JP2681666B2 - Autologous blood storage method - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION [Industrial field of application] The present invention relates to hip acetabular rotary osteotomy, scoliosis surgery,
In addition to total hip arthroplasty, the present invention relates to an autologous blood storage method for preserving autologous blood of a patient who can perform scheduled surgery and can collect blood.

[Conventional Technology and Problems] When surgery is planned in advance and the amount of bleeding is predicted to some extent in the market price, blood transfusion during surgery by autologous blood transfusion is desired to prevent adverse effects due to allogeneic blood transfusion. .

As this method, a preoperative blood collection autologous blood storage method such as a cryopreservation method or a leapfrog method (liquid preservation method) has been conventionally used.

For example, an example of the leapfrog method will be described with reference to FIG.

At the first time, 1 unit of blood was collected in the blood storage bag 8a (
As shown in FIG. 14 (b), the second time, as shown in FIG. 14 (b), 1 unit of blood B is collected from the patient in the blood storage bag 80b, and blood A in the blood storage bag 30a is collected in the patient. After returning, 1 unit of blood B was again collected from the patient into the blood storage bag 80c, and 1 unit of blood B or blood C was collected from the first time.

 At the third time (see FIG. 14 (c)), 1 unit of blood D is collected, 1 unit of blood B collected at the second time is transfused to the patient, and 1 unit of blood E is collected from the patient. .

 At the fourth time (see FIG. 14 (d)), 1 unit of blood F was collected, 1 unit of blood C collected at the second time was transfused to the patient, and 1 unit of blood G was collected from the patient. To do.

 At the fifth time (see FIG. 14 (e)), 1 unit of blood H is collected, blood D collected at the second time is transfused to the patient, and 1 unit of blood I is collected from the patient.

In this way, since 1 unit of blood collected last time is returned and transfused, and 2 units of blood are collected, the amount of stored blood can be increased.

However, the leapfrog method has a limit in blood storage. Reduced oxygen carrying capacity of blood. There is a problem that the blood collection period is limited, and the cryopreservation method has problems of loss of red blood cells during thawing and cost of storage and thawing.

Therefore, the present invention has overcome the above problems and invented a method capable of completely collecting autologous blood required before surgery and storing the blood in a state in which the oxygen carrying capacity of the blood is good.

[Means for Solving the Problems] The first invention is to collect n units of blood collected in the Nth time,
The patient is transfused at the (N + 1) th time and (n + 1)
A new unit of blood is drawn and stored, and the blood is stored in the (N +
2) It is an autologous blood storage method in which a patient is transfused a second time.

The second invention is to collect n units of blood collected at the Nth time,
The patient is transfused at the (N + 2) th time and (n + 1)
This is an autologous blood storage method in which a unit of blood is collected from a patient, stored, and the blood is transfused to the patient at the [[N + 2) +2] th time.

A third invention is an autologous blood storage method in which n units of blood collected from the first to Nth blood are transfused to a patient at the (N + 1) th time, and (n + 1) units of blood are collected.

[Operation] As described above, since blood transfusion and blood sampling are repeated so that the blood sampling amount is relatively large, the burden on the patient is small, and autologous blood storage can be performed while maintaining freshness of blood. it can.

[Example] FIG. 1 is a schematic view of a switch bag type blood collection set 1 used in the autologous blood storage method of the present invention.

The blood collection set 1 is basically composed of a blood transfusion member 3, a blood transfusion member 4, and a blood storage member 5. The blood transfusion member 3 has a connecting tube 13 and a blood filter 14 loaded therein and a blood introduction needle.
The blood transfusion member 4 is composed of a drip tube 12 fitted with 17,
The blood storage member 5 is composed of a blood transfusion needle 20 and a connecting pipe 21.
Is composed of the connecting tube 38 and the blood storage bag 2.

The blood transfusion member 3, the blood transfusion member 4, and the blood storage member 5 are integrally mounted via the connecting pipes 41, 42, 43 to form a closed system.

