JP4978178B2 - Blood purification circuit - Google Patents

Description

  The present invention relates to a blood purification circuit used in carrying out a continuous blood purification method.

Conventionally, for example, in order to purify the blood of a patient with renal insufficiency, continuous slow hemofiltration (CHF), continuous slow hemodialysis (CHD), A treatment using a continuous blood purification method such as continuous hemodiafiltration (CHDF) has been performed. In the continuous blood purification method, the blood perfusion rate is slower than that of conventional hemodialysis, so that blood can be purified gently.

When performing a continuous blood purification method, the flow rate of blood drawn from the patient must be balanced with the flow rate of blood returned to the patient and the replacement fluid injected into the patient. In order to realize the balance, the usage amounts of the dialysate, the replacement fluid, and the filtrate are individually measured (for example, see Patent Document 1).
Japanese Patent No. 3180309

  However, when performing the conventional continuous blood purification method, there are the following problems. That is, a circuit for independently flowing the dialysate, the replacement fluid, and the filtrate is complicated. Moreover, the scale of the apparatus for performing the continuous blood purification method is large. Furthermore, there is a high possibility that the balance will be lost due to the accumulation of errors between the actual usage amount of each liquid and the measured value.

Currently, CHF, CHD, CHDF, and ultrafiltration method (ECUM), which is a method of removing only moisture from a patient, are performed in independent circuits. Therefore, it is necessary to prepare dedicated circuits for each of CHF, CHD, CHDF, and ECUM. Medical personnel wish to perform CHF, CHD, CHDF, and ECUM in a single circuit.

  In consideration of the above problems, the present invention can also be used as a circuit in each mode when carrying out a continuous blood purification method, and can have a simple configuration of an apparatus for carrying out a continuous blood purification method, It aims at providing the blood purification circuit which can implement CHF, CHD, CHDF, and ECUM.

  In order to solve the above problems and achieve the above object, a blood purification circuit according to the present invention includes a liquid supply container for containing a liquid supply, one end connected to the first liquid supply path through which the liquid supply flows, 1st branch part connected with the other end of 1 liquid supply path, and the 2nd liquid supply path where one end was connected with the 1st branch part, and the other end was connected with the purifier which purifies blood. And a third liquid supply path having one end connected to the first branch portion and the other end connected to a blood path through which blood from the patient flows, the second liquid supply path having a first One pump segment is provided, and a second pump segment is provided in the third liquid supply path.

  Here, in the blood purification circuit of the present invention, one end is connected to the first branch portion, and the other end is connected to a supply liquid measuring container for measuring the supply liquid flowing in from the supply container. A liquid channel may be further provided.

  In the blood purification circuit of the present invention, a first opening / closing for guiding or shutting off the liquid supply flowing through the first liquid supply path to the first branch portion is provided in the first liquid supply path. Means may be provided, and the liquid supply in the liquid supply container may be guided to the liquid supply measurement container by a drop.

  Further, the blood purification circuit of the present invention has one end connected to the purifier and a third pump segment, a filtrate path through which the filtrate from the purifier flows, and the other end of the filtrate path Connected to the second branch part, connected to the second branch part, and connected to the drainage container for storing the filtrate flowing through the filtrate path, and to the second branch part, and the purification And a filtrate measuring container for measuring the amount of the filtrate flowing out from the vessel.

  Further, the blood purification circuit of the present invention compares the decrease amount of the liquid stored in the liquid supply measurement container with the increase amount of the filtrate stored in the filtrate measurement container, and performs the purification based on the comparison result. You may further provide the control means which controls increase / decrease in the filtration amount filtered from a vessel. The blood purification circuit of the present invention further includes a drainage path having one end connected to the second branch and the other end connected to the drainage container, and the drainage path includes the drainage path. There may be provided second opening / closing means for guiding or blocking the filtrate flowing through the passage to the drainage container.

  Thereby, when implementing the continuous blood purification method, the circuit in each mode can also be used, and the apparatus for carrying out the continuous blood purification method can have a simple configuration. CHF, CHD, CHDF, and ECUM can be implemented. In addition, when blood purification is performed using CHDF, the ratio of CHD and CHF is arbitrarily determined by the patient by controlling the rotation speed of the pump mounted on the first pump segment and the pump mounted on the second pump segment. Therefore, highly accurate and efficient hemodialysis can be performed.

  The present invention can also be used as a circuit in each mode when the continuous blood purification method is performed, and can have a simple configuration of the device when the continuous blood purification method is performed. CHF, CHD, CHDF, And the blood purification circuit which can implement ECUM can be provided.

