JP2022092160A - Blood purification device - Google Patents

Abstract

To provide a blood purification device capable of suppressing a water removal error in a blood purification treatment, providing a large-sized specific peak, and highly accurately detecting recirculating blood.SOLUTION: A blood purification device comprises a peak provision section capable of providing a specific peak to concentration change in blood extracorporeally circulating in a blood circuit 1, a detector 5 for detecting the specific peak, and a recirculation detecting section 16 for detecting recirculating blood on the basis of the specific peak detected by the detector 5. The peak provision section includes a concentration-side peak provision part concentrating the blood extracorporeally circulating in the blood circuit 1 and providing a specific concentration-side peak, and a dilution-side peak provision part diluting the blood extracorporeally circulating in the blood circuit 1 and providing a specific dilution-side peak. The recirculation detecting section 16 detects the recirculating blood on the basis of the specific peak including the concentration-side peak and the dilution-side peak.SELECTED DRAWING: Figure 1

Description

The present invention relates to a blood purification device that detects recirculated blood in which blood returned to a patient from a venous blood circuit is again guided to an arterial blood circuit and flows.

Generally, in blood purification therapy, for example, hemodialysis treatment, a patient's blood is circulated extracorporeally in a blood circuit, and blood purification is performed by a dialyzer. However, for example, when an arterial puncture needle and a venous puncture needle are punctured into the patient's shunt (the site where the artery and vein are connected by surgery) for extracorporeal circulation, the venous puncture needle is purified from the patient. Blood returned to the body may be introduced into the blood circuit from the arterial puncture needle again without passing through the patient's organs, etc., and recirculated blood may occur. When such recirculated blood occurs, the purified blood is further circulated extracorporeally, and the amount of extracorporeal circulation of blood that needs to be purified is reduced by that amount, which causes a problem that the blood purification efficiency is lowered. It ends up.

In order to detect such recirculated blood, for example, as disclosed in Patent Document 1, a peak imparting portion capable of imparting a peak peculiar to a change in the concentration of blood circulating extracorporeally in the blood circuit and a peak imparting portion attached to the blood circuit are attached. Based on the detection unit that detects the peculiar peak given by the peak giving part and the peculiar peak detected by the detection part, the blood returned to the patient from the venous blood circuit is guided to the arterial blood circuit again. A blood purification device including a recirculation detecting unit for detecting the recirculating blood flowing through the blood has been proposed.

Japanese Unexamined Patent Publication No. 2009-45307

However, in the above-mentioned conventional blood purification device, blood is concentrated exclusively by removing water to give a peculiar peak, so that there are the following problems.
Since the amount of water removed required to give a peculiar peak is not reflected in the integrated water removal value in blood purification treatment, it may cause a water removal error. Therefore, in order to give a peculiar peak. There is a problem that the number of times is limited. Further, in order to accurately detect the recirculated blood by the recirculation detection unit, it is required to increase the size of the peculiar peak given by the peak imparting section. There is a limit.

The present invention has been made in view of such circumstances, and can suppress a water removal error in blood purification treatment and can impart a peculiar peak of a large size to make recirculated blood more accurate. The purpose is to provide a blood purification device that can be detected well.

The present invention has a blood circuit on the arterial side and a blood circuit on the venous side, a blood circuit that circulates the blood of a patient outside the body, a blood purification unit that is connected to the blood circuit and purifies the blood flowing through the blood circuit, and the above. A dialysate introduction line connected to the blood purification unit to introduce dialysate into the blood purification unit, a dialysate discharge line connected to the blood purification unit to discharge dialysate from the blood purification unit, and the blood circuit. A peak-imparting unit that can impart a peak peculiar to a change in the concentration of blood circulating outside the body, a detection unit that is attached to the blood circuit and detects a peculiar peak imparted by the peak-imparting unit, and a detection unit. A blood purification device provided with a recirculation detector for detecting recirculated blood in which blood returned from the venous blood circuit to the patient is guided to the arterial blood circuit again and flows based on the detected peculiar peak. The peak giving portion is unique in that the concentrated side peak giving portion that concentrates the blood circulating outside the body in the blood circuit to give a unique concentrated side peak and the blood circulating outside the body in the blood circuit are diluted. The recirculation detection unit has a diluting side peak imparting unit for imparting a diluting side peak, and the recirculation detection unit is a blood purification device that detects recirculated blood based on a peculiar peak including the enrichment side peak and the diluting side peak. Is.

According to the present invention, the peak giving portion is unique in that the concentrated side peak giving portion that concentrates the blood circulating outside the body in the blood circuit and imparts a unique concentrated side peak, and the concentrated side peak giving portion that dilutes the blood circulating outside the body in the blood circuit. Since it has a diluting side peak imparting section for imparting a diluting side peak and the recirculation detection section detects recirculated blood based on a peculiar peak including a concentrating side peak and a diluting side peak, it is excluded in blood purification treatment. In addition to suppressing water error, it is possible to impart a peculiar peak of a large size, and it is possible to detect recirculated blood more accurately.

