JP5356853B2 - Blood purification equipment - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a blood purification apparatus for improving the automation of a series of works concerning a blood purification treatment. <P>SOLUTION: The blood purification apparatus includes: an overflow line L3 which is branched from a part of an arterial side blood circuit 2 or a venous side blood circuit 3 so as to be extended to a dialysate discharge line L2, and guides a fluid flowing in the arterial side blood circuit 2 or the venous side blood circuit 3 to the dialysate discharge line L2; electromagnetic valves V5, V6 (opening/closing valve means for the overflow line) for optionally opening/closing the flow passage of the overflow line L3; and a control means 12 for controlling a blood pump 8 and the electromagnetic valves V5, V6 at preset timings. <P>COPYRIGHT: (C)2010,JPO&amp;INPIT

Description

  The present invention circulates a patient's blood extracorporeally with an arterial blood circuit and a venous blood circuit, and purifies extracorporeal blood with a blood purifier connected to the arterial blood circuit and the venous blood circuit. The present invention relates to a blood purification apparatus.

  Recently, a dialysis apparatus as a blood purification apparatus has been proposed to perform priming, blood return, and replacement fluid using a dialysis liquid supplied to a dialyzer during dialysis treatment. For example, in Patent Document 1, after connecting the distal end of the arterial blood circuit and the distal end of the venous blood circuit, the dialysate is supplied to the dialyzer, and the dialyzed fluid obtained by reverse filtration of the dialysis membrane flows through the blood circuit. Priming was performed by discharging from an overflow tube connected to the drip chamber. In Patent Document 2, after the arterial blood circuit tip is connected to the venous blood circuit, the dialysate is supplied to the dialyzer, the dialyzed membrane is reverse-filtered, and the blood remaining in the blood circuit The remaining blood was returned to the patient's body from the tip of the venous blood circuit.

  Furthermore, in the case where the blood purifier is applied to hemodiafiltration (HDF) and uses dialysis fluid as a replacement fluid (hereinafter referred to as online HDF), the dialysis fluid is supplemented to the patient's blood only by dehydration. (There is a pre-replacement fluid to be replenished in the arterial blood circuit and a post-replacement fluid to be refilled in the venous blood circuit). As disclosed in Patent Document 3, as applied to such on-line HDF, a dialyzer, a blood circuit including an arterial blood circuit and a venous blood circuit provided with a blood pump, and a dialysate in the dialyzer A dialysate feeding line for introducing the dialysate, a dialysate draining line for discharging the dialysate from the dialyzer, a predilution replacement fluid line for supplying dialysate from the dialysate feeding line to the blood circuit without going through the dialyzer, and Dialysis machines with post-dilution replacement fluid lines have been proposed.

JP 2001-245970 A JP 2001-252352 A Japanese Patent Laid-Open No. 2001-112863

  However, in the above-mentioned conventional blood purification apparatus, it is considered that the use of dialysate as a replacement fluid can facilitate the automation of replacement fluid and other operations (priming, blood return, etc.) to some extent, but the degree of automation Was still incomplete. In other words, blood purification treatment requires a series of operations such as priming, treatment and replacement fluid, blood return, etc., but conventionally, manual operations by workers have been required in many situations. There was a growing need to increase the automation of the work.

  The present invention has been made in view of such circumstances, and it is an object of the present invention to provide a blood purification apparatus that can further enhance automation of a series of operations related to blood purification treatment.