The volumes and numbers of the blood transfusion member 3 and the blood storage member 5 can be freely selected.

2 to 5 are schematic views showing an example of another blood collection set usable in the present invention.

For example, in FIG. 2, the blood collection set 1 is basically composed of a liquid transfusion member 2, blood transfusion members 3a and 3b, a blood transfusion member 4, blood storage members 5a and 5b, and a cleaning liquid storage member 6.

The infusion member 2 includes a liquid introducing needle 7a in which a needle 7c made of stainless steel or the like is implanted in a needle base 7b, connecting pipes 8 and 9 made of flexible polyvinyl chloride, etc., and a filter 10 made of polyamide such as nylon.
A drip tube 11 made of polyvinyl chloride or the like loaded with.

The transfusion member 3a comprises a drip tube 12a made of polyvinyl chloride or the like and a connecting pipe 13a made of flexible polyvinyl chloride or the like, and the drip tube 12a has therein filters 14a, 15a made of polyethylene terephthalate or the like having different pore sizes, respectively. , 16a
And a connecting pipe made of polyvinyl chloride or the like between the blood introducing needle 17a made of polycarbonate or the like and the connecting pipe 13a at the end thereof.
18a is installed. The blood transfusion member 4 has a needle 20b made of stainless steel or the like implanted in the needle base 20c and the rotary blade 20d attached to the needle base 20c.
A blood collection needle 20a equipped with a needle and a flexible polyvinyl chloride-made connecting tube 21, 22 made of polycarbonate, and puncturing buttons 23b, 24b made of silicone rubber or the like are embedded between the two connecting tubes 21, 22. Mixed injection parts 23a, 24a for manufacturing etc. are installed.

The cleaning liquid storage member 6 includes a waste liquid bag 26 made of flexible polyvinyl chloride or the like and connecting pipes 27, 28 made of flexible polyvinyl chloride or the like, and male lures at the ends of the connecting pipes 27, 28. 29 and 30 are mounted, and connected via a connecting pipe 31 made of silicone rubber or the like via the same.

A check valve 33 made of flexible polyvinyl chloride or silicone rubber is attached to the waste liquid inlet 32 of the waste liquid bag 26. The blood storage member 5a includes a parent bag 35a and a child bag 36.
A connecting piece 39a made of polycarbonate or the like is mounted inside the connecting tube 37a. These constituent members 2, 3a, 3b, 4, 6, 5a, 5b, connecting pipes 9, 13a, 13b and 21, 22, 27, 28, 37a, 37b, respectively.
Connection pipes 41, 42, 43 made of polyvinyl chloride or the like are connected via 40.

Roller clamps A, B, C made of polypropylene or the like for the connecting pipes 9, 13a, 13b Dura clamps D, E, F made of polypropylene or the like for the connecting pipes 22, 27, 40, polypropylene for the connecting pipes 37a, 37b, etc. The slide clamps G and H are attached.

The liquid introduction needle 7a, the blood introduction needle 17a, and the blood collection needle 20a are capped with needle caps 101, 102, 103 made of polypropylene or the like so as not to come into contact with the outside air.

Next, regarding an example of how to use these blood collection sets,
This will be described with reference to the drawings.

(1) Priming operation Roll clamps A, B, C and Jura clamp D,
By closing E and F, the liquid introduction needle 7a is connected to a container (not shown) in which physiological saline is enclosed.

While the roll clamp A is opened and the drip tube 11 is pumped, the physiological saline is introduced up to a predetermined liquid level in the drip tube 11.

When the liquid level reaches a predetermined level, the roll clamp B is opened and physiological saline is further introduced into the drip tube 12a through the connecting pipe 13a.

When the liquid level reaches a predetermined level, the roll clamp C is further opened, and physiological saline is introduced into the drip tube 12b to the predetermined liquid level in the same manner.

