JP2770104B2 - How to replace a medical container - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a method for connecting hoses one after another in a sterilized state, and more particularly, to a method for exchanging medical containers optimal for peritoneal perfusion.

[0002]

2. Description of the Related Art Peritoneal perfusion is a method of exchanging perfusate several times to several tens of times a day to remove harmful substances from the body. For peritoneal perfusion, a catheter is inserted into the peritoneal cavity. Connect the joint to the catheter via a hose. A hose connected to a bag filled with the perfusate is connected to the joint, and the perfusate is introduced into the body via the hose. Toxic substances are transferred to the perfusate in the body through the peritoneum. The perfusate to which harmful substances have been transferred is exchanged in tens of minutes to several hours. To change the perfusion fluid, reconnect the hose of the bag filled with perfusion fluid. That is, a catheter is inserted into the body, a joint is connected to the catheter, a hose is connected to the joint, and the bag of the perfusate is exchanged.
This peritoneal perfusion has a dwell time of 30 to 60 minutes, 8 times a day.
There are intermittent peritoneal perfusion with １５15 perfusion exchanges and continuous mobile peritoneal perfusion (CAPD) with perfusion exchange about 4 times per day with a fluid time of about 6 hours. The former is mainly applied to patients with acute renal failure, and the latter is applied to patients with chronic renal failure.
In any case, peritoneal perfusion in which the hose is replaced as described above has a disadvantage that the hose is easily contaminated by bacteria when the hose is replaced. For this reason, a very important factor in peritoneal perfusion, especially in CAPD performed for several years, is how to eliminate bacterial infection.

A method for replacing a medical container for preventing bacterial infection is described in Japanese Patent Application Laid-Open No. 1-238871. Method described in this publication, the following steps are <br/> connecting the hose in such a manner closed sterile vessel 1 shown in FIG. Located on the left side of the sterilization container 1,
The book hose, disposing the single hose on the right. Connecting the joint 3 on the edge of the right of the hose. The old hose 2 of the lower left side, the right of the hose joint 3
Connect to Pull out the lower left hose 2 from the joint 3. 'Remove the cap 4 of the new hose 2 in the upper left side' upper left side of the new hose 2 inserted into the joint 3. As described above, the old hose 2 at the lower left is detached from the joint 3, and the new hose 2 ' at the upper left is connected to the joint 3.

[0004]

In this method, if the sterilization container is completely sealed and the inside of the sterilization container can be completely sterilized, bacterial contamination can be prevented. However,
In the case of changing the bag several times to ten and several times a day as in the case of peritoneal perfusion, it is necessary to open the sterilization container and change the hose when changing the hose. When the sterile container is opened, bacteria enter the inside. The bacteria K that has entered the sterilization container adhere to the surface of the joint from which the old hose was removed. The bacteria K attached to the joint 3 migrate as shown by arrows in FIG. 2 and enter the inside.

Furthermore, when pulling out the old hose 2 from the joint 3, as shown in FIG. 3, the bacterial K adhering to the boundary between the tip and the joint 3 of the old hose 2, as shown in FIG. 4, the old hose As 2 is pulled out, it adheres to the surface of joint 3. This condition, for example, a paste-like coating material is applied to the distal end surface of the hose, when pulled out hose, the paint can be easily inferred from adhering to the surface of the joint 3. For this reason, the conventional method cannot effectively prevent the surface of the joint from being contaminated with bacteria when the old hose is pulled out.

The present invention has been developed to solve this drawback. It is a primary object of the present invention, Kyuho
It is an object of the present invention to provide a method of replacing a medical container, which can prevent bacteria from entering from a joint between a hose and a joint when replacing a new hose with a new hose .

[0007]

According to the method for replacing a medical container of the present invention, a hose is replaced in the following manner to achieve the above-mentioned object. That is, replacing the medical container of the present invention, a plurality of hose joint 3 under sterile conditions
This is an improved method of replacing. The method for replacing a medical container according to the present invention is based on the old hose connected to the joint 3.
It was cut in the vicinity of the joint 3 without pulling out the scan 2,
With the piece of the old hose 2 that was cut off and remained at the joint 3
Push the Old hose piece 2a in the proximal direction of the joint 3
Then, the next new hose 2 ' is connected.

