JP2022063119A - Coelomic fluid treatment system and method for using coelomic fluid treatment system - Google Patents

Abstract

To restrain an increase in the pressure of a concentrator, and thereby restrain an ascitic fluid treatment system from frequently stopping.SOLUTION: An ascitic fluid treatment system 1 comprises a concentrator 12, a first liquid delivery line 14 connected to an inlet 12a of the concentrator 12, a second liquid delivery line 15 connected to a first outlet 12b of the concentrator 12, a third liquid delivery line 16 connected to second outlets 12c and 12d of the concentrator 12, and concentration reduction means 100 for performing concentration reduction operation for introducing low-concentration liquid A whose protein concentration is lower than that of concentrated ascitic fluid located in a space 40a on the primary side of the concentrator 12, into the space 40a on the primary side of the concentrator 12 from the inlet 12a of the concentrator 12, discharging the concentrated ascitic fluid located in the space 40a on the primary side of the concentrator 12, from the first outlet 12b of the concentrator 12, and thereby reducing the protein concentration of liquid located in the space 40a on the primary side of the concentrator 12.SELECTED DRAWING: Figure 1

Description

The present invention relates to a body cavity fluid treatment system and a method of using the body cavity fluid treatment system.

As a treatment method for ascites, which is one of the body cavity fluids, ascites is taken out from the patient, pathogenic substances such as bacteria and cancer cells are removed from the ascites, and the ascites is concentrated with useful components such as albumin remaining. There is ascites filtration concentrated reinfusion therapy (Cell-free and Concentrated Ascites Reinfusion Therapy) that returns ascites to the body.

An ascites treatment system is generally used for such a treatment method. In this ascites treatment system, for example, an ascites bag, a filter, a concentrator, and a concentrated ascites bag are connected in this order, and ascites is flowed by a pump or a head to filter and concentrate the ascites. (See Patent Document 1). Separation membranes such as hollow fiber membranes are used for filters and concentrators.

Japanese Unexamined Patent Publication No. 2019-013491

By the way, when ascites having a high protein concentration flows into the ascites in the ascites treatment system as described above, the pressure of the concentrator (TMP: Trans Membrance Pressure) gradually increases. When the pressure of the concentrator rises and exceeds a predetermined value, the ascites treatment system issues an alarm and stops. If the ascites treatment system is stopped frequently, the work of the medical staff will be required each time, and the treatment will be delayed, which is not preferable.

The present invention has been made in view of this point, and is a body cavity fluid treatment system having a function of coping with an increase in pressure of a concentrator so that the body cavity fluid treatment system for treating body cavity fluid such as ascites does not stop frequently. It is an object of the present invention to provide a method of using a body cavity fluid treatment system.

As a result of diligent studies, the present inventors have found that the above problem can be solved by reducing the pressure of the concentrator by lowering the protein concentration of the concentrator, and have completed the present invention.

