JP5205036B2 - Blood purification equipment - Google Patents

Description

  The present invention relates to a blood purification apparatus for purifying a patient's blood while circulating it extracorporeally, such as dialysis treatment using a dialyzer.

  Generally, at the time of dialysis treatment, a blood circuit for circulating the collected patient's blood extracorporeally and returning it to the body is used. Such a blood circuit is, for example, a dialyzer (blood purification means) having a hollow fiber membrane. It is mainly composed of an arterial blood circuit and a venous blood circuit that can be connected to each other. Then, an arterial puncture needle and a venous puncture needle are connected to the tips of the arterial blood circuit and the venous blood circuit, respectively, and the puncture needle is punctured by the patient to perform extracorporeal circulation of blood in dialysis treatment. .

  By the way, the blood pump is stopped at the end of the dialysis treatment, but since the patient's blood remains in the blood circuit, dialyzer, arterial drip chamber, venous drip chamber, etc. Blood return work is required to return to In such blood return work, generally, physiological saline is introduced from the middle of the arterial blood circuit, and the physiological saline is replaced with blood remaining in the blood circuit.

However, in order to facilitate the automation of the blood return operation, for example, as disclosed in Patent Document 1, the blood pump is used during dialysis treatment while reversely filtering the dialysate from the dialysate flow path of the dialyzer to the blood flow path. Is driven in the reverse direction, and the residual blood is returned to the patient's body from the arterial puncture needle and the venous puncture needle by replacing the dialysate that has been reversely filtered and the blood remaining in the blood circuit. It was.
JP 2001-259024 A

  However, in the above conventional blood purification apparatus, since the dialysate is reverse-filtered and replaced with residual blood, there is a problem as follows. That is, from the viewpoint of hygiene, it is necessary to avoid that the dialysate reversely filtered by the dialyzer (blood purification means) enters the patient's body. Therefore, in returning blood, it is ideal to replace the residual blood by introducing a sanitary guaranteed physiological saline or the like (because it is assumed to be introduced directly into the patient's body by a replacement fluid). However, in this case, there is a problem that it is difficult to automate the blood return work.

  The present invention has been made in view of such circumstances, and it is possible to easily automate the blood return operation, and the dialysate reversely filtered by the blood purification means enters the patient's body. It is an object of the present invention to provide a blood purification device that can reliably avoid the above.

The invention according to claim 1 is composed of an arterial blood circuit and a venous blood circuit, a blood circuit capable of extracorporeally circulating a patient's blood from the tip of the arterial blood circuit to the tip of the venous blood circuit, and the blood A blood flow path that is interposed between the arterial blood circuit and the venous blood circuit of the circuit to purify blood flowing through the blood circuit, and through which a patient's blood flows through a blood purification film for purifying the blood; A blood purification means in which a dialysate flow path through which dialysate flows is formed; a dialysate introduction line and a dialysate discharge line connected to the inlet and outlet of the dialysate flow path of the blood purification means; A replacement liquid supply line capable of supplying a replacement liquid for replacement with blood into the blood circuit and the vicinity of the tip of the arterial blood circuit can be opened and closed to block and open the flow path. Movement A side valve means, a venous side valve means capable of opening and closing the vicinity of the distal end of the venous blood circuit, and capable of closing and opening the flow path; And a replacement fluid valve means capable of closing and releasing the blood flow, and the patient's blood flowing from the tip of the arterial blood circuit to the tip of the venous blood circuit by forward rotation driving by being arranged in the middle of the arterial blood circuit. In the blood purification apparatus comprising a blood pump that can be circulated extracorporeally , blood from the connection portion with the replacement fluid supply line in the arterial blood circuit to the tip of the venous blood circuit is supplied from the replacement fluid supply line The first blood returning step of returning the blood from the connecting portion to the tip of the venous blood circuit to the patient and filling the blood circuit with the replacement fluid by replacing with the replacement fluid. After the first blood return step, the dialysate is back-filtered from the dialysate flow channel to the blood flow channel in the blood purification means, and the replacement fluid filled in the first blood return step is flowed with the dialysate. And a control means for performing a second blood return step for returning blood from the connecting portion to the tip of the arterial blood circuit to the patient, the control means in the first blood return step, While the arterial valve means is closed, the venous valve means and replacement fluid valve means are opened, and the blood pump is driven to rotate forward, and in the second blood return step, the venous valve means and The arterial valve means is opened while the replacement fluid valve means is closed, and the blood pump is driven in reverse rotation, and blood is returned by the first blood return process or by the second blood return process. A detection means for detecting the completion of blood return, The control means can grasp that the blood return by the first blood return step or the blood return by the second blood return step has been completed .

