JP4374660B2 - Hemodialysis apparatus, blood processing method using the hemodialysis apparatus, and recording medium for controlling the hemodialysis apparatus - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a blood treatment apparatus, and in particular, in order to prevent excessive water removal that is likely to occur during hemodialysis and conversely insufficient water removal, an operator can easily control or change the water removal speed during blood treatment, The present invention relates to a hemodialysis apparatus and a hemodialysis method capable of easily storing results in a recording medium.
[0002]
[Prior art]
In order to treat patients with impaired renal function, conventionally, treatment for purifying blood by dialysis and filtration through a semipermeable membrane has been performed. In this device, in order to perform safe and effective blood purification, it is important to appropriately maintain the amount of blood circulating in the patient's body. Abrupt or excessive water removal may reduce the patient's circulating blood volume excessively, thereby causing a decrease in blood pressure, shock, and the like. However, if water removal is slow, blood purification takes a long time, and if sufficient water removal is not possible, high blood pressure, heart failure, etc. may occur.
[0003]
For this reason, hemodialysis apparatuses that perform water removal while monitoring the blood state of patients have been developed. For example, Japanese Examined Patent Publication No. 6-83723 discloses an estimator that estimates a body fluid state with a hematocrit meter, and a control device that controls a blood pump and an external pressure by the output of the estimator. This device is convenient because the water removal is directly controlled by the measured body fluid state, but on the other hand, since the water removal is directly controlled by the measured value, the measuring means is not accurate or causes an abnormality. And it becomes a big problem. Therefore, in such feedback control, it is common to provide an independent line separately from the control line and to attach a safety mechanism to the line. However, if an independent line or a safety mechanism is provided, the apparatus becomes complicated and the operation is troublesome. In addition, the cost of the apparatus increases.
[0004]
Therefore, a simple device as described in JP-A-9-149935 has been devised. That is, while monitoring the blood state of the patient, an alarm is sounded depending on the state, and the water removal pump is stopped. However, this device only recognizes whether water removal control is performed under the control conditions at the start of dialysis by comparing the blood concentration measured before the start of dialysis. If water removal is not performed according to the conditions, the worker must adjust the water removal amount and replenishment amount each time. Therefore, it was safe, but it was cumbersome and burdensome. Furthermore, since the above device is provided with means for measuring the blood state in the venous fluid side line of the blood circuit, the blood state after passing through the blood treatment device (dialyzer) is measured, and the patient's direct May not reflect blood condition.
[0005]
[Problems to be solved by the invention]
An object of the present invention is to provide a hemodialysis apparatus which can easily change and set the hemodialysis condition setting adapted to each patient over time while solving the above problems and monitoring the blood state of each patient. Another object of the present invention is to provide a hemodialysis method using the hemodialysis apparatus, and control system software for controlling the hemodialysis apparatus and hemodialysis method.
[0006]
The present invention relates to a blood measuring means for measuring a blood parameter of a patient, a working part for performing hemodialysis on the patient, and predetermined dialysis conditions (for example, water removal rate, blood flow rate, that is, extracorporeal circulation blood flow rate, fluid replacement rate, dialysate) Concentration, dialysate temperature, patient posture during dialysis, sodium injection rate, etc., but blood that is configured to have at least a control unit that controls the actual working part so as to perform hemodialysis treatment (especially water removal rate) In the dialysis apparatus, the control unit monitors whether the blood index value changes within a set blood index value range set in advance in the dialysis elapsed time as a means for controlling the water removal rate of the hemodialysis apparatus, When the index value falls outside the set blood index value range, the water removal rate is controlled so as to be within the set blood index value range.
[0007]
Hereinafter, each component of the hemodialysis apparatus of the present invention and water removal control of the blood apparatus will be described.
[0008]
The actual working part is a part that performs the substantial operation of hemodialysis, for example, hemodialyzer, blood circuit for communicating hemodialyzer and patient, for sending blood of the patient attached to the blood circuit This includes a blood pump, a dialysate circuit for connecting a dialysate supply source and a hemodialyzer, a dewatering pump attached to the dialysate circuit to remove water from patient blood, and the like. The dialysis treatment can be applied to dialysis treatment such as HDF (blood filtration dialysis) performed by dialysis using a semipermeable membrane or filtration.
