JP3039865B1 - Artificial kidney and puncture guide used for it - Google Patents

Abstract

An artificial kidney that does not require a large amount of dialysate or replenisher and that can purify blood even at home or a travel destination. An extracorporeal circulatory system connected to a circulatory system (3)
A filter (6) for filtering blood extracted from the body to remove water containing waste matter as raw urine, and distilling the raw urine to recover distilled water and filtering the raw urine concentrated with waste matter. A distilling device (7) for discharging, and a purified blood mixer for diluting the concentrated replenisher with the distilled water to a predetermined concentration, and further mixing with the blood from which the original urine has been removed by the filtering device (6) and returning it to the body. (10) is provided. The concentrated replenisher is diluted with distilled water obtained by distilling the raw urine, so there is no need to replenish a large amount of dialysate. Blood can be purified.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

TECHNICAL FIELD The present invention relates to an artificial kidney capable of purifying blood at home or a travel destination, etc., without the need for a patient with renal failure to visit a hospital and to place a considerable burden on their lives.
It relates to a puncture guide used for it.

[0002]

BACKGROUND OF THE INVENTION Patients with renal insufficiency
It is expected to reach one million worldwide and 200,000 in Japan alone. At present, continuous ambulatory peritoneal dialysis, abbreviated as CAPD, which performs dialysis using the peritoneum, kidney transplantation, artificial dialysis and the like are known as the treatment methods. But,
CAPD has a high risk of causing unfavorable complications such as sclerosing peritonitis due to bacteria entering the peritoneal cavity from the tube thread. In addition, kidney transplantation is also becoming more widespread among kidney transplants, with the kidney bank system becoming more widespread.
The number of registered providers is far below the number of patients in demand. For this reason, at present, treatment of most patients with renal failure has to rely on artificial dialysis.

[0003] In artificial dialysis, blood is extracted from the artery via a tube, and the blood is guided to a dialyzer called a dialyzer to purify the blood, and the purified blood is returned to the body. The dialyzer is provided with a dialysis membrane formed of a hollow fiber or a flat membrane inside the dialyzer. When blood flows, waste matter in the blood permeates through the dialysis membrane and diffuses into the dialysate flowing outside. The dialysate is discarded, the components of the cleaned blood are adjusted, and the blood is returned to the vein side again.

[0004]

In this case, two bloods are supplied.
Although it is supplied to the artificial kidney at a rate of 00 cc / min, it still takes about 5 to 6 hours to purify the blood of the whole body. Moreover, since the dialysis must be performed three times a week, that is, about once every two days, the time constraint due to the dialysis is a considerable burden on the patient's life and greatly restricts the social activities of the patient. .

[0005] For this reason, artificial kidneys that can be dialyzed at home or the like have been proposed. However, in artificial dialysis, in order to constantly exchange dirty dialysate in the dialyzer with a new solution, 150 times of dialysis is performed.
As large as ~ 200 liters of dialysate is required, the artificial kidney becomes large. Also, while on dialysis, of course, the patient cannot leave the bed.

[0006] On the other hand, a healthy person filters about 180 liters of blood through the glomeruli of the kidney within 24 hours.
２2% are excreted outside the body and the remaining 98-99% are reabsorbed. This is 125 cc /
min and the extracorporeal discharge is 2 cc / min.

Here, the blood is guided to a filter, and water containing waste matter is taken out at 2 cc / min and excreted. The blood from which waste matter has been removed is mixed with 2 cc / min of a fresh replenisher and returned to the body. For example, the extracorporeal discharge is the same level as a healthy person, and 2 cc is purified per minute. However, since the blood of a dialysis patient contains a large amount of urea and other waste products, it is at least 10 times as large. Removal is required.

In order to satisfy this requirement, 20 cc / mi
n should be obtained, it is sufficient to excrete 20 cc / min of water (raw urine) containing waste products obtained by filtering blood and replace it with 20 cc / min of fresh replenisher.
It is also possible to reduce the size of such a filter to a portable size. However, this method requires 1.2 liters of fresh replenisher in one hour and about 30 liters in 24 hours, and uses too much replenisher. Since it cannot be carried around, it is not only applicable to portable artificial kidneys, but it is still inconvenient to handle it at home.