According to a second aspect of the invention, the blood purification apparatus according to claim 1 Symbol placement, the amount of reverse filtration of the dialysate in the second blood return step, the coupling portion with the replacement liquid supply line in the arterial blood circuit To a pipe volume from the arterial blood circuit to the tip of the arterial blood circuit and less than a pipe volume of the arterial blood circuit.

  According to the invention of claim 1, in the second blood return step, the dialysate is back-filtered from the dialysate flow channel in the blood purification means to the blood flow channel, and the dialysate is filled in the first blood return step. Flowing replacement fluid and returning blood from the connecting part to the tip of the arterial blood circuit to the patient, facilitating automation of blood return work and dialysis that is back-filtered by blood purification means The liquid can be surely avoided from entering the patient's body.

Further , under the control of the control means, in the first blood return step, the venous valve means and the replacement fluid valve means are opened while the arterial valve means is closed, and the blood pump is driven to rotate in the forward direction. In the blood return process, the venous valve means and the replacement fluid valve means are closed while the arterial valve means is opened, and the blood pump is driven in reverse to perform the blood return work. Can be achieved more easily.

Furthermore , it has a detection means which detects that the blood return by the 1st blood return process or the blood return by the 2nd blood return process was complete | finished, The blood return by the said 1st blood return process or the blood return by the 2nd blood return process Since the control means can grasp that the operation has been completed, the blood return operation can be performed more efficiently and reliably.

According to the invention of claim 2 , the amount of backfiltration of the dialysate in the second blood return step is equal to or greater than the piping volume from the connecting portion with the replacement fluid supply line in the arterial blood circuit to the tip of the arterial blood circuit, And since it was made below the piping volume of the artery side blood circuit, it can avoid that a dialysate enters a patient's body more reliably, and can return most residual blood to a patient.

Hereinafter, embodiments of the present invention will be specifically described with reference to the drawings.
The blood purification apparatus according to the first embodiment includes a dialysis apparatus for performing dialysis treatment. As shown in FIG. 1, a blood circuit including an arterial blood circuit 1 and a venous blood circuit 2, and an arterial blood. A dialyzer 3 (blood purification means) interposed between the circuit 1 and the venous blood circuit 2 to purify blood flowing through the blood circuit; a squeezing blood pump 4 disposed in the arterial blood circuit 1; An arterial drip chamber 5 and a venous drip chamber 6 disposed in the venous blood circuit 1 and the venous blood circuit 2, respectively, a dual pump 8 capable of supplying dialysate to the dialyzer 3, and physiological saline as a replacement liquid It is mainly comprised from the accommodating means 7 which accommodated water, and the replacement liquid supply line Ld which connected this accommodating means 7 and the artery side blood circuit 1. FIG.

  The arterial blood circuit 1 is connected to an arterial puncture needle a at the tip thereof, and an iron-type blood pump 4 and an arterial drip chamber 5 for defoaming are disposed in the middle. A venous puncture needle b is connected to the distal end of the side blood circuit 2 and a venous drip chamber 6 is connected in the middle. Then, when the blood pump 4 is driven with the patient punctured with the arterial puncture needle a and the venous puncture needle b, the patient's blood passes through the arterial blood circuit 1 and reaches the dialyzer 3, Blood purification is performed by the dialyzer 3, and bubbles are removed in the venous drip chamber 6, and then returned to the patient's body through the venous blood circuit 2. That is, the blood of the patient is purified by the dialyzer 3 while circulating externally from the tip of the arterial blood circuit 1 to the tip of the venous blood circuit 2 of the blood circuit.