  In addition, when blood purification is performed using CHDF, the ratio of CHD and CHF can be arbitrarily changed by a patient, so that a blood purification circuit capable of performing highly accurate and efficient hemodialysis is provided. Can do.

  The best mode for carrying out the present invention will be described below with reference to the drawings.

  The blood purification apparatus according to the present embodiment includes a blood purification circuit and a control device.

(Blood purification circuit)
First, the blood purification circuit of the present embodiment will be described with reference to FIG.

  FIG. 1 is a configuration diagram of a blood purification circuit according to the present embodiment.

  The blood purification circuit of the present embodiment is a circuit used when the continuous blood purification method is performed, and includes a liquid supply container 1, a liquid supply measurement container 2, a first liquid supply path 3, and a first liquid supply circuit. A branching section 4, a liquid supply metering liquid path 5, a dialyzer 6, a second liquid supply path 7, a gas-liquid separation chamber 8, a third liquid supply path 9, and a first liquid supply transfer pump 10a. The second supply fluid transfer pump 10b, the first valve 11, the venous blood path 16, the first pressure sensor 17, the inflow path 18, the second valve 19, and the arterial first blood path 20, Arterial second blood path 21, blood pump 22, second pressure sensor 23, replacement fluid path 24, third blood path 25, syringe 26, drainage container 27, filtrate path 28, filtration A liquid pump 29, a third pressure sensor 30, a filtrate metering container 31, a filtrate metering path 33, a third valve 34, and a drainage path 43 are provided.

  The blood purification circuit of the present embodiment is connected to the patient 40 via the return side blood circuit 41 and the delivery side blood circuit 42. FIG. 1 also shows a balance detector 35 that doubles as each weighing device.

  The liquid supply container 1 is a container filled with the liquid supply. The liquid supply filled in the liquid supply container 1 is sterilized so that it can be supplied as a replacement liquid or a dialysate. The liquid supply measuring container 2 is a container filled with an amount of liquid supply necessary for performing the continuous blood purification method. The liquid supply container 1 and the liquid supply measurement container 2 are sequentially arranged side by side in the direction of gravity, and the liquid supply filled in the liquid supply measurement container 2 is supplied from the liquid supply container 1 by a drop. The liquid supply measuring container 2 is a container for measuring the amount of liquid supplied from the liquid supply container 1. The first liquid supply path 3 is a tubular path in which one end is connected to the liquid supply container 1 and the other end is connected to the first branch portion 4 and through which the liquid supply flows. Each liquid path in the present embodiment is a tubular path similar to the first liquid supply path 3. The first branch part 4 is a part connected to the other end of the first liquid supply path 3. The liquid supply metering fluid path 5 is a path in which one end is connected to the first branching section 4 and the other end is connected to the liquid supply metering container 2, and the liquid supply filled in the liquid supply container 1 is supplied. This is a liquid supply flow path used when supplying the liquid measurement container 2 or the like.

  The dialyzer 6 performs blood filtration such as blood filtration, dialysis, or filtration and dialysis. The second liquid supply path 7 has one end connected to the first branch 4 and the other end connected to the dialyzer 6. The second liquid supply path 7 is provided with a first liquid supply transfer pump 10a. The second liquid supply path 7 is a path for guiding the liquid supplied from the liquid supply metering container 2 supplied via the first liquid supply path 3 to the dialyzer 6 by the first liquid supply transfer pump 10a. The gas-liquid separation chamber 8 is a container for removing gas flowing through the blood path, and stores blood. The third liquid supply path 9 has one end connected to the first branch 4 and the other end connected to the venous blood path 16. The third liquid supply path 9 is provided with a second liquid supply transfer pump 10b. The third liquid supply path 9 is a path that guides the liquid supplied from the liquid supply measuring container 2 supplied through the first liquid supply path 3 to the venous blood path 16 by the second liquid supply transfer pump 10b. The second liquid supply path 7 and the third liquid supply path 9 are connected to the first branch portion 4. The liquid supply filled in the liquid supply container 1 is supplied to the liquid supply measurement container 2 by a drop. Further, the first liquid supply transfer pump 10a and the second liquid supply transfer pump 10b are configured to supply the liquid supplied to the liquid supply measurement container 2 at a necessary amount or speed at the second liquid supply path 7 or the third liquid supply. It guides to the site | part downstream from the 1st supply liquid transfer pump 10a and the 2nd supply liquid transfer pump 10b, such as the dialyzer 6 and the venous side blood path 16, via the path | route 9.