[0009]
Blood measurement means Blood measurement means is a device that measures various blood parameters such as light transmittance of blood, electrolytic mass, blood osmotic pressure, etc. In order to select dialysis conditions, the measured parameters are converted into appropriate blood index values However, as this index value, for example, hematocrit value (which indicates the volume ratio of red blood cells occupying whole blood; hereinafter also referred to as Ht value) and an index for checking the state of circulating blood volume in each patient Circulating blood volume index (hereinafter referred to as BV for short), % BV , PRR (Plasma Refilling Rate), which means the rate at which plasma is refilled into blood vessels from the body. ) Etc. The PRR measurement indicates the patient's ability to remove water at each time point during dialysis, and the% BV can set an appropriate water removal rate by knowing the measurement result of this PRR. The BV value means a BV change value (BVΔ) defined by the following equation, and the% BV value is a percentage of the BV value.
[0010]
[Expression 1]
BV change value (BVΔ) = (Ht value at the start of dialysis / Ht value at the time of measurement) −1
[0011]
In the following, the present specification mainly describes the BV change value as the blood index value. However, in the present invention, the blood index value is not limited to the BV change value, and the BV change value is the blood index value. The present invention can be applied to any hematocrit value itself or any other blood index value that regulates the blood circulation amount such as a solute concentration in blood.
[0012]
The control unit control unit is a part that controls the active unit to perform hemodialysis under a predetermined condition, and has several important functions. The first function of the control unit is to set various dialysis conditions and processing / operations, and the second is to use data (blood parameters) obtained from blood measurement means so that the control unit can easily use appropriate blood. Conversion to an index value or a change value thereof, and selection of appropriate dialysis conditions set in advance based on the blood data. Third, the selected dialysis conditions and treatment / operation are performed by the working unit. Command and control.
[0013]
As an example of the configuration of the control unit, there is a configuration in which the configuration is divided into two according to functions. That is, various dialysis conditions, treatments / operations are set, the main control unit responsible for the function of instructing and controlling the dialysis unit, and the data from the blood measurement means are converted, and appropriate preset values are set based on the converted data. Two auxiliary control units (hereinafter referred to as control units) having a function of selecting appropriate dialysis conditions. Specific examples of the control unit include a patient monitoring device (hereinafter also referred to as a console) provided with a computer.
[0014]
Next, the configuration and control operation of the control unit and blood measurement unit will be described.
System Constructing Control Unit and Blood Measuring Unit The blood measuring unit and the system constituting the control of the hemodialysis apparatus of the present invention are configured by a system as shown in FIG. A panel computer located in the center of FIG. 1 performs system control with software capable of system control. The panel computer has a communication function with a blood measurement device (hereinafter also referred to as CLM) and a communication function with a patient monitoring device (hereinafter also referred to as a console). The panel computer can always communicate with the CLM and console to send and / or receive information while its system control software is running.
In the above description, the system in which the CLM, the panel computer, and the console are separately independent and are in contact with each other has been described. However, the system is not necessarily limited to the above-described system. It suffices if there is a means for taking out data on which blood index values are based in the vicinity of the patient, and other devices such as a computer represented by a panel computer or the like may be mounted on the console, which is more compact. .
In the communication function described above, the communication function between the CLM and the panel computer is only in one direction of the CLM → computer, but the communication function between the computer and the console can be bidirectional.
[0015]
CLM communication function For example, (1) Measurement time (2) Hct (3)% BV value etc. is taken in by communication from CLM, and if the data measurement value does not come from CLM for a specific time, for example 10 seconds Detects a communication error and tries to resume communication.
[0016]
Data measurement values are captured from the console via the communication unit, and information is transmitted for control. Examples of data measurement values acquired from the console via communication include: 1. Hemato value based on BV value 2. Target water removal amount 3. Water removal speed 4. Target dialysis time 5. Current water removal amount 6. Dialysis elapsed time Dialysis remaining time 8. Blood flow 9 Water removal pump operation flag10. Systolic blood pressure12. Diastolic blood pressure 20. Average blood pressure13. I have a pulse rate.
The control information transmitted to the console includes a water removal rate change rate and a water removal rate. When a command is sent to the console and no response is received for a specific time, for example, 5 seconds, a communication error is detected and communication is attempted again.