That is, the present invention includes the following aspects.
(1) A body cavity fluid treatment system for treating a body cavity fluid, which communicates with a concentrated membrane, an inlet and a first outlet communicating with the space on the primary side of the concentrated membrane, and a space on the secondary side of the concentrated membrane. A concentrator having at least two outlets, a first liquid delivery line connected to the inlet of the concentrator and supplying the body cavity fluid to the concentrator, and a first outlet of the concentrator, concentrated by a concentrating membrane. A second liquid feeding line that discharges the concentrated liquid in the cavity, and a third liquid feeding line that is connected to the second outlet of the concentrator and discharges the liquid removed from the body fluid by the concentrating membrane, and concentration. A low-concentration liquid having a lower protein concentration than the concentrator cavity liquid in the space on the primary side of the vessel is introduced from the inlet of the concentrator into the space on the primary side of the concentrator, and the concentrator cavity liquid in the space on the primary side of the concentrator is introduced. A body cavity fluid treatment system comprising a concentration reducing means for performing a concentration reducing operation of reducing the protein concentration of the liquid in the space on the primary side of the concentrator by discharging the liquid from the first outlet of the concentrator.
(2) A pressure measuring device for measuring at least one of the pressures in the space on the primary side or the space on the secondary side of the concentrator is further provided, and the concentration reducing means is based on the pressure measurement result by the pressure measuring device. The body cavity fluid treatment system according to (1), which is configured to perform the concentration reducing operation.
(3) The concentration reducing means is configured to introduce the low-concentration liquid, which is approximately the volume of the space on the primary side of the concentrator, into the space on the primary side of the concentrator, (1) or (1). The body cavity fluid treatment system according to 2).
(4) The concentration reducing means is configured to introduce the low-concentration liquid into the space on the primary side of the concentrator at a flow rate equal to or smaller than the set flow rate of the body cavity liquid at the time of treating the body cavity liquid. , The body cavity fluid treatment system according to any one of (1) to (3).
(5) The concentration reducing means is configured to introduce the low-concentration liquid into the space on the primary side of the concentrator with the third liquid feeding line closed, (1) to (4). ). The body cavity fluid treatment system according to any one of the following items.
(6) The body cavity liquid treatment system according to any one of (1) to (5), wherein the concentration reducing means has a pump for introducing the low concentration liquid into the space on the primary side of the concentrator. ..
(7) The body cavity liquid according to any one of claims 1 to 6, wherein the concentration reducing means has a supply means for directly or indirectly supplying the low concentration liquid to the first liquid feeding line. Processing system.
(8) The supply means includes an accommodating portion for accommodating the low-concentration liquid, a supply line connecting the accommodating portion and the first liquid feeding line, and an opening / closing means for opening and closing the supply line (8). The body cavity fluid treatment system according to 7).
(9) It has a filter that filters the body cavity liquid before being concentrated by the concentrator, and the first liquid feeding line connects the filter and the concentrator, and the low-concentration liquid is said to be the same. A membrane cleaning operation is carried out by introducing the liquid into the filter through the first liquid feeding line and cleaning the filter membrane of the filter, and the concentration reducing operation is performed in the first liquid feeding line after the membrane cleaning operation. The body cavity liquid treatment system according to any one of (1) to (8), which is configured to introduce a low-concentration liquid into the concentrator.
(10) The concentration reducing means introduces a low-concentration liquid into the space on the primary side of the concentrator, and then introduces the body cavity liquid into the space on the primary side of the concentrator through the first liquid feeding line. It is configured to perform a discharge operation of discharging the low-concentration liquid in the space on the primary side of the concentrator to the space on the secondary side of the concentrator and discharging it from the second outlet to the third liquid feeding line. The body cavity fluid treatment system according to any one of (1) to (9).
(11) The body cavity according to (10), wherein the concentration reducing means is configured to discharge the low-concentration liquid to the third liquid feeding line in a state where the second liquid feeding line is closed. Liquid treatment system.
(12) The body cavity liquid treatment system according to any one of (1) to (11), which is configured to restart the concentration treatment of the body cavity liquid by the concentrator after the concentration reduction operation by the concentration reduction means.
(13) The body cavity liquid treatment system according to any one of (1) to (12), wherein the low-concentration liquid is a physiological saline solution.
(14) A method of using a body cavity fluid treatment system for treating a body cavity fluid, in which the concentration membrane, the inlet and the first outlet communicating with the space on the primary side of the concentration membrane, and the space on the secondary side of the concentration membrane. A concentrator having at least a second outlet for communication, a first liquid feeding line connected to the inlet of the concentrator and supplying the body cavity fluid to the concentrator, and a first outlet of the concentrator for concentrating. A second liquid delivery line that discharges the concentrated body cavity liquid concentrated by the membrane, and a third liquid supply line that is connected to the second outlet of the concentrator and discharges the drainage liquid removed from the body cavity liquid by the concentrated membrane. In a body cavity fluid treatment system equipped with at least, a low-concentration solution having a lower protein concentration than the concentrateer cavity fluid in the space on the primary side of the concentrator is introduced from the inlet of the concentrator into the space on the primary side of the concentrator. The body cavity fluid is discharged from the first outlet of the concentrator in the space on the primary side of the concentrator to reduce the protein concentration of the liquid in the space on the primary side of the concentrator. How to use the processing system.
(15) The method of using the body cavity liquid treatment system according to (14), wherein the concentration reducing operation is performed based on at least one pressure in the space on the primary side or the space on the secondary side of the concentrator.
(16) The concentration reducing operation is carried out by introducing the low-concentration liquid equal to the volume of the space on the primary side of the concentrator into the space on the primary side of the concentrator, (14) or (15). ). How to use the body cavity fluid treatment system.
(17) The concentration reducing operation is carried out by introducing the low-concentration liquid into the space on the primary side of the concentrator at a flow rate equal to or smaller than the set flow rate of the body cavity liquid at the time of treating the body cavity liquid. (14) A method for using the body cavity fluid treatment system according to any one of (16).
(18) The concentration reducing operation is carried out by introducing the low concentration liquid into the space on the primary side of the concentrator with the third liquid feeding line closed, (14) to (17). The method of using the body cavity fluid treatment system according to any one of the above.
(19) The item according to any one of (14) to (18), wherein the concentration reducing operation is performed by directly or indirectly supplying the low concentration liquid to the first liquid feeding line. How to use the body cavity fluid treatment system.
(20) The body cavity liquid treatment system has a filter that filters the body cavity liquid before being concentrated by the concentrator, and the first liquid feeding line connects the filter and the concentrator. In the body cavity liquid treatment system, the low-concentration liquid is introduced into the filter through the first liquid feeding line, a membrane cleaning operation for cleaning the filter membrane of the filter is performed, and the concentration reduction operation is the above-mentioned operation. The body cavity liquid treatment system according to any one of (14) to (19), which is carried out by introducing the low-concentration liquid in the first liquid feeding line into the concentrator after the membrane cleaning operation. how to use.
(21) In the concentration reducing operation, after introducing the low-concentration liquid into the space on the primary side of the concentrator, the body cavity liquid is introduced into the space on the primary side of the concentrator through the first liquid feeding line, and the above-mentioned A discharge operation is performed in which the low-concentration liquid in the space on the primary side of the concentrator is discharged into the space on the secondary side of the concentrator and is discharged from the second outlet to the third liquid supply line (14). A method for using the body cavity fluid treatment system according to any one of (20).
(22) The body cavity liquid treatment according to (21), wherein the draining operation is performed by discharging the low-concentration liquid to the third liquid feeding line with the second liquid feeding line closed. How to use the system.
(23) The method for using the body cavity liquid treatment system according to any one of (14) to (22), wherein the concentration treatment of the body cavity liquid by the concentrator is restarted after the concentration reduction operation.
(24) The method for using the body cavity liquid treatment system according to any one of (14) to (23), wherein the low-concentration liquid is a physiological saline solution.

According to the present invention, it is possible to suppress the pressure rise of the concentrator and prevent the body cavity liquid treatment system from being frequently stopped.

It is explanatory drawing which shows the outline of the structure of the ascites treatment system. It is explanatory drawing which shows the state of the ascites treatment system at the time of a reconcentration treatment. It is a flow chart which shows the control flow of a density reduction operation. It is explanatory drawing which shows the state of the concentrator at the time of ascites treatment. It is explanatory drawing which shows the state of the ascites treatment system at the time of a concentration reduction operation. It is explanatory drawing which shows the state of a concentrator at the time of a concentration reduction operation. It is explanatory drawing which shows the state of the ascites treatment system at the time of a discharge operation. It is explanatory drawing which shows the state of a concentrator at the time of a discharge operation. It is a figure which shows the result of having verified the fluctuation of a concentrator pressure by a concentration reduction operation. It is explanatory drawing which shows the structure of the ascites treatment system in the case of supplying a low-concentration liquid by a head. It is explanatory drawing which shows the state of the ascites treatment system at the time of a membrane washing operation. It is explanatory drawing which shows the state of the ascites treatment system at the time of the concentration reduction operation after the membrane washing operation. It is explanatory drawing which shows the structure of the ascites treatment system when the supply means is provided in the 4th liquid feeding line.

