JP3322987B2 - Diafiltration equipment - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a diafiltration apparatus for dialysis or filtration of a body fluid such as blood, and more particularly, to pushing a dialysate into a body fluid through a semi-permeable membrane and then extracting water from the body fluid (filtration). TECHNICAL FIELD The present invention relates to a diafiltration apparatus capable of easily and alternately repeating an operation with a compact apparatus.

[0002]

2. Description of the Related Art Conventionally, in a dialysis and purification operation of a body fluid such as blood, it has been repeatedly performed to push a dialysate from a dialysate side to a body fluid side and to draw water from a body fluid side to a dialysate side. By performing, hemofiltration (HF) effect and hemodialysis (HD)
Various diafiltration devices have been proposed which combine the effects with high efficiency and enable easy operation of dialysis, and which do not require a replacement liquid introduction mechanism which is indispensable in a conventional HF operation device. ing.

For example, Japanese Patent Application Laid-Open No. 57-173062 discloses an inexpensive diafiltration apparatus which enables highly efficient dialysis and filtration, is easy to operate, and is inexpensive. That is, FIG. 6 shows the configuration of the diafiltration apparatus.
By the alternate operation of the first pump means 10 and the second pump means 12, the amount of dialysate supplied to the dialyzer 14 through the supply passage 13 or the discharge passage 1 from the dialyzer 14
The amount of dialysate discharged to the dialyser 5 is increased or decreased, whereby the difference (per unit time) between the inflow of dialysate into the dialyzer 14 and the outflow of dialysate from the dialyzer 14 is changed from positive to negative. In addition, the dialysate can be repeatedly changed from negative to positive, so that the operation of pushing the dialysate into the body fluid through the semipermeable membrane in the dialyzer 14 and extracting water from the body fluid can be repeatedly performed. It was done.

According to the diafiltration apparatus thus constructed, the amount of dialysate taken out of the system from the dialysate flow path by the first pump 10 and the dialysate flow path by the second pump 12 Since the amount of liquid pushed from outside the system is equal, the amount of liquid drawn from the body and the amount of liquid pushed into the body are subtracted from the body fluid determined by the inflow and outflow adjustment mechanism 16 to outside the body. Water content. By repeating these two types of operations alternately, conventional HF operations can be performed using the same device.
HD operation can also be performed. In FIG. 6, reference numeral 18 denotes a dialysate tank,
Reference numeral 0 denotes a control device for detecting the dialysate level in the tank 12 and controlling the first pump 10 and the second pump 12, and 21 and 22 further denote a dialysate discharge passage 1.
5 to detect the pressure in the first pump 10 and the second pump
And a control device for controlling the pump 12 of FIG.

Further, Japanese Patent Application Laid-Open No. 61-147681 discloses that the backwashing of a membrane in a dialyzer or a filter can be effectively and efficiently achieved with a relatively simple structure, and that a simple operation can be applied to a living body. There is disclosed an artificial kidney device that can be safely handled. That is, FIG. 7 shows the configuration of this artificial kidney apparatus. A dialyzer (filter) 28 that defines a blood system 24 and a dialysate (filtrate) system 26 through a semipermeable membrane (filtration membrane) is provided. And reservoirs 34 and 36 provided with load cells 30 and 32 are connected to the blood system 24 and the dialysate (filtrate) system 26 via reversible liquid sending means P1 and P2, respectively. The diafiltration and backwashing of the semipermeable membrane are performed by changing the pressure condition in the dialyzer (filter) 28 by switching the means P1 and P2 back and forth.

[0006] According to the artificial kidney apparatus configured as described above, it is possible to achieve the backwashing of the membrane while always keeping the amount of liquid returned to the body through the dialyzer 28 of the blood system 24 constant. Therefore, even if the operation is rapidly switched from the dialysis or filtration operation to the reverse operation, for example, there is no disconnection of the system or impact on the living body, and safe and effective backwashing can be realized.

