JP2020151034A - Dialyzer and determination method of circuit set - Google Patents

Abstract

To provide a dialyzer capable of determining contents of a circuit set.SOLUTION: A dialyzer 100A includes: a blood circuit 110; a dialysis fluid circuit 130; a replenishment fluid port 140b; a first replenishment fluid line 141 where a replenishment fluid pump is disposed, one end of which is connected to the dialysis fluid circuit, and the other end of which is connected to the replenishment fluid port; a replenishment fluid pressure sensor 140S for measuring fluid pressure of the first replenishment fluid line; a replenishment fluid clamp 140c for opening and closing a flow channel of a second replenishment fluid line 142, one end of which is connected to the replenishment fluid port, and the other end of which is connected to the blood circuit; and a control device 150A having a first determination part. When the replenishment fluid clamp is opened after dialysis fluid in a predetermined amount is sent to the blood circuit with the replenishment fluid clamp closed, the first determination part determines that the second replenishment fluid line is connected if the replenishment fluid presser drops, and determines that the second replenishment fluid line is not connected if the replenishment fluid pressure is constant.SELECTED DRAWING: Figure 1

Description

The present invention relates to a dialysis machine and a method for determining a circuit set used in the dialysis machine.

Dialysis devices used for treatments such as blood dialysis and blood filtration dialysis include a blood purifier that purifies the patient's blood, a blood circuit that is connected to the blood purifier to circulate the patient's blood, and dialysis on the blood purifier. Dialysis is performed using a circuit set including a dialysate circuit for introducing and deriving a solution and a replacement solution line for sending dialysate to a blood circuit as a replacement solution. Further, the control device mounted on the dialysis apparatus controls the liquid feeding speed of the blood pump provided in the blood circuit and the dialysate pump provided in the dialysate circuit, and controls the priming step, the water removal step, the replenishing step, and the return. It is configured so that various processes such as a blood process can be automatically operated (see Patent Document 1).
The circuit set differs depending on the type of dialysis treatment, such as the presence or absence of a replenisher line and the type of blood purifier, and each part is connected and assembled by a medical worker before the dialysis treatment and attached to the dialysis apparatus. After that, a priming step is performed to clean and clean the inside of the circuit set.

In the automatically performed priming step, a back-filtration dialysate or dialysate is used as the priming solution depending on the type of blood purifier and the presence or absence of a replacement solution line.
Blood purifiers are divided into hollow fiber type and laminated type. Among hollow fiber type, those with high ultrafiltration rate can back-filter dialysate at a primable rate, and those with low ultrafiltration rate , The dialysate cannot be backfiltered at a primable rate. Further, as shown in FIG. 5, the laminated blood purifier is configured so that blood flows between the dialysis membranes (see FIG. 5A), and when pressure is applied from the dialysate side. Since the dialysis membranes are in close contact with each other (see FIG. 5B), the structure is such that backfiltration is difficult. Therefore, hollow fiber type and laminated type blood purifiers having a low ultrafiltration rate need to be primed with a dialysate via a replenisher line as a priming method. Further, in the case of a circuit set to which the replenisher line is connected, since the replenisher line is primed, it is necessary to perform the priming with the dialysate via the replenisher line regardless of the type of blood purifier.

Japanese Unexamined Patent Publication No. 2015-80595

As described above, in the priming process, it is necessary to select an appropriate priming method according to the contents of the circuit set that changes depending on the patient, and the medical staff needs to confirm or change the setting of the priming method at the start of the priming process. .. This setting can be made by a medical worker in a dialysis machine or by a dialysis system that centrally manages a plurality of dialysis machines.
However, due to a setting error or a delay in setting change, the priming method may not correspond to the contents of the circuit set. In that case, it is necessary to notify the medical staff of the abnormality and correct the setting, and priming. The process had to be interrupted.

Therefore, an object of the present invention is to provide a dialysis apparatus capable of determining the contents of a circuit set.

The present invention takes out a blood circuit in which a blood purifier is arranged, a dialysate circuit in which a dialysate pump for sending dialysate to the blood purifier is arranged, and a dialysate directly injected into the blood circuit. A first replenisher port and a replenisher pump having one end connected to the dialysate circuit and the other end connected to the replenisher port and delivering dialysate from the dialysate circuit to the blood circuit are arranged. A replenisher pressure sensor arranged between the replenisher line, the replenisher port and the replenisher pump for measuring the hydraulic pressure of the first replenisher line, and one end of the replenisher port. Whether or not there is a replenisher clamp that is connected and the other end is connected to the blood circuit to open and close the flow path of the second replenisher line, and the second replenisher line that is connected to the replenisher pressure sensor. A dialysis apparatus having a first determination unit for determination and including a dialysate pump, a replenisher fluid pump, and a control device for controlling the operation of the replenisher fluid clamp, wherein the control apparatus is the replenisher fluid. After the dialysate pump and the replenisher pump are stopped after the operation so as to send a predetermined amount of dialysate with the clamp closed, the replenisher clamp is controlled to be opened, and the first determination is made. After the replenisher clamp is controlled to open from the closed state, the unit is connected to the second replenisher line when the hydraulic pressure of the first replenisher line drops. The present invention relates to a dialysis apparatus for determining that the second replenisher line is not connected when the hydraulic pressure of the first replenisher line is constant.

Further, in the present invention, the blood circuit in which the blood purifier is arranged, the dialysate circuit in which the dialysate pump for sending the dialysate to the blood purifier is arranged, and the hydraulic pressure in the dialysate circuit are measured. A dialysate pressure sensor, a control device having a second determination unit for determining whether or not back filtration is possible at a predetermined speed in the blood purifier, and controlling the operation of the dialysate pump. The control device operates the dialysate pump in the reverse filtration direction, and the second determination unit determines that a predetermined time has elapsed after the dialysate pump operates in the reverse filtration direction. When the hydraulic pressure of the dialysate circuit measured by the dialysate pressure sensor is equal to or less than a predetermined threshold value, the blood purifier determines that backfiltration is possible at the predetermined speed. The present invention relates to a dialysis apparatus that determines that backfiltration is impossible at the predetermined speed in the blood purifier when the hydraulic pressure of the dialysate circuit exceeds the predetermined threshold value.