Then, open the Jura clamps D, E, and F, adjust the opening degree of the roll clamp A, add physiological saline solution, and draw the air in the connecting pipes 40, 27, 28 together with the physiological saline solution in the waste bag 26. Then, the clamps D, E and F are closed and the priming is completed.

(2) First Blood Collection The communication piece 39a of the connecting tube 37a is cut to open the slide clamp G, the blood transfusion needle 20a is punctured by the blood donor, and the Jura clamp E is opened.

Blood flows into the parent bag 35a through the blood transfusion needle 20a and the connecting tubes 21, 22, 37a.

After collecting a predetermined amount of blood, slide clamp G
Is closed, the roll clamps A and D are opened, and physiological saline is dropped from the liquid transfusing member 2 into the blood transfusion member 4 through the connecting pipe 40. This can prevent blood from stagnating and coagulating in the blood transfusion member 4 before the next operation is performed.

At this time, the blood collection needle 20a is left punctured by the donor. This is to maintain the closed system until blood transfusion and blood collection are completed.

(3) Blood transfusion operation A blood bag (not shown) in which blood was previously stored and stored by the previous blood collection is attached to the blood introduction needle 17a of the blood transfusion member 13a.
Connect to

With the roll clamp A closed and the roll clamp B opened, blood is transfused to the donor through the connecting tubes 13a, 40, 22, 21, and the blood transfusion needle 20a. The blood transfusion rate at this time is about 60 ml.
/ min (to the extent that it does not become a continuous thread when falling down the drip core) is preferable.

When the blood transfusion in the blood bag (not shown) is completed, the roll clamp B is closed.

The roll clamp A is opened again, and physiological saline is introduced into the blood transfusion member 4 in order to prevent the blood remaining in the blood transfusion member 4 from coagulating.

(4) Second blood sampling Cut the communication piece 39b, and clamp H, clamp E
To release.

Blood is introduced into the parent bag 35b through the blood transfusion needle 20a and the connecting tubes 21, 22, 37b.

After collecting a predetermined amount of blood, the clamp E is closed and the clamp A is opened, and physiological saline is dropped from the transfusion member 2 to the transfusion member 4.

(5) End The clamp E is closed, and the electrolyte solution prepared in advance is replenished to the blood donor through the mixed column portion 23a, the connecting pipe 21, and the blood collection needle 20a.

Finally, the connecting pipes 37a and 37b are hermetically welded by a welder, the blood storage members 5a and 5b are separated, and stored at 4 ° C. for use in the next blood transfusion.

As another embodiment of the blood collection set used in the present invention, the numbers of blood transfusion members and blood storage members can be appropriately combined.

For example, (1) two blood transfusion members (3a, 3b) and three blood storage members (5a, 5b, 5c) (see FIG. 3) (2) three blood transfusion members (3a, 3b, 3c) and three bloods Storage members (5a, 5b, 5c) (see FIG. 4) (3) Three infusion members (3a, 3b, 3c) and four blood storage members (5a, 5b, 5c, 5d) (see FIG. 5) The following modes are possible.

Furthermore, ten types of embodiments can be implemented by combining the number of blood storage members (5a to 5d) and the capacities of the parent bags (38a to 38d) in the blood storage members (5a to 5d).

As shown in Table 1, the blood collection pattern can be combined according to the donor's health condition and physical strength to determine the preparatory blood volume before blood collection.

(First Example) At the first time, 1 unit of blood A is collected in the blood storage bag 45 (see FIG. 6 (a)). At the second time, as shown by the arrow in FIG. 6 (b), one unit of blood B is drawn from the blood collection member 4 through the connecting pipe 37a into the blood storage bag 2a.

The blood A collected for the first time is transfused to the patient via the blood transfusion member 3 and the blood transfusion member 4.

By the same operation as above, blood B is collected from the patient via the blood transfusion member 4 and the conduit 37b into the blood storage bag 2b to collect 1 unit of blood B more than the first time.