Furthermore, Japanese Patent Application Laid-Open No. 5-245195 discloses that the conventional diafiltration apparatus greatly changes the blood flow on the vein side when the dialysate is taken in and out of the filtration dialyzer, and therefore, the physical burden on the patient is large. Also, if the blood flow changes significantly, the burden on the shunt will also increase, shortening the life of the shunt, and it is difficult to confirm whether extracorporeal blood circulation is normal because the blood volume is not stable. A hemofiltration and dialysis device with a function to prevent the performance of the membrane from decreasing to reduce the change in the blood flow on the venous side is disclosed. That is, FIG. 8 shows the configuration of this hemodiafiltration apparatus, in which a filtration dialyzer 40, a blood inlet side (arterial side) 41 and an outlet side (venous side) 4 of this filter dialyzer are shown.
3 and an ultrafiltration control mechanism 46 for controlling the difference in volume between the fresh dialysate flowing into the filter dialyzer and the used dialysate flowing out of the filter dialyzer as a water removal amount. The inside of the cylinder is sandwiched between a dialysate outlet 45 of the filtration dialyzer 40 and the venous blood chamber 44 with a piston 47 interposed therebetween.
Reciprocating pump 4 defined by 7a and dialysate chamber 47b
8, the dialysate outlet 45 of the filtration dialyzer 40 and the dialysate chamber 47b of the reciprocating pump 48, the air chamber 44a of the venous blood chamber 44, and the buffer air chamber 47a of the reciprocating pump 48 Are connected to each other.

[0008] According to the hemodiafiltration apparatus configured as described above, the blood flow on the venous side can be stabilized, so that the burden on the circulatory system of the patient can be reduced, and extracorporeal blood circulation can be achieved. It is easy to check whether the operation is performed normally.

[0009]

However, in the above-described various conventional devices, for example, according to the configurations shown in FIGS. 6 and 7, pumps for injecting and withdrawing dialysate from and to a dialyzer and the like are provided. Power for driving is required, and also in the configuration shown in FIG. 8, power for driving the piston is required to change the volume of the cylinder. Work is troublesome.

Further, as shown in FIG. 7, in an apparatus requiring a reservoir, there is a disadvantage that the reservoir cannot be sufficiently cleaned and disinfected.

However, in a conventional ordinary dialysis apparatus, as shown in FIG. 9, in a dialyzer 50 defined by a semipermeable membrane into a blood chamber and a dialysate chamber, the blood chamber has its inlet. And arterial blood system 51 and venous blood system 5 for outlet
2 are connected to each other, and a dialysate supply system 53 and a dialysate discharge system 5 are connected to an inlet and an outlet of the dialysate chamber.
4 have a configuration in which they are connected to each other. However, the dialysis fluid system is provided with an ultrafiltration amount control mechanism 56. The ultrafiltration amount control mechanism 56 is, for example, a pump comprising a single plunger and two identical volumes, which alternately perform suction and discharge operations. The dialysate supply system 53 is configured to supply the dialysate to the dialysate supply system 53 and discharge the dialysate from the dialysate discharge system 54 simultaneously at a fixed ratio. The dialysate discharge system 54 is branched and connected to a water removal system 59 having a water removal pump 58.

[0012] The conventional dialysis apparatus thus configured is
Due to the structure of the reciprocating pump applied to the ultrafiltration control mechanism 56, the phases of the pump operations for the dialysate supply system 53 and the dialysate discharge system 54 are synchronized as shown in FIG. For this reason, since the amount of the dialysate sent to the dialyzer 50 and the amount of the dialysate discharged from the dialyzer 50 are always equal, the dialysate is properly injected and withdrawn from the dialyzer 50. Can not.

Accordingly, an object of the present invention is to provide a simple and compact structure without requiring a driving source for a mechanism other than the ultrafiltration amount control mechanism, and to inject and withdraw a dialysate from a dialyzer. Is to provide a diafiltration apparatus which has sufficient strength, can be manufactured at low cost, is easy to maintain, and is easy to handle.

