JP2022104283A - Continuous outflow system - Google Patents
Continuous outflow system Download PDFInfo
- Publication number
- JP2022104283A JP2022104283A JP2020219389A JP2020219389A JP2022104283A JP 2022104283 A JP2022104283 A JP 2022104283A JP 2020219389 A JP2020219389 A JP 2020219389A JP 2020219389 A JP2020219389 A JP 2020219389A JP 2022104283 A JP2022104283 A JP 2022104283A
- Authority
- JP
- Japan
- Prior art keywords
- outflow
- continuous
- urine
- source
- bladder
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
Links
- 239000012530 fluid Substances 0.000 claims abstract description 19
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 claims description 5
- 230000006835 compression Effects 0.000 claims description 4
- 238000007906 compression Methods 0.000 claims description 4
- 238000005381 potential energy Methods 0.000 claims description 4
- 230000036581 peripheral resistance Effects 0.000 claims description 2
- 238000000034 method Methods 0.000 abstract description 4
- 210000002700 urine Anatomy 0.000 description 60
- 210000003932 urinary bladder Anatomy 0.000 description 55
- 230000027939 micturition Effects 0.000 description 21
- 206010046555 Urinary retention Diseases 0.000 description 15
- 230000006870 function Effects 0.000 description 13
- 230000002485 urinary effect Effects 0.000 description 13
- 238000003860 storage Methods 0.000 description 11
- 230000000474 nursing effect Effects 0.000 description 9
- 230000002459 sustained effect Effects 0.000 description 9
- 230000007246 mechanism Effects 0.000 description 7
- 208000005189 Embolism Diseases 0.000 description 5
- 230000007774 longterm Effects 0.000 description 5
- 210000003205 muscle Anatomy 0.000 description 5
- 230000008602 contraction Effects 0.000 description 4
- 230000000694 effects Effects 0.000 description 4
- 239000007788 liquid Substances 0.000 description 4
- 238000013461 design Methods 0.000 description 3
- 230000008030 elimination Effects 0.000 description 3
- 238000003379 elimination reaction Methods 0.000 description 3
- 238000005259 measurement Methods 0.000 description 3
- 230000002265 prevention Effects 0.000 description 3
- 230000009467 reduction Effects 0.000 description 3
- 230000011514 reflex Effects 0.000 description 3
- 230000000638 stimulation Effects 0.000 description 3
- 208000019206 urinary tract infection Diseases 0.000 description 3
- 238000009825 accumulation Methods 0.000 description 2
- 230000029142 excretion Effects 0.000 description 2
- 238000000605 extraction Methods 0.000 description 2
- 238000004519 manufacturing process Methods 0.000 description 2
- 230000036453 micturition reflex Effects 0.000 description 2
- 230000002980 postoperative effect Effects 0.000 description 2
- 238000011084 recovery Methods 0.000 description 2
- 238000010992 reflux Methods 0.000 description 2
- 210000005070 sphincter Anatomy 0.000 description 2
- 241000894006 Bacteria Species 0.000 description 1
- 206010069632 Bladder dysfunction Diseases 0.000 description 1
- 206010061698 Bladder injury Diseases 0.000 description 1
- 206010008111 Cerebral haemorrhage Diseases 0.000 description 1
- 206010012289 Dementia Diseases 0.000 description 1
- 206010019280 Heart failures Diseases 0.000 description 1
- 208000019025 Hypokalemia Diseases 0.000 description 1
- 206010028851 Necrosis Diseases 0.000 description 1
- 206010030302 Oliguria Diseases 0.000 description 1
- 208000025865 Ulcer Diseases 0.000 description 1
- 206010046543 Urinary incontinence Diseases 0.000 description 1
- 230000004913 activation Effects 0.000 description 1
- 230000001154 acute effect Effects 0.000 description 1
- 230000006399 behavior Effects 0.000 description 1
- 230000017531 blood circulation Effects 0.000 description 1
- 239000000496 cardiotonic agent Substances 0.000 description 1
- 230000003177 cardiotonic effect Effects 0.000 description 1
- 208000015114 central nervous system disease Diseases 0.000 description 1
- 206010008118 cerebral infarction Diseases 0.000 description 1
- 208000026106 cerebrovascular disease Diseases 0.000 description 1
- 230000008859 change Effects 0.000 description 1
- 238000011161 development Methods 0.000 description 1
- 230000018109 developmental process Effects 0.000 description 1
- 201000010099 disease Diseases 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 239000002934 diuretic Substances 0.000 description 1
- 229940030606 diuretics Drugs 0.000 description 1
- 238000001647 drug administration Methods 0.000 description 1
- 206010013990 dysuria Diseases 0.000 description 1
- 238000002474 experimental method Methods 0.000 description 1
- 230000001771 impaired effect Effects 0.000 description 1
- 230000006698 induction Effects 0.000 description 1
- 208000015181 infectious disease Diseases 0.000 description 1
- 210000003734 kidney Anatomy 0.000 description 1
- 230000003907 kidney function Effects 0.000 description 1
- 238000012423 maintenance Methods 0.000 description 1
- 230000008450 motivation Effects 0.000 description 1
- 230000017074 necrotic cell death Effects 0.000 description 1
- 208000027232 peripheral nervous system disease Diseases 0.000 description 1
- 238000002360 preparation method Methods 0.000 description 1
- 230000003449 preventive effect Effects 0.000 description 1
- 230000008085 renal dysfunction Effects 0.000 description 1
- 208000020431 spinal cord injury Diseases 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 238000012549 training Methods 0.000 description 1
- 231100000397 ulcer Toxicity 0.000 description 1
- 210000001635 urinary tract Anatomy 0.000 description 1
Images
Landscapes
- External Artificial Organs (AREA)
Abstract
Description
本願発明は、体内にある閉鎖空間の流出元から体外にある空間の流出先へ流体物を流出させる技術に関するものである。 The present invention relates to a technique for causing a fluid to flow out from an outflow source of a closed space inside the body to an outflow destination of a space outside the body.
医療の現場では、体内にある閉鎖空間の流出元から体外にある空間の流出先へ流体物を流出させる必要性がある。
例えば、膀胱に溜まった尿である。尿は膀胱留置バルーン(フォーリー)カテーテルを用いて体外へ流出(排出)され、さらに採尿チューブにより蓄尿バッグに繋げられている(採尿チューブ蓄尿バッグ回路)。それは、使用する患者や管理し看護する看護師等にとっては、必ずしも使い出が良くなく、さらにはその時々の尿量を測定するという目的を達するものにはなっていない。
In the medical field, it is necessary to let the fluid flow out from the outflow source of the closed space inside the body to the outflow destination of the space outside the body.
