate pump for sending dialysate from the solution storage bag to the blood purification means and a dialysate discharge line disposed in the dialysate discharge line to send the drainage discharged from the blood purification means to the drainage storage bag And a drainage pump.

  According to a tenth aspect of the present invention, in the blood purification apparatus according to the ninth aspect, the dialysate pump is reversed so that the flow rate of the dialysate pump is equal to or less than the flow rate of the blood pump when the priming solution is filled in priming. By driving, the priming liquid introduced into the blood flow path of the blood purification means from the blood introduction port is filtered through the blood purification membrane into the dialysate flow path, and is derived from the dialysate introduction port. The dialysate flow path can be primed.

  The invention according to claim 11 is the blood purification apparatus according to claim 9 or claim 10, wherein the dialysate-side air trap chamber is disposed between the dialysate pump and the blood purification means in the dialysate introduction line. An air discharge line extending from the upper part of the dialysate side air trap chamber and capable of discharging air in the dialysate side air trap chamber; and air in the dialysate side air trap chamber An air discharging means that can be discharged to the outside through the priming liquid during priming, the gas discharged from the dialysate introduction port is collected in the dialysate side air trap chamber, It is characterized in that the air discharge means can be operated to discharge outside through the air discharge line.

  A twelfth aspect of the present invention is the blood purification apparatus according to the eleventh aspect, further comprising a liquid level detecting unit capable of detecting the liquid level of the dialysate side air trap chamber, On the condition that the liquid level is detected, the discharge of gas by the air discharge means is stopped.

  According to the first aspect of the present invention, when the priming liquid is filled in priming, the blood purification means is held with the blood outlet port facing upward, and is introduced from the blood introduction port into the blood flow path of the blood purification means. Since the priming fluid is filtered through the blood purification membrane into the dialysate flow channel and is led out from the dialysate introduction port so that the dialysate flow channel can be primed, the blood flow channel and the dialysate flow channel of the blood purification means Can be reliably filled with priming liquid, and the work of reversing the blood purification means by the medical staff at the start of blood purification treatment can be made unnecessary.

  According to the invention of claim 2, a priming solution containing bag containing a priming solution can be connected to at least the tip of the arterial blood circuit of the arterial blood circuit and the venous blood circuit. Since the priming solution in the priming solution storage bag can be supplied to the blood circuit at the time of filling, the filling of the priming solution on the blood circuit side can be performed more reliably and smoothly.

  According to the third aspect of the present invention, there is a replacement fluid line capable of communicating a predetermined part of the venous blood circuit with the dialysate introduction line, and the priming fluid is discharged from the dialysate introduction port of the blood purification means when filling with the priming fluid in the priming. Since the gas thus discharged can be discharged to the venous blood circuit via the replacement fluid line, more efficient priming can be performed.

  According to invention of Claim 4, it has a replacement fluid pump which is arrange | positioned at a replacement fluid line and can send a dialysate from a dialysate introduction line to a venous blood circuit, and is filled by the replacement fluid pump at the time of filling of the priming fluid in priming. By setting the flow rate to be equal to or lower than the flow rate by the blood pump, the gas discharged from the dialysate introduction port of the blood purification means can be discharged to the venous blood circuit via the replacement fluid line. More efficient priming can be performed.

  According to the invention of claim 5, the priming liquid in the priming is provided between the blood purification means in the venous blood circuit and the connecting part of the replacement fluid line, and has an opening / closing means that can arbitrarily open and close the flow path. Since the gas discharged from the dialysate introduction port of the blood purification means can be discharged to the venous blood circuit via the replacement liquid line by closing the flow path by closing the opening / closing means when filling The gas discharged through the line can be discharged more reliably, and more efficient priming can be performed.

  According to the invention of claim 6, when filling the priming liquid in the priming, the gas discharged to the venous blood circuit can be collected in the collection container connected to the distal end portion of the venous blood circuit. The gas replaced with the priming liquid at the time of filling the priming liquid can be recovered more reliably.

  According to the seventh aspect of the present invention, when the priming liquid is filled in the priming, the gas discharged to the venous blood circuit is collected in the blood circuit side air trap chamber, the air discharging means is operated, and the air discharge line Therefore, when the priming liquid is filled, the gas substituted for the priming liquid can be reliably discharged to the outside by using the blood circuit side air trap chamber and the air discharging means.

  According to the eighth aspect of the present invention, it is provided that the liquid level detecting means capable of detecting the liquid level of the blood circuit side air trap chamber is provided, and the liquid level detecting means detects a liquid level of a predetermined height. Since the discharge of gas by the air discharge means is stopped, the priming liquid filling operation can be completed by detecting that the priming liquid has been completely replaced with gas by diverting the liquid level detection means. Efficient priming can be performed.

  According to the ninth aspect of the present invention, the blood purification device is connected to the distal end portion of the dialysate introduction line and contains the dialysate storage bag containing the dialysate introduced into the blood purification means, and the distal end portion of the dialysate discharge line. A effluent storage bag capable of storing the effluent discharged from the means, a dialysis fluid pump disposed in the dialysis fluid introduction line, and for delivering the dialysis fluid in the dialysis fluid storage bag to the blood purification means, and a dialysis fluid discharge line And a drainage pump for feeding the drainage discharged from the blood purification means to the drainage storage bag, so that more efficient priming can be performed by using the dialysate pump or the drainage pump. Can be made.