[0017]
Control operation of the control unit Simultaneously with the start of dialysis, a recording medium on which patient data related to hemodialysis such as alarm patterns is recorded on a panel computer having a touch panel screen, such as a floppy disk (FD), and control system software is installed. The alarm pattern suitable for the patient's condition at the time of start-up and hemodialysis is selected, and the BV graph screen shown in FIG. 2 is displayed on the touch panel screen. The above-described control operation is for the second and subsequent control operations, and the initial control is set by the doctor in consideration of the characteristics of the patient.
Moreover, although this embodiment demonstrates FD as a recording medium, a recording medium is not limited to FD.
[0018]
In the BV control screen, the X-axis indicates the position of dialysis elapsed time obtained from the console (converter), and the Y-axis indicates% BV. Reference numerals 1 and 2 are alarm lines 1 and 2 set in advance in the patient FD. 3 is a line graph showing the% BV currently sampled from the patient. In this embodiment, the moving average value of% BVΔ received from the CLM is displayed as a line graph every minute.
[0019]
If the% BV value is within the set% BV value range after starting the dialysis operation, the operation is continued as it is. If the% BV value falls below the set% BV value range, the water removal speed is set to the initial water removal speed. Is reduced by a predetermined rate of change set in advance, and if it exceeds the set% BV value range, the water removal rate is increased by a predetermined rate of change set in advance compared to the initial water removal rate. The water removal rate of the console is controlled so that the% BV value falls within the area between the alarm lines 1 and 2.
[0020]
The alarm line 1 is formed by connecting the time axis of the point region obtained by dividing the dialysis time into a plurality and the intersection 1 (contact point A in FIG. 3) of the upper limit value of the blood index value allowed for each point. The alarm line 2 is formed by connecting the time axis of the point area obtained by dividing the dialysis time into a plurality of intersections 2 (contact point B in FIG. 3) of the lower limit value of the blood index value allowed for each point. The alarm range is set by the alarm line 1 and the alarm line 2.
The intersections can be changed in consideration of patient characteristics. And by setting each intersection, the water removal pattern used as a target can be drawn beforehand and hemodialysis can be performed along it.
For example, the condition setting screen for the alarms 1 and 2 shown in FIG. 3 is displayed, each point arbitrarily divided by the point buttons 1 to 4 on the setting screen is selected, and the alarm button 1 and the alarm button 2 are used. This can be done by raising and lowering the set blood index value to set the contacts A and B of each point.
When setting the conditions for the alarms 1 and 2, when the alarm 1 is selected, the% BV value is added to the rate of change in the water removal speed adopted in the selection block when the alarm 1 deviates. When the alarm 2 is selected, the% BV The subtraction amount employed in the selected block when the value alarm 2 deviates is set (the water removal rate change rate employed in the selection block is also referred to as the set water removal rate change rate). The addition amount and the subtraction amount can be arbitrarily changed according to patient characteristics or a target water removal pattern.
In FIG. 3, a water removal rate change rate display unit for displaying the water removal rate change rate is provided.
Water removal at the set water removal rate change rate adopted during the selection of the alarms 1 and 2 is performed for a predetermined time (hereinafter also referred to as a set alarm monitoring time or an alarm sensitivity time). In FIG. 3, the set alarm monitoring time is displayed on the alarm sensitivity display section and can be set with the alarm sensitivity button.
Further, as described above, when the blood index value falls within the range from outside the set range, the water removal rate change rate that is added or subtracted is maintained or changed as it is, or selectively controlled. Is possible.
[0021]
In addition to the alarm 1 and 2 condition settings, for fail-safe as shown in FIG. 4, a constant level% BV value and a% BV value divided into a plurality of stages are shown in FIG. It is preferable to set alarms 3, 4, 5). In the alarm zone, when the patient's% BV value enters the alarm zone, the water removal speed set immediately in advance immediately prior to the% BV value range set in the alarm 1 line and the alarm 2 line. The water removal speed of the console can be changed forcibly with the rate of change.
[0022]
The alarm zone can be set or changed by selecting each zone with an alarm button for selecting each zone to be displayed on the screen, and moving the level with a button that can move the level of each selected zone up and down. Can be done. In addition, the change rate of the set% BV value of each zone can be displayed on the screen. However, the setting or changing of the alarm zone is performed while satisfying the requirement that the rate of change of the BV value is alarm 3> alarm 4> alarm 5.