For example, urine collected in the bladder. Urine is discharged (excreted) out of the body using a bladder indwelling balloon (Foley) catheter, and is further connected to a urine storage bag by a urine collection tube (urine collection tube urine storage bag circuit). It is not always easy to use for the patients who use it and the nurses who manage and care for it, and it does not reach the purpose of measuring the urine volume at each time.
本願発明者の経験では、カテーテルが膀胱内に留置されていても、そのままにしておくだけでは決して持続的に継続して尿は流れ出ることはない。かえって、塞栓が生じ、膀胱からの流出を阻害し、膀胱に尿が貯留し、利用者に味わったことのない膀胱圧迫感を与え、苦しみを与える。人工的に尿閉状態をつくってしまう。尿を流出させるためには、尿塞栓に物理的条件として位置エネルギーを与え、さらにチューブに振動刺激を与え、尿流出促進操作をしないと流れない。さらに、流れてもきちんと最後の蓄尿バッグまで流れ落ちるかどうか確認しないとまた途中で尿塞栓を形成してしまう場合がある。そのため尿流出操作を何度か繰り返し膀胱の不快な圧迫感を開放して寝ては、膀胱圧迫感で起き、圧迫解放操作をしては寝るというICUでの生活となった。 In the experience of the inventor of the present application, even if the catheter is placed in the bladder, urine never continuously flows out if it is left as it is. On the contrary, embolism occurs, the outflow from the bladder is blocked, urine accumulates in the bladder, giving the user a feeling of bladder pressure that has never been experienced, and causing suffering. It artificially creates a urinary retention state. In order to allow urine to flow out, potential energy is given to the urinary embolus as a physical condition, vibration stimulation is given to the tube, and urine outflow promotion operation is performed. Furthermore, even if it flows, if it is not confirmed whether it flows down to the last urine storage bag properly, a urine embolus may be formed on the way. Therefore, I had to repeat the urine outflow operation several times to release the unpleasant feeling of pressure on the bladder and sleep, then I woke up with the pressure on the bladder, and after performing the pressure release operation, I went to sleep.
これまでにも、膀胱留置バルーン(フォーリー)カテーテルを用いた持続的に排尿するための採尿チューブ蓄尿バッグ回路(以下、蓄尿回路)については、いくつかの研究・開発が行われてきているが(特許文献1~4等)、実際の医療現場ではそのどれもが実用化されていない。 Several studies and developments have been conducted on the urine collection tube urine storage bag circuit (hereinafter referred to as urine storage circuit) for continuous urination using a bladder indwelling balloon (Foley) catheter (hereinafter referred to as urine storage circuit). Patent Documents 1 to 4 etc.), none of them have been put into practical use in the actual medical field.
上記した特許文献などは、膀胱留置カテーテルを用いた排尿装置に「U字管」(特許文献1)や「圧力調整室」(特許文献2~4)などの特別な補助装置を付設するために、当該装置が複雑になったり、移動に不便という課題があった。
The above-mentioned patent documents are used to attach a special auxiliary device such as a "U-shaped tube" (Patent Document 1) or a "pressure adjusting chamber" (
これに対して、本願発明者は、自身の経験からこのような「U字管」や「圧力調整室」などの特別な補助装置は不要であり、一切の機械的な又は電気的な駆動、制御機構は不要であり、膀胱本来の充満、収縮により貯留、排尿できて、自然の膀胱の排尿機能の維持となり、尿閉、残尿を無くし、膀胱への負担と感染のリスクを減らすことを目的として、本願発明を完成させた。 On the other hand, the inventor of the present application does not need such a special auxiliary device such as a "U-shaped tube" or a "pressure adjusting chamber" from his own experience, and any mechanical or electrical drive is required. No control mechanism is required, the bladder can be stored and urinated by the original filling and contraction, the urinary function of the bladder is maintained naturally, urinary retention and residual urine are eliminated, and the burden on the bladder and the risk of infection are reduced. As an object, the invention of the present application has been completed.
上記目的を達成するために、本願発明の第1は、体内にある閉鎖空間の流出元から体外にある空間の流出先へ流体物を持続的に流出させる持続流出システム(SDS:Sustained Drain System)であって、流出元から流体物を流出させるために設けられる流出誘導体と、流出誘導体から流出先までに流体物を移動させるための流出チューブと、を備え、流出元と流出先の圧差をP、流出物の流出に対する抵抗をR、とした場合、P-R>0(NCSDS:necessary condition for SDS)と、流出誘導体に設けられるカテーテルの内容量をVb、流出チューブの内容量をVt、Pを生むために必要な容量をVp、持続流出開始容量をVmin、とした場合、Vb+Vt+Vp=Vmin(VRSDS:Volume Relationship of SDS)と、を満たし、流出誘導体のカテーテル及び流出チューブがサイフォン化されることを特徴としたものである。
本願発明の第2は、Pが、流出元による圧縮圧Pcと、流出元と流出先との位置エネルギーである水圧Ppの和(P=Pc+Pp)であることを特徴とする同持続流出システムである。
本願発明の第3は、Rが、流出チューブにおける抵抗である管路抵抗Rtと、流出先における抵抗である末梢抵抗Rpの和(R=Rt+Rp)であることを特徴とする同持続流出システムである。
本願発明の第4は、Rpが、抵抗を最小限(0)にするための解放ドリップチャンバーを流出チューブと流出先の間に介在させてRp=0として、R=Rtであることを特徴とした同持続流出システムである。
In order to achieve the above object, the first aspect of the present invention is a sustained outflow system (SDS: Sustained Drain System) in which a fluid is continuously discharged from an outflow source of a closed space inside the body to an outflow destination of a space outside the body. It is provided with an outflow derivative provided to allow the fluid to flow out from the outflow source and an outflow tube for moving the fluid from the outflow derivative to the outflow destination, and the pressure difference between the outflow source and the outflow destination is P. When the resistance to the outflow of the outflow is R, the internal volume of the catheter provided in the outflow derivative is Vb, and the internal volume of the outflow tube is Vt, P. When the capacity required to produce is Vp and the continuous outflow start capacity is Vmin, Vb + Vt + Vp = Vmin (VRSDS: Volume Relationship of SDS) is satisfied, and the outflow derivative catheter and outflow tube are siphonized. It is a feature.