  The 1st valve | bulb 11 is provided in the 1st liquid supply path 3, and guides or interrupts | blocks the liquid supply which flows through the 1st liquid supply path 3 to the 1st branch part 4 by opening and closing.

  The venous blood path 16 is a general term for blood circuits that connect the dialyzer 6 and a patient's venous connector (not shown). The blood outlet port of the dialyzer 6 and the upper part of the gas-liquid separation chamber 8 are connected by a blood circuit, and blood purified by the dialyzer 6 is guided from the dialyzer 6 to the gas-liquid separation chamber 8. The first pressure sensor 17 is provided in the venous blood path 16 and detects the pressure of the fluid flowing through the venous blood path 16. The inflow path 18 has one end connected to the gas-liquid separation chamber 8 and the other end connected to the return-side blood circuit 41, or the purified blood from the gas-liquid separation chamber 8 or the purified blood. And a fluid flow path for guiding the fluid supply to the patient 40. The second valve 19 is provided in the inflow path 18 and guides or blocks the fluid flowing through the inflow path 18 to the return-side blood circuit 41.

  The arterial blood circuit is a general term for blood circuits that connect the dialyzer 6 to an arterial connector (not shown) of a patient, and includes an arterial first blood path 20 and an arterial second blood path 21. The arterial first blood path 20 has blood from a patient 40 flowing through the delivery-side blood circuit 42, one end connected to the delivery-side blood circuit 42 and the other end connected to the arterial-side second blood path 21. It is a blood flow path for leading to the dialyzer 6. The blood-side pump segment is a part suitable for pumping provided in the artery-side second blood passage 21, and the blood pump 22 is attached to the part. The arterial second blood path 21 has one end connected to the blood path 20 and the other end connected to the dialyzer 6, and a blood flow path that guides the blood flowing from the arterial side first blood path 20 to the dialyzer 6. It is. The blood pump 22 is a pump attached to the blood side pump segment, and supplies blood from the patient 40 flowing through the delivery side blood circuit 42 and the artery side first blood path 20 to the dialyzer 6. The second pressure sensor 23 is provided in the arterial second blood passage 21 and detects the pressure of blood flowing through the arterial second blood passage 21.

  A solid line shown in FIG. 1 is a path during treatment, and a broken line indicates a path connected during priming.

  During the treatment, one end of the replacement fluid path 24 to be used as a replacement fluid circuit is connected to the artery-side first blood path 20. At the time of priming, the replacement fluid path 24 is used as a path for discarding the priming fluid flowing through the artery-side first blood passage 20 (the fluid supplied in the fluid supply container 1) to the outside of the blood purification circuit. The

  During treatment, a replacement fluid path 25 used as a circuit for injecting a predetermined fluid containing an anticoagulant has one end connected to the artery-side first blood path 20 and the other end connected to the syringe 26. At the time of priming, the other end is connected to the gas-liquid separation chamber 8, and in order to avoid applying excessive pressure to the dialyzer 6, the priming liquid is directly supplied to the replacement fluid path 24 (drainage path at the time of priming). Used as a guiding bypass. The syringe 26 is filled with a predetermined liquid containing an anticoagulant or the like, and injects the filled liquid into the blood flowing in the third blood passage 25 by an operation or an injection device such as a doctor.

  During the treatment, the return blood circuit 41 and the delivery blood circuit 42 are connected to the patient 40. At the time of priming, the return blood circuit 41 and the delivery blood circuit 42 are not connected, and a bypass line through which a gas-liquid separation chamber is connected is connected.

  The drainage container 27 is a container that is provided vertically below the filtrate measuring container 31 and stores the filtrate as drainage. The filtrate path 28 is a filtrate flow path having one end connected to the dialyzer 6 and the other end connected to the second branch portion 32. The drainage path 43 is a filtrate flow path having one end connected to the second branch portion 32 provided in the filtrate path 28 and the other end connected to the drainage container 27. The filtrate pump 29 is provided in the filtrate passage 28 and supplies the filtrate generated by the dialyzer 6 to the drainage container 27. The filtrate pump segment is a portion suitable for pumping provided in the filtrate passage 28, and the filtrate pump 29 is attached to the portion. The third pressure sensor 30 is provided in the filtrate path 28 and detects the pressure of the filtrate flowing through the filtrate path 28. The filtrate measuring container 31 is a container in which filtrate is stored for measuring the filtrate when continuous blood purification is performed. The filtrate measuring path 33 is a filtrate flow path having one end connected to the second branch portion 32 provided in the filtrate path 28 and the other end connected to the filtrate measuring container 31. The third valve 34 is provided in the drainage path 43 and guides or blocks the filtrate flowing through the filtrate metering path 33 to the drainage container 27.