  The dialyzer 3 includes a blood introduction port 3a (blood channel inlet), a blood outlet port 3b (blood channel outlet), a dialysate inlet port 3c (dialysate channel inlet), and a dialysate outlet port 3d. (Dialysate flow path outlet) is formed, of which the arterial blood circuit 1 is connected to the blood introduction port 3a and the venous blood circuit 2 is connected to the blood outlet port 3b. The dialysate introduction port 3c and the dialysate lead-out port 3d are respectively connected to a dialysate introduction line La and a dialysate discharge line Lb extending from the dialyzer body.

  A plurality of hollow fibers are accommodated in the dialyzer 3, and the hollow fibers constitute a blood purification membrane M for purifying blood. Thus, in the dialyzer 3, a blood channel B through which the patient's blood flows and a dialysate channel T through which the dialysate flows are formed through the blood purification membrane M. The hollow fiber constituting the blood purification membrane M is formed with a number of minute holes (pores) penetrating the outer peripheral surface and the inner peripheral surface to form a hollow fiber membrane. Impurities and the like in the blood can pass through the dialysate.

  On the other hand, the duplex pump 8 is arranged in the dialysis machine body so as to straddle the dialysis fluid introduction line La and the dialysis fluid discharge line Lb. A water removal pump (not shown) for removing water is disposed. Furthermore, one end of the dialysate introduction line La is connected to the dialyzer 3 (dialyte introduction port 3c), and the other end is connected to a dialysate supply device (not shown) for preparing a predetermined concentration of dialysate. In addition, one end of the dialysate discharge line Lb is connected to the dialyzer 3 (dialysate outlet port 3d), and the other end is connected to a drain means (not shown), and the dialysate supplied from the dialysate supply device After passing through the dialysate introduction line La to the dialyzer 3, it is sent to the drainage means through the dialysate discharge line Lb.

  A filter 9 is connected in the middle of the dialysate introduction line La (between the duplex pump 8 and the dialyzer 3), and the flow path branches from the filter 9, and the dialysate discharge line is bypassed while bypassing the dialyzer 3. A bypass line Lc connected to the middle of Lb (between the duplex pump 9 and the dialyzer 3) is formed. In the middle of the bypass line Lc, an electromagnetic valve V6 that can close and open the flow path is connected.

Arterial needle a vicinity of the arterial blood circuit 1 (between the connecting portion P and the arterial needle a of the artery side a vicinity of the distal end of the blood circuit 1 substitution solution supply line L d), and the venous blood circuit 2 near the vein-side puncture needle b (near the distal end of the vein-side blood circuit 2 and between the vein-side drip chamber 6 and the vein-side puncture needle b), and an electromagnetic valve V1 as an arterial valve means, and a vein A solenoid valve V2 is provided as a side valve means. These electromagnetic valves V1 and V2 are capable of closing and opening the flow paths in the respective portions provided by opening and closing operations, and the opening and closing operations are controlled by the control means 10.

  As described above, the control means 10 is electrically connected to the electromagnetic valves V1 and V2 as well as the electromagnetic valve V3 (substitution liquid valve means) disposed in the middle of the substitution liquid supply line Ld, and the opening and closing operation thereof is performed. It can be controlled. The electromagnetic valve V3 as the replacement liquid valve means is provided so as to be able to open and close the replacement liquid supply line Ld, and can close and open the flow path. Further, as shown in FIG. 1, the control means 10 is also electrically connected to the electromagnetic valves V4 and V5 and the blood pump 4 respectively disposed in the middle of the dialysate introduction line La and the dialysate discharge line Lb. The opening / closing operation and driving can be controlled.