The second aspect of the present invention is the same continuous outflow system, wherein P is the sum of the compression pressure Pc by the outflow source and the water pressure Pp (P = Pc + Pp) which is the potential energy of the outflow source and the outflow destination. be.
The third aspect of the present invention is the same continuous outflow system, wherein R is the sum of the pipeline resistance Rt, which is the resistance in the outflow tube, and the peripheral resistance Rp, which is the resistance in the outflow destination (R = Rt + Rp). be.
The fourth aspect of the present invention is characterized in that Rp is R = Rt with an release drip chamber for minimizing resistance (0) interposed between the outflow tube and the outflow destination so that Rp = 0. It is the same continuous outflow system.
上記した本願発明によれば、以下のような効果を有する。
(1)本願発明は、上記特許文献1~4のようにサイフォンの原理から出発してはいるが、決してサイフォンそのものではない。サイフォンの原理を応用した持続流出システムである。
(2)本願発明は、特別な装置は必要無く、また、特別な操作も必要無く機能する。最初にサイフォン化のための必要条件をクリアーするように採尿チューブの内径と長さ、蓄尿バッグ等の回路をきちんと設計すれば、後は、膀胱の収縮、弛緩即ち膀胱本来の排泄機能(排尿反射)で排尿が始まり、その回路は持続流出システムとして機能する。
(3)結果として、膀胱の自然の機能は維持され、かつ、尿流出は膀胱にある量貯留し、内圧が上昇することによる排尿刺激により反射的に自律的に起こり、持続的に流出し、採尿チューブにも膀胱にも残尿はなく、尿の逆流も起こらず、尿路感染のリスクを低減する。
According to the above-mentioned invention of the present application, it has the following effects.
(1) Although the invention of the present application starts from the principle of siphon as in Patent Documents 1 to 4, it is not a siphon itself. It is a continuous outflow system that applies the siphon principle.
(2) The invention of the present application functions without the need for a special device and without the need for a special operation. If the inner diameter and length of the urinary collection tube and the circuit such as the urinary storage bag are properly designed so as to first clear the necessary conditions for siphonization, then the bladder contracts and relaxes, that is, the bladder's original excretory function (urination reflex). ) Starts urination, and the circuit functions as a continuous outflow system.
(3) As a result, the natural function of the bladder is maintained, and urine outflow is accumulated in the bladder in a certain amount, and reflexively and autonomously occurs by urination stimulation due to an increase in internal pressure, and the urine outflow is sustained. There is no residual urine in the urine collection tube or bladder, no urine reflux occurs, and the risk of urinary tract infection is reduced.
本願発明の実施形態を図面に基づいて説明する。
なお、本実施形態では、膀胱留置カテーテルを用いた排尿に本願発明の「持続流出システム」を適用しているが、これは一例であり、その他の体内にある閉鎖空間の流出元から体外にある空間の流出先へ流体物を持続的に流出させる技術として適用できることは勿論である。
An embodiment of the present invention will be described with reference to the drawings.
In this embodiment, the "sustained outflow system" of the present invention is applied to urination using an indwelling bladder catheter, but this is an example, and it is outside the body from the outflow source of other closed spaces in the body. Of course, it can be applied as a technique for continuously flowing out a fluid to the outflow destination of the space.
図1(図1-1及び図1-2)は、膀胱留置カテーテルを用いた排尿装置の概要を図示したものである。
図示するように、狭義の膀胱留置カテーテルとしてのバルーンの付いた膀胱内カテーテル(バルーンカテーテル)から、導尿した尿を採尿チューブを介して蓄尿バッグに溜めるというのが基本的構造である。
FIG. 1 (FIGS. 1-1 and 1-2) illustrates an outline of a urination device using an indwelling bladder catheter.
As shown in the figure, the basic structure is to collect the guided urine from an intravesical catheter (balloon catheter) with a balloon as an indwelling bladder catheter in a urine storage bag via a urine collection tube.
図2は、本願発明に係る持続流出システムの概要を図示したものである。
まず、図2-1は、一般的な大気中のサイフォンの場合(左図)と流出元が閉鎖空間である場合(右図:半閉鎖回路)の違いを図示している。
次に、図2-2は、半閉鎖回路で持続流出するためのメカニズム(エネルギー源)を図示している。
FIG. 2 illustrates an outline of the continuous outflow system according to the present invention.
First, FIG. 2-1 illustrates the difference between the case of a general siphon in the atmosphere (left figure) and the case where the outflow source is a closed space (right figure: semi-closed circuit).
Next, FIG. 2-2 illustrates the mechanism (energy source) for continuous outflow in a semi-closed circuit.
図3は、流出元の空間2つを比較して、それぞれの流出先の開閉空間および管の太さの違いで実験した様子を図示したものである。
まず、図3-1について説明すると、流出元の閉鎖空間については次の3つに分類される。
・閉鎖空間1:硬無収縮空間(hard closed space HCS):ペットボトル ボトル
・閉鎖空間2:柔収縮可空間(Soft closed space SCS):ビニール袋
・閉鎖空間3:弾性収縮空間(elastic closed space ECS):膀胱
その流出元の柔収縮可空間(SCS)の元では、(1)サイフォン化容量Vsと(2)圧差容量Vp(管に液体が充満した流出元の状態で、液体の重みのみで管路抵抗に打ち勝って流れる最少液量)以上の液容量があり、(3)上記のNCSDSを満たした圧差Pが生じていれば、管の途中にループあるいは一部流出元より高い所があっても、上記条件を満たしている限りサイフォンとなり流出し続ける(サイフォン化)。
FIG. 3 shows a state in which two spaces of the outflow source are compared and an experiment is performed with different opening / closing spaces and pipe thicknesses of the outflow destinations.
First, FIG. 3-1 will be described. The closed space at the outflow source is classified into the following three categories.