The invention described in claim 1 includes a blood purification membrane, a blood introduction port for introducing blood, and a blood outlet for introducing introduced blood, and a dialysate introduction port for introducing dialysate and the introduction A dialysate discharge port for discharging dialysate is formed, a blood purifier for purifying blood by contacting the blood with the blood via the blood purification membrane, and one end connected to a blood inlet of the blood purifier An arterial blood circuit in which a blood pump is disposed in the middle, a venous blood circuit having one end connected to the blood outlet of the blood purifier, and a dialysate inlet of the blood purifier A dialysate introduction line for introducing dialysate into the blood purifier, and a dialysate discharge line connected to the dialysate discharge port of the blood purifier and discharging dialysate from the blood purifier, Dialysate in the dialysate introduction line A blood purification apparatus configured to be supplied to the arterial blood circuit and the venous blood circuit, extending from a part of the arterial blood circuit or the venous blood circuit and extending to the dialysate discharge line An overflow line capable of guiding the fluid flowing through the arterial blood circuit or the venous blood circuit to the dialysate discharge line, and opening and closing for the overflow line capable of arbitrarily opening and closing the flow path of the overflow line Valve means; control means for controlling the blood pump and overflow line open / close valve means at a preset timing; a part of the arterial blood circuit or venous blood circuit and a branch portion of the overflow line; A different part and the dialysate introduction line are connected, and the dialysate in the dialysate introduction line is connected to the arterial blood circuit or vein side. It is configured to include a replacement fluid line that is capable of supplying to the liquid circuit, the overflow line and the replacement fluid line, which has a blood purification apparatus body of the internal flow path and the blood purification apparatus body outside of the external passage respectively The blood purification device main body includes an overflow line connection port that connects the internal flow path and the external flow path of the overflow line, and a replacement fluid line connection port that connects the internal flow path and the external flow path of the replacement fluid line. And connecting means for connecting the overflow line connection port and the replacement fluid line connection port in a state in which the external flow path of the overflow line and the external flow path of the replacement fluid line are removed. Features.

According to a second aspect of the invention, the blood purification apparatus according to claim 1, wherein the liquid feed while being controlled by said control means, the dialysate of the dialysate introduction line to the arterial blood circuit or the venous blood circuit The liquid feeding means for this is arranged in the replacement fluid line.

According to a third aspect of the present invention, in the blood purification apparatus according to the first or second aspect , the dialysate introduction line is dialyzed in a state where the distal end of the arterial blood circuit and the distal end of the venous blood circuit are connected. A fluid is supplied to the arterial blood circuit and the venous blood circuit, and the dialysate is overflowed through the overflow line to perform a priming step.

According to a fourth aspect of the present invention, in the blood purification apparatus according to the third aspect , the control means drives the blood pump at a speed lower than a dialysate supply speed during the priming step.

According to a fifth aspect of the present invention, in the blood purification apparatus according to any one of the first to fourth aspects, the blood pump is driven when the blood purifier is prefilled with a filling liquid. The control means is configured to supply the dialysate from the replacement fluid line after the filling fluid is filled up to the connection portion of the replacement fluid line with the arterial blood circuit or the venous blood circuit. Features.

The invention according to claim 6 is the blood purification apparatus according to any one of claims 1 to 5 , wherein the coupling means includes the overflow line connection port and the replacement fluid line connection port. It has the recessed part formed in the main body side, and the cover part which can cover this recessed part in the airtight state, It is characterized by the above-mentioned.

The invention according to claim 7 is the blood purification apparatus according to claim 6 , wherein the lid portion is between a position where the recess is covered in a sealed state by a swing operation or a slide operation and a position where the recess is opened. It is possible to operate.

The invention according to claim 8 is the blood purification apparatus according to any one of claims 1 to 7 , wherein the overflow line connection port and the replacement fluid line connection port are opened from the state connected by the connecting means. At this time, the present invention is characterized in that a negative pressure generating means capable of setting the connecting portion in a negative pressure state is provided.

  According to the first aspect of the present invention, the fluid that branches off from a part of the arterial blood circuit or the venous blood circuit and extends to the dialysate discharge line is allowed to flow through the arterial blood circuit or the venous blood circuit. An overflow line capable of being led to the liquid discharge line, an overflow line opening / closing valve means capable of arbitrarily opening and closing the flow path of the overflow line, a blood pump and an overflow line opening / closing valve means are preset. Since the control means for controlling at the timing is provided, the automation of the work related to the blood purification treatment can be further enhanced.