  According to the invention of claim 10, when the priming liquid is filled in the priming, the dialysate pump is reversely driven so that the flow rate of the dialysate pump is equal to or less than the flow rate of the blood pump, whereby blood purification means is provided from the blood introduction port. The priming fluid introduced into the blood flow channel is filtered through the blood purification membrane into the dialysate fluid flow channel, and the dialysate fluid flow channel can be primed by being led out from the dialysate fluid introduction port. By cooperating with the blood pump, more efficient priming can be performed.

  According to the eleventh aspect of the present invention, when the priming liquid is filled in the priming, the gas discharged from the dialysate introduction port is collected in the dialysate-side air trap chamber, the air discharge means is operated, and the air discharge line Thus, the dialysate-side air trap chamber and the air discharge means can be used to reliably discharge the gas substituted for the priming solution to the outside when the priming solution is filled.

  According to the twelfth aspect of the present invention, it is provided that the liquid level detecting means capable of detecting the liquid level of the dialysate side air trap chamber is provided, and the liquid level of the predetermined height is detected by the liquid level detecting means. Since the discharge of gas by the air discharge means is stopped, the priming liquid filling operation can be completed by detecting that the priming liquid has been completely replaced with gas by diverting the liquid level detection means. Efficient priming can be performed.

The schematic diagram which shows the blood purification apparatus which concerns on embodiment of this invention. Schematic diagram showing blood purification means applied to the blood purification apparatus The flowchart which shows the process performed at the time of priming in the blood purification apparatus Schematic showing the blood purification device (when filling with priming solution) Schematic showing the blood purification device (when filling with priming solution) Schematic showing the blood purification device (when filling with priming solution) Schematic showing the blood purification device (when filling with priming solution) Schematic showing the blood purification device (with opening and closing means) The schematic diagram which shows the blood purification apparatus which concerns on other embodiment of this invention.

Hereinafter, embodiments of the present invention will be specifically described with reference to the drawings.
The blood purification apparatus according to this embodiment is applied to a hemodialysis apparatus for purifying a patient's blood while circulating it extracorporeally. As shown in FIG. 1, an arterial blood circuit 1a and a venous blood circuit 1b are used. A blood circuit 1 having a blood flow, a dialyzer 2 (blood purification means) that is interposed between an arterial blood circuit 1a and a venous blood circuit 1b and purifies blood flowing through the blood circuit 1, and an arterial blood circuit 1a. A blood pump P1 including a squeezing type pump, a dialysate introduction line L1 and a dialysate discharge line L2, and a dialysate pump P2 and a drain provided in the dialysate introduction line L1 and the dialysate discharge line L2, respectively. A fluid pump P3, a fluid replacement line L3, a fluid replacement pump P4 disposed in the fluid replacement line L3, and a control means 11 are configured. In addition, the code | symbol P in the figure has shown the pressure detection means.

  The arterial blood circuit 1a and the venous blood circuit 1b are each connected with a connector at the tip, and an arterial puncture needle and a venous puncture needle (not shown) can be connected via the connector. . The blood pump P1 is driven (forward rotation drive) in a state where the patient is punctured with the arterial puncture needle connected to the distal end of the arterial blood circuit 1a and the venous puncture needle connected to the distal end of the venous blood circuit 1b. ), The blood of the patient reaches the dialyzer 2 through the arterial blood circuit 1a, and after blood purification is performed by the dialyzer 2, returns to the patient's body through the venous blood circuit 1b. ing. Instead of puncturing the patient's blood vessel with the arterial puncture needle and vein side puncture needle, a double lumen catheter is inserted into the patient's subclavian vein or femoral vein, or into the patient's arm blood vessel. It may be.

  Further, a blood circuit side air trap chamber 3 is connected in the middle of the venous side blood circuit 1b, and the blood circulating outside the body returns to the patient after the bubbles are removed in the air trap chamber 3. Become. Furthermore, a clamp means 5 is disposed at the distal end of the venous blood circuit 1b, and the flow path at that position can be opened or closed by arbitrarily opening and closing the clamp means 5.

  Still further, the venous blood circuit 1b according to the present embodiment includes a blood circuit side air trap chamber 3 disposed at a connection portion with the replacement fluid line L3, and extends from the upper part of the blood circuit side air trap chamber 3. The air discharge line La that can discharge the air in the blood circuit side air trap chamber 3 and the air discharge means 9 that can discharge the air in the blood circuit side air trap chamber 3 to the outside via the air discharge line La. The blood circuit side air trap chamber 3 is provided with a liquid level detecting means 6 capable of detecting the liquid level of the blood circuit side air trap chamber 3.

  The air discharge means 9 has a flow path communicating with the air discharge line La, the front end of the flow path is open to the atmosphere through a filter, and an electromagnetic valve Va and a squeeze pump are provided in the middle of the flow path. Pa is attached. Then, the solenoid valve Va is opened, and the iron pump Pa is driven to rotate in the forward direction, thereby releasing the air in the blood circuit side air trap chamber 3 to the outside and raising the liquid level of the blood circuit side air trap chamber 3. In addition, the squeezing type pump Pa can be driven to rotate in the reverse direction so that air can be introduced into the blood circuit side air trap chamber 3 and the liquid level of the blood circuit side air trap chamber 3 can be lowered. ing.