In the case of purifying blood using an artificial kidney, an arterial needle and a venous needle are punctured into a blood nodule formed on the arm, so that the blood flows into the extracorporeal circulation system to purify the blood. I try to make it return to the body again. And when purifying blood at home, etc., there is no dedicated staff, so it is necessary to puncture each needle by yourself. But it is necessary to be able to puncture at a certain level.

Therefore, the present invention firstly provides an artificial kidney which can purify blood even at home or a travel destination without requiring a large amount of dialysate or replenisher, and secondly, uses such an artificial kidney. It is an object of the present invention to provide a puncture guide that allows anyone to easily pierce a needle into a blood clot formed in an arm.

[0011]

Means for Solving the Problems In order to solve the first problem, an artificial kidney according to the present invention provides an extracorporeal circulatory system connected to the internal circulatory system by filtering blood extracted from the body and aging. A filter that removes water containing substances as raw urine, a distiller that distills the raw urine to collect distilled water and discharges raw urine in which waste products are concentrated, and a concentrated replenisher that is concentrated with the distilled water. And a purified blood mixer that mixes with the blood from which the original urine has been removed by the filter and returns the mixed blood to the body.

According to the artificial kidney of the present invention, blood of about 125 cc / min is extracted from the body and filtered with a filter, and water (raw urine) containing waste matter is reduced to 30 cc / min.
Is removed as a filtrate. Then, without discharging the filtrate as it is, by distilling with a still,
28 cc / min of distilled water is recovered, and 2 cc / min of raw urine in which waste products are concentrated is discharged. And 28cc / min
Of purified replenisher of about 1 cc / min diluted with distilled water and 95 cc / min of blood from which raw urine has been removed by a filter, and purified blood of about 124 cc / min is returned to the body.

As described above, since distilled water obtained by distilling raw urine is reused and the concentrated replenisher is diluted with the distilled water, blood can be purified with a slight concentrated replenisher. It is. At this time, if a commercially available dialysis stock solution that is 35 times concentrated is used as the concentrated replenisher, the required amount of the dialysis stock solution is 28
/ 35 = approximately 0.8 cc / min. Even if it is assumed that the artificial kidney is portable and purifies blood for 24 hours continuously,
Since 28 × 60 × 24/35 = 1152 cc, it is sufficient to replace a bag containing 300 cc, for example, every 5 to 6 hours. As a result, the blood filtration volume in the body is 28 cc / mi.
n, which is about 2 of 125 cc / min.
It is possible to maintain 5% of renal function, which is considered to be at the same level as the renal function of a patient undergoing dialysis at a dialysis center attached to a university hospital or the like.

Further, in order to solve the second problem, the puncture guide according to the present invention described in claims 7 to 12 of the present application is:
A puncture guide for puncturing one or two blood clots formed in a vein running under the arm, with an arterial needle for extracting blood from the body and a venous needle for returning purified blood to the body, An arterial guide hole that guides the arterial needle obliquely downward from the shoulder side to the wrist side with respect to the blood clot through the holder attached to the arm so as to cover the aneurysm; A vein-side guide hole for guiding the side needle obliquely downward from the wrist side toward the shoulder side with respect to the blood swelling portion is formed.

According to the puncture guide according to the present invention, when the holder is attached to the arm and the arterial needle and the venous needle are inserted into the respective guide holes, the arterial needle is moved relative to the blood swelling portion from the shoulder side. The venous needle is guided obliquely downward toward the wrist and punctured, and the venous needle is punctured while guided obliquely downward from the wrist toward the shoulder with respect to the blood clot. When piercing or unplugging each needle, each needle is guided only in the longitudinal direction by the guide hole, so that anyone can easily puncture under substantially the same conditions without lateral deflection of the needle.