The alarm pattern set as described above can be saved on a floppy disk and reused at any time. With the method described above, it is not necessary to set an alarm pattern for each patient each time, and the operation can be simplified.
[0023]
In the present invention, in addition to the setting of the alarms 1 and 2 as described above, an alarm zone in which% BV is divided into a plurality of stages at a certain level of% BV is provided for fail-safe as shown in FIG. Thus, the following advantages can be obtained. In other words, when the condition setting range of the alarms 1 and 2 is out of range, the water removal rate change rate is maintained so that the% BV value is corrected within the setting range. Depending on the conditions, if the% BV value is not corrected to the set range within the alarm sensitivity time, a water removal speed with an increased rate of change may be applied. In addition, since the rate of change in water removal rate can be set small and fine here, the water removal rate can be changed gently. Therefore, it is convenient for the control of water removal at the initial stage of dialysis in the setting of alarms 1 and 2, and in the alarm zone divided into multiple stages provided for fail-safe, the rate of change of water removal rate is constant. Since it can be changed directly to the range of the rate of change in water removal rate, it is convenient for controlling water removal in a dangerous area, for example, at the end of dialysis.
[0024]
Specifically, the water removal rate of the present invention is controlled as follows, for example.
If% BV value falls outside the set BV value range at a certain point after the start of dialysis, water is removed at the set water removal rate change rate and alarm monitoring time at that point, and the alarm monitoring time has elapsed. Even if the% BV value does not fall within the set BV value range, water removal is performed by adding or subtracting the same set water removal rate change rate to the set alarm monitoring time and water removal rate change rate, respectively. Water removal is performed at a rate of change in speed, and the water removal speed is controlled so as to be repeated until the% BV value falls within the set BV value range.
[0025]
For example, in the alarm 1 / alarm 2 condition setting screen shown in FIG. 3, the water removal rate of change in the alarm area of the point 1 area is 0 to 200%, the alarm sensitivity time is 0 to 99 minutes, preferably 1 to 10 minutes. It can be set to minutes. Therefore, when the% BV value in the point 1 area is above the alarm 1 line or below the alarm 2 line, the dewatering change rate is 1 to 99% for a certain period of time, that is, 10 minutes when this screen is set. Water removal is performed by changing the water removal amount. If the water removal change rate does not enter the set% BV value region, the water removal change rate is further changed by 1 to 99%. Control. The water removal rate change rate and the alarm sensitivity time can be arbitrarily set depending on the patient and purpose. For example, the change rate is 1 to 10% and the alarm sensitivity time is set to 1 to 10 minutes. And although it removed with the water removal change rate of 10% increase for the first 10 minutes, when it says that water removal is further insufficient, it controls to perform water removal with a water removal change rate 20% increase.
[0026]
Since the water removal speed is influenced mainly by the ultrafiltration pressure, the speed of the water removal pump (driving / stopping), and the speed of the blood pump, each of the above devices is controlled to achieve an appropriate water removal speed. In addition, the% BV value of the patient over time decreases with the lapse of hemodialysis time, and the water removal pump stops and the blood pump is decelerated. As a result, the water removal is performed immediately after reaching the set% BV value. When the pump is started to drive, the% BV value decreases again with the start of water removal. If it does so, the pump which started to drive will stop again. If the ON / OFF operation is repeated in such a short time, the pump chatters, which is not preferable. Therefore, when the blood index value enters the set range from outside the set range, the patient's blood index value can be kept constant within the desired range by providing a delay time. Or the said objective can be achieved by enabling it to maintain the set water removal rate change rate as it is (without adding or subtracting).
[0027]
In addition, a prescribed allowable range may be set for blood index values such as a hematocrit value and a% BV value instead of the delay time described above. In this case, the change of the dialysis condition is not instructed immediately by the transition of the blood index value, but is instructed only when the allowable range of the blood index value is exceeded. The blood index value to be set and its allowable range are not particularly limited, but if it is a hematocrit value, it is preferable to set the allowable range of Δ0.25, Δ0.50, Δ1.00 (Δ indicates a change).