Further, the present invention has a blood circuit in which a blood purifier is arranged, a dialysate circuit in which a dialysate pump for supplying dialysate to the blood purifier is arranged, and a dialysate circuit arranged in the dialysate circuit. A dialysate pressure sensor that measures the hydraulic pressure in the fluid circuit, a replenisher port for taking out dialysate that is directly injected into the blood circuit, and one end connected to the dialysate circuit and the other end the replenisher port. A first replenisher line is connected to the dialysate circuit and a replenisher pump for sending dialysate from the dialysate circuit to the blood circuit is arranged, and is arranged between the replenisher port and the replenisher pump. , A replenisher pressure sensor for measuring the hydraulic pressure of the first replenisher line, and a flow path of the second replenisher line having one end connected to the replenisher port and the other end connected to the blood circuit. A replenisher clamp for opening and closing, a first determination unit connected to the replenisher pressure sensor to determine the presence or absence of the second replenisher line, and the dialysate pressure sensor connected to the blood purification A control device having a second determination unit for determining whether or not back filtration is possible at a predetermined speed in the device, and controlling the operation of the dialysate pump, the replenisher pump, and the replenisher clamp. The control device comprises the dialysate pump and the replenisher pump after stopping the dialysate pump and the replenisher pump so as to send a predetermined amount of dialysate with the replenisher clamp closed. After the liquid clamp is controlled to be in the open state and the replenisher liquid clamp is controlled to be in the open state from the closed state, the second replenishment is performed when the hydraulic pressure of the first replenisher liquid line drops. It is determined that the liquid line is connected, and when the liquid pressure of the first replenisher liquid line is constant, it is determined that the second replenisher liquid line is not connected, and the control device determines that the dialysis is performed. The liquid pump is operated in the reverse filtration direction, and the second determination unit determines that the hydraulic pressure of the dialysate circuit reaches a predetermined threshold value when a predetermined time elapses after the dialysate pump operates in the reverse filtration direction. When the following cases are determined, the blood purifier determines that backfiltration is possible at the predetermined speed, and when the hydraulic pressure of the dialysate circuit exceeds the predetermined threshold value, the blood purifier determines the predetermined value. The present invention relates to a dialysis machine that determines that backfiltration is impossible at the speed of.

Further, the dialysis device further includes a notification unit for notifying an abnormality, and the control device is determined by the first determination unit that the second replenishment liquid line is not connected, and the second determination liquid line is not connected. It is preferable to operate the notification unit when the determination unit determines that backfiltration is impossible at the predetermined speed in the blood purifier.

Further, the present invention comprises a blood circuit in which a blood purifier is arranged, a dialysate circuit in which a dialysate pump for supplying dialysate to the blood purifier is arranged, and a dialysate directly injected into the blood circuit. A replenisher port for taking out the dialysate, one end connected to the dialysate circuit and the other end connected to the replenisher port, and a replenisher pump for sending dialysate from the dialysate circuit to the blood circuit are arranged. A replenisher fluid pressure sensor arranged between the replenisher fluid line 1 and the replenisher fluid port and the replenisher fluid pump to measure the hydraulic pressure of the first replenisher fluid line, and one end of the replenisher fluid port. A replenisher clamp that opens and closes the flow path of the second replenisher line that is connected and the other end is connected to the blood circuit, and a control that controls the operation of the dialysate pump, the replenisher pump, and the replenisher clamp. A method for determining a circuit set performed at the start of priming in a dialysis apparatus including an apparatus, wherein a predetermined amount of dialysate is delivered with the replenisher clamp closed, and then the replenisher clamp is opened. At that time, when the hydraulic pressure of the first replenishing liquid line drops, it is determined that the second replenishing liquid line is connected, and when the hydraulic pressure of the first replenishing liquid line is constant, it is determined. The present invention relates to a method for determining a circuit set for determining that the second replenisher line is not connected.

Further, in the present invention, a blood circuit in which a blood purifier for purifying the patient's blood is arranged and a dialysate pump connected to the blood purifier and supplying dialysate to the blood purifier are arranged. Start priming in a dialysate device including a dialysate circuit, a dialysate pressure sensor arranged in the dialysate circuit to measure the hydraulic pressure in the dialysate circuit, and a control device for controlling the operation of the dialysate pump. A method for determining a circuit set, which is sometimes performed, when the hydraulic pressure of the dialysate circuit is equal to or less than a predetermined threshold value when a predetermined time elapses after the dialysate pump operates in the reverse filtration direction. When it is determined that the blood purifier is capable of back-filtering at the predetermined speed and the hydraulic pressure of the dialysate circuit exceeds the predetermined threshold, the blood purifier performs back-filtration at the predetermined speed. The present invention relates to a method for determining a circuit set that is determined to be impossible.

Further, in the present invention, the blood circuit in which the blood purifier is arranged, the dialysate circuit in which the dialysate pump for sending the dialysate to the blood purifier is arranged, and the hydraulic pressure in the dialysate circuit are measured. The dialysate pressure sensor, the replenisher port for taking out the dialysate directly injected into the blood circuit, one end connected to the dialysate circuit and the other end connected to the replenisher port, the dialysate circuit. A first replenisher line in which a replenisher pump for supplying dialysate to the blood circuit is arranged, and a replenisher line is arranged between the replenisher port and the replenisher pump to measure the hydraulic pressure of the replenisher line. The replenisher pressure sensor, the replenisher clamp that opens and closes the flow path of the second replenisher line whose one end is connected to the replenisher port and the other end is connected to the blood circuit, and the dialysate pump. A method for determining a circuit set performed at the start of priming in a dialysis apparatus including a replenisher pump and a control device for controlling the operation of the replenisher clamp, wherein a predetermined amount of dialysate is placed with the replenisher clamp closed. When the liquid pressure of the first replenishing liquid line drops when the replenishing liquid clamp is opened after the liquid is fed, it is determined that the second replenishing liquid line is connected, and the second replenishing liquid line is determined to be connected. When the hydraulic pressure of the replenisher line of 1 is constant, it is determined that the second replenisher line is not connected, and dialysate is sent to the blood purifier so that back filtration occurs, and a predetermined When the time has passed and the hydraulic pressure of the dialysate circuit is equal to or less than a predetermined threshold value, the blood purifier determines that backfiltration is possible at the predetermined speed, and the liquid in the dialysate circuit is determined. The present invention relates to a method for determining a circuit set that determines that backfiltration is impossible at the predetermined speed in the blood purifier when the pressure exceeds the predetermined threshold value.