[0016]

Embodiments of the present invention will be specifically described below with reference to the drawings. FIG. 1 is a fluid circuit diagram showing an example of an artificial kidney according to the present invention, FIG. 2 is a diagram showing a state of use thereof, FIG. 3 is an exploded view showing a puncture guide used therein, and FIG. FIG. 5 is an explanatory view showing the use state, FIG. 6 is an exploded view showing another embodiment of the puncture guide, FIG. 7 is a plan view thereof, FIG.
FIG. 9 is a sectional view taken along the line AA of FIG. 7, FIG. 9 is a sectional view taken along the line BB of FIG. 7, FIG. 10 is an exploded view showing still another embodiment of the puncture guide, FIG. Is a plan view thereof.

The artificial kidney 1 of this embodiment is a portable type which is used by being worn on the body, and is a body unit 2 which can be worn on the body.
In addition, an extracorporeal circulation system 3 for purifying blood and returning it to the body again is formed. The body unit 2 may be one in which a frame forming the extracorporeal circulation system 3 is attached to the body with a belt or the like, or one in which the extracorporeal circulation system 3 is formed in a durable cloth or leather jacket. Is also good. The extracorporeal circulation system 3
A blood inflow tube 5 in with an arterial needle 4 in for extracting blood from the body attached to the tip is connected to a filter 6 for filtering blood to take out water containing waste matter as raw urine.

The filter 6 has a raw urine outlet 6a for taking out the raw urine which has passed through the filtration membrane 6F, and a blood outlet for flowing out the blood from which the raw urine has been removed which contains a large amount of blood cell components which do not pass through the filtration membrane 6F. 6b, the raw urine outlet 6a is connected to the still 7 and the blood outlet 6b is connected to the mixing chamber 12a of the purified blood mixer 10 described later.

The evaporator 7 includes a heating chamber 7A for evaporating water by heating the raw urine supplied from the filter 6, and a condenser 7B for condensing the evaporated water and cooling it to a predetermined temperature. Distilled water storage chamber 7 for storing recovered distilled water
C. The heating chamber 7A and the condenser 7B are covered with a heat insulating material in order to improve thermal efficiency. The heating chamber 7A is provided with a condenser 7B so that the internal cold air is discharged to prevent the internal heat from leaking out. It does not leak.

The heating chamber 7A is connected to an excretion bag 9 via a metering pump 8 for discharging raw urine in which waste products are concentrated at a predetermined flow rate (for example, 2 to 4 cc / min). Is connected to the purified blood mixer 10.

The purified blood mixer 10 is provided with a blood outlet 6b of the filter 6 and a distilled water storage chamber 7C in a mixing chamber 12a of a quantitative bellows pump (pressure pump) 12 operated by a compressor 11. A dialysis stock solution bag 13 containing a 35-fold concentrated commercially available dialysis stock solution serving as a concentrated replenisher is connected, and the venous needle 4
out is attached to the tip of blood return tube 5out.

The dialysis stock solution supplied from the dialysis stock bag 13 to the mixing chamber 12a is
Diluted 35 times with distilled water supplied from the distilled water storage chamber 7C, mixed with blood supplied from the blood outlet 6b of the filter 6, and returned to the body through the blood return tube 5out. It is made as follows.

The blood inflow tube 5in and the blood recirculation tube 5out are provided with a blood flow monitor 15 having an impeller which is rotated by the blood flow. The blood inflow tube 5in is formed with an inlet (not shown) connected to a cylinder pump or the like for automatically injecting a blood coagulation inhibitor such as heparin, and the blood return tube 5out is provided with a medicament of the blood coagulation inhibitor. An injection port (not shown) is formed which is connected to a syringe pump or the like for automatically injecting a drug such as protamine for reversing the blood coagulation action by canceling the blood pressure. Further, a blood outlet (not shown) for supplying blood to a biochemical monitor for analyzing components of blood is formed at a blood outlet 6b of the filter 6.

The filter 6 filters the blood of 80 to 150 cc / min extracted from the body, and filters the blood of 20 to 40 cc / min.
The evaporator 7 has a capacity to discharge raw urine of c / min. The distiller 7 distills raw urine to recover distilled water of 18 to 36 cc / min, and 2 to 4 cc / min of raw urine in which waste products are concentrated. Have the ability to discharge.

