JP2018183408A - Chamber and hemodialysis device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a chamber that can restrain blood from coming into contact with air, and can restrain blood from splattering.SOLUTION: A chamber comprises a chamber body 61 for storing blood, a blood introduction port 611a arranged in the chamber body 61 to introduce blood into the chamber body 61, a blood discharge port 612a arranged in a bottom part of the chamber body 61 to discharge blood stored in the chamber body 61, and a replacement fluid introduction port 616a arranged in a side part of the chamber body 61 to introduce dialysis fluid as replacement fluid into the chamber body 61.SELECTED DRAWING: Figure 1

Description

  The present invention relates to a chamber and a hemodialysis apparatus including the chamber.

  Conventionally, dialysis treatment is performed on patients with renal insufficiency to purify their blood. In dialysis treatment, blood taken out from a patient is dialyzed (hemodialysis) with a dialyzer having a semipermeable membrane to remove impurities from the blood.

  Among dialysis treatments, hemofiltration (HDF) can improve blood purification efficiency by combining filtration with hemodialysis. In HDF, the decrease in blood due to filtration is supplemented to blood before or after dialysis. Among HDFs, in particular, a technique that uses a part of dialysate supplied to a dialyzer as a replacement fluid is called online HDF.

  In such a configuration for implementing online HDF, a dialysis apparatus is known that includes a venous chamber and an arterial chamber, and supplements the blood stored in the venous chamber or the arterial chamber with a reduced amount of blood by filtration. (For example, refer to Patent Document 1).

JP 2004-174235 A

In the venous chamber or the arterial chamber described in Patent Document 1, blood and replacement fluid are introduced from the upper side of the chamber, so that blood is easy to directly touch air, and at the interface where blood and air are in contact with blood, Easy to solidify. In addition, when online HDF is performed, since the replacement fluid is introduced from the upper side of the chamber, it is easy to cause disturbance at the interface and blood jump, and as a result, there is a possibility that a thrombus may be generated in the chamber.
Therefore, there is a demand for a chamber that can suppress blood from coming into contact with air, and can suppress disturbance of the interface between blood and air and blood jumping.

  An object of this invention is to provide the chamber and hemodialysis apparatus which can suppress the formation of the interface which blood and air contact, and can suppress the jumping of blood.

In the present invention, the above problem has been solved by preventing (suppressing) the formation of an interface between blood and air by overlaying a liquid phase with a replacement fluid on the upper surface of the blood stored in the chamber.
That is, the present invention relates to a chamber body that stores blood, a blood introduction port that is disposed in the chamber body and introduces blood into the chamber body, and blood that is disposed at the bottom of the chamber body and is stored in the chamber body. The present invention relates to a chamber provided with a blood outlet for deriving blood and a replacement fluid inlet for introducing a dialysate as a replacement fluid into the chamber body, which is disposed on a side portion of the chamber body.

  The replacement fluid inlet is preferably located above the upper surface of the blood layer.

  Further, it is preferable that the replacement fluid inlet port opens in a direction tangential to the inner peripheral surface of the chamber body.

  The blood introduction port is preferably disposed below the replacement fluid introduction port.

  The blood introduction port is preferably disposed at the bottom of the chamber body.

  The chamber, a hemodialyzer for contacting blood and dialysate through a dialysis membrane, an arterial line having one end connected to the subject's artery and the other end connected to the hemodialyzer, and one end A blood circuit having a venous side line connected to the hemodialyzer and having the other end connected to a vein of the subject, a dialysate introduction line for introducing dialysate into the hemodialyzer, and dialyzing from the hemodialyzer A dialysis fluid circuit having a dialysis fluid derivation line for deriving a fluid; and a control device for controlling the blood circuit and the dialysis fluid circuit, wherein the dialysis fluid circuit is the dialysis fluid introduction line or the dialysis fluid derivation line. The present invention relates to a hemodialysis apparatus having a liquid supply line for supplying a part of dialysate flowing through the chamber as a replacement liquid to the chamber, and a pump disposed in the liquid supply line.

  According to the present invention, a chamber capable of suppressing (preventing) blood from coming into contact with the air by layering a liquid phase composed of a replacement fluid on the upper side of the blood liquid level in the chamber and suppressing blood jumping. Can be provided.

It is a figure showing the whole hemodialysis device composition concerning a 1st embodiment of the present invention. It is a perspective view which shows the structure of the chamber in 1st Embodiment. It is the sectional view on the AA line in FIG. It is a figure which shows the blood purification apparatus which concerns on 2nd Embodiment of this invention. It is a figure which shows the structure of the vein side chamber which concerns on 3rd Embodiment of this invention. It is a figure which shows the structure of the vein side chamber which concerns on 4th Embodiment of this invention. It is a figure which shows the structure of the vein side chamber which concerns on the 1st modification of this invention. It is a figure which shows the structure of the vein side chamber which concerns on the 2nd modification of this invention. It is a figure which shows the structure of a 3rd modification, Comprising: It is a figure which shows typically the example of the positional relationship of a replacement fluid inlet and a side part blood inlet.