Hereinafter, an example of a preferred embodiment of the present invention will be described with reference to the drawings. Unless otherwise specified, the positional relationship such as up, down, left, and right in the present specification shall be based on the positional relationship shown in the drawings.

FIG. 1 is an explanatory diagram showing an outline of the configuration of an ascites treatment system 1 as a body cavity fluid treatment system according to the present embodiment.

The ascites treatment system 1 includes an astonishing water bag 10 as a storage portion for body cavity fluid, a filter 11, a concentrator 12, a concentrated ascites bag 13 as a collection portion for the concentrating body cavity fluid, and a first liquid feeding line 14. , The second liquid feeding line 15, the third liquid feeding line 16, the fourth liquid feeding line 17, the fifth liquid feeding line 18, the sixth liquid feeding line 19, and the low-concentration liquid. It includes a supply means 20, a pressure measuring device 21, a control device 22, and the like.

The ascites bag 10 is, for example, a soft bag and can contain ascites collected from a patient.

The filter 11 has, for example, a cylindrical housing. The filter 11 has liquid passage ports 11a and 11b at both ends in the longitudinal direction (vertical direction), and has two liquid passage ports 11c and 11d on the side surfaces. In this specification, the upper and lower parts of the ascites treatment system 1 are based on the posture during normal use.

The filter 11 includes a filter membrane 30 that removes a predetermined causative substance such as bacteria and cancer cells and allows a predetermined useful component such as albumin to pass through. The filtration membrane 30 is composed of, for example, a large number of hollow fiber membranes. The space 30a on the primary side of the filtration membrane 30 (internal space of the hollow fiber membrane) 30a leads to the liquid passage ports 11a and 11b, and the space 30b on the secondary side of the filtration membrane 30 (outer space of the hollow fiber membrane) 30b allows liquid to pass through. It leads to the mouths 11c and 11d. The liquid passage port 11c is connected to, for example, a pressure sensor.

The concentrator 12 has, for example, a cylindrical housing. The concentrator 12 has liquid passage ports 12a and 12b at both ends in the longitudinal direction (vertical direction), and has two liquid passage ports 12c and 12d on the side surfaces.

The concentrator 12 includes, for example, a concentrating membrane 40 that removes water from ascites and concentrates it. The concentrated film 40 is composed of, for example, a large number of hollow fiber membranes. The space 40a on the primary side of the concentrated membrane 40 (inner space of the hollow fiber membrane) 40a leads to the liquid passage ports 12a and 12b, and the space on the secondary side of the concentrated membrane 40 (outer space of the hollow fiber membrane) 40b allows liquid to pass through. It leads to the mouths 12c and 12d.

The space 40a on the primary side of the concentrated film 40 has a predetermined volume V, and the volume V is defined by the cross-sectional area S inside the hollow fiber membrane, the length L, the number N of the hollow fiber membranes, and the like.
The volume V can be calculated, for example, by a simple calculation method calculated by the following formula, or by actually filling the inside of the hollow fiber membrane with water and measuring the filling liquid. The volume V is, for example, 100 mL.
Volume V = Cross-sectional area inside hollow fiber membrane S x length L x number N

The concentrated ascites bag 13 is, for example, a soft bag and can contain concentrated ascites concentrated by the concentrator 12. The concentrated ascites bag 13 is installed at a position lower than that of the ascites bag 10.

The fourth liquid feeding line 17 connects the ascites bag 10 and the filter 11. The upstream end of the fourth liquid feeding line 17 is connected to the ascites bag 10, and the downstream end of the fourth liquid feeding line 17 is connected to the liquid passing port 11a of the filter 11. .. That is, the liquid passage port 11a of the filter 11 is an inlet of the filter 11 into which ascites flows. In the present specification, the "upstream side" indicates the direction in which the ascites flows toward the upstream side during normal ascites treatment in which the filter and the concentrator flow in this order, and the "downstream side" refers to the direction during normal ascites treatment. Indicates the direction to the downstream side of.

The upstream end of the sixth liquid feeding line 19 is connected to the liquid passing port 11b of the filter 11. The downstream end of the sixth liquid feeding line 19 is connected to, for example, a waste liquid portion (not shown) containing the drainage liquid removed from the ascites by the filter 11.

The first liquid feeding line 14 connects the filter 11 and the concentrator 12. The upstream end of the first liquid feeding line 14 is connected to the liquid passing port 11d of the filter 11, and the downstream end of the first liquid feeding line 14 is the passing of the upper end of the concentrator 12. It is connected to the liquid port 12a. That is, the liquid passage port 11d of the filter 11 is the outlet of the filter 11, and the liquid passage port 12a of the concentrator 12 is the inlet of the concentrator 12.

The first liquid feeding line 14 is provided with, for example, a first valve 50, a first pump 51, and a drip chamber 52 in this order from the upstream side to the downstream side. The first valve 50 opens and closes the first liquid feeding line 14. The first pump 51 is a tube pump that handles and feeds the tube of the first liquid feeding line 14. Since the first pump 51 closes the tube when stopped, it also has a function as a closing means.