Although illustration is omitted, the decoration unit 2 includes:
A controller for controlling each of the pumps 8 and 12 and the distiller 7 and a necessary battery are mounted, and a flow control valve, a check valve, and the like are mounted on each channel as needed.

The artery-side needle 4in and the venous-side needle 4out are connected to the puncture guide 20 shown in FIGS. 3 to 5 to form a blood clot called AVF formed on the upstream and downstream of the vein V running under the arm. Puncture 21A and 21B.

The puncture guide 20 is formed at a center of the holder 24 with a ring-shaped holder 24 mounted, for example, inside a forearm 23 by a belt 22 using a planar fastener such as a magic tape (trade name). 25 through holes
And a pressure screw (hemostatic body) 26 which is inserted into the skin and closely adheres to the skin so as to cover the two blood clots 21A and 21B, and a tightening screw 27 which presses the pressure contact 26 against the skin.

The press contact 26 has a pair of keys 28, 28 formed in the diameter direction thereof, and is adapted to engage with key grooves 29, 29 or 30, 30 formed in the through hole 25 of the holder 24. . These key grooves 29, 30 have different depths, and one of the key grooves 29, 29 is inserted with the keys 28, 28 of the press contact 26 to tighten the tightening screw 27, as shown in FIG. When tightened, it is formed to a depth such that its lower end surface stops at a position corresponding to the lower end surface of the holder 24.
When the key 28 of the press contact 26 is inserted and the tightening screw 27 is tightened as shown in FIG. It is formed to a depth that stops at a more protruding position.

Further, the keys 28, 28 of the press contactor 26 are provided on the holder 24 and the press contact 26 with one keyway 29,
A thin tubular arterial guide hole 31in for guiding the arterial needle 4in and a thin tubular vein for guiding the venous needle 4out so as to penetrate the arterial needle 4in so as to penetrate them while being engaged with the screw 29. A side guide hole 31out is formed.

The artery-side guide hole 31in is formed so as to guide the artery-side needle 4in obliquely downward from the shoulder side to the wrist side with respect to the upstream blood clot 21A. The venous needle 4out is formed so as to be guided obliquely downward from the wrist to the shoulder with respect to the blood clot 21B on the downstream side in a direction opposite to the arterial guide hole 31in.

At the entrances of the guide holes 31in and 31out, the needles 4in and 4out are connected with the blood swelling portions 21A and 21B.
A stopper 32 is attached to the holder 24 for fixing the blood flow monitor 15 attached to the rear end side of the needles 4in and 4out when the needle is punctured. The stopper 32 is formed of a transparent plate or the like so that the rotation of the impeller of the blood flow monitor 15 can be seen. Each needle 4i
n, 4out is a blood swelling 21
The blood flow monitor 15 is selected to have a length in which the blood flow monitor 15 comes into contact with the holder 24 when the blood flow monitor 15 reaches the inside of A, 21B.

Further, the needles 4in and 4out are pulled out, and the keys 28 and 28 of the press contact 26 are connected to the other key grooves 30 and 3 respectively.
When the tightening screw 27 is tightened by engaging with the pin 0, the lower end surface of the press contact 26 projects downward from the lower end surface of the holder 24 and strongly presses the skin. It is suppressed and bleeding is stopped.

The press contact 26 has a lower end surface coated with transparent silicon rubber or the like, and a replaceable sponge 33 is disposed at the center thereof. Further, a drug supply channel 34 for supplying an antiseptic solution, an anti-pain agent or a hemostatic agent from the surface side of the holder 24 to permeate the skin is formed in the sponge 33.

By using the puncture guide 20, the needles 4in and 4out are guided in the longitudinal direction along the guide holes 31in and 31out when the needles 4in and 4out are pierced and pulled out, so that the needles do not swing. No matter who punctures, puncturing can be easily performed under substantially the same conditions. Further, since the needles 4in and 4out are fixed in a state of being pierced into the arm, the needles 4in and 4out do not come off even if they move slightly. Therefore, even when a thick needle of 16 gauge or less is used, the blood clot portions 21A and 21B, which have been used for a relatively short time, can be used for a long period of time.