(First embodiment)
Hereinafter, preferred embodiments of the hemodialysis apparatus of the present invention will be described with reference to the drawings. The overall configuration of the hemodialysis apparatus 1 according to the first embodiment will be described with reference to FIG.
The hemodialysis apparatus 1 of the present invention is an apparatus that performs hemofiltration (HDF). In HDF, the decrease in blood due to filtration is supplemented to blood before or after dialysis. In the present embodiment, a so-called online HDF method is used in which a part of the dialysate supplied to the dialyzer is used as a replacement fluid among HDFs. In the present embodiment, as a blood purification method, a post-dilution method in which blood is replenished on the downstream side of the dialyzer is used in the online HDF.

  As shown in FIG. 1, the hemodialysis apparatus 1 includes a dialyzer 10 as a hemodialyzer, a venous chamber 60, a blood circuit 20, a dialysate circuit 30, a heater 40 as a temperature control unit, and a control device. 50.

  The dialyzer 10 includes a container main body 11 formed in a cylindrical shape and a dialysis membrane (not shown) accommodated in the container main body 11. It is divided into a channel and a dialysate-side flow channel (both not shown). A blood inlet 111 and a blood outlet 112 that communicate with the blood side channel, and a dialysate inlet 113 and a dialysate outlet 114 that communicate with the dialysate side channel are formed in the container body 11.

  The venous side chamber 60 is provided in a venous side line 22 to be described later in order to remove bubbles, blood clots, and the like in the blood circuit 20, and can store a predetermined amount of blood or replacement fluid (dialysate) of about 20 ml, for example. The vein side chamber 60 is made of a flexible material.

  As shown in FIGS. 1 and 2, the venous chamber 60 is disposed at the bottom of the chamber body 61, the chamber body 61 for storing blood, the bottom blood introduction section 611 disposed at the bottom of the chamber body 61, and the chamber body 61. It has a bottom blood derivation unit 612, an overflow unit 613, a venous pressure detection unit 614, an upper blood introduction unit 615, and a replacement fluid introduction unit 616 disposed on the side of the chamber body 61. The chamber body 61 includes a bottom side cylindrical part 62, an intermediate cylindrical part 63, and an upper side cylindrical part 64.

  The intermediate cylindrical portion 63 is formed in a cylindrical shape extending in the vertical direction. The upper cylindrical portion 64 is connected to the upper end portion of the intermediate cylindrical portion 63. The bottom side cylindrical portion 62 is connected to the lower end portion of the intermediate cylindrical portion 63.

  The bottom side cylindrical portion 62 is formed in a cylindrical shape having a bottom surface, extends in the vertical direction, and is shorter in the vertical direction than the intermediate cylindrical portion 63. The bottom side tubular portion 62 is provided with a bottom blood introduction portion 611 and a bottom blood lead-out portion 612 at the bottom thereof.

The bottom blood introduction part 611 extends in the vertical direction. The bottom blood introduction part 611 is connected to the lower part of the bottom side cylindrical part 62 via a bottom blood introduction opening 611a (blood introduction opening) that opens downward.
The bottom blood inlet 611 a is an opening for introducing blood into the chamber body 61. The bottom blood inlet 611a is connected to the blood outlet 112 of the dialyzer 10 via a vein upstream line 22a of the vein line 22 described later.

The bottom blood outlet 612 extends in the vertical direction. The bottom blood outlet 612 is connected to the lower part of the bottom side tubular portion 62 through a bottom blood outlet 612a (blood outlet) that opens downward.
The bottom blood outlet 612 a is an opening for leading blood stored in the chamber body 61 to the outside of the chamber body 61. The bottom blood outlet 612a is connected to the vein of the subject (dialysis patient) via a vein downstream line 22b of the vein line 22 described later.

  The upper cylindrical portion 64 is formed in a cylindrical shape having a top surface and extends in the up-down direction. An overflow part 613, a venous pressure detection part 614, and an upper blood introduction part 615 are disposed on the upper part of the upper cylindrical part 64. A replacement fluid introduction part 616 is disposed on the side part of the upper cylindrical part 64.

The overflow part 613 is connected to the upper part of the chamber main body 61 through the overflow port 613a. The venous pressure detection unit 614 is connected to the upper part of the chamber body 61 via the venous pressure detection port 614a. The upper blood introduction part 615 is connected to the upper part of the chamber body 61 via the upper blood introduction port 615a.
The overflow port 613a, the vein pressure detection port 614a, and the upper blood introduction port 615a all open upward.

A tube extending inside the chamber body 61 is connected to the overflow port 613a, and a lower end portion of the tube is a predetermined height inside the chamber body 61 (in the present embodiment, slightly above the replacement fluid introduction port 616a). ).
A venous pressure sensor 221 is connected to the venous pressure detection port 614a. The venous pressure sensor 221 detects the venous pressure of blood inside the venous chamber 60.
In the present embodiment, nothing is connected to the upper blood inlet 615a. The upper blood inlet 615a is connected to the upper blood inlet 615a without connecting the bottom blood inlet 611a to the venous upstream line 22a of the venous line 22, as described in the second embodiment described later. Can also be configured by connecting the venous upstream line 22a of the venous line 22 connected to the bottom blood inlet 611a.

