JP2804518B2 - Dialysis machine control data input device - Google Patents

Description

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a control data input device for a dialysis machine for performing dialysis, and more particularly, to a control data input device for a dialysis patient based on a predetermined target water removal amount and a predetermined dialysis time. The present invention relates to a control data input device for a dialysis device for removing water.

[Prior Art] A conventional dialysis device draws blood from a dialysis patient, removes water containing waste products in the blood by a dialyzer (dialyzer), and returns the dehydrated blood to the dialysis patient. .

The target amount of dialysis is set and input in advance from the operation switch of the dialysis device together with the dialysis time, and the dialysis device supplies a dialysate to a blood circulation pump or a dialyzer to circulate blood so that the input water removal amount is obtained. The flow rate of the liquid pump is variably set by the control unit.

The target water removal amount used as the dialysis setting condition of the dialysis device is generally calculated by the nurse from the measurement result of the weight based on the difference between the weight of the dialysis patient immediately before dialysis and the daily standard weight. As the weight, the standard weight of the dialysis patient, the weight before dialysis on the day of dialysis, and the weight immediately after the previous dialysis are taken into consideration.

The dialysis time is such that the dialysis patient does not cause imbalance syndrome, usually about 5 hours, is determined from the dialysis patient's past dialysis history.

The target water removal amount and the dialysis time determined in this way were transferred to the medical chart as the dialysis setting conditions. When the actual dialysis was performed, the operator looked at this medical record and determined the target water removal amount per unit time. Calculation is performed using a calculator or the like, and the calculation result is set and input to the dialysis machine as dialysis setting conditions (operating conditions).

[Problems to be Solved by the Invention] However, in the conventional apparatus, there is a possibility that an operation error occurs due to manual input of the dialysis setting conditions. In addition, since the dialysis setting conditions are written directly on a chart or the like, there is a possibility that a transfer error to the chart, a reading error from the chart, and a calculation error of the setting condition may occur.

Furthermore, there are few staff members in charge of dialysis even in hospitals that handle large numbers of dialysis patients.
Labor saving was desired in the procedure for creating medical records.

In view of the above, an object of the present invention is to simplify office work in creating dialysis setting conditions, to make the input operation of the apparatus reliable and easy, and to input control data of the dialysis apparatus with few operational errors. It is to provide a device.

[Means for Solving the Problems] In order to achieve such an object, the present invention provides a weight measuring means for measuring the weight of a dialysis patient immediately before dialysis, a standard weight of the dialysis patient at normal time, and Input means for inputting information indicating a suitable dialysis time; and information writing means for writing the measurement information indicating the weight measured by the weight measuring means and the input information input by the input means to the portable storage medium of the dialysis patient. And reading means for reading the information written by the information writing means from the portable storage medium, based on the information indicating the weight immediately before dialysis and the standard weight read by the reading means, Means for calculating a difference between the standard body weight, target water removal amount setting means for setting the target water removal amount based on the difference, and target water removal amount set by the target water removal amount setting means. Operating condition setting means for calculating an amount of water removal per unit time based on the dialysis time read from the band storage medium, and outputting the amount of water removal per unit time as operating condition information to the dialysis unit. It is characterized by.

[Operation] The present invention uses a portable storage medium as a medical record of a dialysis patient and stores setting information unique to the dialysis patient, that is, standard weight and dialysis time, in the portable storage medium in advance by a writing device. deep. Further, the weight immediately before the dialysis set by the weight measuring means is written in the portable storage medium.

At the time of dialysis, from the storage information of the portable storage medium,
The amount of water removed per unit time, which is the operating condition of the dialysis unit, is automatically calculated by the target water removal amount setting means and the operating condition setting means. It is possible to automate, thereby eliminating calculation errors and operation errors by the operator and contributing to labor saving.

[Example] Hereinafter, an example of the present invention will be described in detail with reference to the drawings.

 FIG. 1 shows the basic configuration of the first embodiment of the present invention.