・ Closed space 1: hard closed space HCS: PET bottle bottle ・ Closed space 2: Soft closed space SCS: plastic bag ・ Closed space 3: elastic closed space ECS ): Bladder Under the flexible contractile space (SCS) of the outflow source, (1) siphonized capacity Vs and (2) pressure difference capacity Vp (in the state of the outflow source where the tube is filled with liquid, only the weight of the liquid is used. If there is a liquid capacity equal to or greater than the minimum amount of liquid that overcomes the pipeline resistance) and (3) a pressure difference P that satisfies the above NCDSS is generated, there may be a loop or a part higher than the outflow source in the middle of the pipe. However, as long as the above conditions are met, it becomes a siphon and continues to flow out (siphonization).
流出回路はサイフォン化容量を満たす以上の水源があればサイフォンとなるが、このSDSの流出開始には上記の(1)~(3)の要素が必要であり、かつ流出が持続するためには持続流出条件(necessary condition for SDS=NCSDS)を満たして初めてサイフォン現象のおこるサイフォン化が可能になる。この条件を満たさなくなると、流出は止まる。しかし、流出元の位置エネルギーを高くするか内圧を高くして、圧差Pを増やしてやれば、この条件を満たし、ループ内の流体を含めて再度流出し始める。なお、流出元が硬無収縮空間(HCS)でも、同様に試してみた結果を図3-1に図示している。 The outflow circuit becomes a siphon if there is a water source that satisfies the siphonization capacity, but the above elements (1) to (3) are necessary to start the outflow of this SDS, and the outflow is to be sustained. Only when the required condition for SDS (NCDSDS) is satisfied, siphonization in which the siphon phenomenon occurs becomes possible. When this condition is no longer met, the outflow will stop. However, if the potential energy of the outflow source is increased or the internal pressure is increased to increase the pressure difference P, this condition is satisfied and the outflow including the fluid in the loop starts again. Even if the outflow source is a rigid non-shrinkage space (HCS), the results of the same trial are shown in FIG. 3-1.
流出元の閉鎖空間状態と圧差と尿量と管の条件により、尿が流出する/しないが決まる。しかし、流出元の閉鎖空間および流出先がどのような種類の空間でも、持続流出条件(NCSDS)は変わらず、その要因を制御して管理すれば、持続的に流出させることが可能となる。すなわち、持続流出条件(NCSDS)をクリアーする回路は持続流出システム(Sustained Drain System SDS)となる。 Whether or not urine flows out is determined by the state of the closed space at the source of the outflow, the pressure difference, the amount of urine, and the conditions of the tube. However, the continuous outflow condition (NCDSS) does not change regardless of the closed space of the outflow source and the space of any kind of outflow destination, and if the factors are controlled and managed, the outflow can be sustained. That is, the circuit that clears the continuous outflow condition (NCDSS) is the Sustained Drain System SDS.
次に、図3-2について説明すると、開放空間から開放空間の普通のサイフォンでは、完全排出が可能である。一方、水圧と陰圧が釣り合い全く流出しない硬無収縮閉鎖空間でも、その閉鎖空間自体が収縮できて、陰圧を解除し、圧差を生み出せれば、流出し続け、完全排出し切れる。サイフォンの原理が働く条件と硬無収縮空間でも持続流出システム(SDS)の回路が持続流出条件(NCSDS)を満たした時の流出前後の状態と、さらに、弾性収縮空間の最後の状態を図3-2で図示した。 Next, with reference to FIG. 3-2, complete discharge is possible with an ordinary siphon from an open space to an open space. On the other hand, even in a rigid non-shrinkage closed space where the water pressure and the negative pressure are balanced and do not flow out at all, if the closed space itself can contract, the negative pressure is released, and a pressure difference is created, the flow continues to flow out and is completely discharged. Fig. 3 shows the conditions before and after the outflow when the circuit of the continuous outflow system (SDS) satisfies the continuous outflow condition (NCDSS) under the conditions where the siphon principle works and the final state of the elastic contraction space even in the rigid non-shrinkage space. Illustrated in -2.
体内の閉鎖空間が弾性収縮閉鎖空間である膀胱で、持続流出システムを構築して最初の持続流出条件を満たし流出しても、途中では必ず、硬無収縮空間と同様に内腔が陰圧になり水圧と釣り合い、圧差容量の残る瞬間はある。しかし、膀胱の弾性機能を発揮して圧縮し、陰圧を解放するとサイフォン化しているので、最後まで流出し、完全排尿は可能である。即ち、図4のようになる。 In the bladder where the closed space in the body is an elastic contraction closed space, even if a continuous outflow system is constructed and the initial continuous outflow condition is satisfied and the outflow occurs, the lumen always becomes negative pressure like the rigid non-contractile space on the way. There is a moment when the pressure difference capacity remains in balance with the water pressure. However, when the bladder exerts its elastic function to compress it and release the negative pressure, it becomes a siphon, so it flows out to the end and complete urination is possible. That is, it becomes as shown in FIG.
図5は、本願発明に係る持続流出システムの構造とサイフォン化の関係を図示したものである。
本願発明に係る持続流出システムでポイントとなるのは、「排尿機序」と「持続流出のためのサイフォン化のための管腔の設計の必要性」である。
尿は腎臓で1ml/Kg/hで生産され、排尿機序として、膀胱に200?400ml溜まると膀胱壁の排尿筋が圧迫伸展され、その伸展受容器により刺激となり、排尿反射が起こり排尿が開始する。その際、「膀胱排尿筋の収縮」+「内尿道括約筋の弛緩」+[外尿道括約筋の弛緩」が起こる。
その排尿刺激となり尿意を催す200mlが尿に溜まり、膀胱内圧が閾値を超え上昇する以前に、蓄尿回路がサイフォン化される必要がある。しかし、出来るだけ少量の尿量で、排出するようにするためにはRtを必要最小限に最小化しておかないとサイフォン化出来ず、持続流出は開始出来ない。
さらには、経時的尿量(時間尿)を計測するためにも出来るだけ残尿を減らす必要がある。例えば、通常200mlで尿意をもようし排尿が始まるまで、膀胱内に尿を貯留するのでは、術後の時間尿の測定用途としては不十分で有り、やはり出来るだけ少ない尿量で、持続排出が開始するようにVminを設計デザインする必要がある(図4参照)。
FIG. 5 illustrates the relationship between the structure of the sustained outflow system according to the present invention and siphonization.
The key points in the continuous outflow system according to the present invention are "urination mechanism" and "necessity of designing a lumen for siphonization for continuous outflow".