  The balance detector 35 detects whether or not the decrease amount of the liquid supply filled in the liquid supply measurement container 2 and the increase amount of the filtrate stored in the filtrate measurement container 31 are balanced. Details of the balance detector 35 will be described later when the control device 50 is described.

  The second liquid supply path 7 is provided with a liquid supply side pump segment as a portion suitable for pumping, and the first liquid supply transfer pump 10a is attached to the liquid supply side pump segment. Similarly, the third liquid supply path 9 is provided with a liquid supply side pump segment as a part suitable for pumping. A second liquid supply transfer pump 10b is attached to the liquid supply side pump segment.

(Control device)
Next, a control device 50 that controls the flow of each liquid flowing through the blood purification circuit of the present embodiment will be described with reference to FIG.

  FIG. 2 is a configuration diagram of the control device 50. The control device 50 is a device that controls the flow of each liquid flowing through the blood purification circuit of the present embodiment, and includes a reception unit 51, a mode selection unit 52, a valve control unit 53, and a valve opening / closing information storage unit 54. A pump control unit 55, a pump operation information storage unit 56, and a display unit 57.

  The receiving unit 51 receives mode information specifying a continuous blood purification mode performed using the blood purification circuit from a user such as a doctor. The mode selection unit 52 selects any one of a plurality of continuous blood purification modes based on the mode information received by the reception unit 51. There are the following four modes. There are four types: (A) CHD mode, (B) CHDF mode, (C) CHF mode, and (D) ECUM mode. In addition, before executing any of these four types of modes, it is necessary to execute a pretreatment for cleaning the path of each liquid, filling the liquid supply, and the like. Here, the preprocessing is referred to as a priming mode. Since CHD, CHDF, CHF, and ECUM have been described in “Background Art”, description thereof will be omitted.

  The valve control unit 53 controls the valve opening / closing operation corresponding to the mode selected by the mode selection unit 52 based on the valve opening / closing information 540 stored in the valve opening / closing information storage unit 54. The valve opening / closing information storage unit 54 stores valve opening / closing information 540 that specifies whether each valve should be opened or closed for each mode.

  FIG. 3 shows valve opening / closing information 540. As shown in FIG. 3, when the (A) CHD mode is performed, the second valve 19 is opened and the third valve 34 is closed. In each of (B) CHDF mode, (C) CHF mode, and (D) ECUM mode, the second valve 19 and the third valve 34 are opened or closed based on the valve opening / closing information 540 shown in FIG.

  The pump control unit 55 controls the operation operation of the pump corresponding to the mode selected by the mode selection unit 52 based on the pump operation information 560 stored in the pump operation information storage unit 56. The pump operation information storage unit 56 stores pump operation information 560 that specifies whether each pump should be operated or stopped for each mode.

  FIG. 4 shows pump operation information 560. As shown in FIG. 4, when the (A) CHD mode is performed, the first feed liquid transfer pump 10a, the blood pump 22, and the filtrate pump 29 are operated. For each of (B) CHDF mode, (C) CHF mode, and (D) ECUM mode, the first feed liquid transfer pump 10a, the second feed liquid transfer pump 10b, based on the pump operation information 560 shown in FIG. The blood pump 22 and the filtrate pump 29 are operated or stopped.

  When the mode selected by the mode selection unit 52 is the (B) CHDF mode, the pump control unit 55 performs the first liquid transfer according to the information regarding the ratio of CHD and CHF input by the user through the reception unit 51. The rotational speeds of the pump 10a and the second liquid supply transfer pump 10b are controlled.

  The pump control unit 55 may be configured such that the balance detector 35 does not balance the amount of decrease in the supply liquid filled in the liquid supply measurement container 2 with the increase in the filtrate stored in the filtrate measurement container 31. If detected, all or part of the first feed liquid transfer pump 10a, the second feed liquid transfer pump 10b, the blood pump 22, and the filtrate pump 29 are set so that the decrease amount and the increase amount are balanced. Control. At this time, the detection by the balance detector 35 is performed by detecting the decrease amount of the liquid supply and the increase amount of the filtrate at a predetermined time at a predetermined time.