According to the dialysis apparatus of the present invention, since the contents of the circuit set can be determined, it is possible to carry out the priming method according to the contents of the circuit set without the setting of the medical staff.

It is a figure which shows the schematic structure of the dialysis machine which concerns on 1st Embodiment of this invention. It is a block diagram of the dialysis machine which concerns on 1st Embodiment. It is a figure which shows the schematic structure of the dialysis apparatus which concerns on 2nd Embodiment of this invention. It is a block diagram of the dialysis machine which concerns on 2nd Embodiment. It is a schematic diagram which shows the internal structure of the laminated type blood purifier.

Hereinafter, preferred embodiments of the method for determining the dialysis machine and the circuit set of the present invention will be described with reference to the drawings. The dialysis apparatus of the present invention can purify the blood of patients with renal failure and drug addiction, remove excess water in the blood, and replenish the blood with dialysate as a replacement solution as needed. is there.

Further, the dialysis apparatus of the present invention continuously automatically performs various steps such as a priming step, a blood removal step, a replenishment step, and a blood return step by controlling the flow of the reverse filtration dialysate and dialysate in the blood circuit. It is an automatic dialysis machine that can be performed in a targeted manner. The method for determining the circuit set of the present invention is performed at the start of the priming step prior to priming.

<First Embodiment>
The overall configuration of the dialysis machine 100A of the first embodiment will be described with reference to FIGS. 1 and 2. FIG. 1 is a diagram showing a schematic configuration of a dialysis machine 100A according to the first embodiment of the present invention, and FIG. 2 is a block diagram showing a configuration of the dialysis machine 100A.

As shown in FIGS. 1 and 2, the dialysis apparatus 100A replenishes the blood circuit 110 for flowing blood, the blood purifier 120, the dialysate circuit 130, the replenisher line 140, the replenisher pump 140a, and the replenisher. It includes a liquid port 140b, a replenishment hydraulic pressure sensor 140S, a replenishment liquid clamp 140c, and a control device 150A. In the present embodiment, the "circuit set" refers to a blood circuit 110, a blood purifier 120, a dialysate circuit 130, and a second replenisher line 142 described later assembled as needed.

The blood circuit 110 has an arterial side line 111, a venous side line 112, and a drainage line 113. The arterial side line 111, the venous side line 112, and the drainage line 113 are all mainly composed of a flexible and soft tube through which a liquid can flow.

One end of the arterial line 111 is connected to a blood inlet 122a of the blood purifier 120, which will be described later. An arterial side connection portion 111a, a blood pump 111b, an arterial side bubble detector 111c, and an arterial side clamp 111d are arranged on the arterial side line 111.
The arterial side connecting portion 111a is arranged on the other end side of the arterial side line 111. A needle that punctures the patient's blood vessel at the start of the water removal process is connected to the arterial connection portion 111a.
The blood pump 111b delivers a liquid such as blood or a priming solution inside the arterial line 111 by squeezing the tube constituting the arterial line 111 with a roller.
The arterial bubble detector 111c detects the presence or absence of bubbles in the tube.
The arterial side clamp 111d is arranged closer to the arterial side connection portion 111a than the arterial side air bubble detector 111c. The arterial side clamp 111d is controlled according to the result of detecting air bubbles by the arterial side air bubble detector 111c, and opens and closes the flow path of the arterial side line 111.

One end of the venous line 112 is connected to the blood outlet 122b of the blood purifier 120, which will be described later. A venous side connection portion 112a, a drip chamber 112b, a venous side bubble detector 112c, and a venous side clamp 112d are arranged on the venous side line 112.
The venous side connecting portion 112a is arranged on the other end side of the venous side line. A needle that punctures the patient's blood vessel is connected to the venous side connection portion 112a at the start of the water removal process. Further, in the priming step, the arterial side connecting portion 111a and the venous side connecting portion 112a are directly connected to each other, resulting in a short-circuited state as shown in FIG.
The drip chamber 112b stores a certain amount of blood in order to remove air bubbles and coagulated blood mixed in the vein side line 112.
The venous side bubble detector 112c is arranged on the downstream side of the drip chamber 112b and detects the presence or absence of air bubbles in the tube.
The venous side clamp 112d is arranged on the downstream side of the venous side bubble detector 112c. The venous side clamp 112d is controlled according to the detection result of air bubbles by the venous side air bubble detector 112c, and opens and closes the flow path of the venous side line 112.

The drainage line 113 is connected to the drip chamber 112b. A drainage line clamp 113a is arranged on the drainage line 113. The drainage line 113 is a line for draining the priming liquid in the priming step.

The blood purifier 120 includes a container body 121 formed in a tubular shape and a dialysis membrane (not shown) housed inside the container body 121. As the blood purifier 120, a dialyzer or a hemodia filter is used. The inside of the container body 121 is divided into a blood flow path and a dialysate flow path by a dialysate membrane (neither is shown). The container body 121 is formed with a blood inlet 122a and a blood outlet 122b communicating with the blood circuit 110, and a dialysate inlet 123a and a dialysate outlet 123b communicating with the dialysate circuit 130.