Urine is produced in the kidney at 1 ml / Kg / h, and as a mechanism of urination, when 200 to 400 ml is accumulated in the bladder, the urinary muscle of the bladder wall is compressed and stretched, stimulated by the extension receptor, and the micturition reflex occurs and urination starts. do. At that time, "contraction of the bladder detrusor muscle" + "relaxation of the internal urethral sphincter muscle" + [relaxation of the external urethral sphincter muscle" occurs.
The urinary storage circuit needs to be siphonized before 200 ml of urinary stimulus and urinary motivation accumulate in urine and the bladder pressure exceeds the threshold value and rises. However, in order to excrete with as little urine as possible, Rt must be minimized to the minimum necessary to siphon, and continuous outflow cannot be started.
Furthermore, it is necessary to reduce residual urine as much as possible in order to measure the amount of urine over time (hourly urine). For example, storing urine in the bladder until urination starts with 200 ml is not sufficient for postoperative time urine measurement, and continuous urination is performed with as little urine volume as possible. It is necessary to design the Vmin so that it starts (see FIG. 4).
まず、サイフォン化するのにも出来るだけ少ない尿量で、蓄尿回路が満たされる必要がある。そのサイフォン化するための尿量をVs(ml)とする。そして、排出力の源の圧力(P=Pc+Pp)を生むために必要な尿量をVp(ml)とする。Vs+Vp=Vminであり、このVminをあらかじめ設計して初めて持続流出システムを管理する事になる。
Vsはバルーンカテーテルの内容量Vbと採尿チューブ内の内容量Vtとの総和である。また、VpはRに比例し、決まる。
Pcは、膀胱排尿筋も尿の貯留により内圧が高まり引き延ばされるからこそ収縮出来Pcが生まれ、ある程度の尿量が必要である。またある量の尿が溜まらないとPpも生じない。即ちPp、PcもRに規定される。実際のVpは利用対象者のその時の全身および膀胱状態により異なり、実際にその時々、個々に計測してみないと分からない量であるが、抵抗Rが小さければVpも少なくなくて済む。それだけに出来るだけ利用者の負担を軽減するためにも、Vminは極力最少になるようにRが最小になるように設計しておく必要がある。
即ち、Vminを規定する因子はRただ1つであり、開放型ドリップチャンバー経由で蓄尿する即ちRp=0とすれば、Rtが唯一制御出来る要素であり、制御して初めてサイフォン化の準備も整い持続流出システムも適量の尿量(Vmin)が膀胱に貯留した時点で排尿開始される。
さらにこの管路抵抗の主となる抵抗Rtは、円管の場合の管の長さ(管長)L、管径d=2r、流体密度σ、流速をvとすると。下記の式で表される。
回路の管が細ければ細いほど抵抗は増し、管の長さが長ければ長いほど抵抗は増す。
Vs is the sum of the content Vb of the balloon catheter and the content Vt of the urine collection tube. Further, Vp is proportional to R and is determined.
Since the internal pressure of the bladder detrusor muscle is increased and stretched due to the accumulation of urine, Pc can be contracted and a certain amount of urine is required. In addition, Pp does not occur unless a certain amount of urine is collected. That is, Pp and Pc are also defined by R. The actual Vp varies depending on the whole body and bladder condition of the user at that time, and is an amount that cannot be known unless it is actually measured individually at that time, but if the resistance R is small, the Vp may not be small. In order to reduce the burden on the user as much as possible, it is necessary to design Vmin to minimize R so as to minimize it.
That is, R is the only factor that defines Vmin, and if urine is collected via an open drip chamber, that is, Rp = 0, Rt is the only element that can be controlled, and only after control is the preparation for siphonization. The continuous outflow system also starts urinating when an appropriate amount of urine (Vmin) is accumulated in the bladder.
Further, it is assumed that the main resistance Rt of this pipeline resistance is the tube length (tube length) L in the case of a circular tube, the tube diameter d = 2r, the fluid density σ, and the flow velocity v. It is expressed by the following formula.
The thinner the tube of the circuit, the higher the resistance, and the longer the tube, the higher the resistance.
一方、サイフォン化するために必要となる尿量(Vb+Vt)は共に下記の式で表される。
管路抵抗には流体の密度と流速も関与するが、流体密度σは生産される尿の濃さによるため制御は出来ない。また流速はその管と圧差により自ずと決まってくるので、やはり制御出来ない。また、Vtはあらかじめ決めることが出来、制御出来る。VpはR=Rt+Rpによりその量は決まってくる。Rtに関しては半径とその長さに規定される。
結局、管の半径rと管長Lとにより抵抗Rも持続流出開始尿量Vminも規定され、SDSの起動も決定される。
即ち、持続流出させるための二大要素はサイフォン化と圧差の制御であり、結局はいずれも回路の内径(半径)とその長さに規定される。
それらは、それぞれあらかじめ設計できる。Vbは、それぞれの既存のバルーンカテーテルであり、規格から計算可能である。一方Vtは使用対象者の状況により調整出来る。
仮に採尿チューブの内径が4mm(半径2mm)、長さを1.2mとすると、Vtは約15mlとなる。実際はそれにプラスアルファーの尿量Vpが必要となる。採尿チューブの尿塞栓およびデッドスペースの発生を抑えるためにも細い管でサイフォン化する必要があり、サイフォン化し、圧差があれば残尿も無く完全排出が可能となる。以上よりP-R>0と共に、このサイフォン化という概念をきちんと理解していないとその製造の際にも、また、実際の運用管理する看護の際にも適切な制御、管理は出来ず、ひいては適切な医療を阻害することとなる。
On the other hand, the urine volume (Vb + Vt) required for siphonization is both expressed by the following formula.
The fluid density and flow velocity are also involved in the pipeline resistance, but the fluid density σ cannot be controlled because it depends on the density of the urine produced. In addition, the flow velocity is naturally determined by the pressure difference between the pipe and the pipe, so it cannot be controlled. In addition, Vt can be determined in advance and can be controlled. The amount of Vp is determined by R = Rt + Rp. Rt is defined by the radius and its length.
Eventually, the resistance R and the continuous outflow start urine volume Vmin are defined by the radius r of the tube and the tube length L, and the activation of SDS is also determined.
That is, the two major factors for continuous outflow are siphonization and pressure difference control, both of which are ultimately defined by the inner diameter (radius) of the circuit and its length.