The above is one configuration example of the present invention, and its operation will be described below. First, the body unit 2 is attached to the body, the puncture guide 20 is fixed to the arm, and the arterial needle 4in and the venous needle 4out are punctured into the upstream and downstream blood swelling portions 21A and 21B, respectively. The extracorporeal circulatory system 3 is connected to a blood vessel via a blood inflow tube 5in and a blood return tube 5out. In this case, the arterial needle 4in and the venous needle 4out are connected to the guide holes 31i.
Since the needles 4in and 4out are guided only in the longitudinal direction by n and 31out, any one of the needles 4in and 4out can easily puncture under substantially the same conditions without lateral swing.

The filter 6 passes through the arterial needle 4in and the blood inflow tube 5in from the upstream blood flow portion 21A.
Is supplied, for example, at 125 cc / min. In the filter 6, the blood is filtered, passed through the filtration membrane 6F, and 30 cc / min of water containing waste products is sent as raw urine from the raw urine outlet 6a to the distilling device 7, and the remaining 95 cc / min.
The blood containing the blood cell component is supplied to the bellows pump 12 from the blood outlet 6b.

In the still 7, the raw urine supplied from the filter 6 is distilled, for example, distilled water of 28 cc / min is recovered, and 2 cc / min of the raw urine in which waste products are concentrated is supplied by the metering pump 8. It is quantitatively discharged to the excretion bag 9. Then, 2 supplied to the bellows pump 12 of the purified blood mixer 10
The 0.8 cc / min undiluted dialysis solution supplied from the undiluted dialysis bag 13 is diluted 35-fold with 8 cc / min of distilled water.
About 124cc / mi when safely mixed with c / min blood
The purified blood is returned to the body through the blood return tube 5out.

That is, if the artificial kidney 1 of this example is used,
In the blood in the body, water containing waste products is purified at a rate of 30 cc / min. As a result, the blood filtration rate becomes 2
8 cc / min, the filtration rate of a healthy person is 125 cc / min.
The renal function of about 25% of min can be maintained, which is considered to be the same level as the renal function of a patient who is undergoing dialysis at a dialysis center attached to a university hospital or the like.

The dialysis stock solution to be supplied is 0.8 cc / mi
Since it is n, blood filtration for 24 hours is at most 1.2 liters. Therefore, if the dialysis stock solution bag 13 containing 300 cc is replaced every 5 to 6 hours, the dialysis stock solution can be replenished. The raw urine in which wastes are concentrated in the still 7 is placed in the excrement bag 9 at 2 cc / mi.
It is discharged at a discharge amount of n, and is stored in an amount of 120 cc in one hour.

When the blood purification is completed,
Withdraw the needles 4in and 4out, remove the fastening screw 27 of the holder 24, change the direction of the press contact 26, and again
When the tightening screw 27 is tightened, the lower end surface of the press contact 26 projects downward from the lower end surface of the holder 24 to strongly press the skin,
In addition, since the direction is different from that when the needles 4in and 4out are pierced, the puncture mark can be pressed at a portion where the guide holes 31in and 31out are not formed.

Thus, even when a thick needle is used, it is possible to effectively stop bleeding. Further, if a hemostatic agent is supplied from the medicine supply channel 34 as needed, the hemostatic agent seeps out of the sponge 33 to the skin, so that the hemostatic effect is enhanced.

The concentrated replenisher is not limited to a commercially available undiluted dialysis solution, but may be any solution obtained by concentrating a solution having a composition close to a serum component to a predetermined concentration.

Although the portable artificial kidney 1 in which the extracorporeal circulation system 3 is formed in the body unit 2 has been described, a stationary artificial kidney in which the extracorporeal circulation system is formed in a bedside console type fixed unit is sufficient. Applicable. Also in this case, since the raw urine is distilled, it is enough to supply about 1.2 liters of dialysis stock per day.
Since there is no need to use liters of dialysate or a large amount of replenisher, it is possible to reduce the size of the device without having to manage dialysate and replenisher, and to purify blood at homes or travel destinations without dedicated staff. can do. Furthermore, when applied to a stationary artificial kidney, a higher purification ability can be obtained as compared with a portable artificial kidney.For example, it is possible to purify blood while sleeping at home, Blood can be purified with a prescription according to the patient, and of course, there is no need to go to the hospital for dialysis.