  The storage means 7 (what is called a “saline bag”) is made of a flexible transparent container and can store a predetermined volume of physiological saline (substitution liquid). It is attached to the tip of a pole (not shown). The replacement liquid supply line Ld is connected to a portion (connecting portion P) between the arterial puncture needle a and the arterial drip chamber 5 in the arterial blood circuit 1 to supply physiological saline (replacement liquid) in the storage means 7. It can be supplied into the blood circuit.

  Here, the dialysis device (blood purification device) according to the present embodiment is configured such that the control means 10 can perform the first blood return step and the second blood return step. Specifically, in the first blood return step, the blood from the connection portion P with the replacement fluid supply line Ld in the artery side blood circuit 1 to the tip of the venous blood circuit 2 is supplied from the replacement fluid supply line Ld. By replacing with saline (substitution fluid), blood from the connecting portion P to the tip of the venous blood circuit 2 is returned to the patient, and blood circuits (arterial blood circuit 1 and venous blood circuit 2) are returned. The second blood return step is a reverse filtration of the dialysate from the dialysate flow channel T to the blood flow channel B in the dialyzer 3 after the first blood return step (see FIG. 2). Causing the physiological saline filled in the first blood return step to flow with the dialysate, and returning blood from the connecting portion P to the tip of the arterial blood circuit 1 to the patient (see FIG. 3). It is.

  In the figure, reference numerals S1 to S3 denote bubble detectors for detecting bubbles, and S4 and S5 denote blood discriminators. That is, on the downstream side of the electromagnetic valve V1 in the arterial blood circuit 1, on the upstream side of the electromagnetic valve V2 in the venous blood circuit 2, and on the upstream side of the electromagnetic valve V3 in the replacement fluid supply line Ld, the bubble detectors S1, S2 and S3 are disposed, and blood discriminators S4 and S5 are disposed on the upstream side of the electromagnetic valve V1 in the arterial blood circuit 1 and on the downstream side of the electromagnetic valve V2 in the venous blood circuit 2, respectively. -ing

Next, blood return work in the dialysis machine as the blood purification apparatus will be described.
When the dialysis treatment by the dialysis apparatus is completed, the blood circuit and blood in the dialyzer 3 are returned to the patient's body. The blood return is performed mainly by the control of the control means 10, and the region (from the connecting part P to the replacement fluid supply line Ld in the arterial blood circuit 1 to the venous puncture needle b (the tip of the venous blood circuit 2) ( The first blood return step) and the part (second blood return step) from the connecting portion P to the arterial puncture needle a (tip of the arterial blood circuit 1) are performed separately.

  More specifically, after the dialysis treatment is completed, as shown in FIG. 2, the control means 10 closes the electromagnetic valve V1 (arterial valve means) and closes the electromagnetic valve V2 (venous valve means) and the electromagnetic valve. The first blood return step is performed by opening the valve V3 (substitution fluid valve means) and driving the blood pump 4 to rotate forward. By this first blood return step, blood from the connecting portion P to the tip of the venous puncture needle b is returned to the patient's body, and the blood circuit (the arterial blood circuit 1 and the venous blood circuit 2) contains accommodation means. The physiological saline supplied from 7 through the replacement liquid supply line Ld is filled. At this time, the electromagnetic valves V4 and 5 are closed, and the electromagnetic valve V6 is opened.

  However, in the first blood return step, it is preferable that the flow rate of the blood pump 4 is continuously changed to control pulsation. That is, as shown in FIG. 4, the blood pump 4 is driven (the flow rate at that time is set to 200 (mL / min), for example) and stopped repeatedly (for example, the drive time is set to 0.5 (seconds) and stopped). If the time is set to 0.2 (seconds) and pulsation is generated, it is effective for washing out blood, reducing the amount of physiological saline (substitution solution) used, and improving blood return efficiency. This can be further improved. The drive time, stop time, flow rate, and the like can be arbitrarily set, and in particular, control can be performed to reduce the flow rate instead of stopping.