Each of them can be designed in advance. Vb is each existing balloon catheter and can be calculated from the standard. On the other hand, Vt can be adjusted according to the situation of the user.
Assuming that the inner diameter of the urine collection tube is 4 mm (
以上のような持続流出システムを膀胱留置カテーテルを用いた排尿に利用した場合に、次のような効果を期待できる。
1.術後の急性期に留置される従来の回路ではできてしまう尿塞栓による患者側の尿閉状態による膀胱圧迫による不快感、苦痛の解消
2.患者の苦痛に関わる看護側の負担の軽減
3.回路による尿閉状態がなく、時間毎の適正な尿量測定により、術後の尿量の適正な迅速な測定が可能となり、誤った医学判断(尿閉、乏尿、心不全等)を無くし、無用の強心剤や利尿剤の使用の減少その他(薬剤投与により招く低カリウム血症など)の医療の質の改善、適正化。
4.余分な尿の膀胱貯留が無く、常に一方向にしか流れず、途中で貯留することがないために尿路感染のリスクの低減
・尿の逆流は起こりようが無く、常に流れは順行である。
・膀胱内の残尿が逆行性に侵入した細菌の培地になる膀胱内の残尿を防げる。
・回路を逆行して感染するが、常に順方向に回路を洗い流している。
5.一度尿閉あるいは排尿困難と診断され、ずっと従来の回路を継続して使われ、かえってさらに排尿困難が慢性化した状態におかれている要介護の高齢者などの従来の回路使用者の救済。尿閉誘導閉鎖回路からの開放。
(1)使用者本人の膀胱圧迫、苦痛からの解放。
(2)それによる認知症、高齢者などの回路使用者自らの膀胱留置カテーテルの自己抜去事故の解消。早期の抜去により膀胱カテーテルによる圧迫等による膀胱壁の血行不良、潰瘍、壊死の予防。
(3)普通、尿の膀胱への貯留、充満により、それにより膀胱壁の伸展受容器が刺激され、それによる排尿反射が起こり、膀胱壁は収縮し、内外尿道括約筋の弛緩により排尿する。従来の回路では常に膀胱が充満し、圧迫され、膀胱壁は伸展され続けているために、排尿反射の元となる刺激が阻害されて、自然の排尿機構が障害されていく。その排尿機構の機能訓練、リハビリとなり、膀胱機能の回復が図れる。
(4)本人の行動制限からの解放
(5)ただでさえ経済的にひっ迫している回路使用者、家族の経済的負担の軽減
(6)家族の排尿に関わる手間暇、介護負担の軽減
6.脊髄損傷、脳出血、脳梗塞、その他の中枢神経の障害、あるいは末梢神経の障害による尿閉状態に対して、あるいは尿失禁する寝たきり等の対象者にも、本人に余計な負担をかけず、自然の原理で排尿可能で有り、持続的に長期的にも使用出来る。残された膀胱機能の維持と上記「5.(3)」による膀胱機能の回復に寄与する。
7.種々の疾患により臥床期間が長くなったり、寝たきりの対象者に円滑な尿路回路を提供することにより、腎機能の維持や改善が期待される。
8.製造販売元の経費削減と信用回復・増加と社会的責任と社会貢献
・自己抜管による事故、膀胱損傷、膀胱機能障害、腎機能障害の予防
・シンプルな構造による製造コストの削減
・自然科学に基づく原理・機序による安心と信頼の製品供給、きちんと効果、効能をうたえる。
・看護・介護領域における簡便性、利便性の向上による看護、介護負担の軽減
・医療における誤診と医療過誤の予防と質の高い医療の実現に寄与する。
・自社、使用者(医療・看護、介護領域)、使用対象者(実際の使用者)の三者の益を創造し提供
・各社の理念、理想、ビジョンの実現とガバナンスの発揮(社会的責任と社会貢献)
・製品という物の販売から、医療、看護、介護の領域での物を介した適正な科学的な思考の啓発、啓蒙とサービスの提供。
・その結果としての会社の責任と信用の確固たる確保。
9.日本国内のみならず、世界中で使用されている従来の回路使用者の救済と今後益々高齢化する未来の超高齢化社会への予防対策(医療、看護、介護負担の軽減・解消、経済的負担の解消、より良い生活QOLの確保維持)
When the above continuous outflow system is used for urination using an indwelling bladder catheter, the following effects can be expected.
1. 1. 2. Elimination of discomfort and pain caused by bladder compression due to urinary retention on the patient side due to urinary embolism that can be created by conventional circuits placed in the acute phase after surgery. Reducing the burden on the nursing side related to patient pain 3. There is no urinary retention due to the circuit, and proper hourly urine volume measurement enables proper and rapid measurement of postoperative urine volume, eliminating erroneous medical judgments (urinary retention, oliguria, heart failure, etc.). Reduced use of useless cardiotonics and diuretics, and improved and optimized the quality of medical care for others (such as hypopotassemia caused by drug administration).
4. There is no excess urinary bladder retention, it always flows in only one direction, and because it does not accumulate in the middle, the risk of urinary tract infection is reduced. ..
・ Residual urine in the bladder can be prevented from becoming a medium for bacteria that have invaded retrogradely.
・ The circuit goes backwards and becomes infected, but the circuit is always washed away in the forward direction.
5. Relief for conventional circuit users such as elderly people requiring long-term care who have been diagnosed with urinary retention or dysuria and have continued to use the conventional circuit for a long time. Release from the urinary retention induction closure circuit.
(1) Relief from pressure and pain on the user's bladder.
(2) Elimination of self-removal accidents of indwelling bladder catheters by circuit users such as dementia and elderly people. Prevention of poor blood circulation, ulcers, and necrosis of the bladder wall due to compression by a bladder catheter by early removal.
(3) Normally, the accumulation and filling of urine in the bladder stimulates the extension receptor of the bladder wall, which causes the urinary reflex, the bladder wall contracts, and the bladder wall relaxes to urinate. In the conventional circuit, the bladder is constantly filled and compressed, and the bladder wall is continuously stretched, so that the stimulus that is the source of the micturition reflex is hindered and the natural micturition mechanism is impaired. It will be a functional training and rehabilitation of the urination mechanism, and the bladder function can be restored.