The replacement fluid introduction part 616 extends in a substantially horizontal direction from the side part of the chamber body 61. The replacement fluid inlet 616 is connected to the side of the chamber body 61 via a replacement fluid inlet 616 a that opens to the side of the chamber body 61.
The replacement fluid inlet 616a introduces dialysate as a replacement fluid into the chamber body 61. As shown in FIG. 3, the replacement fluid inlet 616 a is formed facing the tangential direction of the inner peripheral surface of the chamber body 61 and opens in a substantially horizontal direction.

  As shown in FIG. 1, the blood circuit 20 includes an artery side line 21, a vein side line 22, a drug line 23, and an overflow line 24. The arterial side line 21, the venous side line 22, the drug line 23, and the overflow line 24 are all composed mainly of a flexible tube through which fluid can flow.

One end side of the artery side line 21 is connected to the artery of the subject (dialysis patient), and the other end side is connected to the blood introduction port 111 of the dialyzer 10. In the arterial line 21, a bubble sensor 211, a blood pump 212, and an arterial chamber 213 are arranged.
The bubble sensor 211 detects bubbles contained in the blood flowing through the artery side line 21. The blood pump 212 is disposed downstream of the bubble sensor 211 in the artery side line 21. The blood pump 212 pumps the blood inside the artery side line 21 by squeezing the tube constituting the artery side line 21. The arterial chamber 213 is disposed downstream of the blood pump 212 in the arterial line 21. The arterial chamber 213 stores a predetermined amount (for example, 20 ml) of blood.

The vein side line 22 includes a vein side upstream line 22a and a vein side downstream line 22b.
One end of the venous upstream line 22 a is connected to the blood outlet 112 of the dialyzer 10, and the other end is connected to the bottom blood inlet 611 a of the venous chamber 60.
One end of the venous downstream line 22b is connected to the bottom blood outlet 612a of the venous chamber 60, and the other end is connected to the vein of the subject (dialysis patient). A bubble sensor 222 and a vein-side clamp 223 are disposed on the vein-side downstream line 22b.

  The bubble sensor 222 is disposed on the downstream side of the vein side chamber 60 in the vein side line 22. The bubble sensor 222 detects bubbles contained in the blood flowing through the vein line 22. The vein side clamp 223 is disposed on the downstream side of the bubble sensor 222 in the vein side line 22. The vein side clamp 223 opens and closes the flow path of the vein side line 22.

  The drug line 23 supplies drugs necessary for hemodialysis to the artery side line 21. One end side (base end side) of the drug line 23 is connected to a chemical pump 231 that sends out the drug, and the other end side (tip end side) is connected between the blood pump 212 and the artery side chamber 213 in the artery side line 21. The

  One end side (base end side) of the overflow line 24 is connected to the overflow port 613 a of the vein side chamber 60. The overflow line 24 discharges physiological saline, air, and the like flowing through the vein side line 22 to the outside in the priming process. An overflow clamp 241 is disposed on the overflow line 24. The overflow clamp 241 opens and closes the flow path of the overflow line 24.

  According to the blood circuit 20 described above, the blood taken out from the artery of the subject (dialysis patient) flows through the artery side line 21 by the blood pump 212 and is introduced into the blood side channel of the dialyzer 10. The blood introduced into the dialyzer 10 is purified by dialysate flowing through a dialysate circuit 30 described later via a dialysis membrane. The blood purified in the dialyzer 10 is introduced into the vein chamber 60 and stored. The blood once stored in the venous chamber 60 is replenished with dialysate as a replacement fluid via a liquid feeding line 38 described later. The blood once stored in the venous chamber 60 and supplemented with the replacement fluid flows through the venous line 22 and is returned to the subject's vein.

  In the present embodiment, the dialysate circuit 30 is configured by a so-called sealed capacity control type dialysate circuit 30. The dialysate circuit 30 includes a dialysate chamber 31, a dialysate supply line 32, a dialysate introduction line 33, a dialysate lead-out line 34, a drainage line 35, a bypass line 36, and water removal / reverse filtration. A pump 37, a liquid feed line 38, and an on-line replacement fluid pump 39 as a pump are provided.

  The dialysate chamber 31 includes a hard container 311 that can store a predetermined volume (for example, 300 ml to 500 ml) of dialysate, and a soft diaphragm (diaphragm) 312 that partitions the inside of the container 311. The inside of the dialysate chamber 31 is divided into a liquid feeding storage unit 313 and a drainage storage unit 314 by a diaphragm 312.

  The dialysate supply line 32 has a proximal end connected to a dialysate supply apparatus (not shown) and a distal end connected to the dialysate chamber 31. The dialysate supply line 32 supplies the dialysate to the liquid supply container 313 of the dialysate chamber 31.