  The display unit 57 indicates which of the second liquid supply path 7 and the third liquid supply path 9 of the blood purification circuit is flowing in the mode corresponding to the mode information received by the reception unit 51. Display information.

  Next, the operation of the control device 50 will be described.

  After the blood purification circuit described above is attached to the patient, the reception unit 51 executes one of (A) CHD mode, (B) CHDF mode, (C) CHF mode, and (D) ECUM mode. Mode information specifying the mode is received from a user such as a doctor. When the mode information is received by the receiving unit 51, the mode selection unit 52 transmits the operation start information to the valve control unit 53 and the pump control unit 55. The valve control unit 53 opens the first valve 11 for a first predetermined time. The valve controller 53 keeps the first valve 11 open for a first predetermined time so that a predetermined amount of liquid filled in the liquid supply container 1 is supplied to the liquid supply measurement container 2 by a drop. maintain. Thereby, a predetermined amount of liquid supply is filled in the liquid supply measuring container 2.

  Thereafter, the valve control unit 53 closes the first valve 11. At this time, the second valve 19 is opened. The pump control unit 55 performs the first predetermined liquid transfer pump 10a, the second liquid supply transfer pump 10b, the blood pump 22, and the filtrate pump 29 for a second predetermined time so that the liquid supply passes through each liquid path. Drive.

  After the second predetermined time has elapsed, the mode selection unit 52 transmits the mode information received by the reception unit 51 to the valve control unit 53 and the pump control unit 55.

  The valve control unit 53 controls the opening and closing of the second valve 19 and the third valve 34 according to information corresponding to the transmitted mode information in the valve opening / closing information 540 stored in the valve opening / closing information storage unit 54. For example, when the mode indicated by the mode information is (A) CHD mode, the valve control unit 53 opens the second valve 19 and opens / closes the third valve 34. For example, when the mode indicated by the mode information is (B) CHDF mode, the valve control unit 53 opens the second valve 19 and opens and closes the third valve 34. Basically, the second valve 19 is opened during blood purification, but is closed in the event of an abnormality such as detection of bubbles in the gas-liquid separation chamber 8.

  The pump control unit 55 includes the first supply liquid transfer pump 10a, the second supply liquid transfer pump 10b, according to information corresponding to the transmitted mode information in the pump operation information 560 stored in the pump operation information storage unit 56. The operations of the blood pump 22 and the filtrate pump 29 are controlled. For example, when the mode indicated by the mode information is the (A) CHD mode, the pump control unit 55 operates the first supply liquid transfer pump 10a, the blood pump 22, and the filtrate pump 29. Further, for example, when the mode indicated by the mode information is (D) ECUM mode, the pump control unit 55 operates the blood pump 22 and the filtrate pump 29, and the first supply liquid transfer pump 10a and the second supply liquid transfer pump. 10b is stopped.

  The display unit 57 displays information indicating which of the second liquid supply path 7 and the third liquid supply path 9 of the blood purification circuit flows according to the mode corresponding to the mode information received by the reception unit 51. indicate. Specifically, when the (A) CHD mode is performed, the display unit 57 displays information indicating that the liquid supply flows through the second liquid supply path 7 and does not flow through the third liquid supply path 9. (B) When the CHDF mode is performed, the display unit 57 displays information indicating that the liquid supply flows into both the second liquid supply path 7 and the third liquid supply path 9. (C) When the CHF mode is performed, the display unit 57 displays information indicating that the liquid supply flows through the third liquid supply path 9 and does not flow through the second liquid supply path 7. (D) When the ECUM mode is performed, the display unit 57 displays information indicating that the liquid supply does not flow into the second liquid supply path 7 or the third liquid supply path 9.

  As described above, in the present embodiment, (A) CHD mode, (B) CHDF mode, (C) CHF mode, and (D) ECUM are performed by one blood purification circuit and one control device 50. Modes, i.e. all modes of continuous blood purification, can be performed. Therefore, it is not necessary to use a dedicated device for each mode. In addition, the liquid supply container 1 is filled with the replacement fluid and the dialysate, and the liquid supply metering container 2 is filled with a predetermined amount of the liquid supply and used in any mode. . Since the replacement fluid and dialysate are combined, the circuit for carrying out the continuous blood purification method is simple, and the scale of the device for carrying out the continuous blood purification method can be reduced. The liquid flow rate and the liquid flow rate to the patient can be easily balanced. In addition, a liquid supply path through which the liquid supply flows is branched, and a pump is provided in each of the branched liquid supply paths, and one liquid supply path functions as a dialysis path, and the other liquid supply path functions as a replacement liquid path. Therefore, since the flow rate of the dialysate and the replacement fluid can be controlled independently and with high accuracy, the ratio of CHD and CHF can be arbitrarily changed depending on the patient when blood purification is performed with CHDF, which is highly accurate and efficient. Hemodialysis can be performed.