  Subsequently, as shown in FIG. 3, the control means 10 opens the electromagnetic valve V1 (arterial side valve means) while closing the electromagnetic valve V2 (venous side valve means) and the electromagnetic valve V3 (substitution fluid valve means). At the same time, the second blood return step is performed by driving the blood pump 4 in the reverse direction. In this second blood return process, the dialysate 3 is reversely filtered from the dialysate flow path T to the blood flow path B by the reverse drive of the blood pump 4 and filled with the dialysate in the first blood return process. The supplied physiological saline is caused to flow, and the blood from the connecting portion P to the tip of the arterial blood circuit 1 is returned to the patient. At this time, the solenoid valve V4 is opened while the solenoid valve V6 is open and the solenoid valve V5 is closed. However, even if the solenoid valve V4 is closed, the solenoid valve V4 is in a closed state. No problem.

  However, in the second blood return step, a warning of a venous pressure pressure connected to the arterial drip chamber 5 is issued, or air bubbles in the arterial drip chamber 5 move upstream. Since there is a possibility that an alarm of the bubble detector S1 may be issued, it is preferable that the forward / reverse driving of the blood pump 4 is performed a plurality of times (which can be arbitrarily set in accordance with the water permeability of the dialyzer 3).

  That is, after the first blood return step is completed, as shown in FIG. 3, by rotating the blood pump 4 in reverse, a predetermined amount of dialysate is supplied via the dialyzer 3 (the air in the arterial drip chamber 5 is connected to the connecting portion). To the extent that it does not reach P), the physiological saline filled in the first blood return step is pushed toward the artery side puncture needle a side (push-off step). Thereafter, as shown in FIG. 5, the electromagnetic valve V3 is opened while the electromagnetic valve V1 is closed, and the blood pump 5 is driven forward so that the dialysate that has been reverse-filtered in the flushing process is directed to the dialyzer 3 side. Push back (push back process).

  As described above, if the above-described flushing step and the pushing-back step are repeated a plurality of times in the second blood return step, the pressure alarm of the venous pressure connected to the arterial drip chamber 5 is issued or the arterial drip chamber is concerned. Thus, it is possible to avoid problems such as the bubbles in the air layer 5 moving upstream and the alarm of the bubble detector S1 being issued. In addition, by causing the flushing process and the pushing-back process to be repeated a plurality of times, it is possible to avoid applying an excessive pressure to the blood purification film M of the dialyzer 3, and to damage the blood purification film M. Can be prevented.

As described above, according to the present embodiment, in the second blood return step, the dialysate is reversely filtered from the dialysate flow channel T to the blood flow channel B in the dialyzer 3, and the dialysate is used in the first blood return step. Since the filled physiological saline is caused to flow and blood from the connecting portion P to the tip of the arterial blood circuit 1 is returned to the patient, the blood return operation can be easily automated and the blood purification means can be used. Therefore, it is possible to reliably avoid the back-filtered dialysate from entering the patient's body.

  Further, under the control of the control means 10, in the first blood return step, the solenoid valve V2 (venous side valve means) and the solenoid valve V3 (substitution fluid valve means) are closed while the solenoid valve V1 (arterial side valve means) is closed. In the second return step, the electromagnetic valve V1 (venous side valve means) and the electromagnetic valve V3 (replacement fluid valve means) are closed while the blood pump 4 is driven to rotate forward. Since the arterial valve means) is opened and the blood pump 4 is driven in reverse to perform the blood return operation, the blood return operation can be automated more easily.