Schematic diagram showing a blood purification apparatus according to the first embodiment of the present invention. Graph showing the peculiar peak detected by the detection part of the blood purification device A graph showing a unique peak (assigned a code for calculation) detected by the detection unit of the blood purification device. Schematic diagram showing a method of detecting recirculated blood by the recirculation detection unit using a peculiar peak detected by the detection unit of the blood purification device. Schematic diagram showing a method of detecting recirculated blood by the recirculation detection unit using a peculiar peak detected by the detection unit of the blood purification device. Schematic diagram which shows the blood purification apparatus which concerns on 2nd Embodiment of this invention. Schematic diagram which shows the blood purification apparatus which concerns on 3rd Embodiment of this invention. Schematic diagram which shows the blood purification apparatus which concerns on 4th Embodiment of this invention. A graph showing a peculiar peak detected by the detection unit of the blood purification apparatus according to another embodiment of the present invention. A graph showing a peculiar peak (assigned a code for calculation) detected by the detection unit of the blood purification apparatus according to the other embodiment.

Hereinafter, embodiments of the present invention will be specifically described with reference to the drawings.
The blood purification device according to the present embodiment is for purifying the blood of a patient while circulating it outside the body, and is applied to a hemodialysis device used in hemodialysis treatment. As shown in FIG. 1, such a hemodialysis apparatus mainly comprises a blood circuit 1 to which a dialyzer 2 as a blood purification unit is connected, and a dialysis apparatus main body 6 that removes water while supplying dialysate to the dialyzer 2. In addition, it has a peak-imparting unit (concentrated peak-applying unit and diluted-side peak-imparting unit), a detection unit (first detection unit 5a, second detection unit 5b), a recirculation detection unit 16, and the like.

As shown in the figure, the blood circuit 1 is mainly composed of an arterial blood circuit 1a and a venous blood circuit 1b made of a flexible tube, and the arterial blood circuit 1a and the venous blood circuit 1b of these arterial blood circuits 1a and the venous blood circuit 1b. A dialyzer 2 is connected between them. An arterial side puncture needle a is connected to the tip of the arterial side blood circuit 1a, and an ironing type blood pump 3, an air trap chamber 4a for defoaming, and a first detection unit 5a are arranged in the middle. ing. On the other hand, the vein side puncture needle b is connected to the tip of the vein side blood circuit 1b, and the second detection unit 5b and the air trap chamber 4b for defoaming are connected in the middle.

Then, when the blood pump 3 is driven with the arterial puncture needle a and the venous puncture needle b punctured by the patient, the patient's blood is defoamed in the air trap chamber 4a while the arterial blood circuit 1a is defoamed. After flowing to reach the dialyzer 2 and purifying the blood by the dialyzer 2, the blood is defoamed in the air trap chamber 4b and flows through the venous blood circuit 1b to return to the patient's body. As a result, the patient's blood is purified by the dialyzer 2 while circulating outside the body in the blood circuit 1.

The dialyzer 2 is formed in a housing portion thereof with a blood introduction port 2a, a blood outlet port 2b, a dialysate introduction port 2c, and a dialysate outlet port 2d, of which the blood introduction port 2a has an arterial blood circuit 1a. The proximal end of the venous blood circuit 1b is connected to the blood outlet port 2b. Further, the dialysate introduction port 2c and the dialysate outlet port 2d are
It is connected to a dialysate introduction line 7 for introducing the dialysate into the dialyzer 2 and a dialysate discharge line 8 for discharging the dialysate (drainage) from the dialyzer 2.

A plurality of hollow fibers are housed in the dialyzer 2, and the inside of the hollow fibers serves as a blood flow path, and the dialysate flows between the outer peripheral surface of the hollow fibers and the inner peripheral surface of the housing portion. It is said to be a road. A large number of minute holes (pores) penetrating the outer peripheral surface and the inner peripheral surface of the hollow fiber are formed in the hollow fiber to form a hollow fiber membrane, and impurities in the blood are dialyzed through the hollow fiber membrane. It is configured to be able to permeate into the liquid.

On the other hand, the dialing device main body 6 is connected to the double pump C, the bypass line 9 connected by bypassing the drain side Cb of the double pump C in the dialysate discharge line 8, and the water removal pump 10 connected to the bypass line 9. A pressure pump 11 for flowing dialysate from the dialyzer 2 to the drain side Cb of the double pump C, a bubble separation chamber 12, an atmosphere opening line 13, and an electromagnetic valve 14 are provided.

The compound pump C is arranged so as to straddle the dialysate introduction line 7 and the dialysate discharge line 8, and the dialysate is introduced into the dialyzer 2 from the dialysate introduction line 7 and the dialysate introduced into the dialyzer 2 is introduced. The purpose is to discharge the dialysate from the dialysate discharge line 8. That is, the compound pump C is composed of a quantitative pump in which the supply side Ca and the drain side Cb have substantially the same amount, and the flow path of the dialysate from the supply side Ca to the drain side Cb (specifically, the drain side Cb). , The flow path on the downstream side of the double pump C in the dialysate introduction line 7, the flow path on the upstream side of the double pump C in the dialysate discharge line 8, and the dialysate flow path of the dialyzer 2), the solenoid valve 14 was closed. In this state, a closed system flow path (a flow path in which the airtightness is maintained) is formed.

The pressurizing pump 11 is connected between the dialyzer 2 and the compound pump C in the dialysate discharge line 8 to flow the dialysate from the dialyzer 2 to the compound pump C, and is non-volumetric like the centrifugal type. It consists of a type pump (pressure control type). The water removal pump 10, which will be described later, is also made of a non-volumetric pump (pressure control type) like the centrifugal type, like the pressurizing pump 11.