  Next, details of the balance detector 35 shown in FIG. 1 will be described.

  As described above, the balance detector 35 determines whether or not the decrease amount of the liquid supply filled in the liquid supply measurement container 2 and the increase amount of the filtrate accumulated in the filtrate measurement container 31 are balanced. It is a device to detect. FIG. 5 shows the configuration of the balance detector 35. As shown in FIG. 5, the balance detector 35 includes a base 121, a support rod 122 a, a support rod 122 b, a bridging rod 123, a first rod-shaped member 124, a filtrate rod-shaped member 125, a liquid supply The bar-shaped member 126, the first torque detection unit 128, the second torque detection unit 129, the torque calculation unit 131, the increase / decrease amount calculation unit 132, the weight change amount calculation unit 133, and the display unit 134 are configured. ing. In FIG. 5, the control device 50, the liquid supply measuring container 2 and the filtrate measuring container 31 are also displayed.

  The base 121 is a plate provided with a caster 120 at the lower portion, and can be moved by the caster 120. The support bar 122a and the support bar 122b are fixed on the base 121 so as to be orthogonal to the base 121, and a predetermined distance is provided between the support bar 122a and the support bar 122b. It has been. The bridging rod 123 is a rod that is fixed to the support rod 122a and the support rod 122b horizontally at a predetermined height closer to the base 121 than the uppermost portions of the support rod 122a and the support rod 122b, and the support rod 122a and the support rod By bridging 122b, the support rod 122a and the support rod 122b are helped to stand upright on the base 121.

  The first rod-shaped member 124 is orthogonal to the bridging rod 123 and parallel to the base 121, that is, in a horizontal state, one end is fixed to the center of the bridging rod 123, and the other end is free. Is a stick. As shown in FIG. 5, the first rod-shaped member 124 has a central axis 124a, the same axis as the central axis 124a, and a first outer cylinder 124b, a second outer cylinder 124c, and a third axis that cover the central axis 124a. It is comprised with the external cylinder 124d. The lengths of the first outer cylinder 124b, the second outer cylinder 124c, and the third outer cylinder 124d are shorter than the length when the central shaft 124a is divided into three equal parts, and the first outer cylinder 124b, the second outer cylinder 124c, and The diameter of the space in the central axis portion of the third outer cylinder 124d is such that the central axis 124a is just inserted. The first outer cylinder 124b, the second outer cylinder 124c, and the third outer cylinder 124d are provided at intervals in the direction of the central axis 124a and so as to cover the central axis 124a while being in contact with the central axis 124a. ing. Accordingly, the first rod-shaped member 124 is formed with two portions in the direction of the central axis 124a and a portion thinner than the other portions. The first outer cylinder 124b is fixed to the bridging rod 123, and the first outer cylinder 124b, the second outer cylinder 124c, and the third outer cylinder 124d are provided in order from the side closer to the bridging rod 123.

  The filtrate rod-shaped member 125 is a rod that is orthogonal to the first rod-shaped member 124 and is fixed to the second outer cylinder 124 c of the first rod-shaped member 124 horizontally. A concave holding portion 125 a for holding the filtrate measuring container 31 is provided at a position of a distance L from the connecting portion of the filtrate rod-like member 125 with the first rod-like member 124. The liquid supply rod member 126 is a rod that is orthogonal to the first rod member 124 and is fixed to the third outer cylinder 124d of the first rod member 124 horizontally. A concave holding portion 126 a for holding the liquid supply measuring container 2 is provided at a position of a distance L from the connection portion of the liquid supply rod-like member 126 with the first rod-like member 124. The filtrate rod-like member 125 and the liquid supply rod-like member 126 are provided on the same side with respect to the vertical plane including the first rod-like member 124, as shown in FIG. Further, the liquid supply measuring container 2 and the filtrate measuring container 31 are provided for the upper part of the container. The liquid supply measuring container 2 is used and held in the holding portion 125 a of the liquid rod-like member 125. The filtrate measuring container 31 is used and held in the holding portion 126 a of the liquid supply rod-like member 126.