  As shown in FIG. 2, the dialyzer 2 extends over a blood introduction port 2a through which blood can be introduced, a blood extraction port 2b through which blood can be extracted, and the blood introduction port 2a and the blood extraction port 2b. Blood flow path 2e through which blood can flow, dialysate introduction port 2c through which dialysate can be introduced, dialysate exit port 2d through which dialysate can be derived, dialysate introduction port 2c, and dialysate exit port 2d A dialysis fluid channel 2f that extends through the dialysis fluid in a direction opposite to the blood that circulates in the blood channel 2e, and is interposed between the blood channel 2e and the dialysis fluid channel 2f. A blood purification film 2g capable of purifying blood flowing through the blood flow path 2e.

  More specifically, the dialyzer 2 has a blood inlet port 2a, a blood outlet port 2b, a dialysate inlet port 2c, and a dialysate outlet port 2d protruding from the casing, and of these, the blood inlet port 2a Is connected to the arterial blood circuit 1a, the blood outlet port 2b is connected to the venous blood circuit 1b, the dialysate inlet port 2c is connected to the dialysate inlet line L1, and the dialysate outlet port 2d is dialysate. The discharge lines L2 are connected to each other. Furthermore, in order to perform efficient dialysis treatment, the positional relationship in the vertical direction of the blood introduction port 2a that is the blood inlet and the dialysate introduction port 2c that is the inlet of the dialysate is reversed, and the blood flow path It is comprised so that a dialysate may distribute | circulate in the direction facing the blood which distribute | circulates in 2e.

  A plurality of hollow fiber membranes are accommodated in the dialyzer 2, and these hollow fibers constitute a blood purification membrane 2g for purifying blood. That is, the inside of the blood purification membrane 2g constituting the hollow fiber is the blood flow path 2e, and the space between the housing and the hollow fiber is the dialysate flow path 2f. The blood purification membrane 2g forms a hollow fiber membrane, and a large number of minute holes (pores) penetrating the outer peripheral surface and the inner peripheral surface are formed, and the blood flow channel 2e is circulated through the membrane. Impurities and the like in the blood to be permeated (filtered) into the dialysate flowing through the dialysate channel 2f.

  The dialysate introduction line L1 is composed of a flow path for introducing dialysate into the dialyzer 2, one end of which is connected to the dialysate introduction port 2c of the dialyzer 2, and a dialysate pump P2 is disposed in the midway flow path. Has been. Like the blood pump P1, the dialysate pump P2 is composed of a peristaltic pump that squeezes and feeds a flexible tube constituting the dialysate introduction line L1. The other end of the dialysate introduction line L1 is connected to a dialysate storage bag B1 containing a predetermined volume of dialysate, and the dialysate storage bag B1 is driven by driving the dialysate pump P2 (forward rotation driving). The inside dialysate can be introduced into the dialyzer 2.

  The dialysate discharge line L2 includes a flow path for discharging the drainage liquid from the dialyzer 2, and one end is connected to the dialysate outlet port 2d of the dialyzer 2 and a drainage pump P3 is disposed in the midway path. Has been. Like the blood pump P1, the drainage pump P3 is a peristaltic pump that squeezes and feeds a flexible tube constituting the dialysate discharge line L2. The other end of the dialysate discharge line L2 is connected to a drainage storage bag B2 that can store a predetermined amount of drainage. By driving the drainage pump P3 (forward rotation driving), the dialyzer 2 The discharged dialysate (drainage) can be introduced into the drainage storage bag B2.

  Then, the dialysate in the dialysate storage bag B1 flows and is supplied toward the dialyzer 2 by the positive rotation drive of the dialysate pump P2, and the dialysate ( (Drainage) flows toward the drainage storage bag B2 and is discharged. The weighing scales 4a and 4b are configured so that the dialysate storage bag B1 and the drainage storage bag B2 are respectively hooked and held on the hooks, and the weights of the dialysate storage bag B1 and the drainage storage bag B2 can be measured in real time. Has been. The dialysate storage bag B1 and the drainage storage bag B2 are made of flexible storage containers. Among these, the drainage storage bag B2 stores the drainage therein before starting the blood purification treatment. It is not empty.

  Further, the driving of the blood pump P1, the dialysate pump P2, and the drainage pump P3 (and the replacement fluid pump P4) is controlled based on the weights measured by the weight scales 4a and 4b and preset values stored in advance. ing. The driving speed of the drainage pump P3 is controlled so as to be the same driving speed as that of the dialysate pump P2 when water is not removed from the patient as a treatment condition. The driving speed is controlled by adding the flow rate due to. And when there is a difference between the respective weights of the dialysate storage bag B1 and the drainage storage bag B2 detected by the weighing scales 4a and 4b after the predetermined time, and the theoretical weight, the difference is calculated. The driving speed of the drainage pump P3 can be automatically finely adjusted in order to correct the loss.