One end of the dialysate introduction line 7 is connected to the dialysate introduction port 2c of the dialyzer 2, and the other end is connected to a dialysate supply device (not shown) for preparing a dialysate having a predetermined concentration. Further, one end of the dialysate discharge line 8 is connected to the dialysate outlet port 2d of the dialyzer 2, and the other end is connected to a drainage means (not shown), so that the dialysate supplied from the dialysate supply device can be used. After reaching the dialyzer 2 through the dialysate introduction line 7, the dialysate is sent to the drainage means through the dialysate discharge line 8 and the bypass line 9.

The water removal pump 10 is for removing water from the patient's blood flowing through the dialyzer 2. That is, when the water removal pump 10 is driven, since the compound pump C is a quantitative type, the volume of the liquid discharged from the dialysate discharge line 8 becomes larger than the amount of the dialysate introduced from the dialysate introduction line 7. Water is removed from the blood by the amount of the large amount. In addition, water may be removed from the patient's blood by using a means other than the water removal pump 10 (for example, one using a so-called balancing chamber or the like).

The bubble separation chamber 12 is a so-called degassing chamber, which is composed of a predetermined capacity connected between the pressurizing pump 11 and the compound pump C in the dialysate discharge line 8 and captures bubbles in the dialysate. It is configured to be possible. From the bubble separation chamber 12, the bypass line 9 described above is extended, and the atmosphere opening line 13 is extended. The tip of the atmospheric opening line 13 is open to the atmosphere, and a solenoid valve 14 capable of opening and closing a flow path is connected in the middle of the line.

The solenoid valve 14 is openable and closable to open or close the atmospheric opening line 13, so that the bubble separation chamber 12 communicates with the outside air in the open state and the bubble separation chamber 12 shuts off the outside air in the closed state. It has become. Then, if the solenoid valve 14 is operated to open the atmosphere opening line 13 before or after the dialysis treatment, the bubbles captured in the bubble separation chamber 12 can be released to the atmosphere.

Further, a supply line La is connected to the dialysate introduction line 7 according to the present embodiment. The supply line La includes a priming line that supplies dialysate as a priming solution to the blood circuit 1, and the base end thereof is the supply side Ca of the double pump C in the dialysate introduction line 7 and the dialysate introduction port 2c of the dialyzer 2. The tip is connected to the site between the arterial puncture needle a and the blood pump 3 in the arterial blood circuit 1a.

A squeeze-type pump 15 similar to the blood pump 3 is disposed in the supply line La, and the dialysate of the dialysate introduction line 7 is supplied to the arterial blood circuit 1a by driving the squeeze-type pump 15. It is said that it can be primed. In the present embodiment, the supply line La is composed of a priming line that supplies a dialysate as a priming solution to the blood circuit 1, but the tip is connected to the air trap chamber 4a or the air trap chamber 4b to connect the blood. It may consist of a replacement fluid line that supplies dialysate as a replacement fluid to the circuit 1.

Here, the blood purification device according to the present embodiment has a peak imparting portion capable of imparting a peak peculiar to a change in the concentration of blood circulating extracorporeally in the blood circuit 1, and the peak imparting portion is the blood circuit 1. A concentrated side peak giving part that concentrates the blood circulating outside the body and gives a unique concentrated side peak, and a diluted side peak giving part that dilutes the blood circulating outside the body in the blood circuit 1 and gives a unique diluted side peak. have. In particular, in the present embodiment, the dilution side peak imparting portion is composed of the supply line La and the ironing pump 15, and the enrichment side peak imparting portion is composed of the compound pump C.

The dilution side peak imparting portion is unique in that the blood flowing through the dialyzer 2 is diluted for a short time by driving the ironing type pump 15 to introduce the dialysate from the dialysate introduction line 7 into the arterial blood circuit 1a. (Diluted side peak) can be imparted. That is, during the dialysis treatment, when the ironing type pump 15 is driven, the dialysate can be introduced from the dialysate introduction line 7 into the arterial blood circuit 1a, and the blood circulation circuit 1 can be introduced into the blood circulating outside the body in a short time. It can be diluted.

As a result, blood can be diluted in a short time, and a peak (diluted side peak) peculiar to a change in blood concentration (hematocrit value) can be imparted. For example, as shown in FIG. 2, when the dilution side peak Q1 which is a peak peculiar to the detection value α of the second detection unit 5b can be imparted by the dilution side peak imparting unit, and recirculated blood is generated. , The dilution side peak Q2 corresponding to the dilution side peak Q1 can be imparted in the detection value β of the first detection unit 5a. The term "unique" as used herein means a pattern that can be distinguished from fluctuations of the pump and fluctuation patterns due to other factors due to the body movement of the patient.

In the concentration side peak imparting section, the dialyzer 2 removes blood (normal filtration of water in the blood) as the dialysate is sent to the blood circuit 1 via the supply line La as described above. It imparts a peak on the enriched side. That is, in the present embodiment, the flow path on the downstream side of the double pump C in the dialysate introduction line 7, the flow path on the upstream side of the double pump C in the dialysate discharge line 8, and the dialyzer 2 (dialysis liquid flow path). A closed system flow path is formed, and by supplying the dialysate of the closed system flow path to the blood circuit 1 (arterial side blood circuit 1a), the diluting side peak Q1 is imparted by the diluting side peak imparting portion. By continuously operating the compound pump C, the flow balance in the closed system flow path (the flow balance between the supply side Ca and the drain side Cb in the compound pump C) acts to be uniform in the dialyzer 2. The water is removed and the concentrated peak P1 is imparted.