[0014]

To achieve the above object, a diafiltration apparatus according to the present invention includes a dialyzer for defining a body fluid system such as blood and a dialysate system through a semipermeable membrane. In a diafiltration apparatus for performing diafiltration of bodily fluids by providing an ultrafiltration amount control mechanism for controlling a supply amount and a discharge amount of a dialysate to the dialyzer, the ultrafiltration amount control mechanism includes:
In the dialysate supply system and the dialysate discharge system that are connected to the dialyzer, pump devices that perform the same volume change are connected and arranged, and these pump devices are respectively connected to the liquid sending side.
The outflow side is out of phase and the inflow and outflow of dialysate
It is configured to be connected to a drive source to perform the operation.

In the above-mentioned diafiltration apparatus, the pump device can be configured to be coupled to a common driving source with a phase shift.

Further, the pump devices may be connected to independent drive sources, and may be configured to drive the drive sources such that the opposing pump devices perform pump operations in different phases.

Further, a bag is provided for the venous blood system connected to the dialyzer, either directly or in communication with the upper part of the venous blood chamber, so as to automatically absorb fluctuations in venous pressure. Can be. In this case, a pressure biasing device that applies pressure from the outside is provided on the bag provided directly or in communication with the upper part of the venous blood chamber with respect to the venous blood system, thereby forcing venous pressure fluctuation. It can also be configured to absorb.

[0018]

According to the diafiltration apparatus of the present invention, a dialyzer for defining a body fluid system such as blood and a dialysate system via a semi-permeable membrane is provided, and the amount of dialysate supplied to the dialyzer is controlled. In a diafiltration apparatus that provides an ultrafiltration amount control mechanism for controlling the discharge amount and performs diafiltration of a bodily fluid, the ultrafiltration amount control mechanism includes a dialysis solution supply system that is connected to the dialyzer and a dialysate discharge system, each pump device performing the same volume change connection disposed, inflow and pull the dialysate offset these pump devices phases of the respective liquid feeding side discharge side
Injection of dialysate in contact with bodily fluid through a semipermeable membrane in a dialyzer only by supplying and discharging dialysate by the ultrafiltration amount control mechanism by being configured to be connected to a driving source so as to perform a dispensing operation. And drawer can be effectively achieved. In this case, the phase of the pump operation can be easily adjusted, and accordingly, the amount of water and the amount of dialysate drawn out / injected in the dialyzer can be easily adjusted.

[0019]

Next, an embodiment of a diafiltration apparatus according to the present invention will be described in detail with reference to the accompanying drawings.

FIG. 1 shows an embodiment of a diafiltration apparatus according to the present invention. Reference numeral 60 denotes a dialyzer, and inside the dialyzer 60, a blood chamber is provided via a semipermeable membrane. And a dialysate chamber, and in the blood chamber, an arterial blood system 61 and a venous blood system 62
Are connected to each other, and a dialysate supply system 63 and a dialysate discharge system 64 are connected to the inlet and outlet of the dialysate chamber, respectively. However, the ultrafiltration amount control mechanism 66 is provided in the dialysate system, and supplies the dialysate to the dialysate supply system 63 and the dialysis from the dialysate discharge system 64. The discharge of the liquid is simultaneously performed at a constant ratio.

However, in the present embodiment, the ultrafiltration amount control mechanism 66 serves as a dialysate supply system
And a part of the dialysate discharge system 64, symmetrically provided with pump devices 72a and 72b having independent plunger mechanisms 70a and 70b and performing the same volume change, and the plunger mechanisms 70a and 70b of these pump devices 72a and 72b.
Are connected to the common rotary drive source 74 with a phase shift (180 ° phase shift in the illustrated example). Reference numeral 69 denotes a water removal system provided with a water removal pump 68 that is branched from the dialysate discharge system 64.