  The dialysate introduction line 33 connects the dialysate chamber 31 and the dialysate introduction port 113 of the dialyzer 10, and the dialysate stored in the liquid feed storage portion 313 of the dialysate chamber 31 is supplied to the dialysate side flow path of the dialyzer 10. To introduce.

The dialysate lead-out line 34 connects the dialysate lead-out port 114 of the dialyzer 10 and the dialysate chamber 31, and guides the dialysate discharged from the dialyzer 10 to the drainage storage part 314 of the dialysate chamber 31.
The drainage line 35 is connected to the dialysate chamber 31 at the base end side, and discharges the dialysate drainage stored in the drainage storage portion 314.

The bypass line 36 connects the dialysate outlet line 34 and the drainage line 35.
A dewatering / back filtration pump 37 is disposed in the bypass line 36. The dewatering / back-filtration pump 37 sends the dialysate inside the bypass line 36 in the direction in which the dialysate is circulated to the drain line 35 (water removal direction) and in the direction in which it is circulated to the dialysate lead-out line 34 side (reverse filtration direction). It is composed of a pump that can be driven liquid.

The liquid feeding line 38 connects the dialysate introduction line 33 and the venous chamber 60. One end side of the liquid feeding line 38 is connected in the middle of the dialysate introduction line 33, and the other end side is connected to the replacement fluid introduction port 616 a of the venous chamber 60. The liquid feeding line 38 supplies a part of the dialysate flowing through the dialysate introduction line 33 as a replacement fluid to the vein chamber 60 disposed in the vein line 22.
The on-line replacement fluid pump 39 is disposed in the liquid feeding line 38, and feeds dialysate inside the liquid feeding line 38 toward the venous chamber 60 by squeezing a tube constituting the liquid feeding line 38.

According to the dialysate circuit 30 described above, the dialysate chamber 31 is configured by the rigid container 311 and the diaphragm 312 that partitions the inside of the container 311, so that the amount of dialysate derived from the dialysate chamber 31 (liquid feed) The amount of dialysate supplied to the storage unit 313) and the amount of drainage recovered in the dialysate chamber 31 (drainage storage unit 314) can be made equal.
Thereby, in a state where the water removal / reverse filtration pump 37 is stopped, the flow rate of the dialysate introduced into the dialyzer 10 and the amount of dialysate (drainage) derived from the dialyzer 10 can be made equal.

  When the water removal / reverse filtration pump 37 is driven so as to feed in the water removal direction, the amount of dialysate flowing through the dialysate outlet line 34 is the dialysate recovered in the dialysate chamber 31. (Ie, the amount of dialysate flowing through the dialysate introduction line 33) plus the amount of dialysate flowing through the bypass line 36. Accordingly, the amount of dialysate flowing through the dialysate outlet line 34 flows through the dialysate introduction line 33 by the amount of dialysate (drainage) discharged through the bypass line 36 to the drainage line 35. More than the amount of dialysate. That is, when the water removal / reverse filtration pump 37 is driven to feed in the water removal direction, a predetermined amount of water is removed from the blood in the dialyzer 10.

  On the other hand, when the dewatering / reverse filtration pump 37 is driven so as to send liquid in the reverse filtration direction, a part of the drainage discharged from the dialysate chamber 31 passes through the bypass line 36 and the dialysate discharge line 34. It is again collected in the dialysate chamber 31. Therefore, the amount of dialysate derived from the dialyzer 10 is the amount of dialysate flowing through the bypass line 36 from the amount recovered in the dialysate chamber 31 (that is, the amount of dialysate flowing through the dialysate introduction line 33). The amount is reduced. As a result, the amount of dialysate derived from the dialyzer 10 passes through the dialysate introduction line 33 by the amount of dialysate (drainage) collected again in the dialysate chamber 31 through the bypass line 36. Less than the liquid flow rate. That is, when the dewatering / reverse filtration pump 37 is driven to send the liquid in the reverse filtration direction, a predetermined amount of dialysate is injected into the blood circuit 20 (reverse filtration) in the dialyzer 10.

  In addition, by supplying a part of the dialysate flowing through the dialysate introduction line 33 to the venous chamber 60 as a replacement liquid by the liquid supply line 38, the blood stored in the venous side chamber 60 contains dialysate as a replacement liquid. Is replenished.

  The heater 40 warms the dialysate flowing through the dialysate circuit 30 to a predetermined temperature.

The control device 50 is configured by an information processing device (computer), and controls the operation of the hemodialysis device 1 by executing a control program.
Specifically, the control device 50 controls operations of various pumps and clamps, the heater 40, and the like disposed in the blood circuit 20 and the dialysate circuit 30. Thereby, for example, the control device 50 performs a priming process, which is a preparatory process for cleaning and cleaning the blood circuit 20 and the dialyzer 30, a blood removal process for filling the blood circuit 20 with the blood circuit 20 after puncture, and circulating outside the body, A dialysis step performed following the blood step, a replenishment step of performing a replenishment during execution of the dialysis step, a blood return step of returning the blood in the blood circuit 20 to the body of the patient, and the like are performed.