  The replacement fluid line L3 is a flow path capable of communicating a predetermined portion of the venous blood circuit 1b (in this embodiment, the blood circuit side air trap chamber 3 connected to the venous blood circuit 1b) and the dialysate introduction line L1. Consists of. The replacement fluid line L3 is provided with a replacement fluid pump P4. By driving the replacement fluid pump P4 (forward rotation driving), the dialysate is sent from the dialysate introduction line L1 to the venous blood circuit 1b. Thus, a replacement fluid (post-replacement fluid) is possible. Note that the replacement fluid pump P4 is a peristaltic pump that, like the blood pump P1, squeezes and feeds a flexible tube that constitutes the replacement fluid line L3.

  Furthermore, the dialysate introduction line L1 according to the present embodiment includes a dialysate side air trap chamber 7 disposed between the dialysate pump P2 and the dialyzer 2, and an upper portion of the dialysate side air trap chamber 7. And an air discharge line Lb that can discharge the air in the dialysate-side air trap chamber 7 and air that can discharge the air in the dialysate-side air trap chamber 7 to the outside via the air discharge line Lb. The dialysis fluid side air trap chamber 7 is provided with a liquid level detection means 8 capable of detecting the liquid level of the dialysis fluid side air trap chamber 7.

  The air discharge means 10 has a flow path communicating with the air discharge line Lb. The front end of the flow path is open to the atmosphere through a filter, and a squeezing pump Pb is attached in the middle of the flow path. ing. Then, by driving the squeezing type pump Pb to rotate forward, the air in the dialysate side air trap chamber 7 can be released to the outside and the level of the dialysate side air trap chamber 7 can be raised. By driving the pump Pb to rotate in the reverse direction, air is introduced into the dialysate-side air trap chamber 7 so that the liquid level of the dialysate-side air trap chamber 7 can be lowered.

  The control means 11 comprises a microcomputer or the like disposed in the blood purification device, and includes actuators (blood pump P1, dialysate pump P2, drainage pump P3, replacement fluid pump P4, etc.) and various sensors (liquid level detection means 6, 8). Etc.) and valve means (clamp means 5 etc.), respectively, for performing various controls. In the present embodiment, the control before the blood purification treatment can be automatically performed by the control of the control means 11.

  The priming is a process performed by supplying the priming liquid to the blood circuit 1 (arterial blood circuit 1a and venous blood circuit 1b) by driving the blood pump P1, and as shown in FIG. The filling step S1, the cleaning step S2, and the bubble removal step S3 are included. The filling step S1 of the priming liquid is a process of replacing the gas (air) by filling the flow path of the blood circuit 1, the blood flow path 2e of the dialyzer 2 and the dialysate flow path 2f, and the washing process S2. The step of discharging and cleaning the priming liquid filled in the priming liquid filling step S1 while supplying the priming liquid, and the bubble removing step S3 circulate the priming liquid in the channel filled and washed with the priming liquid. In this step, the remaining bubbles are captured and discharged to the outside.

  Furthermore, a priming solution storage bag B3 containing a priming solution (physiological saline solution) can be connected to the distal ends of the arterial blood circuit 1a and the venous blood circuit 1b according to the present embodiment, and the priming solution in priming can be connected. At the time of filling, the priming solution in the priming solution storage bag B3 can be supplied to the blood circuit 1. In the present embodiment, the priming fluid storage bag B3 is connected to the distal ends of both the arterial blood circuit 1a and the venous blood circuit 1b, but at least the priming fluid is stored in the distal portion of the arterial blood circuit 1a. It is sufficient if the bag B3 is connected.

  Here, in the blood purification apparatus according to the present embodiment, when the priming liquid is filled in priming (priming liquid filling step S1), as shown in FIG. 2, the blood outlet port 2b faces upward (dialysis liquid). While holding the dialyzer 2 (blood purification means) in a state where the introduction port 2c is located above the dialysate outlet port 2d), the priming solution introduced from the blood introduction port 2a into the blood flow path 2e of the dialyzer 2 is purified. The dialysate flow path 2f is filtered through the membrane 2g and led out from the dialysate introduction port 2c so that the dialysate flow path 2f can be primed.

  For example, when filling of the priming liquid in priming (priming liquid filling step S1) is started, as shown in FIG. 4, the dialysate pump P2 and the drainage pump P3 have the same flow rate while the clamp means 5 is closed. In this manner, the pump is driven to rotate in the forward direction, and other pumps such as blood pump P1 and replacement fluid pump P4 are stopped. Thereby, the dialysate in the dialysate accommodation bag B1 can be circulated and filled up to the connection part with the replacement fluid line L3 in the dialysate introduction line L1.

  After the above operation is completed, as shown in FIG. 5, while maintaining the closed state of the clamp means 5, the blood pump P1 is driven to rotate forward and the replacement fluid pump P4 is driven to rotate forward. At this time, the solenoid valve Va in the air discharge means 9 is opened, and the ironing pump Pa is driven to rotate in the forward direction, and other ironing pumps such as the dialysate pump P2 and the drainage pump P3 are stopped. The flow rate of the replacement fluid pump P4 is set to be equal to or lower than the flow rate of the blood pump P1, and the driving speed of the ironing type pump Pa is controlled by the control means 11.