The second liquid feeding line 15 connects the concentrator 12 and the concentrated ascites bag 13. The upstream end of the second liquid feeding line 15 is connected to the liquid passage port 12b at the lower end of the concentrator 12, and the downstream end of the second liquid feeding line 15 is connected to the concentrated ascites bag 13. It is connected. That is, the liquid passage port 12b of the concentrator 12 is the first outlet of the concentrator 12.

The second liquid feeding line 15 is provided with a second pump 60. The second pump 60 is a tube pump that handles and feeds the tube of the second liquid feeding line 15. The second pump 60 also has a function as a closing means because the tube is closed when stopped.

The upstream end of the third liquid feeding line 16 is connected to, for example, the liquid passing ports 12c and 12d of the concentrator 12. That is, the liquid passage ports 12c and 12d of the concentrator 12 are the second outlets of the concentrator 12. The upstream end of the third liquid feeding line 16 may be connected to only one of the liquid passing ports 12c and 12d. The downstream end of the third liquid feeding line 16 is connected to a waste liquid portion (not shown) that houses the drainage liquid removed from the ascites by the concentrator 12. The third liquid feeding line 16 is provided with a second valve 65 that opens and closes the third liquid feeding line 16.

The fifth liquid feeding line 18 connects the concentrated ascites bag 13 and the first liquid feeding line 14. One end (upstream end) of the fifth liquid feeding line 18 is connected to the concentrated ascites bag 13. The other end (downstream end) of the fifth liquid feed line 18 is connected between the first valve 50 and the first pump 51 in the first liquid feed line 14. The fifth liquid feeding line 18 is provided with a third valve 70 that opens and closes the fifth liquid feeding line 18. For example, a soft tube is used for the first to sixth liquid feeding lines 14 to 19.

The low-concentration liquid supply means 20 supplies the first liquid supply line 14 with a low-concentration liquid having a lower protein concentration than the concentrated ascites in the space 40a on the primary side of the concentrator 12. Here, the concentrated ascites in the space 40a on the primary side of the concentrator 12 has at least a higher protein concentration than the ascites of the ascites bag 10, and the concentration of this concentrated ascites can be obtained in advance by past implementation or calculation. Can be done. The low-concentration solution preferably has a protein concentration of 50% or more lower than that of the concentrated ascites of the concentrator 12. The protein concentration of the low-concentration solution is preferably 3.0 g / mL, preferably 1.0 g / mL, and more preferably 0 g / mL. In this embodiment, physiological saline is used as the low-concentration solution.

The supply means 20 includes, for example, a storage unit 80 that stores a low-concentration liquid, a supply line 81 that connects the storage unit 80 and the first liquid supply line 14, and a valve 82 as an opening / closing means for opening and closing the supply line 81. ing. The opening / closing means may be a pump instead of a valve.

The accommodating portion 80 is, for example, a flexible bag, and can accommodate a large amount of low-concentration liquid in an amount larger than the volume of the space 40a on the primary side of the concentrator 12. The supply line 81 is connected between the first pump 51 and the drip chamber 52 in the first liquid feeding line 14. According to the supply means 20, for example, the valve 82 is opened and the second pump 60 is operated to supply the low-concentration liquid of the accommodating portion 80 to the first liquid supply line 14 through the supply line 81, and further to the first liquid supply line 14. It can be supplied to the space 40a on the primary side of the concentrator 12 through the liquid feeding line 14 of 1.

The pressure measuring device 21 communicates with, for example, the drip chamber 52, and can measure the pressure in the space 40a on the primary side of the concentrator 12. The space 40b on the secondary side of the concentrator 12 is open to the atmosphere. In this case, the pressure in the space 40b on the secondary side is normal pressure. Therefore, the pressure in the space 40a on the primary side is measured by the pressure measuring device 21 to concentrate. The differential pressure between the films in the film 40 (the pressure difference between the space 40a on the primary side and the space 40b on the secondary side) can be detected. The measurement result of the pressure measuring device 21 is output to, for example, the control device 22.

The control device 22 is a computer having, for example, a CPU, a memory, and the like. The control device 22 controls the operation of each device such as the first pump 51, the second pump 60, the first valve 50, the second valve 65, the third valve 70, and the valve 82 to perform ascites treatment. Can be executed. The control device 22 can realize ascites treatment by, for example, executing a program stored in the memory on the CPU.

For example, the control device 22 can execute the concentration reduction operation in the concentrator 12 by executing a predetermined program stored in the memory. That is, the control device 22 operates the second pump 60 to supply a predetermined amount of low-concentration liquid in the accommodating portion 80 from the inlet 12a of the concentrator 12 through the supply line 81 and the first liquid supply line 14. It is introduced into the space 40a on the primary side, and the concentrated ascites water in the space 40a on the primary side of the concentrator 12 is discharged from the first outlet 12b of the concentrator 12 to the second liquid feeding line 15 to discharge the concentrated ascites water to the secondary liquid feeding line 15 of the concentrator 12. It is possible to carry out a concentration reducing operation of lowering the protein concentration of the liquid in the side space 40a. Further, the control device 22 operates the first pump 51 after introducing the low-concentration liquid into the space 40a on the primary side of the concentrator 12, and collects the ascites of the first liquid feeding line 14 on the primary side of the concentrator 12. It is possible to carry out a discharge operation of introducing the low-concentration liquid in the space 40a on the primary side of the concentrator 12 into the space 40a and discharging the low-concentration liquid in the space 40a on the primary side to the third liquid feeding line 16 through the concentrating film 40.

In the present embodiment, for example, the supply means 20, the first pump 51, the second pump 60, the second valve 65, and the control device 22 have the protein concentration of the liquid in the space 40a on the primary side of the concentrator 12. Concentration reducing means 100 for performing a concentration reducing operation for reducing the amount of protein.

Next, the ascites treatment performed by using the above-mentioned ascites treatment system 1 will be described.