As a result, the dialysate is sent to the blood circuit 1 via the supply line La by the action of the double pump C, which is a quantitative pump in which the supply side Ca and the drain side Cb have substantially the same amount. As a result, blood can be naturally removed from the dialyzer 2 and a peak (concentrated peak P1) peculiar to a change in blood concentration (hematocrit value) can be imparted. For example, as shown in FIG. 2, when the concentrated side peak P1 which is a peak peculiar to the detection value α of the second detection unit 5b can be imparted by the concentrated side peak imparting unit, and recirculated blood is generated. , The enrichment side peak P2 corresponding to the enrichment side peak P1 can be imparted in the detection value β of the first detection unit 5a.

As described above, in the present embodiment, by imparting the diluted side peak Q1 to the blood circulating extracorporeally in the blood circuit by the diluting side peak imparting portion, the concentrated side peak P1 is imparted to the blood circulating extracorporeally in the blood circuit 1. As a result, as shown in FIG. 2, in the detection value α of the second detection unit 5b, the dilution side peak Q1 is given (continuously) following the concentration side peak P1 which is a peculiar peak. ing. As a result, when recirculated blood is generated, as shown in the figure, in the detection value β of the first detection unit 5a, the enrichment side peak P1 and the dilution side peak P2 and the dilution side peak corresponding to the dilution side peak P1 and the dilution side peak Q1 are generated. Q2 can be given.

The first detection unit 5a and the second detection unit 5b are arranged in the arterial side blood circuit 1a and the venous side blood circuit 1b, respectively, and detect the concentration of blood flowing through these channels (specifically, the hematocrit value). It is a thing. These first detection units 5a and 5b are composed of a hematocrit sensor, and the hematocrit sensor includes, for example, a light emitting element such as an LED and a light receiving element such as a photodiode, and irradiates blood with light from the light emitting element and the light emitting element thereof. By receiving the transmitted light or the reflected light with a light receiving element, the hematoclit value indicating the blood concentration of the patient is detected.

Specifically, the hematocrit value indicating the blood concentration is obtained based on the electric signal output from the light receiving element. That is, each component such as erythrocytes and plasma that compose blood has its own absorption characteristic, and the erythrocyte necessary for measuring the hematocrit value is quantified electro-optically by utilizing this characteristic. The hematocrit value can be obtained by. More specifically, the near-infrared rays emitted from the light emitting element enter the blood and are affected by absorption and scattering, and are received by the light receiving element. The absorption and scattering rate of light is analyzed from the intensity of the received light, and the hematocrit value is calculated.

The first detection unit 5a configured as described above is arranged in the arterial blood circuit 1a, detects the hematocrit value of blood collected from the patient via the arterial puncture needle a during dialysis treatment, and also detects the hematocrit value. The second detection unit 5b is arranged in the venous side blood circuit 1b, and detects the hematocrit value of the blood that is purified or removed by the dialyzer 2 and returned to the patient.

As a result, the enriched peak imparted by opening the solenoid valve 14 is first detected as the enriched peak P1 at the detection value α of the second detection unit 5b, as shown in FIG. 2, and then the blood thereof is detected. When the arterial blood circuit 1a is recirculated again, the concentrated peak remaining in the recirculated blood can be detected as the concentrated peak P2 at the detection value β of the first detection unit 5a.

Further, in the present embodiment, the dilution side peak given by driving the ironing type pump 15 is first detected as the dilution side peak Q1 at the detection value α of the second detection unit 5b, as shown in FIG. After that, when the blood reaches the arterial blood circuit 1a again and there is recirculation, the diluted peak remaining in the recirculated blood can be detected as the diluted peak Q2 at the detection value β of the first detection unit 5a. It has become.

The recirculation detection unit 16 is composed of, for example, a microcomputer arranged in the main body 6 of the dialysis machine, and is a patient from the venous blood circuit 1b based on a peculiar peak detected by the first detection unit 5a and the second detection unit 5b. The blood returned to the dialysis is again guided to the arterial blood circuit 1a to detect the recirculated blood flowing. In this embodiment, the recirculated blood is configured to be detected based on a specific peak including a concentrated side peak and a diluted side peak.

Specifically, as shown in FIG. 3, in the detection value α of the second detection unit 5b, the enrichment side peak P1 that first appeared at time t1, the enrichment side peak P1, and the dilution side peak Q1 are passed, and then the time t3. The area S1 is calculated by connecting the peak P3 on the enrichment side that appears in (1) with a straight line. In order to calculate such an area S1, as shown in FIG. 4, a trapezoidal area S1a (see FIG. 4A) formed by the enriched peak P1 at time t1 and the enriched peak P3 at time t3 is obtained. , The area S1b of the wave shape according to the detected value α including the dilution side peak Q1 (see the figure (b)) is obtained. Then, by subtracting the area S1b from the area S1a, the area S1 shown in FIG. 3C can be obtained.