(4) Release from restrictions on the person's behavior (5) Reducing the financial burden on circuit users and their families who are already financially tight (6) Reducing the time and effort involved in urination of their families and the burden of long-term care 6 .. Naturally, it does not impose an extra burden on the subject such as spinal cord injury, cerebral bleeding, cerebral infarction, other central nervous system disorders, urinary retention due to peripheral nervous system disorders, or bedridden subjects with urinary incontinence. It is possible to urinate on the principle of, and it can be used continuously for a long time. It contributes to the maintenance of the remaining bladder function and the recovery of the bladder function according to the above "5. (3)".
7. It is expected that renal function will be maintained or improved by prolonging the bed rest period due to various diseases and providing a smooth urinary tract circuit to bedridden subjects.
8. Cost reduction and credit recovery / increase and social responsibility and social contribution of manufacturers / Distributors ・ Prevention of accidents due to self-extubation, bladder injury, bladder dysfunction, renal dysfunction ・ Reduction of manufacturing cost by simple structure ・ Based on natural science Providing safe and reliable product supply based on the principle and mechanism, and praising the effect and efficacy properly.
・ Nursing by improving convenience and convenience in the field of nursing and long-term care, reducing the burden of nursing care ・ Contributing to the prevention of misdiagnosis and medical malpractice in medical care and the realization of high-quality medical care.
・ Create and provide the benefits of the company, the user (medical / nursing, long-term care area), and the target user (actual user) ・ Realize the philosophy, ideals, and vision of each company and demonstrate governance (social responsibility) And social contribution)
・ From the sale of products to the enlightenment, enlightenment and provision of services for proper scientific thinking through products in the fields of medical care, nursing and long-term care.
-As a result, the responsibility and credibility of the company are firmly secured.
9. Relief of conventional circuit users used not only in Japan but all over the world and preventive measures for the future super-aging society (medical care, nursing, reduction / elimination of nursing care burden, economical) Eliminating the burden, securing and maintaining a better life QOL)
本願発明に係る持続流出システムは、膀胱留置カテーテルを用いた排尿に利用できるだけでなく、その他の体内にある閉鎖空間の流出元から体外にある空間の流出先へ流体物を持続的に流出させる技術として幅広く利用できる。 The continuous outflow system according to the present invention can be used not only for urination using an indwelling bladder catheter, but also a technique for continuously flowing out fluid from the outflow source of other closed spaces inside the body to the outflow destination of the space outside the body. Can be widely used as.
上記した本願発明によれば、以下のような効果を有する。
(1)本願発明は、上記特許文献1~4のようにサイフォンの原理から出発してはいるが、決してサイフォンそのものではない。サイフォンの原理を応用した持続流出システムである。
(2)本願発明は、特別な装置は必要無く、また、特別な操作も必要無く機能する。最初にサイフォン化のための必要条件をクリアーするように採尿チューブの内径と長さ、蓄尿バッグ等の回路をきちんと設計すれば、後は、膀胱の収縮、弛緩即ち膀胱本来の排泄機能(排尿反射)で排尿が始まり、その回路は持続流出システムとして機能する。
(3)結果として、膀胱の自然の機能は維持され、かつ、尿流出は膀胱にある量貯留し、内圧が上昇することによる排尿刺激により反射的に自律的に起こり、持続的に流出し、採尿チューブにも膀胱にも残尿はなく、尿の逆流も起こらず、尿路感染のリスクを低減する。
According to the above-mentioned invention of the present application, it has the following effects.
(1) Although the invention of the present application starts from the principle of siphon as in Patent Documents 1 to 4, it is not a siphon itself. It is a continuous outflow system that applies the siphon principle.
(2) The invention of the present application functions without the need for a special device and without the need for a special operation. If the inner diameter and length of the urinary collection tube and the circuit such as the urinary storage bag are properly designed so as to first clear the necessary conditions for siphonization, then the bladder contracts and relaxes, that is, the bladder's original excretory function (urination reflex). ) Starts urination, and the circuit functions as a continuous outflow system.
(3) As a result, the natural function of the bladder is maintained, and urine outflow is accumulated in the bladder in a certain amount, and reflexively and autonomously occurs by urination stimulation due to an increase in internal pressure, and the urine outflow is sustained. There is no residual urine in the urine collection tube or bladder, no urine reflux occurs, and the risk of urinary tract infection is reduced.
Claims (4)
体内にある閉鎖空間の流出元から体外にある空間の流出先へ流体物を持続的に流出させる持続流出システムであって、
流出元から流体物を流出させるために設けられる流出誘導体と、
流出誘導体から流出先までに流体物を移動させるための流出チューブと、
を備え、
流出元と流出先の圧差をP、流出物の流出に対する抵抗をR、とした場合、P-R>0と、
流出誘導体に設けられるカテーテルの内容量をVb、流出チューブの内容量をVt、Pを生むために必要な容量をVp、持続流出開始容量をVmin、とした場合、Vb+Vt+Vp=Vminと、
を満たし、流出誘導体のカテーテル及び流出チューブがサイフォン化されることを特徴とした持続流出システム。 (Basic form)
It is a continuous outflow system that continuously causes fluid to flow out from the outflow source of the closed space inside the body to the outflow destination of the space outside the body.
Outflow derivatives provided to allow fluid to flow out of the outflow source,
An outflow tube for moving the fluid from the outflow derivative to the outflow destination,
Equipped with
When the pressure difference between the outflow source and the outflow destination is P and the resistance to the outflow of the outflow is R, then PR> 0.
When the internal volume of the catheter provided in the outflow derivative is Vb, the internal volume of the outflow tube is Vt, the capacity required to generate P is Vp, and the continuous outflow start capacity is Vmin, then Vb + Vt + Vp = Vmin.
A continuous outflow system characterized in that the outflow derivative catheter and outflow tube are siphonized.
Pは、流出元による圧縮圧Pcと、流出元と流出先との位置エネルギーである水圧Ppの和であることを特徴とした請求項1記載の持続流出システム。 (Details of pressure difference P)
The continuous outflow system according to claim 1, wherein P is the sum of the compression pressure Pc by the outflow source and the water pressure Pp which is the potential energy of the outflow source and the outflow destination.