First, as shown in FIG. 1, an ascites bag 10 containing ascites collected from a patient is connected to a fourth liquid feeding line 17. Next, the third valve 70 and the valve 82 are closed, the first valve 50 and the second valve 65 are opened, the first pump 51 and the second pump 60 are operated, and the ascites is filtered and concentrated. Processing is started. At this time, the set flow rate Q1 of the first pump 51 is set to be larger than the set flow rate Q2 of the second pump 60.

The ascites of the ascites bag 10 is sent to the filter 11 through the fourth liquid feeding line 17. The ascites flows into the space 30a on the primary side of the filtration membrane 30 from the liquid passage port 11a of the filter 11, passes through the filtration membrane 30, and flows out to the space 30b on the secondary side of the filtration membrane 30. At this time, the predetermined causative substance is removed from the ascites. The drainage liquid that does not pass through the filtration membrane 30 in the space 30a on the primary side of the filtration membrane 30 is discharged to a waste liquid portion (not shown) through the sixth liquid feeding line 19.

The ascites that has flowed out into the space 30b on the secondary side of the filter membrane 30 flows out from the liquid passage port 11d of the filter 11 to the first liquid feed line 14, and passes through the first liquid feed line 14 to the concentrator 12. Sent. Ascites flows into the space 40a on the primary side of the concentrating membrane 40 from the inlet 12a of the concentrator 12, and is discharged from the first outlet 12b. At this time, since the set flow rate Q1 of the first pump 51 is larger than the set flow rate Q2 of the second pump 60, a part of the ascites water passes through the concentrated film 40 and is on the secondary side of the concentrated film 40. It flows out into the space 40b of. As a result, water is mainly removed from the ascites and the ascites is concentrated. The concentrated ascites concentrated by the concentrator 12 is stored in the concentrated ascites bag 13 through the second liquid feeding line 15. The drainage removed by the concentrator 12 is discharged to a drainage portion (not shown) through the third liquid feed line 16.

For example, when a predetermined time has passed since the filtration / concentration process was started and the ascites of the ascites bag 10 is exhausted, for example, the first valve 50 is closed and the third valve 70 is opened as shown in FIG. Will be done. Subsequently, the second valve 65 is opened, the valve 82 is closed, the first pump 51 and the second pump 60 are activated, and the concentrated ascites of the concentrated ascites bag 13 passes through the fifth liquid feeding line 18. It is supplied to the first liquid feeding line 14, is supplied to the concentrator 12 through the first liquid feeding line 14, and is reconcentrated in the concentrator 12. The concentrated ascites is then returned to the concentrated ascites bag 13 through the second delivery line 15. After performing the reconcentration treatment of the concentrated ascites for a predetermined time, the first pump 51 and the second pump 60 are stopped, and a series of ascites treatment is completed.

FIG. 3 is a flow chart of a concentration reduction operation performed during the ascites treatment. During the ascites treatment, the pressure of the concentrator 12 (the pressure of the space 40a on the primary side) is constantly or periodically measured by the pressure measuring device 21. Then, when the pressure of the concentrator 12 exceeds a predetermined threshold value, the concentration reducing operation is performed. First, the operation of introducing the low-concentration liquid is performed. At this time, as shown in FIG. 4, the space 40a on the primary side of the concentrator 12 is filled with concentrated ascites L1 having a high protein concentration. The first liquid feeding line 14 is filled with ascites L2 before concentration, and the space 40b on the secondary side of the concentrator 12 is filled with drainage L3 that has passed through the concentrating membrane 40. The concentrated film 40 in FIG. 4 is represented as one thick hollow fiber membrane for the sake of brevity, but is actually composed of a large number of hollow fiber membranes. Then, as shown in FIG. 5, for example, while the second pump 60 is operating, the first pump 51 is stopped, the valve 82 of the supply line 81 is opened, and the second valve of the third liquid feeding line 16 is opened. 65 is closed. When the concentration reduction operation is performed during the filtration / concentration process, for example, the first valve 50 is opened, the third valve 70 is maintained in a closed state, and the concentration reduction operation is performed during the reconcentration process. At that time, for example, the first valve 50 is closed and the third valve 70 is maintained in an open state.

As a result, the low-concentration liquid A is introduced from the accommodating portion 80 through the supply line 81 and the first liquid feeding line 14 from the inlet 12a into the space 40a on the primary side of the concentrator 12. At this time, the low-concentration liquid A having a volume V of the space 40a on the primary side of the concentrator 12 is introduced into the space 40a on the primary side. Further, the low-concentration liquid A is introduced into the space 40a on the primary side of the concentrator 12 at a flow rate equal to or smaller than the set flow rate Q1 of the ascites during the ascites treatment. Then, the concentrated ascites L1 in the space 40a on the primary side is pushed out from the first outlet 12b to the second liquid feeding line 15 and discharged. In this way, the concentrated ascites L1 in the space 40a on the primary side of the concentrator 12 is replaced with the low-concentration liquid A, and the protein concentration of the liquid in the space 40a on the primary side is reduced. In principle, it is desirable to introduce a low-concentration liquid A having a volume V of the space 40a on the primary side of the concentrator 12, but this concentration reduction operation may be performed until the pressure becomes equal to or less than a predetermined threshold value. It may be carried out for a specified time.

Next, the operation of discharging the low-concentration liquid is performed. As shown in FIG. 7, the first pump 51 operates, the second pump 60 stops, the valve 82 closes, and the second valve 65 opens. As a result, ascites L2 is supplied to the space 40a on the primary side of the concentrator 12 through the first liquid feeding line 14, and the low-concentration liquid A in the space 40a on the primary side of the concentrator 12 is supplied as shown in FIG. It is discharged to the space 40b on the secondary side through the concentration film 40, and is discharged from the second outlets 12c and 12d to the third liquid feeding line 16. In this discharge operation, the pressure in the space 40a on the primary side of the concentrator 12 may drop too much due to the introduction operation of the low-concentration liquid A, so that the pressure in the space 40a on the primary side recovers to a predetermined threshold value or more. You may continue until you do.