FIGS. 6 to 9 show another embodiment of the puncture guide. 3 to 5 are denoted by the same reference numerals, and detailed description will be omitted. Puncture guide 4 of this example
0 is the arterial guide hole 31in and the venous guide hole 31ou
By rotating the holder 24 in which the t is formed, the direction of the guide holes 31in and 31out is changed, and each needle 4
The puncturing directions of in and 4out can be changed.

The holder 24 is formed in a substantially truncated cone shape.
The bottom surface 24a is fitted in a circular concave portion 42 of a base plate 41 fixed to the arm by the belt 22 or the like, and is formed to be rotatable left and right.

The base plate 41 is provided at its diametrically opposed position with the locking piece 4 which is in contact with the slope of the holder 24.
3 and 44 are formed.
A screw hole 46 into which a set screw 45 for fixing
Are formed, and a projection 47 is formed inside the other locking piece 44. The width of each locking piece 43, 44 is formed to be equal to or smaller than the width of a concave groove 48in, 48out to be described later.

In the holder 24, concave grooves 48in and 48out having the guide holes 31in and 31out formed therein are formed at diametrically opposed positions, and the concave grooves 48i are formed.
The respective blood flow monitors 15 having the arterial needle 4in and the venous needle 4out attached to n, 48out are fitted. The guide holes 31in and 31out are formed, for example, in a tangential direction of a circle having an eccentric distance as a radius so that the needles 4in and 4out can puncture the blood clot 21 at a position eccentric from the center of rotation. (See FIG. 7). The set screw 45 and the projection 4 are provided on the side surface 24b.
7 are brought into contact with the diametrically corresponding positions in the diametrical direction, for example, within a range of 90 °.
It is formed at 2.5 ° intervals.

First, each groove 48 of the holder 24
in, 48out with the locking pieces 43, 44 and the holder 2
When the holder 24 is rotated with the set screw 45 loosened after the base plate 41 is mounted on the base plate 41, the projection 47
Is clicked each time the robot enters the positioning recess 50... And when you tighten the set screw 45,
The tip of the holder 2 is brought into contact with the positioning recess 49 to hold the holder 2.
4 is fixed.

Next, a sterile medical sponge 33 or cotton wool is placed in a through hole 25 formed in the center of the holder 24 and tightened with a tightening screw 27.
When the out is inserted into the guide holes 31in and 31out and inserted, the tip of the outgoing hole is punctured into the blood swelling portion 21 through the through hole 41a of the base plate 41.

By using the puncture guide 40, the needles 4in and 4out are guided in the longitudinal direction along the guide holes 31in and 31out when the needles 4in and 4out are pierced and pulled out, so that the needles do not swing. No matter who punctures, puncturing can be easily performed under substantially the same conditions. Assuming that blood purification is performed every day on weekdays, holder 2
The needles 4in and 4out can be pierced into different puncture points from different directions for the same clot 21 for 5 days with respect to the same clot 21. Therefore, puncturing from the same puncturing point is performed every other week, so that the burden on the skin is reduced and the blood clot 21
May have a longer lifespan.

Further, when the holder 24 is viewed from above, the angle of each of the needles 4in and 4out with respect to the direction of blood flow flowing through the blood clot 21 is selected to be a maximum of 45 °. For example, there is no problem in introducing blood from the arterial needle 4in and returning blood from the venous needle 4out.

FIGS. 10 to 12 show still another embodiment of the puncture guide according to the present invention. The same reference numerals as in FIGS. 3 to 5 denote the same parts, and a detailed description thereof will be omitted. The puncture guide 60 according to the present embodiment is such that the puncture direction of each of the needles 4in and 4out can be changed without rotating the holder 24. A plurality (for example, five) of arterial guide holes 31in... For guiding the needle 4in so that it can be punctured at different puncture points of the same clot 21 are formed. A plurality (for example, five) of vein-side guide holes 31out are formed to guide the puncture point so that the puncture can be performed.