  Here, in the blood return step, the blood purified in the dialyzer 10 is introduced into the venous chamber 60 through the bottom blood inlet 611a. In addition, by operating the online replacement fluid pump 39, dialysate as a replacement fluid is introduced into the venous chamber 60 through the replacement fluid inlet 616a provided at the side of the venous chamber 60. . Since the replacement fluid introduction port 616a is formed facing the tangential direction of the inner peripheral surface of the chamber body 61, the replacement fluid introduced from the replacement fluid introduction port 616a is introduced into the chamber body 61 while forming a swirling flow. The replacement fluid introduced into the chamber main body 61 is layered so as to cover the upper part of the blood stored in the venous chamber 60 and stored in the upper part of the blood. The blood and replacement fluid stored in the venous chamber 60 are led out of the venous chamber 60 through the bottom blood outlet 612a. The blood led out from the venous chamber 60 is returned to the patient via the venous downstream line 22b.

  As described above, the venous chamber 60 of the present embodiment is configured to introduce blood from the bottom blood introduction port 611a at the bottom of the chamber body 61 and blood from the bottom blood outlet 612a at the bottom of the chamber body 61. Is configured to derive Furthermore, the venous chamber 60 is introduced into the chamber body 61 while forming a swirling flow by introducing dialysate as a replacement fluid from the replacement fluid inlet 616a on the side of the chamber body 61. The dialysate as a replacement fluid is configured to be stored in the upper part of the blood stored in the bottom of the chamber body 61.

According to the vein side chamber 60 of the first embodiment described above, the following effects can be obtained.
(1) The venous chamber 60 includes a chamber main body 61 that stores blood, a bottom blood outlet 612a that is disposed at the bottom of the chamber main body 61 and that guides blood stored in the chamber main body 61, and a side portion of the chamber main body 61. And a replacement fluid inlet 616a for introducing a dialysis fluid as a replacement fluid into the chamber body 61. Thereby, since the dialysate as a replacement fluid can be introduced from the side of the chamber body 61 in a substantially horizontal direction, the jumping of blood stored in the bottom of the chamber body 61 can be suppressed. In addition, since the replacement fluid can be introduced so as to cover the upper part of the blood stored in the bottom of the chamber body 61, the formation of the interface between the blood and air can be suppressed, and the blood can be prevented from contacting the air.

  (2) The replacement fluid inlet 616a was opened in the tangential direction of the inner peripheral surface of the chamber body 61. As a result, the replacement fluid forms a swirling flow, so that the jumping of blood can be further suppressed. In addition, since the replacement fluid forms a swirling flow in the upper part of the blood stored in the bottom of the chamber main body 61, the dialysate as the replacement fluid can easily form a layer covering the upper portion of the blood, and the blood contacts the air. It can be further suppressed.

  (3) The bottom blood inlet 611a is arranged at the bottom of the chamber body 61. Thereby, blood can be introduced from the bottom of the chamber body 61 and blood can be led out from the bottom of the chamber body 61. Therefore, it is easier to lead out blood from the bottom of the chamber body 61 than when blood is introduced from the top of the chamber body 61 and led out from the bottom, and the blood can be suppressed from remaining at the bottom of the chamber body 61.

(Second Embodiment)
Next, a hemodialysis apparatus 1A according to a second embodiment of the present invention will be described with reference to FIG. The hemodialysis apparatus 1A of the second embodiment is mainly in that the venous upstream line 22a of the venous side line 22 is connected to the upper blood inlet 615a (blood inlet) of the venous chamber 60. And different. In the description of the second embodiment, the same components are denoted by the same reference numerals, and the description thereof is omitted or simplified.

In the hemodialysis apparatus 1A of the second embodiment, the venous upstream line 22a of the venous line 22 is not connected to the bottom blood inlet 611a at the bottom of the venous chamber 60 as in the first embodiment. , Connected to the upper blood inlet 615a at the top of the venous chamber 60.
The upper blood introduction port 615 a is an opening through which blood stored in the chamber body 61 is led out of the chamber body 61. The upper blood introduction port 615a is connected to the vein of the subject (dialysis patient) via the vein-side downstream line 22b of the vein-side line 22.
As a result, blood is introduced from the upper blood inlet 615a at the top of the venous chamber 60, and stored in the venous chamber 60, and the blood is led out from the bottom blood inlet 611a at the bottom of the venous chamber 60. be able to.

  According to the hemodialysis apparatus 1A of the second embodiment described above, the effects (1) and (2) described above are exhibited.

(Third embodiment)
Next, a vein side chamber 60A according to a third embodiment of the present invention will be described. FIG. 5 is a diagram showing a configuration of a vein side chamber 60A according to the third embodiment of the present invention.
Instead of the venous chamber 60 of the first and second embodiments, the venous chamber 60A of the third embodiment can be used.