  Furthermore, in the present embodiment, the amount of dialysate backfiltration in the second blood return step is the piping from the connecting portion P to the replacement fluid supply line Ld in the arterial blood circuit 1 to the tip of the arterial blood circuit 1. The volume (the total volume of the flow path at the site) is equal to or greater than the volume of the arterial blood circuit 1 (the total volume of the flow path at the site). Thus, it is possible to more reliably avoid the dialysate from entering the patient's body and return most of the residual blood to the patient. When the piping volume of the arterial blood circuit 1 is Va and the piping volume from the connecting portion P to the tip of the arterial blood circuit 1 is Vb, Va is preferably at least 1.5 times Vb or more.

  However, there is provided a detecting means for detecting that the blood return by the first blood return step or the blood return by the second blood return step is completed, and the blood return by the first blood return step or the blood return by the second blood return step. It is preferable that the control means 10 be able to grasp that the process has been completed. In this case, the blood return operation can be performed more efficiently and reliably. The detecting means detects the end of blood return by the first blood return step or the second blood return step based on the elapsed time from the start of the first blood return step or the second blood return step, the blood pump 4 May be the one that detects the end of blood return by the first blood return step or the second blood return step, or the one that detects the end of blood return directly by an optical sensor or the like It may be detected by the devices S4 and S5.

Next, a second embodiment according to the present invention will be described.
As in the first embodiment, the blood purification apparatus according to the second embodiment includes a dialysis apparatus for performing dialysis treatment. As shown in FIG. 6, the blood purification apparatus includes an arterial blood circuit 1 and a venous blood circuit 2. The blood circuit, the dialyzer 3 (blood purification means), the squeezed blood pump 4, the arterial drip chamber 5 and the venous drip chamber 6, the dual pump 8, and the replacement fluid supply line Ld ′ are mainly used. It is configured. In addition, the same code | symbol is attached | subjected to the component similar to 1st Embodiment, and those description is abbreviate | omitted.

  The replacement fluid supply line Ld ′ is in the middle of the dialysate introduction line La (specifically, between the filter 9 and the electromagnetic valve V4) and in the middle of the arterial blood circuit 1 (specifically, the electromagnetic valve V1 and the blood pump). 4), the dialysate flowing through the dialysate introduction line La (fresh dialysate (substitution fluid) filtered by the filter 9) can be supplied into the blood circuit. In the middle of the replacement liquid supply line Ld ', an electromagnetic valve V7 (substitution liquid valve means) is connected. In addition, it is preferable to connect a filter similar to the filter 9 disposed in the middle of the dialysate introduction line La in the middle of the replacement liquid supply line Ld ′.

  However, the dialysis apparatus (blood purification apparatus) according to the present embodiment is configured to be able to perform the first blood return process and the second blood return process by the control means 10 as in the first embodiment. Specifically, in the first blood return step, blood from the connection portion P with the replacement fluid supply line Ld ′ in the artery side blood circuit 1 to the tip of the venous blood circuit 2 is supplied from the replacement fluid supply line Ld ′. By replacing with the dialysate (substitution fluid), blood from the connecting portion P to the tip of the venous blood circuit 2 is returned to the patient, and blood circuits (arterial blood circuit 1 and venous blood circuit 2) are returned. ) Is filled with the replacement fluid (see FIG. 7), and the second blood return step reverses the dialysate from the dialysate flow channel T to the blood flow channel B in the dialyzer 3 after the first blood return step. Filtering, flowing the physiological saline filled in the first blood return step with the dialysate, and returning the blood from the connecting portion P to the tip of the arterial blood circuit 1 to the patient (see FIG. 8). ).

  More specifically, after the dialysis treatment is completed, as shown in FIG. 7, the control means 10 closes the electromagnetic valve V1 (arterial valve means) and closes the electromagnetic valve V2 (venous valve means) and the electromagnetic valve. The first blood return step is performed by opening the valve V7 (substitution liquid valve means) and driving the blood pump 4 to rotate forward. By this first blood return step, blood from the connecting portion P to the tip of the venous puncture needle b is returned to the patient's body, and the blood circuit (arterial side blood circuit 1 and venous side blood circuit 2) has dialysate. The dialysate supplied from the introduction line La via the replacement liquid supply line Ld ′ is filled. At this time, the electromagnetic valves V4 and 5 are closed, and the electromagnetic valve V6 is opened. However, as in the first embodiment, in the first blood return step, it is preferable to control the flow rate of the blood pump 4 to continuously change to generate pulsation.