In FIG. 1, reference numeral 1000 denotes weight measuring means for measuring the weight of a dialysis patient immediately before dialysis.

Reference numeral 1001 denotes input means for inputting information indicating a normal weight of the dialysis patient at normal time and dialysis time suitable for the dialysis patient.

An information writing unit 1002 writes the measurement information indicating the weight measured by the weight measurement unit and the input information input by the input unit to the portable storage medium 1003 of the dialysis patient.

A reading unit 1004 reads the information written by the information writing unit from the portable storage medium.

1005 is a target water removal amount setting that sets a target water removal amount by calculating a difference between the body weight immediately before dialysis and the standard weight based on the information indicating the weight immediately before dialysis and the standard weight read by the reading means. Means.

1006 calculates a water removal amount per unit time based on the target water removal amount set by the target water removal amount setting means and the dialysis time read from the portable storage medium, and calculates a water removal amount per unit time. Dialysis unit 10 as operating condition information
This is an operating condition setting means for outputting to 07.

FIG. 2 shows a specific circuit configuration of the dialysis apparatus according to the first embodiment of the present invention.

In FIG. 2, reference numeral 1 denotes an IC used as a portable storage medium.
The following information is stored in the IC card 1 by the writing device 50 in advance.

(1) Setting conditions for dialysis to be performed this time (standard weight at normal time, measured weight before dialysis, dialysis time) (2) Setting conditions for previous dialysis (water removal amount or measured body weight immediately before dialysis, dialysis time, dialysate) (3) Medical record information of dialysis patients (a) Personal information such as name, age, and gender, registered personal identification number of IC card (b) Dialysis history and physical information (dialysis date and time, body weight, blood pressure at that time, Pulse, body temperature, hematocrit, heparin, antibiotic use, blood transfusion), and the physical information includes the physical information measured this time.

(C) Regular equipment information of dialysis patients (device name, dializer name) A dashed line block 10 indicates a dialysis device. Dialysis machine 10
Are the card reader / writer 11, the dialysis unit 100, and the concentration adjustment unit.
101 and an input device 30.

The card reader / writer 11 writes and reads information to and from an IC card as writing means and reading means.

The input device 30 operates as a control unit of the dialysis device 10. The operation control of the dialysis unit 100 and the concentration adjustment unit 101 and the operation control of reading and writing information from and to the IC card 1 are performed.

 Next, the circuit configuration of the input device 30 will be described.

Input / output interfaces 12, 19, which constitute the input device 30,
Central processing unit (CPU) 13 Read-on-memory (ROM) 1
4, a random access memory (RAM) 15, a printing device 16, a command key 17, a display device 18, and a timer 21 are connected to a common bus.

The input / output interface 12 is connected to the card reader / writer 11 and transfers write information and read information.

The CPU 13 operating as the target water removal amount setting means and the operating condition setting means performs the following control processing according to an operation instruction from the command key 17.

(1) The current and previous dialysis setting conditions and chart information are read from the IC card 1 received immediately before dialysis, and RAM1 is read.
Store temporarily in 5.

(2) The current and previous dialysis setting conditions and chart information stored in the RAM 15 are displayed. Output to the display device 18 or the printing device 16.

(3) Physical information in the chart information is displayed in time series (trend progress diagram) for each type.

(4) Prior to the start of the operation of the dialysis unit 100 and the concentration adjusting unit 101, the difference between the current time and the previous time is obtained for each of the information stored in the RAM 15 and the dialysis time, and the difference is used as a corresponding specified value (threshold value). If it is larger than the above, a warning message to that effect is displayed on the display device 18 or a warning sound is generated.

(5) Based on the stored information stored in the RAM 15, the amount of water removed per unit time is calculated, and the dialysis unit 100 and the concentration adjusting unit 101 are calculated.
, For example, the flow rate of the pump is set. Here, the amount of water removal per unit time is obtained as follows.