[0028]
Furthermore, when the% BV value of the patient over time decreases as the hemodialysis time elapses, the dewatering pump stops, and when the blood pump starts operating, the replacement fluid device starts operating together with it and enters the patient's body. Treatment can be performed by injecting a replacement fluid and increasing the decreased BV of the patient. In this case, it is not necessary to stop the water removal pump or decelerate the blood pump by replenishing the solution, so that efficient hemodialysis can be performed without interrupting the water removal. The replacement fluid operation is convenient when dialysis using HDF (blood filtration dialysis) performed by dialysis or filtration using a semipermeable membrane. Furthermore, this replacement fluid is also useful when it is necessary to replenish the blood circulation urgently, such as when a patient develops dehydration.
[0029]
By pressing the PRR measurement button on the BV graph screen, the PRR measurement for setting the water removal amount is started immediately. When this PRR measurement is performed (for example, PRR1 to PRRn times), the PRR value is displayed on the BV screen. May be. The PRR measurement procedure is as follows.
(A) The precipitation rate from the console is stored at the start of PRR measurement, and the PRR measurement water removal rate setting value is set for the console.
(B) After the PRR measurement water removal time has elapsed, a water removal stop command is transmitted to the console.
(C) Further, PRR calculation is performed for the PRR measurement delay time and the PRR measurement water removal stop time, and the water removal speed stored at the start is set in the console and the setting is terminated.
The PRR measurement is indicated by the slope in FIG. 5 and can be obtained by the following equation (2).
[0030]
[Expression 2]
PRR = UFR ÷ (1 − (% BVΔ1 ÷ T1) ÷ (% BVΔ2 ÷ T2)) (2)
In the previous equation, UFR is the water removal rate in FIG.
[0031]
In the above embodiment, the control unit, which is a characteristic point of the present invention, has been mainly described. However, as the actual working unit and the blood measurement unit, conventionally known units are employed, and the scope of the present invention is not deviated. The control unit, which is a characteristic point of the present invention, the working unit, and the blood measuring hand can be combined in various variations. In this way, by measuring the PRR value, it is possible to predict whether the pre-measured water removal conditions and patterns are suitable for the patient, or the patient's condition after a predetermined time after dialysis.
[0032]
【The invention's effect】
The blood treatment conditions can be set and changed easily so that blood treatment suitable for the patient can be performed while monitoring the patient's blood condition, reducing the burden on medical personnel. . Furthermore, since the apparatus of the present invention has a simple configuration, it can be easily introduced into a facility, and the cost of the apparatus main body can be reduced.
[Brief description of the drawings]
FIG. 1 is a diagram showing an example of a system constituting a blood measurement unit and a control unit of a hemodialysis treatment apparatus of the present invention.
FIG. 2 is a diagram showing a BV graph screen displayed on a touch panel screen of a panel computer constituting the control system of the hemodialysis treatment apparatus of the present invention.
FIG. 3 is a diagram showing a condition setting screen for alarms 1 and 2 displayed on a touch panel screen of a panel computer constituting the control system of the hemodialysis treatment apparatus of the present invention.
FIG. 4 is an alarm zone in which a% BV value is divided into a plurality of stages at a certain level of% BV value for fail-safe displayed on the touch panel screen of a panel computer constituting the control system of the hemodialysis treatment apparatus of the present invention. It is a figure which shows the condition setting screen.
FIG. 5 is a diagram illustrating a PRR measurement method.
[Explanation of symbols]
1 Alarm line 1 preset in patient FD
2 Alarm line 2 preset in patient FD
Line graph showing% BV currently sampled from 3 patients

Claims (8)

Blood measurement means (A) for measuring a blood parameter of a patient, an active part (B) for performing blood processing, and a control part (C) for controlling the active part to perform blood processing at a predetermined water removal rate A hemodialysis apparatus, wherein the control section (C) performs the following controls (1) to (3) in a hemodialysis apparatus configured to include at least:
1. The blood parameter sampled by the blood measuring means (A) is expressed as a BV change value (BVΔ) represented by the following expression (1) or a% BV value (hereinafter referred to as blood) expressed as a percentage of the BV change value (BVΔ). Whether the taken blood index value changes within a preset BV change value (BVΔ) or% BV range (hereinafter also referred to as a set blood index value range). Monitoring and controlling the water removal rate of the working part (B) so that it falls within the set blood index value when the current value of the blood index value deviates from the set blood index value range. .