According to the diafiltration apparatus of this embodiment configured as described above, the phases of the pump operations of the pump apparatuses 72a and 72b constituting the ultrafiltration amount control mechanism 66 are shifted as shown in FIG. It will have a phase difference. Therefore, in the first half cycle operation of the rotary drive source 74, when dialysate is supplied from one pump device 72a to the dialysate supply system 63, dialysate discharge on the dialyzer 60 side is performed in the other pump device 72b. Since the dialysate is not sucked from the system 64, the dialysate in the dialysate supply system 63 including the dialyzer 60 is in a stagnant state, and the dialysate volume in the dialysate supply system 63 temporarily becomes excessive. The pressure also increases, so that the dialysate is infused through the semi-permeable membrane to the blood side. In the next half cycle operation, since the dialysate is not supplied from the one pump device 72a to the dialysate supply system 63, the other pump device 72b draws out the dialysate in the dialyzer 60. The water on the blood side is drawn out to the dialysate side via the semipermeable membrane.

FIG. 3 shows another embodiment of the diafiltration apparatus according to the present invention. That is, this embodiment is different from the embodiment shown in FIG. 1 in that the plunger mechanisms 70a, 70b of the pump devices 72a, 72b provided independently for the dialysate supply system 63 and the dialysate discharge system 64, respectively.
Are connected to independent drive sources 74a and 74b, respectively. Thus, the driving sources 74a, 7a
If the phase of the pump operation is set to be shifted in 4b, the diafiltration action in the dialyzer 60 can be easily achieved in exactly the same manner as in the previous embodiment.

In the embodiment shown in FIGS. 1 and 3, by appropriately adjusting the phase shift of the pump operation of the opposing pump devices 72a and 72b, the amount of water and the amount of dialysate drawn out / injected into the dialyzer 60 are adjusted. Volume adjustments can be made.

When the dialysate is infused / withdrawn in the dialyzer 60 when the diafiltration apparatus according to the present invention is applied, the flow rate of blood returned to the patient repeatedly increases and decreases. Causes the venous pressure to fluctuate. Therefore, if the fluctuation of the venous pressure is suppressed, the physical burden on the patient will be further reduced. Therefore, for example, in the step of injecting the dialysate, the filling amount in the blood tube is increased, and in the withdrawal step, the filling amount in the blood tube is reduced so that the blood return flow rate is averaged. preferable.

FIG. 4 shows an embodiment of the diafiltration apparatus according to the present invention which is configured to suppress the fluctuation of the venous pressure without external power. That is, in this embodiment, the venous blood system 62 of the embodiment shown in FIG.
A soft bag 82 is arranged so as to communicate with the upper part of the zero. It is preferable that the bag 82 is made of a resilient material. With this configuration, when the blood return flow rate increases and the venous pressure rises, the volume of the bag 82 increases and the effect of reducing the blood return flow acts to prevent the venous pressure from becoming excessive. be able to. Further, when the blood return flow rate decreases and the venous pressure decreases during the withdrawal step, the volume of the bag 82 decreases and the effect of increasing the blood return flow rate acts, thereby preventing the venous pressure from becoming too small. be able to.

FIG. 5 shows an embodiment of the diafiltration apparatus according to the present invention, which is configured to suppress the fluctuation of the venous pressure by using an external power. That is, in the present embodiment, a pressure is externally applied to the bag 82 provided in the embodiment shown in FIG. 4 by an appropriate pressure urging device 84 to forcibly constitute the venous blood system 62. By changing the amount of blood filling in the tube, it is possible to prevent the venous pressure from becoming too high and to prevent the venous pressure from becoming too low, as in the above embodiment.

Although the preferred embodiments of the present invention have been described above, the present invention not only allows these embodiments to be used in combination with each other, but also various other embodiments without departing from the spirit of the present invention. It is needless to say that the design can be changed.

[0029]

As is apparent from the above-described embodiment, according to the present invention, a dialyzer for defining a body fluid system such as blood and a dialysate system via a semipermeable membrane is provided, In a diafiltration apparatus for providing diafiltration of bodily fluids by providing an ultrafiltration amount control mechanism for controlling the supply amount and discharge amount of the dialysate, the ultrafiltration amount control mechanism is connected to the dialyzer. Pump devices that perform the same volume change are connected to the dialysate supply system and the dialysate discharge system, respectively, and these pump devices are out of phase with each other on the liquid sending side and the discharge side.
By connecting to the drive source to perform the inflow and withdrawal operation of the dialysate, only the supply and discharge operations of the dialysate by the ultrafiltration amount control mechanism, the body fluid through the semi-permeable membrane in the dialyzer Infusion and withdrawal of the dialysis fluid in contact can be effectively achieved.