The types of blood purifier 120 are generally classified into a hollow thread type and a laminated type.
The hollow thread type blood purifier 120 is a bundle of several thousand to 10,000 hollow threads having a large number of holes, and blood flows inside the hollow threads and dialysate flows outside. Among the hollow fiber types, those having a high ultrafiltration rate due to membrane performance can back-filter the dialysate in the blood purifier 120 at a primable speed. Further, if the ultrafiltration rate is low due to the membrane performance, it is difficult to back-filter the dialysate in the blood purifier 120 at a primable rate.
In the laminated blood purifier 120, as shown in FIG. 5A, a blood flow path is formed inside the two dialysis membranes. Further, two dialysis membranes and a support member are alternately laminated and arranged inside the container body, and a flow path of dialysate is formed on the outside of the two dialysis membranes. As shown in FIG. 5 (c), when pressure is applied from the dialysate side, the dialysate adheres to each other, so that back filtration is almost impossible. In the present embodiment, the blood purifier 120 is not distinguished between the hollow fiber type and the laminated type, but is classified into one that can be back-filtered at a primable rate and one that cannot be back-filtered.
Therefore, the hollow fiber type and laminated type blood purifier 120 having a low ultrafiltration rate that cannot be back-filtered at a predetermined speed needs to be primed using a dialysate via a replenisher line 140 described later as a priming method. is there. Further, in the case of a circuit set to which the replenisher line 140 (second replenisher line 142) is connected, the replenisher line 140 is primed, so that the replenisher line 140 is used regardless of the type of the blood purifier 120. It is necessary to perform priming with the dialysate.

According to the above blood circuit 110 and blood purifier 120, the blood taken out from the artery of the subject (dialysis patient) flows through the arterial line 111 by the blood pump 111b and enters the blood flow path of the blood purifier 120. be introduced. The blood introduced into the blood purifier 120 is purified by the dialysate circulating in the dialysate circuit 130 described later via the dialysate membrane. The blood purified in the blood purifier 120 passes through the vein side line 112 and is returned to the subject's vein.

In the present embodiment, the dialysate circuit 130 is configured by a so-called closed capacity control type circuit. The dialysate circuit 130 includes a dialysate supply line 131a, a dialysate drainage line 131b, a dialysate introduction line 132a, a dialysate lead-out line 132b, a dialysate pump 133, and a dialysate pressure sensor 130S. Be prepared.

The dialysate pump 133 includes a dialysate chamber 1331, a bypass line 1332, and a water removal / reverse filtration pump 1333, and is applied to the blood purifier 120 so as to apply negative pressure or positive pressure to the dialysate membrane (filtration membrane). Send dialysate.
The dialysate chamber 1331 is composed of a hard container capable of accommodating a constant volume (for example, 300 mL to 500 mL) of dialysate, and the inside of the container is provided with a soft diaphragm (diaphragm) to accommodate the liquid feed accommodating portion 1331a and drainage. It is divided into parts 1331b.
The bypass line 1332 connects the dialysate lead-out line 132b and the dialysate drainage line 131b.

The water removal / backfiltration pump 1333 is located at bypass line 1332. The water removal / reverse filtration pump 1333 has a direction in which the dialysate inside the bypass line 1332 is circulated to the dialysate drainage line 131b side (water removal direction) and a direction in which the dialysate is circulated to the dialysate discharge line 132b side (back filtration direction). It consists of a pump that is driven so that the liquid can be sent to the dialysis machine.

The dialysate supply line 131a has a proximal end connected to a dialysate supply device (not shown) and a distal end connected to the dialysate chamber 1331. The dialysate supply line 131a supplies the dialysate to the liquid supply accommodating portion 1331a of the dialysate chamber 1331.

The dialysate introduction line 132a connects the dialysate chamber 1331 and the dialysate introduction port 123a of the blood purifier 120, and dialysates the dialysate contained in the liquid supply accommodating portion 1331a of the dialysate chamber 1331 to the blood purifier 120. Introduce into the liquid flow path.

The dialysate lead-out line 132b connects the dialysate outlet 123b of the blood purifier 120 and the dialysate chamber 1331, and leads the dialysate discharged from the blood purifier 120 to the drainage accommodating portion 1331b of the dialysate chamber 1331. To do.

The base end side of the dialysate drainage line 131b is connected to the dialysate chamber 1331, and drainage of the dialysate contained in the drainage storage portion 1331b is discharged.

The dialysate pressure sensor 130S is for measuring the dialysate pressure in the dialysate circuit 130, and is provided on the dialysate lead-out line 132b.

According to the dialysate circuit 130 described above, by partitioning the inside of the hard container constituting the dialysate chamber 1331 with a soft diaphragm (diaphragm), the amount of dialysate derived from the dialysate chamber 1331 (condensation of the dialysate). The amount of dialysate supplied to section 1331a) and the amount of drainage collected in the dialysate chamber 1331 (drainage accommodating section 1331b) can be made equal.
As a result, when the water removal / reverse filtration pump 1333 is stopped, the flow rate of the dialysate introduced into the blood purifier 120 and the amount of dialysate (drainage) drawn out from the blood purifier 120 are the same. Can be done.

Further, when the water removal / reverse filtration pump 1333 is driven so as to send the liquid in the reverse filtration direction, a part of the drainage discharged from the dialysate chamber 1331 causes the bypass line 1332 and the dialysate lead-out line 132b. It passes through and is collected again in the dialysate chamber 1331. Therefore, the amount of dialysate derived from the blood purifier 120 is the amount of dialysate collected in the dialysate chamber 1331 (that is, the amount of dialysate flowing through the dialysate introduction line 132a), and the amount of dialysate flowing through the bypass line 1332. The amount is the amount obtained by subtracting the amount of liquid. As a result, the amount of dialysate derived from the blood purifier 120 is distributed through the dialysate introduction line 132a by the amount of dialysate (drainage) collected again in the dialysate chamber 1331 through the bypass line 1332. It will be less than the flow rate of dialysate. That is, when the water removal / back filtration pump 1333 is driven so as to send the liquid in the back filtration direction, a predetermined amount of dialysate is injected (back filtration) into the blood circuit 110 in the blood purifier 120.

On the other hand, when the water removal / reverse filtration pump 1333 is driven to send the liquid in the water removal direction, the amount of dialysate flowing through the dialysate lead-out line 132b is the dialysate collected in the dialysate chamber 1331. (That is, the amount of dialysate flowing through the dialysate introduction line 132a) plus the amount of dialysate flowing through the bypass line 1332. As a result, the amount of dialysate flowing through the dialysate lead-out line 132b is equal to the amount of dialysate (drainage) discharged to the dialysate drainage line 131b through the bypass line 1332. It will be larger than the amount of dialysate in circulation. That is, when the water removal / reverse filtration pump 1333 is driven so as to send the liquid in the water removal direction, the blood purifier 120 removes a predetermined amount of water from the blood.