Similarly to the second time, the third time, as shown by the arrow in FIG. 6 (c), 1 unit of blood C is collected from the patient in the blood storage bag 2c, and 1 unit of blood is collected from the blood storage bag 2a. B is transfused to the patient, 1 unit of blood C is collected from the patient in the blood storage bag 2d, 1 unit of blood B is transfused from the blood storage bag 2b to the patient, and 1 unit of blood C is stored from the patient. Blood is collected in bag 2e.

In the fourth time, as described above, as shown by the arrow in FIG. 6 (d), 1 unit of blood D was collected from the patient in the blood storage bag 2f, and 1 unit of blood C was collected from the blood storage bag 2c. 1 unit of blood D is collected from the patient in a blood reservoir bag 2g, 1 unit of blood C is collected from the blood reservoir bag 2d into the patient, and 1 unit of blood D is collected from the patient in a blood reservoir bag 2h. Then, 1 unit of blood C is transfused to the patient from the blood storage bag 2e, and 1 unit of blood D is collected from the patient to the blood storage bag 2i.

However, each blood sampling interval must be performed during the effective storage period of blood (within 21 days after blood sampling).

As described above, in the present embodiment, the first to Nth
This is an autologous blood storage method in which n units of blood collected by the second time are transfused to a patient at the (N + 1) th time and (n + 1) units of blood are collected.

By the above operation, the patient always collects only one unit of extra blood, and the blood collected at the Nth time is always transfused to the patient at the (N + 1) th time. Can store blood.

(Second Embodiment) Similar to the first embodiment, one unit of blood A is stored in each of the first and second blood storage bags 45a, 45b.
Blood is collected from B (see FIG. 7 (a)) At the third time, as shown by an arrow in FIG.
Blood is collected in a blood storage bag via 37a, and 1 unit of blood A collected first is transferred to the patient via transfusion member 3 and blood collection member 4, and 1 unit of blood C is collected from the patient into blood storage bag 2b. Collect blood.

As shown in the arrow of FIG. 7 (d) at the 4th time, as in the 3rd time, 1 unit of blood D was collected from the patient into the blood storage bag 2c, and 1 unit of blood collected at the 2nd time was collected. Blood B is transfused to the patient, and 1 unit of blood D is collected from the patient in the blood storage bag 2d.

As shown in the order of arrows in FIG. 6 (c) at the fifth time, 3 units of blood D are collected from the patient, and 2 units of blood 2c collected at the fourth time are alternately transfused.

As described above, in this embodiment, n units of blood collected at the Nth time are transfused to the patient at the (N + 2) th time, and (n + 1) units of blood are collected from the patient and stored. This is an autologous blood storage method in which the blood is transfused to a patient at the [(N + 2) +2] th time.

As described above, in this embodiment, since blood is collected in two series of the first embodiment, the number of blood storage bags used in performing each operation is the same as that in the first embodiment. The restraint time of is shortened and a large amount of blood can be stored.

However, the blood collection time for each series, such as the first and third cycles, must be performed during the effective storage period of blood (within 21 days after blood collection).

(Third Embodiment) As shown in FIGS. 8 (a) to 8 (c), one unit of blood is stored in each of the blood storage bags 45a, 45b, and 45c at the first to third times. (A total of 3 units of blood) was collected, and as shown by the arrow in FIG. 8 (d) at the 4th time, blood D was collected from the patient in 2a1 units of blood storage bag, and the blood collected at the 1st time was collected. A is transfused to the patient, blood D of 2b1 units of blood storage bag is collected from the patient, blood B of the second collection is transfused to the patient, blood D of 2c1 unit of blood storage bag is collected from the patient, and The blood C collected for the third time is transfused to the patient, and 2 d1 units of the blood D is collected from the patient.