On the other hand, when there is blood recirculation, as shown in FIG. 3, in the detection value β of the first detection unit 5a, the enrichment side peak P2, the enrichment side peak P2, and the dilution side peak Q2 that first appeared at time t2 are observed. After that, the area S2 is calculated by connecting the peak P4 on the enrichment side, which appears at time t4, with a straight line. In order to calculate such an area S2, as shown in FIG. 5, a trapezoidal area S2a (see FIG. 5A) formed by the enriched peak P2 at time t2 and the enriched peak P4 at time t4 is obtained. , The area S2b of the wave shape according to the detected value β including the dilution side peak Q2 (see the figure (b)) is obtained. Then, by subtracting the area S2b from the area S2a, the area S2 shown in FIG. 3C can be obtained.

In this way, by predicting the time t1 until the blood reaches the second detection unit 5b and the time t2 until the blood recirculates and reaches the first detection unit 5a, the cardiopulmonary recirculation (purified blood is the heart). It is possible to distinguish between the recirculation, which is the object of measurement, and the phenomenon in which the blood is pulled out of the body without passing through only the lungs or other tissues or organs. Instead of such a method, the recirculation detection unit 16 detects that the hematocrit value detected by the first detection unit 5a and the second detection unit 5b exceeds a predetermined value, and the hematocrit value exceeds the value. You may try to compare each other.

Then, by substituting the area S1 formed by the detection value α of the second detection unit 5b and the area S2 formed by the detection value β of the first detection unit 5a into the following arithmetic expression (1), The ratio of recirculated blood (recirculation rate) can be obtained. This makes it possible for the medical staff to recognize not only the presence or absence of blood recirculation but also the ratio thereof, and the subsequent treatment (re-puncture the puncture needle or re-form the shunt to suppress blood recirculation). It can be used as a reference for measures such as).
Rrec (%) = S2 / S1 × 100 ... Calculation formula (1)

Next, a second embodiment of the present invention will be described.
Similar to the first embodiment, the blood purification device according to the present embodiment is for purifying the patient's blood while circulating it outside the body, and is applied to the hemodialysis device used in the hemodialysis treatment. .. As shown in FIG. 6, such a hemodialysis apparatus mainly comprises a blood circuit 1 to which a dialyzer 2 as a blood purification unit is connected, and a dialysis apparatus main body 6 that removes water while supplying dialysate to the dialyzer 2. In addition, it has a peak-imparting unit (concentrated peak-applying unit and diluted-side peak-imparting unit), a detection unit (first detection unit 5a, second detection unit 5b), a recirculation detection unit 16, and the like.

Here, in the blood purification device according to the present embodiment, the concentration side peak imparting portion is composed of the atmosphere opening line 13 and the solenoid valve 14, and the dilution side peak imparting portion is composed of the water removal pump 10. The same components are designated by the same reference numerals, and detailed description thereof will be omitted.

By operating the solenoid valve 14 to open the atmosphere opening line 13, the enrichment side peak imparting portion can concentrate the blood flowing through the dialyzer 2 for a short time and impart a unique peak (concentration side peak). It has become like. That is, during dialysis treatment, when the electromagnetic valve 14 is operated to open the closed atmosphere opening line 13, the outlet pressure of the pressurizing pump 11 becomes substantially equal to the atmospheric pressure. A high negative pressure is instantaneously generated, and the blood flowing through the dialyzer 2 (blood flow path) is rapidly and shortly drained (blood concentration).

As a result, water can be removed from the blood in a short time, which is much larger than the extrafiltration pressure generated by driving the water removal pump 10, which is peculiar to changes in blood concentration (hematocrit value). A peak (concentrated peak) can be imparted. For example, as shown in FIG. 2, when the concentrated side peak P1 which is a peak peculiar to the detection value α of the second detection unit 5b can be imparted by the concentrated side peak imparting unit, and recirculated blood is generated. , The enrichment side peak P2 corresponding to the enrichment side peak P1 can be imparted in the detection value β of the first detection unit 5a.

The dilution side peak imparting portion according to the present embodiment is composed of a water removal pump 10, and as shown in FIG. 6, the water removal pump 10 is reversely driven to supply the dialysate of the dialysate discharge line 8 to the dialyzer 2. Blood flowing through the dialyzer 2 by back-filtering the dialysate from the dialysate flow path to the blood flow path (water is filtered from the blood flowing through the blood flow path in the dialyzer 1 to the dialysate flow path via the hollow thread membrane). It is possible to impart a peculiar peak (diluted side peak Q1) by diluting the blood for a short time.

According to the present embodiment, the concentrated side peak P1 is imparted to the blood circulating extracorporeally in the blood circuit by the concentrating side peak imparting portion, and then the blood circulating extracorporeally in the blood circuit 1 by back-filtering at the diluting side peak imparting portion. As shown in FIG. 2, in the detection value α of the second detection unit 5b, the dilution side peak Q1 is continuously provided to the concentration side peak P1 which is a peculiar peak. It is supposed to be granted. As a result, when recirculated blood is generated, as shown in the figure, in the detection value β of the first detection unit 5a, the enrichment side peak P1 and the dilution side peak P2 and the dilution side peak corresponding to the dilution side peak P1 and the dilution side peak Q1 are generated. Q2 can be given.