The replenisher line 140 includes a first replenisher line 141 arranged in the main body (console) C of the dialysis machine 100A and a second replenisher line 142 that is a part of a component of the circuit set. The replenisher line 140 is a line for directly injecting the dialysate in the dialysate circuit 130 into the blood circuit 110, and the replenisher pump 140a for sending the dialysate toward the blood circuit 110 is the first. Is placed on the replenisher line 141. Further, the replacement liquid port 140b is a port for taking out the dialysate to be directly injected into the blood circuit 110, and is arranged in the main body C of the dialyzer 100A. Further, the replenishing liquid pressure sensor 140S is arranged between the replenishing liquid pump 140a and the replenishing liquid port 140b in the first replenishing liquid line 141, and measures the hydraulic pressure of the first replenishing liquid line 141. The replenisher clamp 140c is a clamp arranged in the main body C of the dialysis apparatus 100A for opening and closing the flow path of the second replenisher line 142, and is included in the circuit set as shown in FIG. It is attached to the downstream side (the side close to the blood circuit 110) of the replenisher line 142.

As shown in FIG. 1, in the present embodiment, one end of the first replenisher line 141 is connected between the dialysate chamber 1331 and the dialysate introduction port 123a in the dialysate introduction line 132a of the dialysate circuit 130. The other end is connected to the replenisher port 140b. When the second replenisher line 142 constitutes a part of the circuit set, the second replenisher line 142 is connected to the first replenisher line 141 via the replenisher port 140b on one end side, and the other. It is connected to the blood circuit 110 at the end side and attached to the replenisher clamp 140c, and the replenisher line 140 is composed of the first replenisher line 141 and the second replenisher line 142. If the circuit set does not include the second replenisher line 142, the replenisher port 140b is covered to prevent dialysate from leaking from the first replenisher line 141.
The dialysate circuit 130 side, which is one end side of the first replenisher line 141, may be connected to either the dialysate introduction line 132a or the dialysate lead-out line 132b. Further, the blood circuit 110 side may be connected to either the downstream side of the blood pump 111b or the venous side line 112 (for example, the drip chamber 112b) of the arterial side line 111.

The control device 150A is composed of an information processing device, has a first determination unit 151, and controls the operation of various pumps and the opening and closing of various clamps. An operation button 153 or the like operated by the operator is connected to the control device 150A. The operation button 153 is, for example, a priming start button, various setting buttons, and the like.

The first determination unit 151 determines whether or not the second replenisher line 142 is connected to the replenisher port 140b, that is, whether or not the circuit set includes the second replenisher line 142. It is provided for this purpose and can be connected to the replenishment hydraulic pressure sensor 140S to acquire the hydraulic pressure in the first replenishment liquid line 141.

The method for determining the presence or absence of the second replenisher line 142 will be described in detail below. Since the appropriate priming method changes depending on the presence or absence of the second replenisher line 142, a determination is made at the start of the priming process after assembling the circuit set.
In this case, the control device 150A stops by operating the dialysate pump 133 (water removal / reverse filtration pump 1333) and the replenisher pump 140a so as to send a predetermined amount of dialysate with the replenisher clamp 140c closed. Let me. As a result, the pressure (replenishment hydraulic pressure) measured by the replenishment hydraulic pressure sensor 140S rises. After that, when the control device 150A controls the replenishing liquid clamp 140c to open the replenishing liquid clamp 140c, the replenishing liquid pressure behaves differently depending on whether or not the second replenishing liquid line 142 is connected. Specifically, when the second replenisher line 142 is connected, it is filled up to the position where the replenisher clamp 140c of the first replenisher line 141 and the second replenisher line 142 is arranged. When the replenisher clamp 140c is opened from the closed state, the replenisher fluid flows to the blood circuit 110 side, and the replenisher fluid pressure drops. On the other hand, when the second replenisher line 142 is not connected, only the first replenisher line 141 is filled with the replenisher, and the replenisher pressure is affected by the opening and closing of the replenisher clamp 140c. It remains constant without receiving.

In this way, when a predetermined amount of dialysate is sent to the blood circuit 110 as a replenisher and the replenisher clamp 140c is opened, the second is the case where the replenisher pressure sensor 140S measures the lowering. It can be determined that the replenisher line 142 of the above is connected, and in a certain case, it can be determined that the second replenisher line 142 is not connected.

The control device 150A described above controls and operates the operation of the dialysis device 100A by executing control programs of various steps described below.
When the control device 150A determines that the second replenisher line 142 is connected based on the result determined by the first determination unit 151 at the start of the priming process, the control device 150A passes through the replenisher line 140. When it is determined that the second replenisher line 142 is not connected, priming is performed with the dialysate, and priming is performed with the back-filtered dialysate via the blood purifier 120.

Further, the control device 150A is performed following a priming step, a blood removal step of filling the blood circuit 110 with the patient's blood after puncture and circulating it extracorporeally, and a water removal step of dialyzing and purifying the blood. , A replenishment step performed when blood pressure drops during dialysis treatment, a blood return step of returning blood in the blood circuit 110 to the patient's body, and the like are carried out.

According to the method for determining the dialysis machine 100A and the circuit set according to the first embodiment described above, the following effects are obtained.