BV change value (BVΔ) = (Ht value at the start of dialysis / Ht value at the time of measurement) −1 ··· (1)
2. In the control of 1 above, when the current value of the blood index value falls below the set blood index value range, the predetermined water removal rate change rate preset in each set blood index value range is subtracted from the initial water removal rate. Water is removed at a water removal speed obtained by subtracting the water speed. If the current value of the blood index value exceeds the set blood index value, a predetermined value set in advance from the initial water removal speed to each set blood index value range. The water removal rate of the working part (B) is adjusted so that the current value of the blood index value falls within the set blood index value range by the water removal. It must be controlled.
3. In the control of 2 above, water removal at the added water removal rate is performed for a predetermined alarm monitoring time (hereinafter also referred to as a set alarm monitoring time), and the current value of the blood index value has passed the set alarm monitoring time. Even if it does not fall within the set blood index value range, water removal is subsequently performed at a water removal rate change rate obtained by further adding the same water removal rate change rate to the added water removal rate , Alternatively, when the subtracted water removal rate is depleted at a set alarm monitoring time of a predetermined time, and the current value of the blood index value does not fall within the set blood index value range even if the set alarm monitoring time elapses In the control control for performing water removal at a water removal rate change rate obtained by subtracting the same water removal rate change rate from the subtracted water removal rate, the current value of the blood index value is set for alarm monitoring. Until it falls within the set blood index value range in time It is carried out in return Ri. When the current value of the blood index value falls within the set blood index value range, the control unit (C) immediately performs water removal at the initial water removal rate instead of water removal at the added or subtracted water removal rate. instead of the delay time provided, according to claim 1 and controls to perform water removal by initially water removal speed in place of the water removal by adding or subtracting the water removal speed in the embodiment after the lapse of the delay time The hemodialysis apparatus according to 1. Blood measurement means (A) for measuring a blood parameter of a patient, an active part (B) for performing blood processing, and a control part (C) for controlling the active part to perform blood processing at a predetermined water removal rate The hemodialysis apparatus, wherein the control section (C) performs the following controls 1 to 3 in a hemodialysis apparatus configured to have at least.
1. The blood parameter sampled by the blood measuring means (A) is expressed as a BV change value (BVΔ) represented by the following expression (1) or a% BV value (hereinafter referred to as blood) expressed as a percentage of the BV change value (BVΔ). Whether the taken blood index value changes within a preset BV change value (BVΔ) or% BV range (hereinafter also referred to as a set blood index value range). Monitoring and controlling the water removal rate of the working part (B) so that it falls within the set blood index value when the current value of the blood index value deviates from the set blood index value range. .
BV change value (BVΔ) = (Ht value at the start of dialysis / Ht value at the time of measurement) −1 ··· (1)
2. In the control of 1 above, when the current value of the blood index value falls below the set blood index value range, the predetermined water removal rate change rate preset in each set blood index value range is subtracted from the initial water removal rate. Water is removed at a water removal speed obtained by subtracting the water speed. If the current value of the blood index value exceeds the set blood index value, a predetermined value set in advance from the initial water removal speed to each set blood index value range. The water removal rate of the working part (B) is adjusted so that the current value of the blood index value falls within the set blood index value range by the water removal. It must be controlled.