  Thus, the priming solution (saline solution) in the dialysate storage bag B3 flows through the arterial blood circuit 1a to the blood channel 2e of the dialyzer 2, and is filtered by the blood purification membrane 2g to be dialysate channel. 2f, and after being discharged from the dialysate introduction port 2c, it is circulated and filled to the venous blood circuit 1b via the replacement fluid line L3, and is replaced with the gas (air) in the flow path. . In the filling process of the priming solution, the gas discharged to the venous blood circuit 1b (that is, the air replaced with the priming solution) is collected in the blood circuit side air trap chamber 3 and the air discharging means 9 is operated. Is discharged to the outside through the air discharge line La.

  The blood pump P1 and the replacement fluid pump P4 are stopped on the condition that the liquid level detecting means 6 has detected a liquid level of a predetermined height, and the solenoid valve Va in the air discharging means 9 is closed and the ironing pump Pa is stopped. However, instead of the priming operation as described above, as shown in FIG. 8, it is disposed between the dialyzer 2 and the connecting part of the replacement fluid line L3 in the venous blood circuit 1b, and the flow path can be arbitrarily opened and closed. A gas discharged from the dialysate introduction port 2c of the dialyzer 2 (substitute air) by having the opening / closing means 12 and closing the flow path by closing the opening / closing means 12 when filling the priming liquid in the priming. May be discharged to the venous blood circuit 1b through the replacement fluid line L3.

  As described above, during filling of the priming liquid in the priming (priming liquid filling step S1), the gas discharged from the dialysate introduction port 2c of the dialyzer 2 (that is, the air replaced with the priming liquid) is supplied via the replacement liquid line L3. Thus, it can be discharged to the venous blood circuit 1b. Further, when the priming liquid is filled in the priming (priming liquid filling step S1), the gas discharged from the dialysate introduction port 2c of the dialyzer 2 is set by setting the flow rate by the replacement fluid pump P4 to be equal to or less than the flow rate by the blood pump P1 ( That is, the air replaced with the priming solution can be discharged to the venous blood circuit 1b through the replacement fluid line L3.

  Further, instead of the gas discharged from the dialysate introduction port 2c of the dialyzer 2 as described above (air replaced with the priming solution) flowing to the venous blood circuit 1b via the replacement fluid line L3, the dialyzer 2 The gas discharged from the dialysate introduction port 2c (air replaced with the priming solution) is collected in the dialysate-side air trap chamber 7 in the dialysate introduction line L1, and the air discharge means 10 is operated to discharge the air. You may comprise so that it may discharge outside via the line Lb.

  In this case, the priming solution introduced into the blood flow path 2e of the dialyzer 2 from the blood introduction port 2a by driving the dialysate pump P2 in reverse so that the flow rate of the dialysate pump P2 is equal to or less than the flow rate of the blood pump P1. Can be filtered through the blood purification membrane 2g into the dialysate flow path 2f and led out from the dialysate introduction port 2c to prime the dialysate flow path 2f. As a result, the air replaced with the priming solution is collected in the dialysate-side air trap chamber 7, so that the air discharge is performed on condition that the liquid level detecting means 8 detects the liquid level of a predetermined height. The gas discharge by the means 10 can be stopped.

  After the above operation, as shown in FIG. 6, the blood pump P1 is driven to rotate in the forward direction while maintaining the closed state of the clamp means 5, and the solenoid valve Va in the air discharge means 9 is opened so that the iron pump Pa By driving forward rotation, the air in the flow path from the connection part of the dialyzer 2 to the blood circuit side air trap chamber 3 in the blood flow path 2e of the dialyzer 2 and the venous side blood circuit 1b is replaced with the priming liquid. At this time, the driving speed of the ironing type pump Pa is controlled so that the liquid level detected by the liquid level detecting means 6 is constant.

  Then, the clamp means 5 is opened while the positive rotation drive of the blood pump P1 is maintained, the solenoid valve Va in the air discharge means 9 is closed, and the ironing pump Pa is stopped to discharge to the venous blood circuit 1b. The gas thus collected can be collected in a collection container (in this embodiment, a priming solution storage bag B3) connected to the tip of the venous blood circuit 1b. Thereby, it is possible to fill the space between the tip of the venous blood circuit 1b and the blood circuit side air trap chamber 3 with the priming liquid.

  As shown in FIG. 7, when the priming fluid storage bag B3 is connected to the distal end portion of the venous blood circuit 1b, the electromagnetic valve Va in the air discharge means 9 is opened while the clamp means 5 is opened. The priming pump Pa may be driven to rotate in the normal state so that the air in the flow path to the distal end of the venous blood circuit 1b and the blood circuit side air trap chamber 3 may be replaced with the priming liquid. Since the filling step S1 of the priming liquid is completed as described above, the series of priming is completed by sequentially performing the cleaning step S2 and the bubble removal step S3.