Target water removal amount = body weight immediately before dialysis-standard body weight Water removal amount per unit time = target water removal amount / dialysis time (6) The above set values and dialysis unit 100 and concentration adjustment unit 101
Based on the measurement signals sent from the various detectors, the operation of the dialysis unit 100 and the concentration adjustment unit 101 is controlled as in the conventional example. In addition, the measurement result of the detector is displayed on the display device 18 to notify the operator of the dialysis status.

(7) During the execution of dialysis, the amount of water removed during the predetermined time period measured by the timer 21 is calculated, and when the calculation result reaches the set target amount of water removal, the dialysis unit 10 is operated.
The operation of 0 and the density adjustment unit 101 is stopped.

(8) This dialysis history information (date of dialysis execution,
Dialysis equipment name, operator name, etc.).

The RAM 14 stores in advance a control program for executing the above control processing.

 The RAM 15 temporarily stores input / output information for the CPU 13.

The input / output interface 19 is connected to the dialysis unit 100 and the concentration adjustment unit 101, and sends an operation instruction signal from the CPU 1 to the dialysis unit 100.
Then, it is transferred to the density adjusting unit 101.

The writing device 50 mainly includes a card reader / writer 11 as a writing means, an input / output interface 12, a CPU 13, a command key 17, a display device 18, and a weight scale, and information input from the command key 17 and input from the weight scale. The measured information is written to the IC card 1 via the card reader / writer 11. The writing device 50 is arranged at a measurement place for the blood pressure, pulse, weight, etc. of the dialysis patient.

FIG. 3 shows a dialysis unit 100 and a concentration adjusting unit 101 shown in FIG.
Of each solution supply system and its control system.

 First, the dialysis unit 100 will be described.

A blood pump 61 for circulating blood is provided in a blood line 61 for transferring blood drawn from a dialysis patient for dialysis.
A dialyzer 53 for dialyzing blood with a dialysate is provided.

In addition, a heparin solution line 66 and a blood transfusion line 67 are branched and connected to the blood line 61, respectively.
The heparin solution and transfusion are transferred to the blood line
It is possible to supply to.

The dialyzer 53 supplies a dialysate to the dialyser line 62.
And a drainage line 66 for draining the water removed from the blood.

The dialysate is supplied to the digitizer 53 by moving the partition 56-1 of the dialysate pump 56. The water removal liquid taken out by the dializer 53 is discharged by the dialysate pump 56 or the water removal pump 55.

 Next, the density adjusting unit 101 will be described.

A water supply line 63 and a sodium hydrogen carbonate solution line 64 are connected to the mixing tank, and the sodium hydrogen carbonate solution whose concentration has been adjusted in the mixing tank 58 is supplied to the mixing tank 57.

The mixing tank 57 is connected to a line 65 for supplying a sodium chloride or potassium chloride solution. In the mixing tank 57,
A dialysate is prepared, and the dialysate is supplied to a dialysate pump 56.

Next, a control system of the dialysis unit 100 and the concentration adjusting unit 101 will be described.

The controller 70 is connected to the input / output interface 19 of the input device 30 shown in FIG. 2, receives the operation instruction signal transmitted from the CPU 13 of the input device 30, and removes water so that the flow rate is instructed by the operation instruction signal. A drive signal is transmitted to the pump 55 and the supply pumps 59 and 60.

The concentration controller 71 is connected to the input / output interface 19, receives the operation instruction signal transmitted from the CPU 13, and variably sets the flow rates of the supply pumps 59 and 60 so as to have the concentration indicated by the operation instruction signal.

Furthermore, the concentration detectors 61 and 62 are
9, the density detection signals of the density detectors 61 and 62 are transmitted to the CPU 13 of the input device 30 via the input / output interface 19.

The operation of the dialysis apparatus having such a configuration will be described with reference to the flowcharts of FIGS. 4 (A) and 4 (B).