Further , a portion of the arterial blood circuit or venous blood circuit that is different from the branch portion of the overflow line is connected to the dialysate introduction line, and the dialysate in the dialysate introduction line is used as the arterial blood. Since the fluid replacement line that can be supplied to the circuit or the venous blood circuit is provided, for example, the dialysate is supplied from the dialysate introduction line to the arterial blood circuit and the venous blood circuit through the blood purification membrane of the blood purifier. Compared with the so-called reverse filtration type, the dialysate can be supplied reliably and smoothly without depending on the membrane permeation performance of the blood purifier. Automation of a series of operations further in to suit involved in blood purification treatment can be achieved.
Furthermore, the overflow line and the replacement fluid line have an internal flow path inside the blood purification apparatus body and an external flow path outside the blood purification apparatus body, respectively, and connect the internal flow path and the external flow path of the overflow line. Since the connection port for the overflow line and the connection port for the replacement fluid line that connects the internal flow path and the external flow path of the replacement fluid line are respectively formed in the blood purification apparatus body, the internal flow path inside the blood purification apparatus body It can be easily connected to an external flow path outside the blood purification apparatus main body, on the overflow line side from the arterial side or vein side blood circuit branch to the dialysate discharge line, and on the replacement fluid side Between the dialysate introduction line and the arterial or venous blood circuit branch that is different from the overflow line It can be connected while maintaining liquid tightness. As a result, the supply of dialysate through the replacement fluid line is ensured, and the surplus liquid receiver required for receiving the liquid discharged from the overflow line by the conventional method (the open air system extended from the dialysate discharge line). (Drainage receiver) is not required. Furthermore, since the connection configuration of the blood circuit and the like is the same as that when online HDF is performed, it is not necessary to reconnect the blood circuit or the like after priming (excluding connection / disconnection with the patient). In this way, since it is not necessary to change the connection part in a series of operations, automation can be further enhanced.
On the other hand, as another effect, the necessary replacement fluid line and overflow line can be simplified (saved) by separating the internal flow path and the external flow path. That is, conventionally, a replacement fluid circuit including a pump squeezing unit for introducing a replacement fluid from the dialysate introduction line must be used separately from the blood circuit. It is sufficient if a replacement fluid line corresponding to the road portion is connected.
Furthermore, since the connecting means for connecting the overflow line connection port and the replacement fluid line connection port in a state in which the external flow path of the overflow line and the external flow path of the replacement fluid line are removed, the connection by the connecting means is provided. In this state, it is possible to easily clean or disinfect the internal flow path inside the blood purification apparatus main body in the overflow line and the replacement fluid line.

According to the second aspect of the present invention, the liquid supply means for supplying the dialysate in the dialysate introduction line to the arterial blood circuit or the venous blood circuit is disposed in the replacement fluid line, as controlled by the control means As a result, the dialysate can be supplied more reliably and smoothly through the replacement fluid line.

According to the invention of claim 3 , the dialysate in the dialysate introduction line is supplied to the arterial blood circuit and the venous blood circuit in a state where the distal end of the arterial blood circuit and the distal end of the venous blood circuit are connected. Since the dialysis solution is overflowed in the overflow line and the priming step is performed, the priming step can be automated.

According to the invention of claim 4 , since the control means drives the blood pump at a speed lower than the dialysate supply speed during the priming step, the arterial blood circuit and the venous blood circuit before blood purification treatment are dialyzed. Since the liquid can be filled and allowed to overflow from the overflow line, the blood purifier, the arterial blood circuit and the venous blood circuit can be more reliably and quickly vented.