As described above, in the present embodiment, the first to Nth
This is an autologous blood storage method in which n units of blood collected by the second time are transfused to a patient at the (N + 1) th time and (n + 1) units of blood are collected.

In this way, the entire amount of blood collected in the final blood collection is returned to the patient, and 1 extra blood is newly collected (the interval from the first blood collection to the final blood collection requires an effective preservation period of 21 days for blood). By using it, it is possible to store fresh blood relatively easily within a limited range.

Next, specific examples of each part of the autotransfusion set of the present invention will be described.

When there are two or more pairs of blood transfusing members 3, as shown in FIG. 9 (a), a plurality of connecting pipes 63a and 63b equipped with blood introducing needles 62a and 62b may be attached to one drip tube 61. good. Alternatively, as shown in FIG. 9 (b), the connecting pipe 64 of the infusion member is formed.
May be attached to the drip tube 61 together with the connecting tubes 63a and 63b.

As a result, the number of parts can be reduced by the amount of the deleted drip tube.

A specific mode of the check valve 33 formed in the cleaning liquid storage member 6 is shown in FIGS. 10 and 11.

(A) is a plan view, (b) is an AA sectional view and a BB sectional view of (a).

The check valve 64 of FIG. 10 is formed by stacking two sheets of flexible polyvinyl chloride 65 on each other and forming an end portion 66 as a heat seal.

The check valve 67 shown in FIG. 11 is generally called a "duck beak valve" and is integrally formed of flexible polyvinyl chloride or silicone rubber. 68 is a beak portion formed thinly.

Connect these check valves 64 and 67 to the waste liquid inlet port 32 of the waste liquid bag 26.
When the pressure is applied from the outside of the waste liquid bag 26 after the cleaning liquid is introduced into the waste liquid bag 26 by mounting the external pressure on the seat 65, 65 of the check valve 64 or the beak portion of the check valve 67.
Since it works in the direction of crushing 68, the used cleaning solution does not re-enter the inside of the autotransfusion set and hygiene is maintained.

The male lures 29, 30 attached to the ends of the connecting pipes 27, 28 of the cleaning liquid storage member 6 are used as follows.

When puncturing a blood donor with blood transfusion needle 20a and collecting blood, if a problem occurs due to blood cell clogging inside needle 20b of blood transfusion needle 20a, remove connecting tube 31 to expose male luer 30. Then, for example, as shown in FIG. 9, the blood collecting needle 71 is connected to the female luer 72 of the blood collecting needle 71 prepared for a spare, and the blood collecting needle 71 is punctured by the donor.

Blood is introduced into the parent bag 35a of the blood storage member 5a via the connecting pipes 27 and 37a. On the contrary, the blood collection needle 20a is connected to the other male luer 29 and used for waste liquid treatment.

Various filters 14a, 15 loaded inside the drip tube 12a
The pore sizes of a and 16a are 210μ, 160μ and 35μ, respectively.
And it is made small from the blood inlet to the outlet. As a result, it is possible to completely prevent microaggregates in blood from entering the autotransfusion set.

The filters 14a, 15a, 16a are formed by laminating 14a and 15a and welding them in the drip tube, and 16a is attached to the lower end of the drip tube by welding.

14a, 15a and 16a are laminated together and attached by welding to the inner surface of the drip tube.

 As described above, the drip tube 12a can be loaded.

In the blood storage member 5a (the parent bag 35a via the connecting pipe 38a
The child bag 36a (mounted on) is used when the blood collected in the parent bag 35a is sampled for a blood test or the like.

It is especially useful for blood tests that require large sample volumes.

Further, the liquid introduction needle 7a attached to the blood collection set used in the present invention, the blood introduction needle 17a, the number of the blood collection needle 20a and the connecting tube 41,
The shapes of 42 and 43 and the materials of the constituent members 2, 3a, 4, 5a and 6 can be arbitrarily set according to the purpose of use.