After the concentration reduction operation is completed, the second pump 60 is operated, and the above-mentioned ascites treatment (filtration / concentration treatment and reconcentration treatment) is restarted.

According to the present embodiment, the ascites treatment system 1 applies a low-concentration liquid A having a protein concentration lower than that of the concentrated ascites in the space 40a on the primary side of the concentrator 12 from the inlet 12a of the concentrator 12 to the primary side of the concentrator 12. The concentrated ascites in the space 40a on the primary side of the concentrator 12 is discharged from the first outlet 12b of the concentrator 12, and the protein concentration of the liquid in the space 40a on the primary side of the concentrator 12 is discharged. It is provided with a concentration reducing means 100 that performs a concentration reducing operation for reducing the amount of protein. As a result, the protein concentration of the liquid in the space 40a on the primary side decreases, and the liquid easily passes through the concentrating membrane 40, so that the pressure of the concentrator 12 can be reduced. In this regard, as shown in FIG. 9, according to the verification by the inventors, when the pressure of the concentrator 12 (intermembrane pressure difference) rises, the concentration reduction operation is performed, so that the pressure of the concentrator 12 suddenly increases. It has been confirmed that it will go down.

The concentration reducing means 100 is configured to perform a concentration reducing operation based on the pressure measurement result by the pressure measuring device 21. As a result, the pressure of the concentrator 12 can be reliably reduced.

The concentration reducing means 100 is configured to introduce a low-concentration liquid A having a substantially volume of the space 40a on the primary side of the concentrator 12 into the space 40a on the primary side of the concentrator. As a result, it is possible to prevent a large amount of the low-concentration liquid A from entering the second liquid feeding line 15 and being collected in the concentrated ascites bag 13, so that the concentrated ascites collected in the concentrated ascites bag 13 is adjusted to a desired concentration. It will be easier.

The concentration reducing means 100 is configured to introduce the low-concentration liquid A into the space 40a on the primary side of the concentrator 12 at a flow rate equal to or smaller than the set flow rate at the time of introduction of ascites. By doing so, it is possible to suppress an increase in pressure in the concentrator 12 due to the introduction of the low-concentration liquid A.

The concentration reducing means 100 is configured to introduce the low concentration liquid A into the space 40a on the primary side of the concentrator 12 in a state where the third liquid feeding line 16 is closed. As a result, the low-concentration liquid A does not leak from the third liquid feeding line 16, and the low-concentration liquid A can be efficiently introduced into the concentrator 12.

The concentration reducing means 100 has a second pump 60 for introducing the low concentration liquid A into the space 40a on the primary side of the concentrator 12. As a result, the amount of the low-concentration liquid A introduced can be accurately controlled, and as a result, the low-concentration liquid A can be introduced into the concentrator 12 without excess or deficiency.

The concentration reducing means 100 has a supply means 20 for directly supplying the low concentration liquid A to the first liquid feeding line 14. This makes it possible to suitably supply the low-concentration liquid A.

The supply means 20 has a storage unit 80 that stores the low-concentration liquid A, a supply line 81 that connects the storage unit 80 and the first liquid supply line 14, and a valve 82. This makes it possible to suitably supply the low-concentration liquid A with a simple configuration.

The concentration reducing means 100 introduces the low-concentration liquid A into the space 40a on the primary side of the concentrator 12, and then introduces ascites into the space 40a on the primary side of the concentrator 12 through the first liquid feeding line 14. The low-concentration liquid A in the space 40a on the primary side is discharged to the space 40b on the secondary side of the concentrator 12, and is discharged from the second outlets 12c and 12d to the third liquid feeding line 16. It is configured. As a result, the low-concentration liquid A of the concentrator 12 can be discharged to the third liquid feeding line 16, so that the low-concentration liquid A is collected in the concentrated ascites bag 13 through the second liquid feeding line 15. It can be suppressed. This makes it easy to adjust the concentrated ascites collected in the concentrated ascites bag 13 to a desired concentration.

The concentration reducing means 100 is configured to discharge the low-concentration liquid A to the third liquid feeding line 16 in a state where the second liquid feeding line 15 is closed. As a result, it is possible to reliably prevent the low-concentration liquid A from entering the second liquid feeding line 15.

In the above embodiment, the low concentration liquid A is introduced into the concentrator 12 (concentration reduction operation) based on the pressure measurement result by the pressure measuring device 21, but when a predetermined time has elapsed after the start of the ascites treatment, , May be done when a predetermined amount of ascites is treated. Further, the pressure measuring device 21 may measure the pressure correlated with the pressure of the concentrator 12 (the differential pressure between the films of the concentrating film 40), and the space 40a on the primary side or the space 40b on the secondary side of the concentrator 12 may be measured. At least one of the pressures may be measured.

In the above embodiment, the low concentration liquid A is introduced into the concentrator 12 by using the second pump 60, but it may be performed by the drop pressure. In such a case, for example, as shown in FIG. 10, the accommodating portion 80 is provided at a position higher than the concentrator 12 and the concentrated ascites bag 13. Then, the valve 82 is opened for a predetermined time, and the low-concentration liquid A of the accommodating portion 80 is introduced into the space 40a on the primary side of the concentrator 12 by the drop pressure.

The membrane cleaning operation for cleaning the filtration membrane 30 of the filter 11 may be performed using the low-concentration liquid A.