According to the invention of claim 5 , when a blood purifier in which a filling liquid is filled in advance is used, the blood pump is driven to supply the filling liquid to the arterial blood circuit or venous blood circuit of the replacement fluid line. Since the control means controls to supply the dialysate from the replacement fluid line after filling up the connection portion of the blood, the blood from the connection portion with the replacement fluid line in the arterial blood circuit or the venous blood circuit during the priming step It can be avoided that the air in the flow path to the purifier is introduced into the blood purifier.

According to the invention of claim 6 , the connecting means can cover the concave portion formed on the blood purification apparatus main body side including the overflow line connection port and the replacement fluid connection port, and the concave portion in a sealed state. With the lid portion, the internal flow path inside the blood purification apparatus main body in the overflow line and the replacement fluid line can be cleaned or disinfected with a simple configuration.

According to the seventh aspect of the invention, the lid portion can operate between a position where the concave portion is covered in a sealed state by a swinging operation or a sliding operation and a position where the concave portion is opened, so that it overflows more easily and smoothly. The internal flow path inside the blood purification apparatus main body in the line and the replacement fluid line can be cleaned or disinfected.

According to the invention of claim 8 , when the overflow line connection port and the replacement fluid line connection port are released from the state of being connected by the connecting means, the connecting portion can be brought into a negative pressure state by the negative pressure generating means. It is possible to prevent the liquid from leaking to the outside when the connecting portion is opened, and the connecting means and the vicinity thereof can be kept clean.

1 is an overall schematic diagram showing a blood purification apparatus according to a first embodiment of the present invention. Overall schematic diagram showing the blood purification device (priming process) Overall schematic diagram showing the blood purification device (priming process) Overall schematic diagram showing the blood purification device (gas purge process) Overall schematic diagram showing the blood purification device (blood removal process) Overall schematic diagram showing the blood purification device (treatment process) Overall schematic diagram showing the blood purification device (replacement process) Overall schematic diagram showing the blood purification device (blood return process) Overall schematic diagram showing the blood purification device (drainage process) Overall schematic diagram showing the blood purification device (cleaning process) Front view showing connecting means in the blood purification apparatus Partial sectional view showing the connecting means The top view which shows the state which made the cover part in the connection means the open state Longitudinal sectional view showing the connecting means Whole schematic diagram showing blood purification apparatus according to second embodiment of the present invention Overall schematic diagram showing the blood purification device (priming process) Overall schematic diagram showing the blood purification device (replacement process) Overall schematic diagram showing the blood purification device (blood return process) Schematic diagram showing a blood purification apparatus according to another embodiment of the present invention, comprising negative pressure generating means.

Hereinafter, embodiments of the present invention will be specifically described with reference to the drawings.
The blood purification apparatus according to the first embodiment is applied to hemodiafiltration (online HDF). As shown in FIG. 1, the blood purification device is connected to a dialyzer 1 serving as a blood purification apparatus with an arterial blood circuit 2 and a vein side. Mainly from blood circuit A to which blood circuit 3 is connected, blood purification apparatus body B having dialysate introduction line L1 and dialysate discharge line L2, overflow line L3, replacement fluid line L4, and control means 12. It is configured.

  The dialyzer 1 contains a blood purification membrane (not shown) (in this embodiment, a hollow fiber type hemodiafiltration membrane, but includes a flat membrane type, a hemodialysis membrane, and a blood filtration membrane), and blood into which blood is introduced. The inlet 1a and the blood outlet 1b for leading the introduced blood are formed, and the dialysate inlet 1c for introducing the dialysate and the dialysate outlet 1d for discharging the introduced dialysate are formed. The blood is purified by bringing the dialysate into contact with the blood introduced from the blood introduction port 1a through the hollow fiber membrane.

  The arterial blood circuit 2 is mainly composed of a flexible tube, one end of which is connected to the blood inlet 1a of the dialyzer 1 and guides blood collected from the patient's artery into the hollow fiber membrane of the dialyzer 1. A connector 6a to which an arterial puncture needle a can be attached is formed at the other end of the arterial blood circuit 2, and an arterial drip chamber 9 and a blood pump 8 are connected midway. The blood pump 8 is a squeezing type pump (with a structure in which blood is allowed to flow in a predetermined direction from the outside of the flexible tube when rotated forward).