The vein-side chamber 60A of the third embodiment is provided in the vein-side line 22 shown in FIG. 1 instead of the vein-side chamber 60 of the first and second embodiments provided in the vein-side line 22 shown in FIG. It is done.
As shown in FIG. 5, the venous chamber 60 </ b> A has a chamber body 71 that stores blood. The chamber main body 71 includes a bottom side cylindrical portion 72, an intermediate cylindrical portion 73, and an upper side cylindrical portion 74. The intermediate cylindrical portion 73 is formed in a cylindrical shape that extends in the vertical direction. The upper cylindrical portion 74 is connected to the upper end portion of the intermediate cylindrical portion 73. A bottom side cylindrical portion 72 is connected to the lower end portion of the intermediate cylindrical portion 73.

  The bottom side cylindrical portion 72 is formed in a cylindrical shape having a bottom surface, extends in the vertical direction, and is shorter in the vertical direction than the intermediate cylindrical portion 73. The bottom side tubular portion 72 has a bottom blood lead-out portion 712 disposed at the bottom thereof. The bottom blood outlet 712 is connected to the bottom of the chamber body 71 through a bottom blood outlet 712a (blood outlet) that opens downward.

  The bottom blood outlet 712a guides the blood stored in the chamber body 71 to the outside of the chamber body 71. The bottom blood outlet 712 a is connected to the vein of the subject (dialysis patient) via the vein downstream line 22 b of the vein line 22.

  The upper cylindrical portion 74 is formed in a cylindrical shape having a top surface and extends in the vertical direction. An overflow portion 713 is disposed on the upper side cylindrical portion 74. The overflow part 713 is connected to the upper part of the chamber main body 71 through the overflow port 713a. A tube extending inside the chamber body 71 is connected to the overflow port 713a, and a lower end portion of the tube has a predetermined height inside the chamber body 71 (in this embodiment, the position of the side blood introduction port 701). (Upward position). Since the upper surface of the blood layer is covered with the replacement fluid layer, the lower end portion of the tube connected to the overflow port 713a is located inside the replacement fluid layer and does not come into contact with air. This makes it difficult for thrombus to be generated at the lower end of the tube connected to the overflow port 713a.

  A side blood introduction part 711 and a replacement fluid introduction part 716 arranged above the side blood introduction part 711 are arranged on the side part of the upper cylindrical part 74 (chamber body 71).

  The side blood introduction unit 711 introduces blood into the chamber body 71. The side blood introduction part 711 is formed in a cylindrical shape extending in the horizontal direction, as shown in FIG. The side blood introduction part 711 is connected to the side part of the chamber main body 71 via a side part blood introduction port 701 (blood introduction port). The side blood inlet 701 opens in the horizontal direction toward the side of the chamber body 71.

  The replacement fluid introduction unit 716 introduces dialysate as a replacement fluid into the chamber body 71. As shown in FIG. 5, the replacement fluid introduction part 716 is formed in a cylindrical shape extending in the horizontal direction. The replacement fluid introduction part 716 is connected to the side part of the chamber body 71 via the replacement fluid introduction port 702. The replacement fluid inlet 702 is located above the upper surface of the blood layer (the boundary surface K between the blood layer and the dialysate layer). The replacement fluid inlet 702 opens in the horizontal direction toward the side of the chamber body 71. The position of the replacement fluid inlet 702 in the height direction is preferably disposed at a position higher than 70% of the length of the chamber body 71 in the vertical direction from the bottom of the chamber body 71.

  The replacement fluid inlet 702 and the side blood inlet 701 are arranged in the vertical direction above the center of the chamber body 71 in the vertical direction. Regarding the vertical positional relationship between the replacement fluid introduction port 702 and the side blood introduction port 701, the replacement fluid introduction port 702 is disposed on the upper side, and the side blood introduction port 701 is disposed below the replacement fluid introduction port 702. The replacement fluid introduction port 702 and the side blood introduction port 701 are spaced apart from each other by a predetermined distance in the vertical direction, and in the chamber main body 71, between the replacement fluid introduction port 702 and the side blood introduction port 701. A boundary surface K between the blood layer and the dialysate layer is formed. The boundary surface K is also the upper surface of the blood layer and the lower surface of the dialysate layer as a replacement fluid layer. Since the replacement fluid introduction port 702 and the side blood introduction port 701 are spaced apart from each other by a predetermined distance in the vertical direction, it is difficult to mix the blood and the replacement fluid. In addition, the vertical position of the replacement fluid inlet 702 and the side blood inlet 701 is not limited, and may be arranged at a position moved upward or downward.

  In the vein side chamber 60A of the third embodiment configured as described above, the replacement fluid introduction port 702 is arranged on the upper side in the side portion of the chamber main body 71, and the side blood introduction port 701 is located above the replacement fluid introduction port 702. By arrange | positioning at the lower side, in the side part of the chamber main body 71, blood is introduce | transduced by lower side and a dialysate is introduce | transduced by upper side. Thereby, the disturbance of the liquid level of the boundary surface K between the blood layer and the dialysate layer can be further reduced, and the upper surface of the blood layer can be covered with the dialysate layer as a replacement fluid.