[0008]

[Action] How to replace the medical container of the present invention is to replace the hose in the following manner. Old hose connected to joint 3 as shown in FIG.
Part 2 is pressed and closed as shown by arrow A. Old e
In order to close the case 2 , the outside of the flexible old hose 2 is clamped by a clip (not shown), or the old hose 2 is clamped and welded in a heated state. Closed part is joint 3
Near. Without pulling out the old hose 2 from the joint 3,
As shown by a broken line B in FIG. 5, the old hose 2 is cut off at a position slightly away from the mouth of the joint 3, and the old hose 2 is separated from the joint 3. In this state, joint 3
The old hose 2 is covered to prevent bacteria from adhering. The cut old hose piece 2a is moved in the proximal direction, that is,
In push to Komu state before the figure, as shown in FIG. 6, insert the following new hose 2 'in the joint 3. The new hose 2 ′ to be inserted into the joint 3 is closed at the tip and opened immediately before insertion into the joint 3, thereby effectively preventing the invasion of bacteria. Old hose pieces incorporated pushed proximally of the joint 3
2a can be removed from the joint 3 by cutting a part vertically and cutting open.

[0009] Replacing the medical container of the present invention as described above, when replacing the hose, with a hose inserted earlier, to cover the connecting portion of the join preparative preventing bacterial adhesion. For this reason, bacteria can be prevented from adhering to the surface of the joint with the previously connected hose removed from the joint. Therefore, when the hose is replaced, there is a feature that bacteria can be effectively prevented from entering through the joint portion.

[0010]

Embodiments of the present invention will be described below with reference to the drawings. However, the following examples illustrate a method of replacing a medical container for embodying the technical idea of the present invention. The method of replacing a medical container of the present invention The shape, material, structure and arrangement of are not specified below. The method for replacing a medical container of the present invention can be variously modified within the scope of the claims.

Further, in this specification, in order to make it easy to understand the claims, the numbers corresponding to the members shown in the embodiments are referred to as "claims", "actions", and "actions". In the column of "Means for solving the problem". However, the members shown in the claims are
It is by no means specific to the members of the embodiment.

Hereinafter, a method of using the medical container replacement method for peritoneal perfusion will be described. However, the present invention does not specify the use of the medical container replacement method for peritoneal perfusion,
Can be used for all applications where hoses are replaced under sterile conditions.

In peritoneal perfusion, as shown in FIG.
The catheter 5 is inserted into the peritoneal cavity in the body. The rear end of the catheter 5 connecting the hose, connecting the joint 3 to the rear end of the hose. After that, the exchange <br/> conversion of the hose in the following manner. The cross-sectional shape of the joint used at this time is shown in FIG.
11 to FIG . Joint 3 shown in these figures, connecting the hose coupled to the catheters at the left end,
Connecting the hose coupled to back grayed filling the perfusate to the right end. Left of the joint 3 in order to communicate <br/> forming the hose of the catheters, but is slightly smaller outer diameter providing a step. In the vicinity of the right end of the joint 3, in order to effectively clamp the old hose 2 and the new hose 2 ′ with the caulking fitting 7,
Grooves are provided in the circumferential direction. Caulking fitting 7, the spring member obtained by a ring-shaped, connecting the hose to the joint 3 presses the outer periphery of the elastically hose. Further, the right end portion of the Oite joint 3 in the figure indicates a tapered slimming tip for insertion of the hose smoothly. Furthermore, as shown in FIG. 8, the joint 3 comprises a nucleic a portion for inserting a hose coupled to back grayed and cut
The length b of the portion where the old hose piece is advanced is designed to be sufficiently long, for example, b / a is designed to be 1.5 or more. The joint 3 of this structure is made of metal or hard plastic. The old hose 2 and the new hose 2 connected to the joint 3
A flexible material is used for the switch 2 ' . Hoses were <br/> connected to back grayed are joint 3 via a caulking fitting 7
Linked to

Using the joint shown in this figure, the hoses are connected as follows. The joint 3 which is connected to the catheter 5, by connecting the flexibility of the hose, as shown in FIG. 7, for connecting the bag 6 filled with the perfusate to the catheter 5 through the hose. In this state, through the hose and the catheter 5, add perfusate bag 6 intraperitoneally copy. To place the perfusate in the peritoneal cavity, the bag 6 is lifted up as shown in FIG. Toxic substances in the body are transferred to the perfusate placed in the peritoneum via the peritoneum. The peritoneum transfers harmful substances in the body to the perfusate on the principle of membrane parallel. The perfusate placed in the body is adjusted, for example, to a range of 1.5 to 2 liters. After the perfusate dwells in the body for tens of minutes to several hours,
The liquid is discharged into the original bag 6. In order to return the perfusate from the peritoneum to the bag 6, the bag 6 is lowered and allowed to flow naturally.
Note that the bag 6 may be cut off after the perfusate is injected, and another bag may be used at the time of drainage.

[0015] As shown in A of FIG. 9, the portion near the joint 3
The old hose 2 is closed, and the old hose 2 is cut at a portion indicated by B closer to the mouth of the joint 3 at the front end than the closed portion. To close the old hose 2, and pinched the old hose 2 by clips (not shown), or welding the old hose 2 and clamped by heating the outer periphery of the old hose 2. It should be noted that the hose
It is preferable that the front side (the side of the body) of the joint 3 be closed with a clip or the like.