Each of the guide holes 31in..., 31out.
The needles 4in and 4out are formed radially in the tangential direction of the virtual circle so that the needles 4in and 4out can be punctured at different positions along the small diameter virtual circle drawn on the blood clot 21.

The blood flow monitor 15 to which the needles 4in and 4out are attached is formed with an engagement piece 63 which is inserted into and engaged with the concave groove 62 of the stopper 61 fixed to the upper surface of the holder 24. I have.

Then, the holder 24 is fixed at a predetermined position on the arm, and a sterile sponge 33 or absorbent cotton is put in the through-hole 25.
After the stopper 61 is placed on the holder 24 and the tightening screw 27 is lightly tightened, the needles 4 in and 4 out are inserted from desired guide holes 31 in and 31 out to puncture the blood clot 21, and the blood flow monitor 15 When the engaging piece 63 and the concave groove 62 of the stopper 61 are fitted to each other and the tightening screw 27 is tightened, each engaging piece 63 is pressed against the stopper 61, and the needles 4in and 4out are fixed.

By using the puncture guide 60, the needles 4in and 4out are guided in the longitudinal direction along the guide holes 31in..., 31out. Puncturing can be easily performed under substantially the same conditions regardless of who punctures. Further, if the guide holes 31in and 31out are changed every day, in this example, the needles 4i are moved to different puncturing points from different directions for the same blood mass 21 for 5 days.
You can stab n, 4 out. Therefore, puncturing from the same puncturing point occurs every other week, and there is a possibility that the burden on the skin is reduced and the life of the blood clot 21 is prolonged.

[0057]

As described above, according to the artificial kidney of the present invention, the concentrated replenisher is diluted with distilled water obtained by distilling raw urine, and the diluted replenisher is mixed with blood so as to return to the body. Therefore, when using a commercially available dialysis stock solution that is 35 times concentrated as a replenisher, it is sufficient to supply about 1.2 liters of dialysis stock per day, and it is not necessary to replenish a large amount of dialysis solution. Even at the front end, there is a very excellent effect that the blood can be purified by himself using the bedtime.

According to the puncture guide according to the present invention,
When piercing or removing the arterial and venous needles, each needle is guided only in the longitudinal direction by the guide hole, so that each needle does not swing sideways and anyone can easily puncture under almost the same conditions. Therefore, there is an extremely excellent effect that adverse effects on the skin and blood swelling due to puncture errors are reduced.

[Brief description of the drawings]

FIG. 1 is a fluid circuit diagram showing an artificial kidney according to the present invention.

FIG. 2 is a diagram showing the state of use.

FIG. 3 is an exploded view showing a puncture guide used for the puncture guide.

FIG. 4 is a diagram showing a state in which a puncture guide is mounted on an arm.

FIG. 5 is an explanatory diagram showing a use state.

FIG. 6 is an exploded view showing another embodiment of the puncture guide.

FIG. 7 is a plan view thereof.

FIG. 8 is a sectional view taken along line AA of FIG. 7;

FIG. 9 is a sectional view taken along line BB of FIG. 7;

FIG. 10 is an exploded view showing still another embodiment of the puncture guide.

FIG. 11 is a cross-sectional view thereof.

FIG. 12 is a plan view thereof. 1 ... Artificial kidney 2 ... Body unit 3 ... Extracorporeal circulation system 4in ... Arterial needle 4out ... Vein side needle 5in ... Blood inflow tube 5out ... Blood recirculation tube 6 · · · Filter 7 · · · Distiller 10 · · · Purified blood mixer 12 · · · quantitative bellows pump (pressure pump) 20 · · · puncture guide 21, 21A, 2
1B: Blood swelling part 24: Holder 26: Pressure contactor (hemostatic body) 31in: Arterial guide hole 31out: Vein guide hole 32: Stopper 34: Drug supply channel