  Subsequently, as shown in FIG. 8, the control means 10 opens the electromagnetic valve V1 (arterial side valve means) while closing the electromagnetic valve V2 (venous side valve means) and the electromagnetic valve V7 (substitution fluid valve means). At the same time, the second blood return step is performed by driving the blood pump 4 in the reverse direction. In this second blood return process, the dialysate 3 is reversely filtered from the dialysate flow path T to the blood flow path B by the reverse drive of the blood pump 4 and filled with the dialysate in the first blood return process. The dialysis fluid thus made is flowed, and the blood from the connecting portion P to the tip of the arterial blood circuit 1 is returned to the patient. At this time, the solenoid valve V4 is opened while the solenoid valve V6 is open and the solenoid valve V5 is closed. However, even if the solenoid valve V4 is closed, the solenoid valve V4 is in a closed state. No problem. However, in the second blood return step, as in the first embodiment, it is preferable to perform forward / reverse rotation of the blood pump 4 a plurality of times (which can be arbitrarily set according to the water permeability of the dialyzer 3).

As described above, according to the present embodiment, in the second blood return step, the dialysate is reversely filtered from the dialysate flow channel T to the blood flow channel B in the dialyzer 3, and the dialysate is used in the first blood return step. Since the filled dialysate is caused to flow and the blood from the connecting portion P to the tip of the arterial blood circuit 1 is returned to the patient, the blood return operation can be easily automated as in the first embodiment. In addition, it is possible to reliably avoid the dialysate that has been back-filtered by the blood purification means from entering the patient's body.

  As mentioned above, although this embodiment was described, this invention is not limited to these, For example, it replaces with the physiological saline accommodated in the accommodating means 7, or a fresh dialysate, and other substitution liquid (in dialyzer 3). It may be configured such that the blood circuit is filled in the blood return circuit in the first blood return step. In this embodiment, in the second blood return step, the blood pump 4 is reversely driven to reversely filter the dialysate, but instead of or in combination with this, the dual pump 8 is driven. Alternatively, the dialysate may be reverse filtered.

  In this embodiment, the present invention is applied to a dialysis apparatus used at the time of dialysis treatment, but is used in other apparatuses that can purify the patient's blood while circulating it outside the body (for example, blood filtration dialysis, blood filtration, AFBF). The present invention may be applied to blood purification devices, plasma adsorption devices, and the like.

By replacing the blood from the connecting portion with the replacement fluid supply line in the arterial blood circuit to the tip of the venous blood circuit with the replacement fluid supplied from the replacement fluid supply line, the tip of the venous blood circuit from the connecting portion A first blood return step for returning blood to the patient from the tip of the venous blood circuit while filling with the replacement fluid, and after the first blood return step, from the dialysate flow path in the blood purification means The dialysate is back-filtered into the blood flow path, the replacement solution filled in the first blood return step is flowed with the dialysate, and the blood from the connecting portion to the tip of the arterial blood circuit is returned to the patient. And a control means for performing the second blood return step, and the control means opens the venous valve means and the replacement fluid valve means in the first blood return step while closing the arterial valve means. At the same time, the blood pump is driven forward to return the second blood. The arterial valve means is opened while the venous valve means and the replacement fluid valve means are closed, and the blood pump is driven in reverse rotation. A detecting means for detecting the completion of the blood return by the second blood return process, and the control means can grasp that the blood return by the first blood return process or the blood return by the second blood return process has been completed; The blood purification apparatus can be applied to other forms and uses.