  The first torque detector 128 is provided on the central shaft 124 a between the first outer cylinder 124 b and the second outer cylinder 124 c of the first rod-shaped member 124, and is disposed on the filtrate rod-shaped member 125. Torque in the holding part 125a (hereinafter referred to as “torque around the second outer cylinder 124c”) and torque in the holding part 126a provided in the liquid supply rod-like member 126 (hereinafter referred to as “around the third outer cylinder 124d”). The sum of "torque") is detected. The second torque detector 129 is provided on the central shaft 124a between the second outer cylinder 124c and the third outer cylinder 124d of the first rod-like member 124, and detects the torque around the third outer cylinder 124d. .

  The torque calculator 131 calculates the torque around the second outer cylinder 124c based on the detection results obtained by the first torque detector 128 and the second torque detector 129. Specifically, the torque calculation unit 131 subtracts the value detected by the second torque detection unit 129 from the value detected by the first torque detection unit 128, thereby calculating the torque around the second outer cylinder 124c. calculate.

  The increase / decrease amount calculation unit 132 is based on the torque around the second outer cylinder 124c and the torque around the third outer cylinder 124d obtained by the second torque detection unit 129 and the torque calculation unit 131, and An increase / decrease amount of the weight of the filtrate measuring container 31 from the initial normal state is calculated. That is, the increase / decrease amount calculation unit 132 calculates the total amount of filtrate actually discarded and the total amount of liquid supply actually used. The increase / decrease amount calculation unit 132 calculates the total amount of filtrate actually discarded by dividing the increase amount from the initial normal state of the torque around the second outer cylinder 124c calculated by the torque calculation unit 131 by the distance L. . Further, the increase / decrease amount calculation unit 132 divides the decrease amount from the initial normal state of the torque around the third outer cylinder 124d detected by the second torque detection unit 129 by the distance L, so that the actually used liquid supply The total amount of is calculated.

  The weight change amount calculation unit 133 is based on the torque around the second outer cylinder 124c and the torque around the third outer cylinder 124d obtained by the second torque detection unit 129 and the torque calculation unit 131. And the amount of change over time of the weight of the filtrate measuring container 31, that is, the flow rate of the filtrate to be discarded and the flow rate of the feed solution to be used are calculated. The value obtained by dividing the increase in the total amount of the filtrate with the change in time by the specific gravity of the filtrate is the flow rate of the discarded filtrate, and the decrease in the total amount of the supply with respect to the change in time is divided by the specific gravity of the supply liquid The value is the flow rate of the feed used. Therefore, the weight change amount calculation unit 133 calculates the temporal change amount of the torque around the second outer cylinder 124c calculated by the torque calculation unit 131, divides the obtained value by the distance L, and is further estimated. The flow rate of the discarded filtrate is calculated by dividing by the specific gravity of the filtrate. The weight change amount calculation unit 133 calculates a temporal change amount of the torque around the third outer cylinder 124d detected by the second torque detection unit 129, divides the obtained value by the distance L, and further supplies By dividing by the specific gravity of the liquid, the flow rate of the used liquid supply is calculated.

  In addition, the weight change amount calculation unit 133 determines whether or not the calculated temporal change amount of the torque around the second outer cylinder 124c is “constant”. When the temporal change amount of the torque around the second outer cylinder 124c is constant, the temporal decrease amount of the liquid supply coincides with the temporal increase amount of the filtrate, and the flow rate of the blood taken out from the patient 40 and the patient 40 The blood flow returned to the flow rate and the flow rate of the liquid supply (replacement fluid) injected into the patient 40 are balanced. Here, the “constant” may be “within a predetermined range”.

  The display unit 134 displays the detection results obtained by the first torque detection unit 128 and the second torque detection unit 129, and the detection results obtained by the torque calculation unit 131, the increase / decrease amount calculation unit 132, and the weight change amount calculation unit 133. Display the results.

  When it is determined by the weight change amount calculation unit 133 that the temporal change amount of the torque around the second outer cylinder 124c is not “constant”, the pump control unit 55 causes the above temporal change amount to be “constant”. In addition, all or part of the first feed liquid transfer pump 10a, the second feed liquid transfer pump 10b, the blood pump 22, and the filtrate pump 29 are controlled. Thereby, the decreasing amount of the liquid supply with which the liquid supply measuring container 2 is filled and the increase amount of the filtrate stored in the filtrate measuring container 31 are balanced. That is, the flow rate of the blood taken out from the patient 40 and the flow rate of the blood returned to the patient 40 and the supply fluid (replacement fluid) injected into the patient 40 are balanced.