  If the priming solution supplied to the blood circuit 1 is discharged through the dialysate discharge line L2 in the washing step S2, a priming solution collection bag that is connected only during priming can be dispensed with. The cost for priming can be reduced. In particular, in the present embodiment, since it has the replacement fluid line L3 capable of communicating the predetermined part of the venous blood circuit 1b and the dialysate introduction line L1, at the time of discharging the priming fluid in priming (washing step S2), If the priming solution supplied to the blood circuit 1 flows to the dialysate discharge line L2 through the replacement fluid line L3 and is discharged, efficient replacement of the replacement fluid line L3 can be performed. Then, when blood purification treatment is performed after priming is completed, the priming fluid storage bag B3 is removed from the distal ends of the arterial blood circuit 1a and the venous blood circuit 1b, and a puncture needle is connected.

  According to the embodiment, when filling the priming liquid in priming, the dialyzer 2 is held with the blood outlet port 2b facing upward, and the priming introduced from the blood introduction port 2a to the blood flow path 2e of the dialyzer 2 The solution (physiological saline solution in the priming solution storage bag B3) is filtered through the blood purification membrane 2g into the dialysate flow channel 2f, and is led out from the dialysate introduction port 2c so that the dialysate flow channel 2f can be primed. Therefore, the blood flow path 2e and the dialysate flow path 2f of the dialyzer 2 can be reliably filled with the priming solution, and the work of reversing the dialyzer 2 by the medical staff at the start of blood purification treatment is not required. Can do. In the present embodiment, when the blood purification treatment is started, the operation of replacing the storage bags such as the dialysate bag B1 and the drainage bag B2 can be omitted, and the workability can be further improved.

  A priming solution storage bag B3 containing a priming solution (physiological saline solution) can be connected to at least the tip of the arterial blood circuit 1a of the arterial blood circuit 1a and the venous blood circuit 1b. At the time of filling the priming liquid, the priming liquid in the priming liquid storage bag B3 can be supplied to the blood circuit 1, so that the filling of the priming liquid on the blood circuit 1 side can be performed more reliably and smoothly.

  Furthermore, it has a replacement fluid line L3 that allows the predetermined part of the venous blood circuit 1b and the dialysate introduction line L1 to communicate with each other, and the gas discharged from the dialysate introduction port 2c of the dialyzer 2 when filling with the priming fluid in priming. Since it can be discharged to the venous blood circuit 1b via the replacement fluid line L3, more efficient priming can be performed. In particular, in the present embodiment, it has a replacement fluid pump P4 that is disposed in the replacement fluid line L3 and can send dialysate from the dialysate introduction line L1 to the venous blood circuit 1b. When filling the priming fluid in priming, By setting the flow rate of the replacement fluid pump P4 to be equal to or less than the flow rate of the blood pump P1, the gas discharged from the dialysate introduction port 2c of the dialyzer 2 can be discharged to the venous blood circuit 1b via the replacement fluid line L3. The replacement fluid pump P4 can be used for more efficient priming.

  Furthermore, it has an opening / closing means 12 (see FIG. 8) that is disposed between the dialyzer 2 and the connecting part of the replacement fluid line L3 in the venous blood circuit 1b, and can arbitrarily open and close the flow path. When the fluid is filled, the opening / closing means 12 is closed to close the flow path, so that the gas discharged from the dialysate introduction port 2c of the dialyzer 2 can be discharged to the venous blood circuit 1b via the replacement fluid line L3. Thus, the gas discharged through the replacement fluid line L3 can be more reliably discharged, and more efficient priming can be performed.

  Further, when the priming liquid is filled in the priming, the gas discharged to the venous blood circuit 1b is collected in a recovery container (in this embodiment, a priming liquid containing bag B3) connected to the tip of the venous blood circuit 1b. Since the gas can be recovered, the gas replaced with the priming liquid can be more reliably recovered when the priming liquid is filled. In addition, you may make it connect the collection container for exclusive use for collect | recovering gas to the front-end | tip part of the venous blood circuit 1b.

  Further, when the priming liquid is filled in the priming, the gas discharged to the venous blood circuit 1b is collected in the blood circuit side air trap chamber 3, the air discharging means 9 is operated, and the air is discharged via the air discharging line La. Since it can be discharged to the outside, the blood circuit side air trap chamber 3 and the air discharge means 9 can be diverted to reliably discharge the gas replaced with the priming liquid when filling the priming liquid. In particular, the liquid level detection means 6 capable of detecting the liquid level in the blood circuit side air trap chamber 3 is provided, and the air discharge is performed on condition that the liquid level detection means 6 detects a liquid level of a predetermined height. Since the discharge of the gas by the means 9 is stopped, it is possible to detect that the priming liquid has been completely replaced with the gas by diverting the liquid level detecting means 6 and to finish the filling operation of the priming liquid. Priming can be performed.

  Still further, connected to the distal end of the dialysate introduction line L1, connected to the dialysate storage bag B1 containing the dialysate introduced into the dialyzer 2 and the distal end of the dialysate discharge line L2, and discharged from the dialyzer 2 A effluent storage bag B2 that can store effluent, a dialysis fluid introduction line L1, a dialysis fluid pump P2 that feeds the dialysis fluid in the dialysis fluid storage bag B1 to the dialyzer 2, and a dialysis fluid discharge line L2. Equipped with a drainage pump P3 that is disposed and feeds the drainage discharged from the dialyzer 2 to the drainage storage bag B2, so that the dialysate pump P2 or the drainage pump P3 can be used for more efficient priming. Can be performed.