Therefore, according to the present embodiment, as in the first embodiment, the enriched side peak P1 and the diluted side peak Q1 are imparted at the detection value α of the second detection unit 5b, and when there is recirculated blood, the first detection is performed. Since the enrichment side peak P2 and the dilution side peak Q2 corresponding to the enrichment side peak P1 and the dilution side peak Q1 can be imparted to the detection value β of the part 5a, the area formed by the detection value α of the second detection unit 5b. With the area S2 formed by the detection value β of the first detection unit 5a, the recirculation detection unit 16 can detect the recirculation blood.

Next, a third embodiment of the present invention will be described.
Similar to the first embodiment, the blood purification device according to the present embodiment is for purifying the patient's blood while circulating it outside the body, and is applied to the hemodialysis device used in the hemodialysis treatment. .. As shown in FIG. 7, such a hemodialysis apparatus mainly comprises a blood circuit 1 to which a dialyzer 2 as a blood purification unit is connected, and a dialysis apparatus main body 6 that removes water while supplying dialysate to the dialyzer 2. In addition, it has a peak-imparting unit (concentrated peak-applying unit and diluted-side peak-imparting unit), a detection unit (first detection unit 5a, second detection unit 5b), a recirculation detection unit 16, and the like.

Here, in the blood purification apparatus according to the present embodiment, the concentration side peak imparting portion is composed of the atmosphere opening line 13 and the solenoid valve 14, and the dilution side peak imparting portion is composed of the accommodating portion B and the introduction line Lb. There is. The same components are designated by the same reference numerals, and detailed description thereof will be omitted.

In the present embodiment, the concentrated side peak imparting portion is composed of the atmosphere opening line 13 and the solenoid valve 14, as in the second embodiment, and the diluted side peak imparting portion contains a liquid such as physiological saline. It is configured to have an accommodating portion B and an introduction line Lb extending from the accommodating portion B and connected to the arterial blood circuit 1a. A priming solution (liquid) such as a physiological saline solution having a predetermined volume is contained in the accommodating portion B.

Specifically, as shown in FIG. 7, the dilution side peak imparting portion according to the present embodiment includes a storage portion B containing a physiological saline solution (which may be another liquid), a storage portion B, and a blood circuit. It has an introduction line Lb that communicates with 1, and by supplying the physiological saline solution or the like in the accommodating portion B to the blood circuit 1 via the introduction line Lb, the blood flowing through the dialyzer 2 is diluted for a short time. It is possible to impart a peculiar peak (dilution side peak Q1).

According to the present embodiment, the concentrated side peak P1 is imparted to the blood circulating outside the body by the concentrated side peak imparting portion, and then the liquid of the accommodating portion B is supplied by the diluted side peak imparting portion to supply the blood circuit. Since 1 is controlled to give the diluted side peak Q1 to the blood circulating outside the body, as shown in FIG. 2, the detection value α of the second detection unit 5b is continuous with the concentrated side peak P1 which is a peculiar peak. The dilution side peak Q1 is imparted. As a result, when recirculated blood is generated, as shown in the figure, in the detection value β of the first detection unit 5a, the enrichment side peak P1 and the dilution side peak P2 and the dilution side peak corresponding to the dilution side peak P1 and the dilution side peak Q1 are generated. Q2 can be given.

Therefore, according to the present embodiment, as in the first embodiment, the enriched side peak P1 and the diluted side peak Q1 are imparted at the detection value α of the second detection unit 5b, and when there is recirculated blood, the first detection is performed. Since the enrichment side peak P2 and the dilution side peak Q2 corresponding to the enrichment side peak P1 and the dilution side peak Q1 can be imparted to the detection value β of the part 5a, the area formed by the detection value α of the second detection unit 5b. With the area S2 formed by the detection value β of the first detection unit 5a, the recirculation detection unit 16 can detect the recirculation blood.

Next, a fourth embodiment of the present invention will be described.
Similar to the first embodiment, the blood purification device according to the present embodiment is for purifying the patient's blood while circulating it outside the body, and is applied to the hemodialysis device used in the hemodialysis treatment. .. As shown in FIG. 8, such a hemodialysis apparatus mainly comprises a blood circuit 1 to which a dialyzer 2 as a blood purification unit is connected, and a dialysis apparatus main body 6 that removes water while supplying dialysate to the dialyzer 2. In addition, it has a peak-imparting unit (concentrated peak-applying unit and diluted-side peak-imparting unit), a detection unit (first detection unit 5a, second detection unit 5b), a recirculation detection unit 16, and the like. The same components are designated by the same reference numerals, and detailed description thereof will be omitted.

In the present embodiment, the enrichment side peak imparting portion is composed of the atmosphere opening line 13 and the solenoid valve 14 as in the second and third embodiments, and the dilution side peak imparting portion is a double pump in the dialysate introduction line 7. It is configured to have a bypass line 16 connected by detouring the liquid supply side Ca of C, and a liquid supply pump 17 connected to the bypass line 16. Specifically, the diluting side peak imparting portion according to the present embodiment includes a bypass line 16 and a liquid supply pump 17, and as shown in FIG. 8, the liquid supply pump 17 is driven to perform dialysis of the dialysate introduction line 7. By supplying the liquid to the dialyzer 2 and back-filtering the dialysate from the dialysate flow path to the blood flow path, the blood flowing through the dialyzer 2 is diluted for a short time to obtain a peculiar peak (diluted side peak). It can be granted.