(1) The dialysate device 100A is connected to the blood circuit 110, the dialysate circuit 130, the replenisher port 140b for taking out the dialysate directly injected into the blood circuit 110, and the replenisher port 140b, and the dialysate circuit 130. The first replenisher line 141 in which the replenisher pump 140a for supplying dialysate to the blood circuit 110 is arranged, the replenisher pressure sensor 140S, one end is connected to the replenisher port 140b, and the other end is the blood circuit 110. A second replenisher line 142 connected to is attached to the replenisher liquid clamp 140c for opening and closing the flow path of the second replenisher liquid line 142, and a first replenisher liquid line 142 for determining the presence or absence of the second replenisher liquid line 142. A control device 150A having a determination unit 151 is included, and the dialysate pump 133 and the replenisher pump 140a are operated so as to send a predetermined amount of dialysate to the control device 150A with the replenisher liquid clamp 140c closed. After stopping later, the replenisher liquid clamp 140c is controlled to be in the open state, and when the replenisher liquid clamp 140c is changed from the closed state to the open state by the first determination unit 151, the first replenisher liquid line 141 When the hydraulic pressure drops, it is determined that the second replenisher line 142 is connected, and when the hydraulic pressure of the first replenisher line 141 is constant, the second replenisher line 142 is connected. It was judged that it was not. Thereby, the dialyzer 100A determines whether the second replenisher line 142 is connected to the replenisher port 140b, that is, whether the circuit set includes the second replenisher line 142. be able to. Therefore, even if the medical worker does not set the priming method, the priming method can be automatically selected according to the contents of the circuit set and the priming process can be performed.

<Second Embodiment>
Next, the overall configuration of the dialysis machine 100B according to the second embodiment will be described with reference to FIGS. 3 and 4. FIG. 3 is a diagram showing a schematic configuration of the dialysis apparatus 100B according to the second embodiment of the present invention, and FIG. 4 is a block diagram showing the configuration of the dialysis apparatus 100B.
In the dialysis apparatus according to the second embodiment, in addition to the first determination unit in which the control device determines the presence or absence of the second replenisher line, it further determines whether or not back filtration is possible in the blood purifier. It differs from the case of the first embodiment in that it has a second determination unit and that it includes a notification unit. In the following description of the second embodiment, the same configurations as those described in the first embodiment are designated by the same reference numerals and the description thereof will be omitted.

As shown in FIGS. 3 and 4, the dialysis apparatus 100B includes a blood circuit 110 for flowing blood, a blood purifier 120, a dialysate circuit 130, a dialysate pressure sensor 130S, a replenisher line 140, and the like. It includes a replenisher pump 140a, a replenisher port 140b, a replenisher pressure sensor 140S, a replenisher clamp c, a control device 150B, and a notification unit 160.

The dialysate circuit 130 is configured by a so-called closed capacity control type circuit as in the first embodiment. The dialysate circuit 130 includes a dialysate supply line 131a, a dialysate drainage line 131b, a dialysate introduction line 132a, a dialysate lead-out line 132b, and a dialysate pump 133, and includes a dialysate pressure sensor 130S. Is provided.

The dialysate pressure sensor 130S is for measuring the hydraulic pressure of the dialysate circuit 130, and is connected to either the dialysate introduction line 132a or the dialysate lead-out line 132b communicating via the blood purifier 120. Can be installed. In this embodiment, the dialysate pressure sensor 130S is attached to the dialysate lead-out line 132b as shown in FIG.

The control device 150B is composed of an information processing device, has a first determination unit 151 and a second determination unit 152, and controls the operation of various pumps and the opening and closing of various clamps. The control device 150B is connected to an operation button 153 or the like operated by the operator as in the first embodiment. The operation button 153 is, for example, a priming start button, various setting buttons, and the like.

The second determination unit 152 is provided to determine whether or not back filtration is possible at a predetermined speed that allows priming in the blood purifier 120, that is, to determine the type of the blood purifier 120. It can be connected to the dialysate pressure sensor 130S to acquire the hydraulic pressure in the dialysate circuit 130.

The method for determining the type of the blood purifier 120 will be described in detail below. Since the appropriate priming method varies depending on the type of blood purifier 120, a determination is made at the start of the priming process after assembling the circuit set. The determination by the second determination unit 152 may be performed either before or after the determination by the first determination unit 151.

In the second embodiment, the control device 150B operates the dialysate pump 133 (water removal / backfiltration pump 1333) to deliver a predetermined amount of dialysate so that backfiltration occurs in the blood purifier 120. At this time, the replenisher pump 140a is stopped.
Here, when back filtration is possible at a predetermined speed in the blood purifier 120, the pressure (dialysate pressure) measured by the dialysate pressure sensor 130S rises and then converges to a constant value and is in an equilibrium state. Is shown. On the other hand, when the blood purifier 120 cannot perform back filtration at a predetermined speed, the dialysate cannot sufficiently flow out to the blood circuit 110 side by back filtration, so that the dialysate pressure continues to rise.

Therefore, when the dialysate pressure after a lapse of a predetermined time after operating the dialysate pump 133 is equal to or less than a predetermined threshold value, it is determined that the blood purifier 120 can perform back filtration at a predetermined speed. Can be done. Further, when the dialysate pressure exceeds a predetermined threshold value after a lapse of a predetermined time, it can be determined that back filtration is impossible at a predetermined speed in the blood purifier 120.
In this way, the second determination unit 152 can determine the type of the blood purifier 120 based on the dialysate pressure measured by the dialysate pressure sensor 130S.

The notification unit 160 is for notifying the dialysis device 100B by an alarm or the like when the control device 150B determines that there is some abnormality, and is controlled by the control device 150B.

The control device 150B described above controls and operates the operation of the dialysis device 100B by executing control programs of various steps described below.
When it is determined that the second replenisher line 142 is connected based on the result determined by the first determination unit 151 at the start of the priming process, the control device 150B passes through the replenisher line 140. And perform priming with dialysate. If it is determined that the second replenisher line 142 is not connected and the second determination unit 152 determines that back filtration is possible in the blood purifier 120, the blood purifier 120 Priming is performed with a back-filtration dialysate via. Further, the first determination unit 151 determines that the second replenisher line 142 is not connected, and the second determination unit 152 determines that backfiltration is impossible in the blood purifier 120. In this case, neither the back-filtration dialysate nor the dialysate can be used as the priming solution, and the priming step cannot be executed. Therefore, the notification unit 160 is operated to notify the abnormality of the circuit set.

Further, the control device 150B is performed following a priming step, a blood removal step of filling the blood circuit 110 with the patient's blood after puncture and circulating it extracorporeally, and a water removal step of dialyzing and purifying the blood. , A replenishment step performed when blood pressure drops during dialysis treatment, a blood return step of returning blood in the blood circuit 110 to the patient's body, and the like are carried out.