In particular, in the present invention, the phase of the pump operation can be easily adjusted with respect to the opposing pump device, and accordingly, the adjustment of the amount of water and the amount of dialysate withdrawn / injected in the dialyzer is also easy. Can be done.

Further, since it can be operated only by driving the pump device, there are advantages that the structure is simplified, the durability is excellent, and the maintenance work is easy. Further, the size of the apparatus can be reduced, so that not only the manufacturing cost can be reduced, but also the operation cost can be maintained in the same manner as a normal dialysis apparatus. Furthermore, since the configuration is simple, cleaning and disinfection operations can be easily and sufficiently performed.

[Brief description of the drawings]

FIG. 1 is a main part system diagram showing one embodiment of a diafiltration apparatus according to the present invention.

FIG. 2 is a waveform diagram showing the sending and discharging characteristics of dialysate in the diafiltration apparatus shown in FIG.

FIG. 3 is a main part system diagram showing another embodiment of the diafiltration apparatus according to the present invention.

FIG. 4 is a main part system diagram showing another embodiment of the diafiltration apparatus according to the present invention.

FIG. 5 is a main part system diagram showing a modification of the diafiltration device shown in FIG. 4;

FIG. 6 is a system diagram showing a configuration of a conventional diafiltration device.

FIG. 7 is a system diagram showing a configuration of a conventional artificial kidney apparatus for performing diafiltration.

FIG. 8 is a system diagram showing a configuration of a conventional hemofiltration / dialysis apparatus for performing diafiltration.

FIG. 9 is a system diagram showing a configuration of a conventional ordinary dialysis device.

FIG. 10 is a waveform diagram showing a dialysate sending and discharging characteristic in the dialysis device shown in FIG. 9;

[Explanation of symbols]

 Reference Signs List 60 dialyzer 61 arterial blood system 62 venous blood system 63 dialysate supply system 64 dialysate discharge system 66 ultrafiltration amount control mechanism 68 water removal pump 69 water removal system 70a, 70b plunger mechanism 72a, 72b pump device 74 rotating drive Sources 74a, 74b Driving source 80 Intravenous blood chamber 82 Bag 84 Pressure biasing device

──────────────────────────────────────────────────続 き Continued on the front page (58) Field surveyed (Int.Cl. ⁷ , DB name) A61M 1/02-1/36

Claims (5)

(57) [Claims] An ultrafiltration system for providing a dialyzer for defining a body fluid system such as blood and a dialysate system through a semipermeable membrane and for controlling a supply amount and a discharge amount of the dialysate to the dialyzer. A diafiltration apparatus for providing diafiltration of bodily fluid by providing a volume control mechanism, wherein the ultrafiltration volume control mechanism has the same volume as the dialysate supply system and the dialysate discharge system that are connected to the dialyzer. The pump devices that perform the changes are connected and arranged, and these pump devices are dialyzed out of phase on the liquid sending side and the discharging side, respectively.
A diafiltration apparatus characterized by being connected to a driving source so as to perform a liquid inflow and a withdrawal operation . 2. The diafiltration device according to claim 1, wherein the pump devices are respectively coupled to the common drive source with a phase shift. 3. The diafiltration device according to claim 1, wherein the pump devices are coupled to independent drive sources, and are configured to drive the drive sources such that opposing pump devices perform pump operations in different phases. . 4. A venous blood system connected to the dialyzer is provided with a bag so as to communicate directly or in the upper part of the venous blood chamber, and is configured to automatically absorb fluctuations in venous pressure. The diafiltration apparatus according to any one of claims 1 to 3, wherein 5. A bag provided so as to communicate with the venous blood system directly or at the top of the venous blood chamber,
5. The diafiltration device according to claim 4, wherein a pressure biasing device for applying pressure from outside is provided, and the diafiltration device is configured to forcibly absorb fluctuations in venous pressure.