Then, after the enrichment side peak imparting portion imparts the enrichment side peak to the blood circulating extracorporeally in the blood circuit, the dilution side peak imparting portion controls to impart the dilution side peak to the blood circulating extracorporeally in the blood circuit, and FIG. As shown in the above, in the detection value α of the second detection unit 5b, the dilution side peak Q1 is continuously imparted to the concentration side peak P1 which is a peculiar peak. As a result, when recirculated blood is generated, as shown in the figure, in the detection value β of the first detection unit 5a, the enrichment side peak P1 and the dilution side peak P2 and the dilution side peak corresponding to the dilution side peak P1 and the dilution side peak Q1 are generated. Q2 can be given.

Therefore, according to the present embodiment, as in the first embodiment, the enriched side peak P1 and the diluted side peak Q1 are imparted at the detection value α of the second detection unit 5b, and when there is recirculated blood, the first detection is performed. Since the enrichment side peak P2 and the dilution side peak Q2 corresponding to the enrichment side peak P1 and the dilution side peak Q1 can be imparted to the detection value β of the part 5a, the area formed by the detection value α of the second detection unit 5b. With the area S2 formed by the detection value β of the first detection unit 5a, the recirculation detection unit 16 can detect the recirculation blood.

According to the first to fourth embodiments of the present invention, the peak imparting portion includes a concentrated side peak imparting portion that concentrates blood circulating outside the body in the blood circuit 1 and imparts a unique concentrated side peak P1, and a blood circuit 1 It has a diluting side peak imparting part that dilutes the blood circulating outside the body and imparts a peculiar diluting side peak Q1, and the recirculation detection unit 16 has a peculiar peak including the concentrating side peak P1 and the diluting side peak Q1. Since the recirculated blood is detected based on the above, it is possible to suppress the water removal error in the blood purification treatment, and it is possible to impart a peculiar peak of a large size, improve the SN ratio, and make the recirculated blood more accurate. It can be detected well.

In particular, according to the first embodiment of the present invention, there is a compound pump C that is arranged so as to straddle the dialysate introduction line 7 and the dialysate discharge line 8 and that introduces and discharges the dialysate to the dialyzer 2. In addition to being provided, a closed system flow is provided in the flow path on the downstream side of the double pump C in the dialysate introduction line 7, the flow path on the upstream side of the double pump C in the dialysate discharge line 8, and the dialyzer 2 (dialysate flow path). A path is formed, and the concentration side peak P1 and the dilution side peak Q1 are imparted by supplying the dialysate of the closed system flow path to the blood circuit 1, so that the flow rate balance in the closed system flow path becomes uniform. Can be naturally imparted with a concentrated peak P1 and a diluted peak Q1.

Further, according to the first embodiment of the present invention, the supply line La for supplying the dialysate of the dialysate introduction line 7 to the blood circuit 1 is provided, and the diluting side peak imparting portion is provided via the supply line La. By supplying the dialysate to the blood circuit 1, the diluting side peak Q1 is imparted, and in the concentrated side peak imparting portion, the dialyzer 2 moves as the dialysate is sent to the blood circuit 1 via the supply line La. Since the concentrated peak P1 is imparted by removing the blood, the dialysate of the dialysate introduction line 7 can be reliably and smoothly supplied to the blood circuit 1 by the supply line La. However, since the supply line La consists of a priming line that supplies the dialysate as a priming solution to the blood circuit 1, or a replacement fluid line that supplies the dialysate as a replacement fluid to the blood circuit 1, the priming line or the replacement fluid line is diverted. It can be used as a peak imparting portion on the diluting side.

Further, according to the second and fourth embodiments of the present invention, the concentrated side peak imparting portion concentrates the blood by removing the blood of the dialyzer 2 to impart the concentrated side peak P1 and the diluted side peak. Since the imparting unit dilutes the blood by back-filtering the dialysate of the dialysate introduction line 7 or the dialysate discharge line 8 into the blood circuit 1 to impart the diluting side peak Q1, the priming line, the replenishment line, etc. are separated. The dialysate can be supplied to the blood circulating in the blood circuit 1 to impart a diluting side peak while eliminating the need for the flow path of the above.

Further, according to the third embodiment of the present invention, the concentrated side peak imparting portion concentrates the blood by removing the blood of the dialyzer 2 to impart the concentrated side peak P1 and imparts the diluted side peak imparting portion. By supplying the liquid of the accommodating portion B connected to the blood circuit 1 to the blood circuit 1, the blood is diluted to give the diluted side peak Q1, so that the blood circuit 1 is circulated without the need for back filtration. The liquid in the accommodating portion B can be supplied to the blood to be imparted with the dilution side peak Q1.

Although the present embodiment has been described above, the present invention is not limited to this. For example, after imparting a diluted side peak to blood circulating extracorporeally in the blood circuit 1 by a diluted side peak imparting portion, blood is imparted by a concentrated side peak imparting portion. The circuit 1 may be controlled to impart a concentrated side peak to the blood circulating outside the body, and as shown in FIG. 9, in the detected value α of the second detection unit 5b, following the diluted side peak Q1 which is a peculiar peak. (Continuously) the enriched peak P1 may be imparted. In this case, the dilution side peak Q1 is detected first at the detection value α, then the concentration side peak P1 and the dilution side peak Q3 are subsequently detected, and when there is recirculated blood, the dilution side peak Q1 is diluted at the detection value β. The diluted peak Q2 corresponding to the side peak Q1 is detected first, and then the concentrated peak P2 and the diluted peak Q4 corresponding to the concentrated peak P1 and the diluted peak Q3 are detected.