According to the method for determining the dialysis machine 100B and the circuit set according to the second embodiment described above, the following effects are obtained.

(2) The control device 150B includes a second determination unit 152, and the second determination unit 152 is dialyzed when a predetermined time elapses after the dialysate pump 133 operates in the back filtration direction. When the hydraulic pressure of the liquid circuit 130 is equal to or lower than a predetermined threshold value, the blood purifier 120 determines that backfiltration is possible at a predetermined speed, and the hydraulic pressure of the dialysate circuit 130 exceeds a predetermined threshold value. , The blood purifier 120 was made to determine that backfiltration was impossible at a predetermined speed. As a result, the type of blood purifier 120 included in the circuit set, that is, the hollow thread type blood purifier having a high ultrafiltration rate that allows the blood purifier 120 to perform backfiltration at a predetermined speed that allows priming. It can be determined whether the air purifier is a hollow thread type blood purifier or a laminated blood purifier having a low ultrafiltration rate, which cannot be back-filtered at a predetermined speed. Therefore, even if the medical worker does not set the priming method, the priming method can be automatically selected according to the contents of the circuit set and the priming process can be performed.
Further, the first determination unit 151 determined that the second replenisher line 142 was not connected, and the second determination unit 152 determined that back filtration was possible in the blood purifier 120. In this case, priming can be performed with a back-filtered dialysate via the blood purifier 120. If it is determined that the second replenisher line 142 is not connected and the second determination unit 152 determines that backfiltration is not possible in the blood purifier 120, backfiltration dialysis is performed. It can be determined that neither the liquid nor the dialysate can be used as the priming liquid and the priming step cannot be performed.

(3) The dialysis apparatus 100B is configured to include a notification unit 160 for notifying an abnormality, and it is determined by the first determination unit 151 that the second replenisher line is not connected to the control device 150B. Further, when the second determination unit 152 determines that the blood purifier 120 cannot perform back filtration at a predetermined speed, the notification unit 160 is operated. As a result, when it is determined that neither the reverse filtration dialysate nor the dialysate can be used as the priming solution and the priming step cannot be executed, the medical staff can be notified of the abnormality of the circuit set. it can.

Although the preferred embodiments of the method for determining the dialysis machine and the circuit set of the present invention have been described above, the present invention is not limited to the above-described embodiments and can be appropriately modified.

For example, in the above-described embodiment, the second replacement fluid line is connected from the dialysate introduction line of the dialysate circuit to the arterial side line of the blood circuit, but one end of the replacement fluid line is connected to the dialysate lead-out line. Alternatively, the other end may be connected to the venous side line.
Further, in the above-described embodiment, an appropriate priming method is carried out by determining the presence or absence of the second replacement fluid line, but similarly, the liquid used in the blood removal step, the blood return step, and the replacement fluid step. With respect to the above, an appropriate type can be selected based on the result of determination by the first determination unit of the first embodiment.

Further, the priming step is carried out based on the result of the determination method of the circuit set of the present invention, but similarly, the liquid used in the blood removal step, the blood return step, and the fluid replacement step is also based on the determination result. And you can choose the right type.

100A, 100B Blood dialysis machine 110 Blood circuit 120 Blood purifier 130 Dialysate circuit 130S Dialysate pressure sensor 132a Dialysate introduction line 132b Dialysate lead-out line 133 Dialysate pump 1333 Water removal / back filtration pump 140 Supplementary solution line 141 First Replenisher line 142 Second replenisher line 140a Replenisher pump 140b Replenisher port 140c Replenisher clamp 140S Replenisher pressure sensor 150A, 150B Controller 160 Notification unit

Claims (7)