In FIG. 2, a writing device 50 command key is applied to the individually assigned IC card 1 of a dialysis patient prior to dialysis.
When dialysis time information, standard weight information, and chart information are input from 17, the CPU 13 of the writing device 50 sends the above information to each of the pre-allocated areas of the free area of the IC card 1 (see FIG. 5) by using the card reader / writer 11. (Steps S1 → S6 → S7 → S3 → S5 in FIG. 4 (A)). When the measured weight is input from the weighing scale 22, an instruction to that effect is given from the command key 17, and then the measurement result of the weighing scale 22 is written to the IC card 1 via the input / output interface 19 (see FIG. ) Steps S1 → S2 → S3 → S5).

If there is no empty area in the IC card 1, the oldest data in the area is erased to create an empty area, and new input information is written in this empty area (step S2 in FIG. 4A). S3 → S4).

When dialysis is performed, the IC card 1 is inserted into the card reader / writer 11 of the input device 30, and when a personal identification number assigned to each dialysis patient is input from the command key 17, the CPU 13
Then, the registered PIN code stored in the IC card 1 in advance,
The collation with the password input from the command key 17 is performed. Based on the collation result, the authenticity of the IC card 1 and the dialysis patient are confirmed (step S1 in FIG. 4 (B)).

When the CPU 13 determines that the IC card 1 is true, the stored information, that is, the current and previous dialysis setting conditions and chart information are read from the IC card 1 by the card reader / writer 11 (see FIG. 4B). Step S10 → S1
2) The above information is stored in the RAM 15 via the input / output interface 12. The stored information is also displayed on the display device 18 (step S13 in FIG. 4B).

Next, when an instruction to start dialysis is input from the command key 17 by the operator, the current target water removal amount and the previous target water removal amount are calculated from the standard body weight and the previous and current body weight before dialysis. Subsequently, the CPU 13 compares the previous dialysis setting conditions (target water removal amount, dialysis time) with the current dialysis setting conditions. When the current dialysis setting condition is significantly different from the previous dialysis setting condition, that is, when at least one of the dialysis time difference value and the water removal amount difference value is, for example, 20% or more of the current or previous condition value. Generates a warning buzzer and displays a warning message on the display 18 (steps S21 → S22 → S31 in FIG. 4 (B)).

When the current dialysis condition is equal to or less than the threshold value, the water removal amount per unit time is calculated based on the current target water removal amount and the dialysis time stored and stored in the RAM 15. Based on this calculation result, the flow rate of the water removal pump 55 is set by the CPU 13 (steps S24S → S25 in FIG. 4 (B)).

These set values are used together with the drive start command together with the corresponding controllers 70 and 71 (third control unit) in the dialysis unit 100 and the concentration adjustment unit 101.
(See step S2 in FIG. 4 (B)).
Five). The dialysis unit 100 and the concentration adjustment unit 101 start dialysis of blood based on an instruction signal from the CPU 13. During the execution of dialysis, the CPU 13 calculates the amount of water removal to be executed at predetermined time intervals, receives the measurement results of the concentration detectors 61 and 62, displays the result on the display device 18 together with the amount of water removal, and dialys the operator. The situation is notified (step S26).

On the other hand, the dialysis unit 100 and the concentration adjusting unit 101 (see FIG. 3)
In, the flow rates of the supply pumps 59 and 60 are variably set to the concentration specified by the IC card 1, and a dialysate suitable for a dialysis patient is produced in the mixing tank 58 via the mixing tank 57. The dialysate thus produced is supplied to the dialyzer 53 by the dialysate pump 56.

On the other hand, blood drawn from a dialysis patient is supplied to a dialyzer 53 by a blood pump 52. The dialyzer 53 dialyzes the blood, and discharges the dialyzed fluid including the dewatered water to the outside by the dewatering pump 55 and the dialysate pump 56.