  Similar to the arterial blood circuit 2, the venous blood circuit 3 is mainly composed of a flexible tube, and one end of the venous blood circuit 3 is connected to the blood outlet 1b of the dialyzer 1 to derive blood that has passed through the hollow fiber membrane. is there. At the other end of the venous blood circuit 3, a connector 6b to which a venous puncture needle b can be attached is formed, and a venous drip chamber 10 is connected midway. Electromagnetic valves V10 and V11 for opening and closing the flow paths are disposed on the distal end side (near the connectors 6a and 6b) of the arterial blood circuit 2 and the venous blood circuit 3.

  A dialysate introduction line L1 and a dialysate discharge line L2 are connected to the dialysate introduction port 1c and the dialysate discharge port 1d of the dialyzer 1, respectively, and introduced into the dialyzer 1 through the dialysate introduction line L1. The dialysate can be discharged from the dialysate discharge line L2 through the outside of the hollow fiber membrane. An electromagnetic valve V1 and an electromagnetic valve V2 are connected to the dialysate introduction line L1 and the dialysate discharge line L2, respectively.

  The dialysate introduction line L1 and the dialysate discharge line L2 are connected to a dual pump 5 for supplying the dialysate adjusted to a predetermined concentration to the dialyzer 1 and discharging it from the dialyzer 1. A filtration filter 4 is connected between the duplex pump 5 and the electromagnetic valve V1 in the line L1. The filtration filter 4 is for filtering and purifying the dialysate flowing through the dialysate introduction line L1, and the bypass line for bypassing the dialysate from the filter filter 4 to the dialysate discharge line L2 to guide the dialysate. L5 is formed.

  In addition, the code | symbol V3 in the figure has shown the solenoid valve for opening and closing a flow path arrange | positioned in the middle of the bypass line L5. Furthermore, the dialysate discharge line L2 is formed with bypass lines L6 and L7 for bypassing the dual pump 5, and the bypass line L6 is used for removing water from the blood of the patient flowing through the dialyzer 1. A pump is disposed, and an electromagnetic valve V4 is disposed in the bypass line L7.

  The overflow line L3 branches from the upper part of the venous drip chamber 10 (a part of the venous blood circuit 3) and extends to the dialysate discharge line L2, and fluid (such as dialysate) flowing through the venous blood circuit 3 Fluid) can be led to the dialysate discharge line L2. The overflow line L3 includes an internal flow path L3a inside the blood purification apparatus main body B and an external flow path L3b outside the blood purification apparatus main body B. The internal flow path L3a and the external flow path L3b are: The blood purification device main body B is connected by an overflow line connection port R2 formed in the blood purification device main body B.

  Further, the overflow line L3 includes an electromagnetic valve V5 (disposed on the internal flow path L3a side) and an electromagnetic valve V6 (on the external flow path L3b side) as overflow line on / off valve means capable of arbitrarily opening and closing the flow path. And disposed in the vicinity of the vein-side drip chamber 10). A check valve V9 is disposed on the internal flow path L3a side in the overflow line L3, and fluid flow from the venous drip chamber 10 to the dialysate discharge line L2 is allowed, but in the opposite direction. Fluid flow is regulated.

  The replacement fluid line L4 is a part of the arterial blood circuit 2 and connects between the portion different from the branch portion of the overflow line L3 (in this embodiment, the arterial drip chamber 9) and the dialysate introduction line L1, The dialysis fluid in the dialysis fluid introduction line L1 (the dialysis fluid filtered and purified by the filtration filter 4) can be supplied to the arterial blood circuit 2. The replacement fluid line L4 includes an internal flow path L4a inside the blood purification apparatus main body B and an external flow path L4b outside the blood purification apparatus main body B. The internal flow path L4a and the external flow path L4b are: The blood purification device main body B is connected to a replacement fluid line connection port R1 formed in the blood purification device body B.