Rは、流出チューブにおける抵抗である管路抵抗Rtと、流出先における抵抗である末梢抵抗Rpの和であることを特徴とした請求項1又は2記載の持続流出システム。 (Details of resistance R)
The continuous outflow system according to claim 1 or 2, wherein R is the sum of the pipeline resistance Rt, which is the resistance in the outflow tube, and the peripheral resistance Rp, which is the resistance in the outflow destination.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP2020219389A JP6990291B1 (en) | 2020-12-28 | 2020-12-28 | Sustained outflow system |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP2020219389A JP6990291B1 (en) | 2020-12-28 | 2020-12-28 | Sustained outflow system |
Publications (2)
Publication Number | Publication Date |
---|---|
JP6990291B1 JP6990291B1 (en) | 2022-01-12 |
JP2022104283A true JP2022104283A (en) | 2022-07-08 |
Family
ID=80185453
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2020219389A Active JP6990291B1 (en) | 2020-12-28 | 2020-12-28 | Sustained outflow system |
Country Status (1)
Country | Link |
---|---|
JP (1) | JP6990291B1 (en) |
Families Citing this family (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP7158792B1 (en) | 2021-12-03 | 2022-10-24 | 和彦 福井 | Continuous outflow system circuit and its quality control system |
JP7493290B1 (en) | 2023-07-05 | 2024-05-31 | 和彦 福井 | Storage bag in continuous outflow system circuit, continuous outflow system circuit, quality control system for continuous outflow system circuit, and quality control method for storage bag in continuous outflow system circuit |
Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JPS51133997A (en) * | 1975-04-15 | 1976-11-20 | Jaerund Devello Ab | Urinary disease patient*s bladder training device |
JPS6083664A (en) * | 1983-10-12 | 1985-05-11 | 岡本 静幸 | Urination method and apparatus for keeping bladder function by using urethra fixing balloon catheter |
JPS60171047A (en) * | 1984-02-16 | 1985-09-04 | ユニチカ株式会社 | Auxiliary bladder apparatus |
JPS60176661A (en) * | 1984-02-23 | 1985-09-10 | ユニチカ株式会社 | Auxiliary bladder apparatus |
JP2020182866A (en) * | 2014-09-28 | 2020-11-12 | ポトレロ メディカル,インコーポレイテッド | System, device, and method for sensing physiological data and draining and analyzing bodily fluid |
-
2020
- 2020-12-28 JP JP2020219389A patent/JP6990291B1/en active Active
Patent Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JPS51133997A (en) * | 1975-04-15 | 1976-11-20 | Jaerund Devello Ab | Urinary disease patient*s bladder training device |
JPS6083664A (en) * | 1983-10-12 | 1985-05-11 | 岡本 静幸 | Urination method and apparatus for keeping bladder function by using urethra fixing balloon catheter |
JPS60171047A (en) * | 1984-02-16 | 1985-09-04 | ユニチカ株式会社 | Auxiliary bladder apparatus |
JPS60176661A (en) * | 1984-02-23 | 1985-09-10 | ユニチカ株式会社 | Auxiliary bladder apparatus |
JP2020182866A (en) * | 2014-09-28 | 2020-11-12 | ポトレロ メディカル,インコーポレイテッド | System, device, and method for sensing physiological data and draining and analyzing bodily fluid |
Also Published As
Publication number | Publication date |
---|---|
JP6990291B1 (en) | 2022-01-12 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
JP6990291B1 (en) | Sustained outflow system | |
US20200054800A1 (en) | Catheter and Method for Inducing Negative Pressure in a Patient's Bladder | |
WO2006039337A2 (en) | Inhibition action incontinence device and method | |
EP2675513A2 (en) | Catheters | |
WO1996002214A1 (en) | Urinary catheter | |
JP7158792B1 (en) | Continuous outflow system circuit and its quality control system | |
Munro | The Rehabilitation of Patients Totally Paralyzed below the Waist: With Special Reference to Making Them Ambulatory and Capable of Earning Their Living: Tidal Drainage, Cystometry and Bladder Training | |
Langworthy et al. | Behavior of the human bladder freed from cerebral control | |
EP2470249A2 (en) | Suprapubic urethral catheters | |
Szasz et al. | Effect of distension of the bladder and of contraction of sphincters on blood pressure. | |
Wyndaele et al. | Urodynamic testing after spinal cord injury | |
Spiro | Bladder training for the incontinent patient | |
Scott et al. | Management of neuropathic urinary incontinence in children by intermittent catheterisation. | |
Newman et al. | For CE Credit: Restoring Urinary Continence | |
Kaya et al. | An Important Problem for the Individuals with Spinal Cord Injury: Neurogenic Bladder | |
Fingeroth et al. | Medical management and nursing care for the paralyzed patient | |
JPS6083664A (en) | Urination method and apparatus for keeping bladder function by using urethra fixing balloon catheter | |
TWM394807U (en) | Medical urine bag | |
Rosier | Practice of urodynamics in patients with neurogenic lower urinary tract dysfunction | |
Shepherd et al. | Simple practical techniques in the management of urinary incontinence | |
Miles | Catheterisation and catheter care | |
Engel et al. | Care of the neurogenic bladder in spinal cord injuries | |
Nazarko | Continence problems following stroke | |
Colborn | The promotion of continence in adult nursing | |
JPS60171047A (en) | Auxiliary bladder apparatus |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
A621 | Written request for application examination |
Free format text: JAPANESE INTERMEDIATE CODE: A621 Effective date: 20210118 |
|
A871 | Explanation of circumstances concerning accelerated examination |
Free format text: JAPANESE INTERMEDIATE CODE: A871 Effective date: 20210118 |
|
A975 | Report on accelerated examination |
Free format text: JAPANESE INTERMEDIATE CODE: A971005 Effective date: 20210420 |
|
A131 | Notification of reasons for refusal |
Free format text: JAPANESE INTERMEDIATE CODE: A131 Effective date: 20210430 |
|
A521 | Request for written amendment filed |
Free format text: JAPANESE INTERMEDIATE CODE: A523 Effective date: 20210629 |
|
TRDD | Decision of grant or rejection written | ||
A01 | Written decision to grant a patent or to grant a registration (utility model) |
Free format text: JAPANESE INTERMEDIATE CODE: A01 Effective date: 20211001 |
|
A61 | First payment of annual fees (during grant procedure) |
Free format text: JAPANESE INTERMEDIATE CODE: A61 Effective date: 20211203 |
|
R150 | Certificate of patent or registration of utility model |
Ref document number: 6990291 Country of ref document: JP Free format text: JAPANESE INTERMEDIATE CODE: R150 |