For example, when the pressure of the concentrator 12 rises and the concentration reduction operation is performed, the membrane cleaning operation is first performed before the concentration reduction operation. At this time, as shown in FIG. 11, for example, in a state where the second pump 60 is stopped, the first valve 50 and the valve 82 are opened, and the third valve 70 is closed, the first pump 51 is reversed. The low-concentration liquid A of the accommodating portion 80 is supplied to the filter 11 through the supply line 81 and the first liquid supply line 14, and the low-concentration liquid A is supplied from the space 30b on the secondary side of the filter membrane 30. The filter membrane 30 is washed by flowing out to the space 30a on the primary side. The low-concentration liquid A that has flowed out into the space 30a on the primary side of the filtration membrane 30 is discharged through the sixth liquid feeding line 19. In this membrane cleaning operation, for example, the first liquid feeding line 14 and the filter 11 are filled with the low-concentration liquid A.

Next, a concentration reduction operation is performed, the first pump 51 and the second pump 60 are operated, the first valve 50 is opened, the second valve 65, and the third valve are operated as shown in FIG. With the 70 and the valve 82 closed, the low-concentration liquid A of the first liquid feeding line 14 is introduced into the concentrator 12. According to such an example, the membrane cleaning of the filtration membrane 30 can be performed using the low-concentration liquid A.

In the above embodiment, the supply means 20 directly supplies the low-concentration liquid A to the first liquid feeding line 14, but it may be indirectly supplied. In this case, for example, as shown in FIG. 13, the supply line 81 of the supply means 20 may be connected to the fourth liquid supply line 17.

The configuration of the ascites treatment system 1 is not limited to that of the above embodiment.

For example, the positions of the first pump 51 and the second pump 60 can be changed as appropriate. In particular, the first pump 51 may be in the fourth liquid feeding line 17. The configuration of the concentration reducing means 100 is not limited to the configuration of the above embodiment as long as it can realize the concentration reducing operation of introducing the low concentration liquid into the space 40a on the primary side of the concentrator 12 as described above. The ascites treatment system 1 may not include a fifth liquid feeding line 18 and may not be reconcentrated.

In the above embodiment, the first liquid feeding line 14 and the second liquid feeding line 15 are connected to the inner region of the concentrating membrane 40 of the concentrator 12, and the third liquid feeding line 16 concentrates the concentrator 12. It was connected to the outer region of the membrane 40, but vice versa, that is, the first liquid feed line 14 and the second liquid feed line 15 were connected to the outer region of the concentrating membrane 40 of the concentrator 12, and the third feed. The liquid line 16 may be connected to the inner region of the concentrating membrane 40 of the concentrator 12. Further, the fourth liquid feed line 17 and the sixth liquid feed line 19 are connected to the inner region of the filter membrane 30 of the filter 11, and the first liquid feed line 14 is connected to the outer region of the filter membrane 30. However, the opposite is true, that is, the fourth liquid feed line 17 and the sixth liquid feed line 19 are connected to the outer region of the filter membrane 30 of the filter 11, and the first liquid feed line 14 is inside the filter membrane 30. It may be connected to the area. Further, the filter 11 and the concentrator 12 may be installed upside down. That is, the filter 11 may be installed so that the inlet 11a is at the bottom and the outlet 11b is at the top, and the concentrator 12 is installed so that the inlet 12a is at the bottom and the outlet 12b is at the top.

The above embodiment is an example in which the present invention is applied to the ascites treatment system 1 for treating ascites, but the present invention can also be applied to a body cavity fluid treatment system for treating other body cavity fluids such as pleural effusion. ..

The present invention is useful in suppressing the pressure rise of the concentrator to prevent the body cavity fluid treatment system from stopping frequently.

1 Ascites treatment system 10 Ascites bag 11 Filter 12 Concentrator 13 Concentrated ascites bag 14 First liquid feed line 15 Second liquid feed line 16 Third liquid feed line 17 Fourth liquid feed line 18 Fifth feed Liquid line 19 6th liquid feeding line 22 Control device 40 Concentrating membrane 40a Space on the primary side 100 Concentration reducing means

Claims (24)