  Further, the replacement fluid line L4 is provided with an electromagnetic valve V7 (arranged on the internal flow path L4a side) and an electromagnetic valve V8 (arranged on the external flow path L4b side) whose flow paths can be arbitrarily opened and closed. Yes. A pump 7 serving as a liquid feeding means for feeding the dialysate from the dialysate introduction line L1 to the arterial blood circuit 2 is disposed on the internal flow path L4a side in the replacement fluid line L4. In addition, you may comprise the pump 7 as a liquid feeding means so that it may be arrange | positioned in the external flow path L4b side in the replacement fluid line L4. Further, the pump 7 as the liquid feeding means is preferably provided with a quantitative type such as a dewatering pump on the internal flow path L4a. You may arrange | position on the path L4b side.

  The control means 12 includes a microcomputer or the like disposed in the blood purification apparatus main body B, and controls the blood pump 8 and the electromagnetic valves V5 and V6 as the overflow line opening / closing valve means at a preset timing. It is. However, in order to automatically perform a series of operations related to blood purification treatment, the control means 12 according to the present embodiment, for example, as a dual pump 5 and a liquid feeding means in addition to the blood pump 8 and the electromagnetic valves V5 and V6. The pump 7, the water removal pump 11 and other electromagnetic valves can be controlled.

Next, the action in the blood purification apparatus (the action during a series of operations related to blood purification treatment and treatment) will be described.
(Priming process)
First, as shown in FIG. 2, after the connectors 6a and 6b are connected to form a closed loop, the dual pump 5 and the pump 7 are driven and the blood pump 8 is driven in reverse by the control by the control means 12. At this time, under the control of the control means 12, the electromagnetic valves V1 and V2 are closed, the electromagnetic valves V3 to V8 and V10 and V11 are opened, and the dialysate supply speed (by driving the pump 7) The blood pump 8 is driven at a lower speed than the supply speed. As a result, the dialysate (dialysate that has been filtered and purified by the filtration filter 4) in the dialysate introduction line L1 can be supplied to the arterial blood circuit 2 via the arterial drip chamber 9 and supplied. The dialysate thus circulated through the flow path on the blood pump 8 side and the flow path on the dialyzer 1 side.

  The dialysate flowing through each flow path reaches the overflow line L3 via the venous drip chamber 10, and is guided to the dialysate discharge line L2 via the overflow line L3. When the dialyzer 1 is of a dry type (not prefilled with a filling liquid or the like), as shown in the figure, the blood outlet 1b is directed upward to improve air bleeding. Is preferred.

  Further, when using a dialyzer 1 (so-called wet type) in which a filling liquid is filled in advance, the blood pump 8 is driven (reversely driven in the present embodiment) to supply the filling liquid to the arterial blood in the replacement fluid line L4. It is preferable that control is performed by the control means 12 so that the dialysate is supplied from the replacement fluid line L4 after filling the connection portion with the circuit 2 (in the present embodiment, the arterial drip chamber 9). Thus, during the priming step, air in the flow path from the connecting portion with the fluid replacement line L4 in the arterial blood circuit 2 to the dialyzer 1 (blood purifier) is avoided from being introduced into the dialyzer 1. Can do.

  Thereafter, as shown in FIG. 3, the drive of the dual pump 5 and the pump 7 is maintained and the blood pump 8 is driven to rotate forward. As a result, the dialysate flowing through the arterial blood circuit 2 and the venous blood circuit 3 flows in one direction, and the dialysate reaches the overflow line L3 via the venous drip chamber 10 and passes through the overflow line L3. Thus, it is guided to the dialysate discharge line L2. At this time, the blood pump 8 may be stopped. The priming process is completed as described above, and then a gas purge process is performed.