  The blood purification circuit of the present invention is useful as a circuit for performing a continuous blood purification method.

It is a block diagram of the blood purification circuit of an embodiment. 2 is a configuration diagram of a control device 50. FIG. It is a figure which shows the valve opening / closing information 540. It is a figure which shows the pump operation information 560. FIG. 4 is a diagram showing a configuration of a balance detector 35.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Liquid supply container 2 Liquid supply measurement container 3 1st liquid supply path 4 1st branch part 5 Liquid supply measurement liquid path 6 Dialyzer 7 2nd liquid supply path 8 Gas-liquid separation chamber 9 3rd liquid supply path 10a 1st Liquid supply transfer pump 10b Second liquid supply transfer pump 11 First valve 14 Fourth liquid supply path 16 Vein side blood path 17 First pressure sensor 18 Inflow path 19 Second valve 20 Arterial side first blood path 21 Arterial side second Blood path 22 Blood pump 23 Second pressure sensor 24 Fluid replacement path 25 Third blood path 26 Syringe 27 Drainage container 28 Filtration path 29 Filtration pump 30 Third pressure sensor 31 Filtration metering container 33 Filtration metering path 34 3rd Valve 35 Balance detector 41 Return side blood circuit 42 Delivery side blood circuit 43 Drainage path 50 Control device 51 Reception unit 52 Mode selection unit 53 Valve control unit 54 Valve open / close information storage unit 55 Pump control unit 56 Pump operation information storage unit

Claims (7)

A liquid supply container for containing the liquid supply and one end connected to the first liquid supply path through which the liquid supply flows;
A first branch connected to the other end of the first liquid supply path;
A second liquid supply path having one end connected to the first branch portion, the other end connected to a purifier that purifies blood, and a first pump segment ;
A third liquid supply path having one end connected to the first branch, the other end connected to a blood path through which blood from the patient flows , and a second pump segment provided ;
Receiving means for receiving mode information specifying which of the plurality of continuous blood purification modes is to be performed, and controlling on / off of the first pump segment and the second pump segment based on the mode information; Control means,
The control means includes
In a mode of performing continuous slow blood filtration (CHF), turning off the first pump segment and turning on the second pump segment;
In a mode of performing continuous slow hemodialysis (CHD), turning on the first pump segment and turning off the second pump segment;
In a mode in which continuous hemodiafiltration (CHDF) is performed , the blood purification circuit is characterized by turning on the first pump segment and turning on the second pump segment . A metering fluid path is further provided, one end of which is connected to the first branch portion and the other end of which is connected to a fluid metering container for metering the fluid supplied from the fluid container. Item 2. The blood purification circuit according to Item 1. The first liquid supply path is provided with first opening / closing means for guiding or blocking the liquid supply flowing through the first liquid supply path to the first branch portion,
The blood purification circuit according to claim 2, wherein the liquid supply in the liquid supply container is guided to the liquid supply measurement container by a drop. A filtrate path through which filtrate from the purifier is connected at one end to the purifier and provided with a third pump segment;
A second branch connected to the other end of the filtrate path;
A drainage vessel connected to the second branch and containing the filtrate flowing through the filtrate path;
The blood purification circuit according to claim 3, further comprising: a filtrate measuring container connected to the second branch part and configured to measure the amount of the filtrate flowing out of the purifier. The control means compares the decrease amount of the liquid stored in the liquid supply measuring container with the increase amount of the filtrate stored in the filtrate measurement container, and performs filtration from the purifier based on the comparison result blood purification circuit according to claim 4, characterized in that controlling the amount of increase or decrease. A drainage path having one end connected to the second branch and the other end connected to the drainage container;
Wherein the drainage channel leads the filtrate flowing through the drains in the drainage container, or the second switching means is provided it is to block,
The control means further controls opening and closing of the first opening and closing means and the second opening and closing means based on the mode information,
The control means includes
In a mode in which continuous slow hemofiltration (CHF), continuous slow hemodialysis (CHD), and continuous hemodiafiltration (CHDF) are performed, the first opening / closing means is opened and the second opening / closing is performed. Open the means,
6. The blood purification circuit according to claim 5 , wherein in the mode of performing ultrafiltration (ECUM), the first opening / closing means is closed and the second opening / closing means is opened . The control means includes
In a mode in which ultrafiltration (ECUM) is performed, the first pump segment is turned off and the second pump segment is turned off.
The blood purification circuit according to claim 1 or 6, characterized in that.

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