1 is a schematic diagram showing a dialysis device (blood purification device) according to a first embodiment of the present invention. The schematic diagram which shows the state in which the 1st blood return process by the dialysis device is performed The schematic diagram which shows the state in which the 2nd blood return process by the dialysis device is performed The graph which shows the drive timing of the blood pump which shows other embodiment at the time of the 1st blood return process by the same dialysis device The schematic diagram which shows other embodiment at the time of the 2nd blood return process by the same dialysis apparatus. The schematic diagram which shows the dialysis apparatus (blood purification apparatus) which concerns on the 2nd Embodiment of this invention. The schematic diagram which shows the state in which the 1st blood return process by the dialysis device is performed The schematic diagram which shows the state in which the 2nd blood return process by the dialysis device is performed

Explanation of symbols

1 Arterial blood circuit 2 Venous blood circuit 3 Dialyzer (blood purification means)
4 Blood Pump 5 Arterial Drip Chamber 6 Vein Side Drip Chamber 7 Accommodating Means 8 Duplex Pump 9 Filter 10 Control Means V1 Solenoid Valve (Arterial Side Valve Means)
V2 Solenoid valve (Venous valve means)
V3, V7 Solenoid valve (substitution valve means)
La Dialysate introduction line Lb Dialysate discharge line Ld, Ld 'Replacement fluid supply line

Claims (2)

A blood circuit comprising an arterial blood circuit and a venous blood circuit, and capable of extracorporeally circulating the patient's blood from the distal end of the arterial blood circuit to the distal end of the venous blood circuit;
A blood flow that is interposed between the arterial blood circuit and the venous blood circuit of the blood circuit to purify the blood flowing through the blood circuit and to which the patient's blood flows through a blood purification film for purifying the blood Blood purification means in which a dialysis fluid flow path through which the passage and dialysis fluid flow is formed;
A dialysate introduction line and a dialysate discharge line connected to the dialysate flow path inlet and outlet of the blood purification means;
A replacement fluid supply line capable of supplying a replacement fluid for performing replacement with blood in the blood circuit after treatment into the blood circuit;
An arterial valve means provided near the distal end of the arterial blood circuit as being openable and closable and capable of closing and opening the flow path;
A venous valve means provided near the distal end of the venous blood circuit as being openable and closable and capable of closing and opening the flow path;
A replacement liquid valve means provided so as to be able to open and close the replacement liquid supply line, and capable of closing and opening the flow path;
A blood pump that is disposed in the middle of the arterial blood circuit and is capable of extracorporeally circulating the patient's blood from the tip of the arterial blood circuit to the tip of the venous blood circuit by forward rotation;
In the blood purification apparatus comprising
By replacing the blood from the connecting portion with the replacement fluid supply line in the arterial blood circuit to the tip of the vein blood circuit with the replacement fluid supplied from the replacement fluid supply line, the blood from the connecting portion to the vein side A first blood return step for returning blood up to the tip of the blood circuit to the patient and filling the blood circuit with the replacement liquid;
After the first blood return step, the dialysate is back-filtered from the dialysate flow channel to the blood flow channel in the blood purification means, and the replacement fluid filled in the first blood return step is flowed with the dialysate. A second blood return step for returning blood from the connecting portion to the tip of the arterial blood circuit to the patient;
The control means is configured to open the venous valve means and the replacement fluid valve means while the arterial valve means is closed in the first blood return step, and The blood pump is driven to rotate forward, and in the second blood return step, the arterial valve means is opened while the venous valve means and replacement fluid valve means are closed, and the blood pump is driven in reverse. And
A detecting means for detecting completion of blood return by the first blood return step or blood return by the second blood return step, and blood return by the first blood return step or blood return by the second blood return step. A blood purification apparatus characterized in that the control means can grasp that it has been completed . The amount of dialysate backfiltration in the second blood return step is equal to or greater than the piping volume from the connection portion with the replacement fluid supply line to the distal end of the artery side blood circuit in the artery side blood circuit, and the artery side claim 1 Symbol placement of the blood purification apparatus is characterized in that the less piping volume of the blood circuit.

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