(Gas purge process)
The gas purge step is a step of filling the flow path between the dialysate introduction port 1c and the dialysate discharge port 1d in the dialyzer 1 and, as shown in FIG. The compound pump 5 is driven and the pump 7 and the blood pump 8 are stopped. At this time, the electromagnetic valves V1 and V2 are opened, and the electromagnetic valves V3, V5, V6, and V8 are closed. The open / close state of the other solenoid valves is maintained, but the solenoid valve V7 may be closed.

(Blood removal process)
After the gas purging step is finished, as shown in FIG. 5, the connectors 6a and 6b are disconnected, and the arterial puncture needle a and the venous puncture needle b are attached to each, and the arterial puncture needle a and the venous puncture are attached. The needle b is punctured into the patient's body (such as a shunt). However, under the control of the control means 12, the water removal pump 11 and the blood pump 8 are driven to rotate forward, and the compound pump 5 and the pump 7 are stopped. At this time, the electromagnetic valves V1 and V4 are closed, and the closed states of the electromagnetic valves V3, V5, V6, and V8 and the open states of the other electromagnetic valves are maintained.

  For example, if the dewatering pump 11 is driven at a flow rate of 100 (mL / min) and the blood pump 8 is driven at a flow rate of 50 (mL / min), the artery side puncture needle a and the vein side puncture needle b are used. Blood can be aspirated at a flow rate of 50 (mL / min), respectively, and blood can be removed simultaneously on both the arterial side and the venous side. By this blood removal process, the dialysate filled in the arterial blood circuit 2 and the venous blood circuit 3 in the priming process is guided to the dialyzer 1 and filled with the patient's blood so as to replace the dialysate. Therefore, the subsequent blood purification treatment can be performed without allowing the dialysate to flow into the patient's body.

(Blood purification treatment process)
After all the dialysate filled in the arterial blood circuit 2 and the venous blood circuit 3 is guided to the dialyzer 1 by the blood removal step and replaced with blood, blood purification treatment is performed. As shown in FIG. 6, in this blood purification treatment, the electromagnetic valves V1, V2, V7, V8, V10, and V11 are opened and the electromagnetic valves V3, V4, V5, and V6 are controlled by the control unit 12. Is closed, and the dual pump 5, the dewatering pump 11, the pump 7 and the blood pump 8 are driven (normal rotation driving in the blood pump 8).

  As a result, when the pump 5 is driven, the dialysate prepared to a predetermined concentration is supplied to the dialyzer 1 via the dialysate introduction line L1, and the blood pump 8 is driven forward so that the artery side blood circuit 2 Blood is circulated extracorporeally to the side blood circuit 3. In the process, dialysis using the dialyzer 1 is performed. In addition, when the pump 7 is driven, the dialysate is supplied to the arterial blood circuit 2 via the replacement fluid line L4, and the blood before reaching the dialyzer 1 is diluted with the dialysate.

(Replacement fluid process)
During the blood purification treatment as described above, when the blood pressure of the patient drops rapidly, a fluid replacement process (emergency fluid replacement) may be performed. As shown in FIG. 7, in the fluid replacement step, the electromagnetic valves V1 and V2 are closed and the electromagnetic valve V3 is opened by the control of the control unit 12. As a result, the dialysate flowing through the dialysate introduction line L1 reaches the arterial drip chamber 9 of the arterial blood circuit 2 exclusively through the replacement fluid line L4, and the replacement fluid is made. At this time, the water removal pump 11 is stopped. The replacement fluid speed and the replacement fluid amount are controlled by the drive and control means 12 of the pump 7.

(Blood return process)
After the blood purification treatment process is completed, a blood return process for returning the blood in the arterial blood circuit 2 and the venous blood circuit 3 to the patient's body is performed. As shown in FIG. 8, the blood return step is performed by controlling the control means 12 to close the electromagnetic valves V1 and V2 and open the electromagnetic valves V3 and V4. Keep driving. Further, the blood pump 8 is driven in the reverse direction, and the driving speed is set lower than the dialysate supply speed (the dialysate supply speed by the pump 7).