In this example, based on the dialysis performance of the dialyzer 53, the CPU 13 calculates a water removal amount executed at regular intervals, and stops the apparatus when the target water removal amount is reached. The dialysis performance of the dializer 53 is preferably stored in the RAM 14. When the CPU 13 detects that the target water removal amount instructed by the IC card 1 has been reached, the operation stop instruction signal is sent from the CPU 13 to the controller 7.
0, transmitted to the density controller 71. Controller 70
The concentration controller 71 stops the operation of the controlled device, and the controller 70 turns on the display lamp 67 to notify the operator of the end of the dialysis.

Returning to FIG. 2, the name of the instrument and date information executed for the current dialysis in response to the end of the dialysis are used as the dialysis history information as CP.
The data is written to the IC card 1 in response to the instruction U (step S28 in FIG. 4B). Thereafter, the operation of the entire dialysis device 10 ends.

As described above, in the first embodiment, the IC card 1 is used as a medical record, and the dialysis setting conditions and the medical record information, as well as the measurement results of the weight scale are input and displayed directly from the IC card 1 to the dialysis apparatus 10. As a result, there is no operation error due to manual input or information reading error from the medical record as in the conventional device. Further, since the information stored in the IC card 1 may be written at a time convenient for the operator before performing the dialysis, the operation labor of the operator immediately before the dialysis is greatly reduced.

Next, a third embodiment will be described with reference to FIG.

In the above-described first embodiment, an input device is used as an input device of the control unit of the entire dialysis device and the dialysis device 100 and the concentration adjusting unit 101.
Although the example using 30 has been described, the third practical example uses the dialysis unit 100 and the concentration adjustment unit using the control unit and the input device using a portable information processing device separate from the dialysis unit 100 and the concentration adjustment unit 101. This is an example of use as an input device for the unit 101.

FIG. 6 shows a circuit configuration of an information processing apparatus according to a third embodiment of the present invention.

In FIG. 6, the same portions as those shown in FIG. 2 are denoted by the same reference numerals, and detailed description thereof will be omitted.

In FIG. 6, a card reader / writer 2, a command key 17, a display device 18, an input / output interface 19, a microcomputer 32, a weight scale 22, and a sphygmomanometer 23 are connected to a common bus. Microcomputer 32 is CPU13, ROM14, RAM1
5 is integrated into one chip, and performs the same processing as the processing of the CPU 13 of the first embodiment.

As the display device 18, a small display such as a liquid crystal display or a plasma display is used. If a transparent touch panel is used as the command key 17 and provided on the display screen of the display device 18, the size of the device can be further reduced.

Such a portable information processing device 80 is carried by a person such as a nurse when performing periodic patrols for dialysis patients admitted to a hospital. When physical information such as blood pressure, pulse, and body temperature of a dialysis patient is measured, the measured value of the physical information is immediately input to the portable information processing device 80 at the measurement location, and the IC card is read via the card reader / writer 2. 1 is stored.

In addition, by displaying the measured values stored so far in the IC card 1 on the display device 18 in time series for each type, it is possible to grasp the health information of the patient.

Further, when the input / output interface 19 of the portable information processing device 80 is connected to the dialysis unit 100 and the concentration adjusting unit 101 (see FIG. 3), it also functions as an input device of the dialysis device. As described above, when a portable information processing device is used, this device is used as a control unit for the entire dialysis device 10 and an IC card 1.
It also functions as a writing device for the dialysis device and an input device for the dialysis device 10, respectively.

Further, since the information stored in the IC card 1 is displayed on the display device 18 and can be corrected, the operator notices an input error and correct information is stored in the IC card 1.

In addition, the IC card 1 is better than a chart in the form of a recording paper.
Because of the excellent preservation and confidentiality of the information, there is an advantage that the privacy of the dialysis patient is protected.

 In addition to the embodiment described above, the following example is given.