[Effects of the Invention] As described above, according to the present invention, blood collected from a donor is transfused without loss of freshness, and at the same time, blood in an amount equal to or greater than the amount transfused from the donor is balanced in body fluid balance. It is possible to collect blood without hindrance, and these can be used in a recycling system, which is particularly suitable for autologous blood of a donor.

Since the constituent members (1) to (5) are integrally connected, the operation can be performed in the closed system, so that hygiene can be ensured.

Patients whose blood function is normal enough to collect a certain amount of blood (100-500 ml) and to metabolize citric acid in the blood preservation solution without blood-derived diseases ( It is effective for surgery such as orthopedic surgery.

It is also effective when you have a rare blood type and it is judged that you cannot secure a sufficient amount of blood during surgery.

 It is an excellent invention having such effects.

[Brief description of the drawings]

FIG. 1 is a schematic diagram showing the basic configuration of a switch bag type blood collection set used in the present invention. FIG. 2, FIG. 3, FIG. 4 and FIG. 5 are schematic views showing other embodiments of the switch bag type blood collection set usable in the present invention. FIG. 6, FIG. 7 and FIG. 8 are schematic views of an embodiment showing the autologous blood storage method of the present invention. FIG. 9A is a schematic view showing another embodiment of the infusion member constituting the blood collection set. FIG. 9 (b) is a schematic view showing another embodiment of the transfusion member and the blood transfusion member. 10 and 11 are embodiments of the check valve mounted on the cleaning liquid storage member, (a) is a plan view and (b) is a sectional view of (a). FIG. 12 is an enlarged view of the vicinity of the connection pipe of the cleaning liquid storage member. FIG. 13 is a schematic view showing an example of how to use the male luer of the cleaning liquid storage member. FIG. 14 is a schematic diagram showing a conventional autologous blood storage method. In the figure, 1 is a switch bag type blood collection set, 2 is a transfusion member, 2a, 2b, 2c, 2d, 2f, 2g, 2h and 2i are blood storage bags, 3 is a transfusion member, 4 is a transfusion member, 5a and 5b. Is a blood storage member, 6 is a cleaning liquid storage member, 11, 12a and 12b are drip tubes, 7a
Is a liquid introduction needle, 17a is a blood introduction needle, 20a is a blood transfusion needle, 23
a and 24a are mixed injection parts, 26 is a waste bag, 29 and 30 are male lures, 31 is a connecting pipe, 33 is a check valve, 35a and 35b are parent bags, 36
a, 36b are child bags, 39a, 39b are communicating pieces, 41, 42, 43
Is a connecting pipe, 8, 9, 13a, 13b, 21, 22, 27, 28, 37a, 3
7b, 38a and 38b are connecting pipes, A, B and C are roll clamps,
D, E, and F indicate Jura clamps, and G and H indicate slide clamps.

Claims (3)

(57) [Claims] 1. At least a blood transfusion member, which is used to collect a predetermined amount of blood from a patient and store it in advance, and to collect and store a new amount of blood from the patient. An autologous blood storage method using a blood collection set consisting of a blood transfusion member and a blood storage member, wherein n units of blood collected at the Nth time are transfused to a patient at the (N + 1) th time and (n + 1) ) An autologous blood storage method, characterized in that a unit of blood is newly collected and stored, and the blood is transfused to the patient at the (N + 2) th time. 2. An autologous blood storage method using the blood collection set according to claim 1, wherein n units of blood collected at the Nth time are transfused to the patient at the (N + 2) th time, and (n +
1) An autologous blood storage method, which comprises collecting a unit of blood from a patient, storing the blood, and transfusing the blood into the patient at the [[N + 2) +2] th time. 3. An autologous blood storage method using the blood collection set according to claim 1, wherein n units of blood collected from the first to Nth blood are transfused to a patient at the (N + 1) th time. In addition, the autologous blood storage method is characterized in that (n + 1) units of blood are collected and stored.