  Further, when filling the priming solution in the priming, the dialysate pump P2 is driven in reverse so that the flow rate of the dialysate pump P2 is equal to or less than the flow rate of the blood pump P1, whereby the blood flow path of the dialyzer 2 from the blood introduction port 2a. Since the priming solution introduced into 2e is filtered through the blood purification membrane 2g into the dialysate flow path 2f and led out from the dialysate introduction port 2c, the dialysate flow path 2f can be primed. More efficient priming can be performed by cooperation of P2 and blood pump P1.

  Further, when the priming liquid is filled in the priming, the gas discharged from the dialysate introduction port 2c is collected in the dialysate-side air trap chamber 7 and the air discharge means 10 is operated to pass through the air discharge line Lb. If the gas can be discharged to the outside, the dialysate-side air trap chamber 7 and the air discharge means 10 can be used to reliably discharge the gas replaced with the priming liquid when the priming liquid is filled. In particular, the liquid level detection means 8 capable of detecting the liquid level in the dialysate side air trap chamber 7 is provided, and the air discharge is performed on condition that the liquid level detection means 8 detects a liquid level of a predetermined height. If the gas discharge by the means 10 is stopped, the filling operation of the priming liquid can be completed by detecting that the priming liquid has been completely replaced with the gas by diverting the liquid level detecting means 8. More efficient priming can be performed.

  As mentioned above, although this embodiment was described, this invention is not limited to these, For example, as shown in FIG. 9, the compound pump 13 arrange | positioned ranging over the dialysate introduction line L1 and the dialysate discharge line L2, You may apply to the blood purification apparatus provided with the bypass line L4 which connects to the dialysate discharge line L2, and bypasses the compound pump 13, and the water removal pump 14 connected to the bypass line L4. In this blood purification apparatus, the dialysate introduction line L1 is connected to a water supply means (not shown), and is connected to a storage tank T1 containing the A stock solution and a storage tank T2 containing the B stock solution, and the pump 15 , 16 is driven to supply the A stock solution and the B stock solution to the dialysate introduction line L1, so that a dialysate having a predetermined concentration is prepared and introduced into the dialyzer 2.

  Even in this case, when filling the priming liquid in the priming, the dialyzer 2 (blood purification means) is held with the blood outlet port 2b facing upward, and the blood flow path 2e of the dialyzer 2 from the blood introduction port 2a. It is possible to filter the priming liquid introduced into the dialysate flow path 2f through the blood purification membrane 2g and lead out from the dialysate introduction port 2c to prime the dialysate flow path 2f.

  Furthermore, the present invention is applied to a blood purification apparatus that does not include the blood circuit side air trap chamber 3, the dialysate side air trap chamber 7, and the air discharge means 9, 10, or a blood purification apparatus that does not include the replacement fluid line L3 and the replacement fluid pump P4. Also good. The blood purification means is not limited to the one provided with the blood purification membrane 2g made of a hollow fiber membrane, and may have other forms that can purify and treat blood. The present invention is not limited to the treatment, and may be another treatment for purifying the patient's blood while circulating it extracorporeally.

  When filling the priming liquid in priming, the blood purification means is held with the blood outlet port facing upward, and the priming liquid introduced from the blood introduction port into the blood flow path of the blood purification means is passed through the blood purification membrane. As long as the blood purification apparatus is filtered through the dialysate flow path and led out from the dialysate introduction port so that the dialysate flow path can be primed, a blood purification apparatus to which other functions are added may be used.

DESCRIPTION OF SYMBOLS 1 Blood circuit 1a Arterial blood circuit 1b Venous blood circuit 2 Dialyzer (blood purification means)
3 Blood circuit side air trap chamber 4a, 4b Weigh scale 5 Clamp means 6 Liquid level detection means 7 Dialysate side air trap chamber 8 Liquid level detection means 9, 10 Air discharge means 11 Control means 12 Opening / closing means L1 Dialysate introduction line L2 Dialysate discharge line L3 Replacement fluid line P1 Blood pump P2 Dialysate pump P3 Drainage pump P4 Replacement fluid pump

Claims (12)