  Further, since the replacement fluid inlet 702 is positioned above the upper surface of the blood layer, the upper part of the blood stored in the bottom of the chamber body 71 can be reliably covered with a layer of dialysate as a replacement fluid. Thereby, formation of the interface which blood and air contact can be suppressed, and it can suppress that blood contacts air.

  In addition, the blood guided to the side blood introduction part 711 extending in the horizontal direction is introduced into the chamber body 71 in the horizontal direction via the side blood introduction port 701 and is guided to the replacement fluid introduction part 716 extending in the horizontal direction. The dialysate as a replacement fluid is introduced in the horizontal direction via the replacement fluid inlet 702. Thereby, the disturbance of the liquid level of the boundary surface K between the blood layer and the dialysate layer can be reduced.

(Fourth embodiment)
Next, a vein chamber 60B according to a fourth embodiment of the present invention will be described. FIG. 6 is a diagram showing a configuration of a vein chamber 60B according to the fourth embodiment of the present invention.
The venous chamber 60B of the fourth embodiment is different from the third embodiment in that the replacement fluid introduction part 716A and the side blood introduction part 711A are inclined with respect to the venous side chamber 60A of the third embodiment. . In the description of the fourth embodiment, the description of the same configuration as that of the third embodiment is omitted.

  As shown in FIG. 6, the side blood introduction part 711 </ b> A is formed in a cylindrical shape extending in a downwardly inclined state with a downward angle β (−45 ° to 0 °) with respect to the horizontal direction. The side blood introduction part 711A is connected to the side part of the venous side chamber 60B via the side part blood introduction port 701a. The side blood introduction port 701a opens with a downward angle β inclined toward the side of the chamber body 71.

  As shown in FIG. 6, the replacement fluid introduction part 716 </ b> A is formed in a cylindrical shape extending in an upwardly inclined state with an upward angle α (0 ° to 45 °) with respect to the horizontal direction. The replacement fluid introduction part 716A is connected to the side part of the vein side chamber 60B via the replacement fluid introduction port 702a. The replacement fluid inlet 702a is opened with an upward angle α inclined toward the side of the chamber body 71.

In the vein side chamber 60B of the fourth embodiment configured as described above, the replacement fluid introduction port 702a is arranged on the upper side and the side blood introduction port 701a is arranged on the lower side in the side portion of the chamber body 71. In the side of the chamber body 71, blood is introduced on the lower side and dialysate is introduced on the upper side. Thereby, the disturbance of the liquid level of the boundary surface K between the blood layer and the dialysate layer can be reduced, and the upper surface of the blood can be covered with the dialysate layer as a replacement fluid.
In the chamber main body 71, the blood guided to the replacement fluid introduction part 716A extending in a state inclined at the upward angle α (0 ° to 45 °) passes through the replacement fluid introduction port 702a and the upward angle α (0 ° to 45 °). The dialysis fluid as a replacement fluid introduced to the side blood introduction part 711A that is introduced at the side and extends while being inclined at the downward angle β (−45 ° to 0 °) is introduced through the side blood introduction port 701a into the upward angle α (0 At 45 °). Therefore, the crossing of the inflow direction of the blood and the inflow direction of the dialysate as the replacement fluid is suppressed, and the disturbance of the liquid level at the boundary surface K between the blood layer and the dialysate layer can be reduced.

As mentioned above, although each preferred embodiment of the hemodialysis apparatus of this invention was described, this invention is not restrict | limited to embodiment mentioned above and can change suitably.
For example, the vein side chambers 60C to 60F can be configured as in the following first to third modifications.

  The first modification and the second modification will be described. The first variation and the second variation are different in the combination of the replacement fluid introduction portions 716 and 716A and the side blood introduction portions 711 and 711A of the third embodiment and the fourth embodiment. FIG. 7 is a diagram showing a configuration of a vein-side chamber 60C according to the first modification of the present invention. FIG. 8 is a view showing a configuration of a vein side chamber 60D according to the second modification of the present invention.

As shown in FIG. 7, in the venous chamber 60C of the first modified embodiment, the side blood introduction part 711 is formed in a cylindrical shape extending in the horizontal direction, and the side blood introduction port 701 of the side blood introduction part 711 is formed. Open horizontally toward the side of the chamber body 71.
As shown in FIG. 7, the replacement fluid introduction part 716 </ b> A is formed in a cylindrical shape extending in an upwardly inclined direction α (0 ° to 45 °) with respect to the horizontal direction, and the replacement fluid introduction port of the replacement fluid introduction part 716 </ b> A. The opening 702a is inclined toward the side of the chamber main body 71 with an upward angle α.