3. In the control 2 described above, when the current value of the blood index value falls within the set blood index value range, water removal is immediately performed at the initial water removal rate instead of the water removal at the added or subtracted water removal rate. Instead, a delay time is provided, and control is performed so that water removal is performed at the initial water removal rate instead of water removal by the addition or subtraction water removal rate being performed after the delay time has elapsed. The control unit (C) intersects 1 of the time axis of the point area obtained by dividing the set blood index value range into a plurality of dialysis times and the upper limit value of the blood index value allowed for each point (hereinafter referred to as an alarm upper limit value). An alarm line (hereinafter also referred to as “alarm line 1”) formed by connecting each other, a time axis of a point area obtained by dividing a dialysis time into a plurality of points, and an intersection 2 (hereinafter, It is set between alarm lines (hereinafter also referred to as alarm line 2) formed by connecting the alarm lower limit values), and the intersection 1 and / or the intersection 2 can be arbitrarily set and changed. The hemodialysis apparatus according to any one of claims 1 to 3 . When the current value of the blood index value exceeds the upper limit value of the alarm value, the control unit (C) increases the water removal rate change rate, and when the blood index value has not reached the alarm lower limit value, the control unit (C) The hemodialysis apparatus according to claim 4 , wherein the hemodialysis apparatus can be controlled so as to reduce the rate of change in water speed. In addition to the set blood index value range, the control unit (C) further sets a plurality of alarm zones for the blood index value for fail safe, and the current value of the blood index value has entered one of the plurality of alarm zones In this case, the hemodialysis apparatus according to any one of claims 1 to 5 , wherein the hemodialysis apparatus can be controlled so that water is immediately removed preferentially at a water removal rate change rate set in the zone. Blood measurement means (A) for measuring a blood parameter of a patient, an active part (B) for performing blood processing, and a control part (C) for controlling the active part to perform blood processing at a predetermined water removal rate The hemodialysis apparatus, wherein the control section (C) performs the following controls 1 to 3 in a hemodialysis apparatus configured to have at least.
1. The blood parameter sampled by the blood measuring means (A) is expressed as a BV change value (BVΔ) represented by the following equation (1) or a% BV value (hereinafter referred to as a percentage) of the BV change value (BVΔ). The blood index value), and whether the taken blood index value changes within a preset BV change value (BVΔ) or% BV range (hereinafter also referred to as a set blood index value range) Whether or not the current value of the blood index value deviates from the set blood index value range, and the water removal rate of the working part (B) is controlled so that it falls within the set blood index value. .
BV change value (BVΔ) = (Ht value at the start of dialysis / Ht value at the time of measurement) −1 ··· (1)
2. In the control of 1 above, when the current value of the blood index value falls below the set blood index value range, the predetermined water removal rate change rate preset in each set blood index value range is subtracted from the initial water removal rate. Water is removed at a water removal speed obtained by subtracting the water speed. If the current value of the blood index value exceeds the set blood index value, a predetermined value set in advance from the initial water removal speed to each set blood index value range. The water removal rate of the working part (B) is adjusted so that the current value of the blood index value falls within the set blood index value range by the water removal. To control.
3. In addition to the set blood index value range, a plurality of alarm zones are further set for the blood index value for fail-safe, and when the current value of the blood index value enters any one of the plurality of alarm zones, priority is given. Control to remove water immediately at the rate of change of water removal speed set in the zone. Blood measurement means (A) for measuring a blood parameter of a patient, an active part (B) for performing blood processing, and a control part (C) for controlling the active part to perform blood processing at a predetermined water removal rate The recording medium which recorded the control information of following 1-3 as hemodialysis process control information of the hemodialysis apparatus comprised at least.
1. The blood parameter sampled by the blood measurement means (A) is expressed as a BV change value (BVΔ) represented by the following formula (1) or a% BV value (hereinafter referred to as a percentage) of the BV change value (BVΔ). Whether or not the taken blood index value changes within a preset BV change value (BVΔ) or% BV range (hereinafter also referred to as a set blood index value range). Control information for controlling the water removal speed of the working part (B) so that the blood index value falls within the set blood index value range when the current value of the blood index value deviates from the set blood index value range. .
BV change value (BVΔ) = (Ht value at the start of dialysis / Ht value at the time of measurement) −1 ··· (1)
2. In the control of 1 above, when the current value of the blood index value falls below the set blood index value range, the predetermined water removal rate change rate preset in each set blood index value range is subtracted from the initial water removal rate. Water is removed at a water removal speed obtained by subtracting the water speed. If the current value of the blood index value exceeds the set blood index value, a predetermined value set in advance from the initial water removal speed to each set blood index value range. The water removal rate of the working part (B) is adjusted so that the current value of the blood index value falls within the set blood index value range by the water removal. Control information to control.
3. In addition to the set blood index value range, a plurality of alarm zones are further set for the blood index value for fail-safe, and when the current value of the blood index value enters any of the alarm zones, Control information for controlling the working part (B) so as to immediately remove water at the rate of change of the water removal speed set in the zone.

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