(1) As a portable storage medium, in addition to an IC card, a magnetic card and a static RA backed up by a battery
A memory card using M, a memory card using electrically erasable EEPROM, and an optical disk card can be used. In particular, cards using static RAM or optical disks can store large amounts of information,
It is suitable for storing patient's medical record information.

(2) In the first embodiment, an example in which the dialysis unit 100 and the concentration adjustment unit 101 are automatically controlled has been described. Needless to say, the above control may be performed.

(3) In the first embodiment, the dialysis history information is stored only in the IC card 1. However, a disk storage device is connected to the input device 30, and the above-described history information is stored in a disk or the like.
If the information is stored as a backup for the card 1, the preservation of information is enhanced.

(4) In this embodiment, the water removal amount per unit time is determined,
An example of removing water at a constant water removal rate has been described.
It can be variably set by the instruction of 3. In this case, the amount of water removal per unit time indicated every time the time elapses as shown in FIG. 7 is stored in advance in the ROM 14 in the form of a table in accordance with the magnitude of the total amount of water removal. Next, a table corresponding to the target water removal amount read from the IC card 1 is selectively extracted, and thereafter, the water removal amount per unit time is variably set by the CPU 13 over time according to this table. Alternatively, dialysis performed at a constant water removal rate as described above and dialysis performed to variably set the water removal rate may be switched and set.
Instruct and enter the type of dialysis from 17.

(5) In the present embodiment, the IC card 1 is assigned to each dialysis patient, but data of a plurality of dialysis patients is assigned to one IC card 1.
May be stored.

[Effects of the Invention] As described above, in the present invention, in addition to the automatic writing of the measured weight to the portable storage medium, calculation of the target water removal amount from the measured weight and the standard weight is conventionally performed by humans. Is performed automatically, so that labor saving of the operator is achieved. Further, since the operation conditions are automatically input to the dialysis machine from the information stored in the portable storage medium, not only is there no mistake in the input of the machine during the execution of the dialysis, but also the time for inputting the information to the dialysis machine is greatly reduced. This has the effect of being shortened.

[Brief description of the drawings]

FIG. 1 is a block diagram showing a basic configuration of the first embodiment of the present invention, FIG. 2 is a block diagram showing a concrete circuit configuration of the first embodiment of the present invention, and FIG. 3 is a first embodiment of the present invention. FIG. 4 (A) is a block diagram showing a control procedure executed by the CPU 13 of the writing device 50 shown in FIG. 2, and FIG. 4 (B) is a block diagram showing a control procedure thereof. 5 is a flowchart showing control means executed by the CPU 13 of the input device 30, FIG. 5 is a memory map showing a memory configuration of the IC card 1 of the first embodiment of the present invention, and FIG. 6 is information processing of a second embodiment of the present invention. FIG. 7 is a block diagram showing a circuit configuration of the apparatus 80. FIG. 7 is an explanatory diagram showing time characteristics of dialysis conditions according to the third embodiment of the present invention. 1 ... IC card, 10 ... Dialysis machine, 11 ... Card reader / writer, 12,19 ... I / O interface, 13 ... CPU, 53 ... Dializer.

Claims (1)

(57) [Claims] A weight measuring means for measuring a weight of the dialysis patient immediately before dialysis; an input means for inputting information indicating a normal weight of the dialysis patient in a normal state and a dialysis time suitable for the dialysis patient; An information writing unit that writes the measurement information indicating the weight measured by the measurement unit and the input information input by the input unit to a portable storage medium, and the information written by the information writing unit is stored in the portable storage medium. Reading means for reading from the storage medium for reading, based on information indicating the weight immediately before dialysis and the standard weight read by the reading means, means for calculating a difference between the weight immediately before dialysis and the standard weight, Target water removal amount setting means for setting the target water removal amount according to the following: the target water removal amount set by the target water removal amount setting means; and reading from the portable storage medium. Operating condition setting means for calculating a water removal amount per unit time based on the dialysis time thus determined, and outputting the water removal amount per unit time to the dialysis unit as operating condition information. Control data input device.