It is a body cavity fluid treatment system that processes body cavity fluid.
A concentrator having at least an inlet and a first outlet communicating with the space on the primary side of the concentrated membrane and a second outlet communicating with the space on the secondary side of the concentrated membrane.
The first liquid delivery line, which is connected to the inlet of the concentrator and supplies the coelomic fluid to the concentrator,
A second liquid delivery line connected to the first outlet of the concentrator and discharging the concentrator cavity liquid concentrated by the concentrating membrane,
A third liquid delivery line connected to the second outlet of the concentrator and draining the drainage removed from the body cavity fluid by the concentrating membrane.
A low-concentration liquid having a lower protein concentration than the concentrator cavity liquid in the space on the primary side of the concentrator is introduced from the inlet of the concentrator into the space on the primary side of the concentrator, and the concentrator cavity in the space on the primary side of the concentrator. A body cavity fluid treatment system comprising a concentration reducing means for performing a concentration reducing operation of discharging a liquid from a first outlet of the concentrator to reduce the protein concentration of the liquid in the space on the primary side of the concentrator. Further equipped with a pressure measuring device for measuring the pressure of at least one of the space on the primary side or the space on the secondary side of the concentrator is provided.
The body cavity fluid treatment system according to claim 1, wherein the concentration reducing means is configured to perform the concentration reducing operation based on the pressure measurement result by the pressure measuring device. The concentration reducing means according to claim 1 or 2, wherein the low concentration liquid is introduced into the space on the primary side of the concentrator by substantially the volume of the space on the primary side of the concentrator. Body cavity fluid treatment system. The concentration reducing means is configured to introduce the low-concentration liquid into the space on the primary side of the concentrator at a flow rate equal to or smaller than the set flow rate of the body cavity liquid at the time of treating the body cavity liquid. The body cavity fluid treatment system according to any one of 1 to 3. Any one of claims 1 to 4, wherein the concentration reducing means is configured to introduce the low-concentration liquid into the space on the primary side of the concentrator with the third liquid feeding line closed. The body cavity fluid treatment system described in the section. The body cavity liquid treatment system according to any one of claims 1 to 5, wherein the concentration reducing means has a pump for introducing the low concentration liquid into the space on the primary side of the concentrator. The body cavity liquid treatment system according to any one of claims 1 to 6, wherein the concentration reducing means has a supply means for directly or indirectly supplying the low concentration liquid to the first liquid feeding line. The seventh aspect of the present invention comprises a storage unit for accommodating the low-concentration liquid, a supply line connecting the accommodating unit and the first liquid feeding line, and an opening / closing means for opening and closing the supply line. The described body cavity fluid treatment system. It has a filter that filters the body cavity fluid before it is concentrated in the concentrator,
The first liquid feeding line connects the filter and the concentrator.
The low-concentration liquid is introduced into the filter through the first liquid feeding line, and a membrane cleaning operation for cleaning the filter membrane of the filter is performed.
The concentration reducing operation is according to any one of claims 1 to 8, wherein the low concentration liquid in the first liquid feeding line is introduced into the concentrator after the membrane cleaning operation. Body cavity fluid treatment system. The concentration reducing means introduces the low-concentration liquid into the space on the primary side of the concentrator, then introduces the body cavity liquid into the space on the primary side of the concentrator through the first liquid feeding line, and causes the concentrator. The low-concentration liquid in the space on the primary side is discharged to the space on the secondary side of the concentrator, and is discharged from the second outlet to the third liquid feeding line. The body cavity fluid treatment system according to any one of claims 1 to 9. The body cavity liquid treatment system according to claim 10, wherein the concentration reducing means is configured to discharge the low-concentration liquid to the third liquid feeding line in a state where the second liquid feeding line is closed. .. The body cavity liquid treatment system according to any one of claims 1 to 11, wherein the concentration treatment of the body cavity liquid by the concentrator is restarted after the concentration reduction operation by the concentration reduction means. The body cavity liquid treatment system according to any one of claims 1 to 12, wherein the low-concentration liquid is a physiological saline solution. It is a method of using a body cavity fluid treatment system that treats body cavity fluid.
A concentrator having at least an inlet and a first outlet communicating with the space on the primary side of the concentrated membrane and a second outlet communicating with the space on the secondary side of the concentrated membrane.
The first liquid delivery line, which is connected to the inlet of the concentrator and supplies the coelomic fluid to the concentrator,
A second liquid delivery line connected to the first outlet of the concentrator and discharging the concentrator cavity liquid concentrated by the concentrating membrane,
In a coelomic fluid treatment system, the coelomic fluid treatment system is connected to a second outlet of the concentrator and includes at least a third liquid feeding line for draining the coelomic fluid removed from the coelomic fluid by the concentrating membrane.
A low-concentration liquid having a lower protein concentration than the concentrator cavity liquid in the space on the primary side of the concentrator is introduced from the inlet of the concentrator into the space on the primary side of the concentrator, and the concentrator cavity in the space on the primary side of the concentrator. A method of using a coelomic fluid treatment system that drains a liquid from a first outlet of a concentrator to perform a concentration reduction operation that lowers the protein concentration of the liquid in the space on the primary side of the concentrator. The method of using the coelomic fluid treatment system according to claim 14, wherein the concentration reducing operation is performed based on at least the pressure in the space on the primary side or the space on the secondary side of the concentrator. The body cavity according to claim 14 or 15, wherein the concentration reducing operation is carried out by introducing the low-concentration liquid, which is substantially the volume of the space on the primary side of the concentrator, into the space on the primary side of the concentrator. How to use the liquid treatment system. The concentration reducing operation is carried out by introducing the low-concentration liquid into the space on the primary side of the concentrator at a flow rate equal to or smaller than the set flow rate of the body cavity liquid at the time of treating the body cavity liquid. 16. The method of using the body cavity fluid treatment system according to any one of 16. One of claims 14 to 17, wherein the concentration reducing operation is carried out by introducing the low concentration liquid into the space on the primary side of the concentrator with the third liquid feeding line closed. How to use the body cavity fluid treatment system described in. The body cavity liquid treatment system according to any one of claims 14 to 18, wherein the concentration reducing operation is performed by directly or indirectly supplying the low concentration liquid to the first liquid feeding line. How to use. The coelomic fluid treatment system has a filter that filters the coelomic fluid before being concentrated by the concentrator, and the first liquid feeding line connects the filter and the concentrator.
In the body cavity liquid treatment system, the low-concentration liquid is introduced into the filter through the first liquid feeding line, and a membrane cleaning operation for cleaning the filter membrane of the filter is performed.
The concentration reduction operation is carried out by introducing the low concentration liquid in the first liquid feeding line into the concentrator after the membrane cleaning operation, according to any one of claims 14 to 19. How to use the body cavity fluid treatment system. In the concentration reduction operation, after introducing the low-concentration liquid into the space on the primary side of the concentrator, the body cavity liquid is introduced into the space on the primary side of the concentrator through the first liquid feeding line, and the concentrator is operated. 14.20 of claims 14 to 20, wherein the low-concentration liquid in the space on the primary side is discharged into the space on the secondary side of the concentrator, and the liquid is discharged from the second outlet to the third liquid feeding line. A method of using the body cavity fluid treatment system according to any one of the following items. The use of the body cavity liquid treatment system according to claim 21, wherein the draining operation is performed by discharging the low-concentration liquid to the third liquid feeding line with the second liquid feeding line closed. Method. The method for using the body cavity liquid treatment system according to any one of claims 14 to 22, wherein the concentration treatment of the body cavity liquid by the concentrator is restarted after the concentration reduction operation. The method for using the body cavity liquid treatment system according to any one of claims 14 to 23, wherein the low-concentration liquid is a physiological saline solution.

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