Blood introduction port through which blood can be introduced, blood delivery port through which blood can be derived, blood flow path extending through the blood introduction port and blood delivery port, allowing blood to flow, and dialysate can be introduced A dialysis fluid introduction port, a dialysis fluid derivation port from which the dialysis fluid can be derived, and a direction extending across the dialysis fluid introduction port and the dialysis fluid derivation port and facing the blood flowing in the blood flow path Blood purification means having a dialysate flow path capable of flowing dialysate, and a blood purification membrane that is interposed between the blood flow path and the dialysate flow path and can purify blood flowing through the blood flow path When,
From an arterial blood circuit connected to the blood introduction port of the blood purification means and a venous blood circuit connected to the blood outlet port, from the tip of the arterial blood circuit to the tip of the venous blood circuit A blood circuit capable of circulating the patient's blood extracorporeally;
A dialysate introduction line connected to the dialysate introduction port of the blood purification means and capable of introducing dialysate into the blood purification means, and a drainage fluid from the blood purification means connected to the dialysate outlet port of the blood purification means Dialysate discharge line capable of discharging
A blood pump disposed in the arterial blood circuit and capable of extracorporeally circulating patient blood from the arterial blood circuit toward the venous blood circuit;
And a blood purification device that is capable of priming by supplying a priming fluid to the blood circuit by driving the blood pump,
When filling the priming liquid in priming, the blood purification means is held with the blood outlet port facing upward, and the priming liquid introduced into the blood flow path of the blood purification means from the blood introduction port A blood purification apparatus, wherein the dialysate flow path is filtered through the blood purification membrane, and the dialysate flow path can be primed by being led out from the dialysate introduction port.   A priming solution storage bag containing a priming solution can be connected to at least a distal end portion of the arterial blood circuit of the arterial blood circuit and the venous blood circuit, and when the priming solution is filled in the priming, the priming The blood purification apparatus according to claim 1, wherein a priming liquid in a liquid storage bag can be supplied to the blood circuit.   A replacement fluid line capable of communicating a predetermined part of the venous blood circuit with a dialysate introduction line, and the gas discharged from the dialysate introduction port of the blood purification means when the priming solution is filled in priming 3. The blood purification apparatus according to claim 1, wherein the blood purification apparatus can be discharged to the venous blood circuit via a line.   A replacement fluid pump disposed in the replacement fluid line and capable of feeding dialysate from the dialysate introduction line to the venous blood circuit, and when filling the priming fluid in priming, the flow rate of the replacement fluid pump is set to the blood The gas discharged from the dialysate introduction port of the blood purification means can be discharged to the venous blood circuit through the replacement fluid line by setting the flow rate to be lower than the pump flow rate. The blood purification apparatus as described.   Between the blood purification means in the venous blood circuit and the connecting part of the replacement fluid line, and having opening and closing means that can arbitrarily open and close the flow path, when filling the priming liquid in priming, The gas discharged from the dialysate introduction port of the blood purification means can be discharged to the venous blood circuit through the replacement fluid line by closing the flow path with the opening / closing means closed. The blood purification apparatus according to claim 3.   The gas discharged to the venous blood circuit at the time of filling with the priming liquid in priming can be collected in a collection container connected to the distal end of the venous blood circuit. The blood purification apparatus according to any one of 5. A blood circuit side air trap chamber disposed in a connection portion with the replacement fluid line in the venous side blood circuit;
An air discharge line extending from the upper part of the blood circuit side air trap chamber and capable of discharging air in the blood circuit side air trap chamber;
Air discharge means capable of discharging the air in the blood circuit side air trap chamber to the outside through the air discharge line;
And when the priming liquid is filled in priming, the gas discharged to the venous blood circuit is collected in the blood circuit side air trap chamber, and the air discharging means is operated to operate the air discharging line. The blood purification apparatus according to any one of claims 3 to 5, wherein the blood purification apparatus can be discharged to the outside through the tube.   A gas level detection means capable of detecting the liquid level of the blood circuit side air trap chamber is provided, and the gas discharged by the air discharge means is provided on condition that the liquid level detection means detects a liquid level of a predetermined height. The blood purification apparatus according to claim 7, wherein the blood purification is stopped. A dialysate containing bag that is connected to the tip of the dialysate introduction line and contains dialysate introduced into the blood purification means;
A drainage storage bag connected to the distal end of the dialysate discharge line and capable of storing drainage discharged from the blood purification means;
A dialysate pump that is disposed in the dialysate introduction line and feeds the dialysate in the dialysate containing bag to the blood purification means;
A drainage pump disposed in the dialysate drainage line for feeding the drainage drained from the blood purification means to the drainage storage bag;
The blood purification apparatus according to any one of claims 1 to 8, wherein the blood purification apparatus is provided.   During filling of the priming solution in priming, the dialysate pump is reversely driven so that the flow rate of the dialysate pump is equal to or less than the flow rate of the blood pump, so that the blood flow path of the blood purification means from the blood introduction port The priming fluid introduced into the dialysis fluid flow path is filtered through the blood purification membrane into the dialysate fluid flow path, and the dialysis fluid flow path can be primed by being led out from the dialysate fluid introduction port. 9. The blood purification apparatus according to 9. A dialysate-side air trap chamber disposed between the dialysate pump and the blood purification means in the dialysate introduction line;
An air discharge line extending from the upper part of the dialysate-side air trap chamber and capable of discharging air in the dialysate-side air trap chamber;
Air discharge means capable of discharging the air in the dialysate side air trap chamber to the outside through the air discharge line;
And when the priming liquid is filled in the priming, the gas discharged from the dialysate introduction port is collected in the dialysate-side air trap chamber, the air discharge means is operated, and the air discharge line 11. The blood purification apparatus according to claim 9 or 10, wherein the blood purification apparatus can be discharged to the outside via a tube.   A gas level detection means capable of detecting the liquid level of the dialysate side air trap chamber and a gas by the air discharge means provided that the liquid level detection means detects a liquid level of a predetermined height. The blood purification apparatus according to claim 11, wherein the blood purification is stopped.

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