──────────────────────────────────────────────────続 き Continued on the front page (58) Field surveyed (Int.Cl. ⁷ , DB name) A61M 1/14 A61F 2/50 A61M 1/34 A61M 5/00

Claims (12)

(57) [Claims] An extracorporeal circulatory system connected to a circulatory system (3)
A filter (6) for filtering blood extracted from the body to remove water containing waste matter as raw urine, and distilling the raw urine to recover distilled water and filtering the raw urine concentrated with waste matter. A distilling device (7) for discharging, and a purified blood mixer for diluting the concentrated replenisher with the distilled water to a predetermined concentration, and further mixing with the blood from which the original urine has been removed by the filtering device (6) and returning it to the body. (10) An artificial kidney comprising: 2. A pressure pump (12) for sucking blood from the body into the extracorporeal circulation system (3) or supplying purified blood to the body.
The artificial kidney according to claim 1, wherein the artificial kidney is interposed. 3. The artificial kidney according to claim 1, further comprising a metering pump (8) for discharging the raw urine concentrated in the still (7) at a predetermined flow rate. 4. The filter (6) filters blood of 80 to 150 cc / min extracted from the body and filters the blood at 20 to 40 cc / min.
The distiller (7) has a capacity of discharging raw urine at a rate of 18 to 36 cc / min, and has a capacity of discharging 18 to 36 cc / min of distilled water. mi
n purified urine, and the purified blood mixer (10) further dilutes the mixture obtained by diluting the concentrated replenisher 35 times concentrated with the distilled water into a filter. The artificial kidney according to claim 1, 2 or 3, wherein the artificial kidney is mixed with 40 to 130 cc / min of blood from which raw urine has been removed in (6). 5. A blood inflow tube (5 in) for extracting blood from the body and a blood return tube (5ou) for returning blood to the body.
The blood flow monitor (15) provided with an impeller rotated by the blood flow is attached to one or both of t).
5. The artificial kidney according to 2, 3 or 4. 6. The extracorporeal circulation system (3) is formed on a body unit (2) that can be worn on the body.
The artificial kidney according to 3, 4 or 5. 7. An arterial needle (4in) for extracting blood from the body and a venous needle (4out) for returning purified blood to the body, one or two hem veins formed in a vein running under the arm. (21A, 21B, 21), which penetrates a holder (24) attached to the arm so as to cover the blood clots (21A, 21B, 21), and 4
The artery-side guide hole (31in) that guides the incline obliquely downward from the shoulder side toward the wrist side with respect to the blood swelling portion (21A, 21).
And the vein side needle (4out) is connected to the blood swelling part (21B, 2B).
A puncture guide characterized in that a vein-side guide hole (31out) for guiding obliquely downward from the wrist side to the shoulder side with respect to 1) is formed. 8. Each of the needles (4in, 4out) is inserted into each of the guide holes (31in, 31out), and the tip of each needle is inserted into each of the blood swelling portions.
(21A, 21B, 21) with each needle (4i
8. A puncture guide according to claim 7, wherein a stopper (32) for fixing the holder (24) to the holder (24) is formed. 9. Each guide hole (31in, 31) of said holder (24).
The puncture guide according to claim 7 or 8, wherein a drug supply flow path (34) is formed to allow the disinfectant, anti-pain agent or hemostatic agent to permeate the skin from or near the outlet (31out). 10. A hemostat (26) that presses a puncture mark formed on the skin by each of the needles (4in, 4out) from the front side of the holder (24) on the bottom surface of the holder (24). The puncture guide according to claim 7, 8 or 9, wherein the puncture guide is provided. 11. The holder (24) is rotatably attached to a base plate (41) fixed to an arm, and the guide holes (31in, 31out) are eccentric from a rotation center of the holder (24). The needle (4)
in, 4out), formed so as to be able to puncture.
The puncture guide according to 8, 9, or 10. 12. The arterial guide holes (31in...) And the puncture points of the needles (4in, 4out) can be changed while the holder (24) is mounted at the same position on the arm. The puncture guide according to claim 7, 8, 9 or 10, wherein a plurality of vein-side guide holes (31out) are formed.