Thereby, as in the first to third embodiments, the recirculated blood can be detected based on the peculiar peak including the concentrated side peak and the diluted side peak, and the second detection can be performed as shown in FIG. By substituting the area S1 formed by the detection value α of the portion 5b and the area S2 formed by the detection value β of the first detection unit 5a into the above-mentioned calculation formula (1), the ratio of recirculated blood (1) (Recirculation rate) can be obtained.

Further, the enriched peak imparting portion and the diluted peak imparting portion are not limited to those of the above-described embodiment, and may be other components as long as they can impart the concentrated side peak and the diluted side peak. Further, the detection unit according to the present embodiment is supposed to be composed of a hematocrit sensor, but if it is attached to the blood circuit 1 and detects a peculiar peak given by the peak giving part, another sensor can be used. There may be. The detection unit according to the present embodiment has a first detection unit 5a attached to the arterial side blood circuit 1a and a second detection unit 5b attached to the venous side circuit 1b, but the arterial side blood circuit. It may be attached to either 1a or the venous blood circuit 1b.

If the purpose is the same as that of the present invention, it can be applied to those having different appearance shapes or those to which other functions are added.

1 Blood circuit 1a Arterial side blood circuit 1b Vein side blood circuit 2 Dializer (blood purification unit)
3 Blood pump 4a, 4b Air trap chamber 5a 1st detection unit 5b 2nd detection unit 6 Dialysis device main body 7 Dialysis solution introduction line 8 Dialysis solution discharge line 9 Bypass line 10 Water removal pump 11 Pressurization pump 12 Bubble separation chamber 13 Atmosphere Open line 14 Electromagnetic valve 15 Ironing type pump 16 Recirculation detector C Duplex pump La Supply line Lb Introduction line

Claims (7)

It has an arterial blood circuit and a venous blood circuit, and has a blood circuit that circulates the patient's blood outside the body.
A blood purification unit that is connected to the blood circuit and purifies the blood flowing through the blood circuit,
A dialysate introduction line connected to the blood purification unit and introducing dialysate into the blood purification unit,
A dialysate discharge line connected to the blood purification unit and discharging dialysate from the blood purification unit,
A peak giving portion that can give a peak peculiar to a change in the concentration of blood circulating outside the body in the blood circuit, and a peak giving portion.
A detection unit attached to the blood circuit and detecting a peculiar peak imparted by the peak imparting portion,
Based on the peculiar peak detected by the detection unit, the recirculation detection unit detects the recirculating blood in which the blood returned to the patient from the venous blood circuit is guided to the arterial blood circuit again and flows.
It is a blood purification device equipped with
The peak imparting portion includes a concentrated side peak imparting portion that concentrates blood circulating outside the body in the blood circuit to impart a unique enriched side peak, and a diluted side peak that dilutes the blood circulating extracorporeally in the blood circuit. The recirculation detection unit is a blood purification device that detects recirculated blood based on a peculiar peak including the enrichment side peak and the dilution side peak. A double pump that is arranged across the dialysate introduction line and the dialysate discharge line and that introduces and discharges the dialysate to the blood purification unit is provided, and the double pump in the dialysate introduction line is provided. A closed flow path is formed in the downstream flow path, the upstream side flow path of the double pump in the dialysate discharge line, and the blood purification unit, and the dialysate in the closed system flow path is used in the blood circuit. The blood purification apparatus according to claim 1, wherein the enriched peak and the diluted peak are imparted by supplying the blood. The diluting side peak imparting portion is provided with a supply line for supplying the dialysate of the dialysate introduction line to the blood circuit, and the diluting side peak imparting portion supplies the dialysate to the blood circuit via the supply line to the diluting side. A peak is imparted, and the concentrated side peak imparting portion receives the concentrated side peak by removing water from the blood purification unit as the dialysate is sent to the blood circuit via the supply line. 2. The blood purification device according to claim 2. The blood purification apparatus according to claim 3, wherein the supply line includes a priming line that supplies a dialysate as a priming solution to the blood circuit, or a replacement fluid line that supplies a dialysate as a replacement fluid to the blood circuit. The concentrated side peak giving part concentrates blood by removing water from the blood purification part to give the concentrated side peak, and the diluted side peak giving part is the dialysate introduction line or the dialysate. The blood purification apparatus according to claim 1, wherein the dialysate of the discharge line is supplied to the blood purification unit and back-filtered in the blood circuit to dilute the blood and impart the diluted side peak. The concentrated side peak imparting portion concentrates blood by removing water from the blood purification unit to impart the concentrated side peak, and the diluted side peak imparting portion is a storage connected to the blood circuit. The blood purification apparatus according to claim 1, wherein the blood is diluted by supplying the liquid of the portion to the blood circuit to impart the diluted side peak. The blood purification device according to any one of claims 1 to 6, wherein the detection unit comprises a hematocrit sensor for detecting a hematocrit value of blood flowing through the blood circuit.

Images