The blood circuit where the blood purifier is placed and
A dialysate circuit in which a dialysate pump for sending dialysate to the blood purifier is arranged, and
A replenisher port for taking out dialysate that is directly injected into the blood circuit,
A first replenisher line in which one end is connected to the dialysate circuit and the other end is connected to the replenisher port, and a replenisher pump for delivering dialysate from the dialysate circuit to the blood circuit is arranged.
A replenishment hydraulic pressure sensor, which is arranged between the replenishment liquid port and the replenishment liquid pump and for measuring the hydraulic pressure of the first replenishment liquid line,
A replenisher clamp having one end connected to the replenisher port and the other end opening and closing the flow path of a second replenisher line connected to the blood circuit.
A control that is connected to the replenisher pressure sensor and has a first determination unit that determines the presence or absence of the second replenisher liquid line, and controls the operation of the dialysate pump, the replenisher liquid pump, and the replenisher liquid clamp. A dialysis machine equipped with a device,
The control device closes the replenisher clamp and stops the dialysate pump and the replenisher pump after operation so as to send a predetermined amount of dialysate, and then opens the replenisher clamp. Control and
In the first determination unit, when the hydraulic pressure of the first replenisher line drops after the replenisher clamp is controlled to open from the closed state, the second replenisher line is activated. A dialysis apparatus that determines that the first replenisher line is connected and, if the hydraulic pressure of the first replenisher line is constant, determines that the second replenisher line is not connected. The blood circuit where the blood purifier is placed and
A dialysate circuit in which a dialysate pump for sending dialysate to the blood purifier is arranged, and
A dialysate pressure sensor that measures the hydraulic pressure in the dialysate circuit,
A dialysis device including a second determination unit for determining whether or not back filtration is possible at a predetermined speed in the blood purifier, and a control device for controlling the operation of the dialysate pump. ,
The control device operates the dialysate pump in the reverse filtration direction.
In the second determination unit, when a predetermined time elapses after the dialysate pump operates in the reverse filtration direction, the hydraulic pressure of the dialysate circuit measured by the dialysate pressure sensor is equal to or less than a predetermined threshold value. In this case, it is determined that the blood purifier can perform back filtration at the predetermined speed, and when the hydraulic pressure of the dialysate circuit exceeds the predetermined threshold value, the blood purifier determines the predetermined value. A dialysis machine that determines that backfiltration is not possible at a rate. The blood circuit where the blood purifier is placed and
A dialysate circuit in which a dialysate pump for sending dialysate to the blood purifier is arranged, and
A dialysate pressure sensor arranged in the dialysate circuit and measuring the hydraulic pressure in the dialysate circuit,
A replenisher port for taking out dialysate that is directly injected into the blood circuit,
A first replenisher line in which one end is connected to the dialysate circuit and the other end is connected to the replenisher port, and a replenisher pump for delivering dialysate from the dialysate circuit to the blood circuit is arranged.
A replenishment hydraulic pressure sensor, which is arranged between the replenishment liquid port and the replenishment liquid pump and for measuring the hydraulic pressure of the first replenishment liquid line,
A replenisher clamp that opens and closes the flow path of a second replenisher line, one end of which is connected to the replenisher port and the other end of which is connected to the blood circuit.
A first determination unit connected to the replenishment fluid pressure sensor to determine the presence or absence of the second replenishment fluid line, and a blood purifier connected to the dialysate pressure sensor to perform back filtration at a predetermined speed. A dialysis apparatus comprising a second determination unit for determining whether or not it is possible, and a control device for controlling the operation of the dialysate pump, the replenisher pump, and the replenisher clamp.
The control device closes the replenisher clamp and stops the dialysate pump and the replenisher pump after operation so as to send a predetermined amount of dialysate, and then opens the replenisher clamp. Control and
In the first determination unit, when the hydraulic pressure of the first replenisher line drops after the replenisher clamp is controlled to open from the closed state, the second replenisher line is activated. It is determined that the first replenisher line is connected, and when the hydraulic pressure of the first replenisher line is constant, it is determined that the second replenisher line is not connected.
The control device operates the dialysate pump in the reverse filtration direction.
The second determination unit is the blood purifier when the hydraulic pressure of the dialysate circuit is equal to or less than a predetermined threshold value when a predetermined time elapses after the dialysate pump operates in the reverse filtration direction. When it is determined that backfiltration is possible at the predetermined speed and the hydraulic pressure of the dialysate circuit exceeds the predetermined threshold value, backfiltration is not possible at the predetermined speed in the blood purifier. A dialysis machine that determines. It is equipped with a notification unit that notifies abnormalities.
In the control device, the first determination unit determines that the second replenisher line is not connected, and the second determination unit performs backfiltration in the blood purifier at the predetermined speed. The dialysis apparatus according to claim 3, wherein the notification unit is operated when it is determined that it is impossible. The blood circuit where the blood purifier is placed and
A dialysate circuit in which a dialysate pump for sending dialysate to the blood purifier is arranged, and
A replenisher port for taking out dialysate that is directly injected into the blood circuit,
A first replenisher line in which one end is connected to the dialysate circuit and the other end is connected to the replenisher port, and a replenisher pump for sending dialysate from the dialysate circuit to the blood circuit is arranged.
A replenishment hydraulic pressure sensor, which is arranged between the replenishment liquid port and the replenishment liquid pump and measures the hydraulic pressure of the first replenishment liquid line,
A replenisher clamp that opens and closes the flow path of a second replenisher line, one end of which is connected to the replenisher port and the other end of which is connected to the blood circuit.
A method for determining a circuit set performed at the start of priming in a dialysis apparatus including the dialysate pump, the replenisher pump, and a control device for controlling the operation of the replenisher clamp.
If the hydraulic pressure of the first replenisher line drops when the replenisher clamp is opened after the predetermined amount of dialysate is sent with the replenisher clamp closed, the second replenisher is described. A method for determining a circuit set that determines that the replenisher line is connected and determines that the second replenisher line is not connected when the hydraulic pressure of the first replenisher line is constant. A blood circuit in which a blood purifier for purifying the patient's blood is placed, and
A dialysate circuit that is connected to the blood purifier and has a dialysate pump that sends dialysate to the blood purifier.
A dialysate pressure sensor arranged in the dialysate circuit and measuring the hydraulic pressure in the dialysate circuit,
A method for determining a circuit set performed at the start of priming in a dialysing device including a control device for controlling the operation of the dialysate pump.
When a predetermined time elapses after the dialysate pump operates in the reverse filtration direction and the hydraulic pressure of the dialysate circuit is equal to or lower than a predetermined threshold value, the blood purifier reverse-filters at the predetermined speed. A method for determining a circuit set that determines that backfiltration is not possible at the predetermined speed in the blood purifier when the hydraulic pressure of the dialysate circuit exceeds the predetermined threshold value. .. The blood circuit where the blood purifier is placed and
A dialysate circuit in which a dialysate pump for sending dialysate to the blood purifier is arranged, and
A dialysate pressure sensor that measures the hydraulic pressure in the dialysate circuit,
A replenisher port for taking out dialysate that is directly injected into the blood circuit,
A first replenisher line in which one end is connected to the dialysate circuit and the other end is connected to the replenisher port, and a replenisher pump for delivering dialysate from the dialysate circuit to the blood circuit is arranged.
A replenisher hydraulic pressure sensor arranged between the replenisher liquid port and the replenisher liquid pump and measuring the hydraulic pressure of the first replenisher liquid line,
A replenisher clamp having one end connected to the replenisher port and the other end opening and closing the flow path of a second replenisher line connected to the blood circuit.
A method for determining a circuit set performed at the start of priming in a dialysis apparatus including the dialysate pump, the replenisher pump, and a control device for controlling the operation of the replenisher clamp.
If the hydraulic pressure of the first replenisher line drops when the replenisher clamp is opened after sending a predetermined amount of dialysate with the replenisher clamp closed, the second replenisher is replenished. It is determined that the liquid line is connected, and when the liquid pressure of the first replenishing liquid line is constant, it is determined that the second replenishing liquid line is not connected.
The dialysate is sent to the blood purifier so as to cause back filtration, and when a predetermined time elapses and the hydraulic pressure of the dialysate circuit is equal to or less than a predetermined threshold value, the blood purifier is used. It is determined that backfiltration is possible at a predetermined speed, and when the hydraulic pressure of the dialysate circuit exceeds the predetermined threshold value, it is determined that backfiltration is not possible at the predetermined speed in the blood purifier. How to determine the circuit set to be used.

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