Further, as shown in FIG. 8, in the vein-side chamber 60D of the second modification, the side blood introduction part 711A is inclined downward at a downward angle β (−45 ° to 0 °) with respect to the horizontal direction. The side blood introduction port 701 a of the side blood introduction part 711 </ b> A opens at a downward angle β toward the side of the chamber body 71.
As shown in FIG. 8, the replacement fluid introduction part 716 is formed in a cylindrical shape extending in the horizontal direction, and the replacement fluid introduction port 702 of the replacement fluid introduction part 716 opens in the horizontal direction toward the side of the chamber body 71.

  In the 1st modification and the 2nd modification constituted as mentioned above, there can exist the same effect as a 3rd embodiment and a 4th embodiment.

  A third modification will be described. FIG. 9 is a diagram showing the configuration of the third modified embodiment, and is a diagram schematically showing an example of the positional relationship between the replacement fluid introduction port 702 (702a) and the side blood introduction port 701 (701a). The third variation is a variation in which the positional relationship between the replacement fluid inlet 702 (702a) and the side blood inlet 701 (701a) is different.

  As shown in FIG. 9A, the positional relationship between the replacement fluid introduction port 702 (702a) and the side blood introduction port 701 (701a) is similar to that in the third embodiment and the fourth modification described above in plan view. Further, they may be arranged at the same position in the circumferential direction of the chamber main body 71, or may be arranged at positions separated by θ1 (for example, 90 °) in the circumferential direction of the chamber main body 71 as shown in FIG. However, as shown in FIG. 9C, the chamber body 71 may be disposed at a position spaced apart by θ2 (for example, 180 °) in the circumferential direction. The angle at which the replacement fluid inlet 702 (702a) and the side blood inlet 701 (701a) are separated is not limited to these.

  Further, in the first embodiment and the second embodiment, a configuration in which dialysate as a replacement fluid is supplied to the venous chamber 60 using a method by post-dilution in a so-called online HDF as a blood purification method has been described. However, the method is not limited to this, and a pre-dilution method may be used. In this case, a configuration in which dialysate as a replacement fluid is supplied to the arterial chamber is described in the first embodiment instead of a configuration in which dialysate as a replacement fluid is supplied to the vein chamber 60 in the first embodiment. By applying the same configuration as that of the vein-side chamber 60 to the artery-side chamber 213, it is possible to achieve the same effects as those of the first embodiment and the second embodiment.

  Moreover, in the said embodiment, although it comprised so that the dialysate as a replacement fluid might be supplied to the venous side chamber 60 from the dialysate introduction line 33 via the liquid feeding line 38, it is not restricted to this, The dialysate may be supplied from the dialysate outlet line 34 to the venous chamber 60 via the liquid feed line.

  Moreover, in the said embodiment, although the blood inlet 615a was arrange | positioned in the bottom part of the chamber main body 61, it is not restricted to this. That is, the blood inlet may be disposed below the replacement fluid inlet on the side of the chamber body.

1,1A hemodialysis machine 10 dialyzer
20 Blood circuit 21 Arterial side line 22 Venous side line 30 Dialysate circuit 33 Dialysate introduction line 34 Dialysate lead-out line 38 Liquid feed line 39 Online fluid replacement pump (pump)
50 Control device 60, 60A, 60B, 60C, 60D, 60E, 60F Venous side chamber (chamber)
61, 71 Chamber body 611a Bottom blood inlet (blood inlet)
612a Bottom blood outlet (blood outlet)
615a Upper blood inlet (blood inlet)
616a, fluid replacement inlet 701, 701a side blood inlet (blood inlet)
702, 702a Fluid replacement inlet 712a Bottom blood outlet (blood outlet)

Claims (6)

A chamber body for storing blood;
A blood inlet that is disposed in the chamber body and introduces blood into the chamber body;
A blood outlet that is disposed at the bottom of the chamber body and leads out the blood stored in the chamber body;
A chamber provided on a side of the chamber body, and a replacement fluid introduction port for introducing a dialysate as a replacement fluid into the chamber body.   The chamber according to claim 1, wherein the replacement fluid inlet is located above the upper surface of the blood layer.   3. The chamber according to claim 1, wherein the replacement fluid introduction port opens toward a tangential direction of an inner peripheral surface of the chamber main body.   The chamber according to any one of claims 1 to 3, wherein the blood introduction port is disposed below the replacement fluid introduction port.   The chamber according to claim 4, wherein the blood inlet is disposed at a bottom portion of the chamber body. A chamber according to any of claims 1 to 5;
A hemodialyzer for contacting blood and dialysate through a dialysis membrane;
One end side is connected to the subject's artery and the other end side is connected to the hemodialyzer, and one end side is connected to the hemodialyzer and the other end side is connected to the subject's vein. Blood circuit,
A dialysate introduction line for introducing dialysate into the hemodialyzer, and a dialysate circuit having a dialysate lead-out line for deriving dialysate from the hemodialyzer;
A controller for controlling the blood circuit and the dialysate circuit,
The dialysate circuit includes a liquid feed line that supplies a part of dialysate flowing through the dialysate introduction line or the dialysate lead-out line to the chamber as a replacement liquid, and a pump disposed in the liquid feed line. Hemodialysis machine having.

Images