[0016] After cutting the old hose 2, as shown in FIG. 10, to advance the old hose piece 2a which remains in the joint 3, the new hose
Connect the 2 'end . The cut old hose piece 2a can be advanced by inserting a sterilized pipe 8 as shown in FIG. Further, it can be advanced by a new hose 2 ' inserted later. Old moving forward along joint 3
The hose piece 2 a is cut vertically and removed from the joint 3. The new hose 2 ' to be newly connected to the joint 3 is shown in FIG.
As shown in FIG. 1, the tip is closed to prevent bacteria from entering. When inserted into the joint 3, the tip is cut at the position of the wavy line to open. New hose inserted into joint 3
2 ', as shown in FIG. 9, is fastened and fixed to the grooves of the joint 3 in caulking fittings 7. Thus, the new bag 6 is connected to the catheter 5, the perfusate is again put into the peritoneal cavity, and the harmful substances are discharged from the body. Is repeated several times to several tens of times to complete peritoneal perfusion for one day.
Note that the cutting and connecting operations need to be performed in a sterile environment so that bacteria in the air do not enter through the mouth of the joint 3. Therefore, these series of operations are preferably performed, for example, in a sterile box. In this case, it is convenient to perform the operations semi-automatically by mechanical means instead of manually.

[0017]

According to the method for replacing a medical container of the present invention, when replacing a hose, bacteria can be effectively prevented from entering from a joint portion, and the old hose can be kept in a sterilized state.
There is a feature that can be replaced with a new hose . This feature is similar to the traditional method when replacing the hose.
Without pulling out the old hose from the joint, and cut, leaving the tip of the old hose <br/> the joint, the old hose piece which remains disconnected by joint Komu press forward at the next new hose insert This is achieved by: That is, the old hose that is not cut and pulled out of the joint covers the hose connection portion of the joint to prevent it from being contaminated with bacteria. As described above, the method of the present invention in which a part of the old hose previously inserted into the joint is used in combination with the bacteria-inhibiting material does not require the use of a special member, and can effectively prevent bacterial contamination of the joint.

Furthermore, the method of the present invention does not pull out the previously inserted old hose from the joint.
When the old hose is pulled out, bacteria adhering to the tip of the hose and the joint do not adhere to the surface of the joint. Therefore, in a state of connecting the old hose joint, it is attached bacteria between the old hose and the joint,
When moving the old hose piece forward, the bacteria in this part may be moved forward, but do not move to the rear end of the joint and enter the inside of the joint or the new hose . For this reason, the medical container replacement method of the present invention has a feature that bacterial contamination due to this can be effectively prevented. Therefore, the method of the present invention has an advantage that bacterial contamination can be effectively prevented by a very low-cost method without using special parts, and the hose can be replaced in a sterilized state.

[Brief description of the drawings]

FIG. 1 is a plan view showing a conventional medical container replacement method.

FIG. 2 is a sectional view showing a state in which the joint is contaminated with bacteria in the method for replacing a medical container shown in FIG. 1;

FIG. 3 is a sectional view showing a state in which the joint is contaminated with bacteria in the medical container replacement method shown in FIG. 1;

FIG. 4 is a sectional view showing a state in which the joint is contaminated with bacteria in the medical container replacement method shown in FIG. 1;

FIG. 5 is a sectional view showing a method for replacing a medical container according to an embodiment of the present invention.

FIG. 6 is a sectional view showing a method for replacing a medical container according to an embodiment of the present invention.

FIG. 7 is a schematic side view showing a state of peritoneal perfusion.

FIG. 8 is a sectional view showing an example of a joint used in the method for replacing a medical container of the present invention.

FIG. 9 is a sectional view showing a method for replacing a medical container according to an embodiment of the present invention.

FIG. 10 is a sectional view showing a method for replacing a medical container according to an embodiment of the present invention.

FIG. 11 is a sectional view showing a method for replacing a medical container according to an embodiment of the present invention.

[Explanation of symbols]

1 ... Sterile container 2 ... Old hose 2 '... New hose 2a ... Old hose
Piece 3 ... joint 4 ... cap 5 ... catheter 6 ... bag 7 ... caulking fitting 8 ... pipe K ... bacteria

Claims (1)

(57) [Claims] 1. A is connected to the joint (3) of the sterile
Replace old hose (2) with new hose (2 ')
In the container replacement method, the old hose (2) connected to the joint (3) is cut off near the joint (3) without being pulled out, and
It is in Push old hose pieces remaining in the joint (3) (2a) in the proximal direction of the joint (3), then the new hose
A method for exchanging medical containers, wherein (2 ′) is connected.