  For example, if the pump 7 is driven at a flow rate of 100 (mL / min) and the blood pump 8 is driven reversely at a flow rate of 50 (mL / min), the arterial puncture needle a and the venous side puncture needle b respectively Blood can be returned at a flow rate of 50 (mL / min), and blood can be returned simultaneously on both the arterial side and the venous side. The determination of the end of the blood return is provided, for example, on the distal side of the arterial blood circuit 2 (near the arterial puncture needle a) and on the distal side of the venous blood circuit 3 (near the venous side puncture needle b). It is preferably done by detection with a blood discriminator.

(Drainage process)
After the blood return process is completed, the dialysate in the dialyzer 1, the arterial blood circuit 2 and the venous blood circuit 3 is guided to the dialysate discharge line L2 via the dialyzer 1 and the dialysate discharge line L2, and discharged to the outside. A draining process is performed. This draining process is performed after the arterial puncture needle a and the venous puncture needle b are removed from the patient. As shown in FIG. 9, the drainage pump 11 and the blood pump are controlled by the control means 12. 8 is rotated forward and the dual pump 5 and the pump 7 are stopped. At this time, the electromagnetic valves V1 and V4 are closed, and the closed states of the electromagnetic valves V3, V5, V6, and V8 and the open states of the other electromagnetic valves are maintained.

  For example, if the dewatering pump 11 is driven at a flow rate of 100 (mL / min) and the blood pump 8 is driven at a flow rate of 50 (mL / min), the artery side puncture needle a and the vein side puncture needle b are used. Air can be aspirated at a flow rate of 50 (mL / min) and drained simultaneously on both the arterial side and the venous side. Since the dialysate filled in the dialyzer 1, the arterial blood circuit 2 and the venous blood circuit 3 in the blood return process is discharged to the outside through the dialyzer 1 and the dialysate discharge line L2 by the draining process. 1. The arterial blood circuit 2 and the venous blood circuit 3 can be easily discarded.

(Washing process)
The dialyzer 1, the arterial blood circuit 2 and the venous blood circuit 3 (including the external flow path L3b in the overflow line L3 and the external flow path L4b in the replacement fluid line L4) are removed from the dialysate introduction line L1 and the dialysate discharge line L2. In the state, as shown in FIG. 10, the dialysate introduction line L1 and the dialysate discharge line L2 are connected and short-circuited by the short-circuit means 13 composed of a coupler or the like, and the connection means 14 is connected to the overflow line. The port R2 is connected to the replacement fluid line connection port R1.

  Then, under the control of the control means 12, the electromagnetic valves V1, V2, V4, V5, V7 are opened, the electromagnetic valve V3 is closed, and the dual pump 5, the dewatering pump 11, and the pump 7 are driven. . At this time, the piping (including the internal flow path L3a in the overflow line L3 and the internal flow path L4a in the replacement fluid line L4) in the blood purification apparatus main body B is washed by flowing cleaning water and disinfecting liquid through the dialysate introduction line L1. Or it can be disinfected.

  As shown in FIGS. 11 to 14, the connecting means 14 includes a recess 15a formed on the blood purification apparatus main body B side including an overflow line connection port R2 and a replacement fluid line connection port R1, and a swing shaft 14a. It has a lid portion 16 that can swing in the center and can cover the concave portion 15a in a sealed state, and a connecting means main body 15 that is formed with the concave portion 15a and is fixed to the blood purification device main body B. A sealing material 20 is formed on the opening edge of the connecting means main body 15 (periphery of the recess 15a) at a portion that comes into contact with the edge of the cover 16, and the cover 16 covers the recess 15a. It can be sealed in the state.

  Thus, the lid portion 16 is configured to be able to operate between a position where the concave portion 15a is covered in a sealed state and a position where the concave portion 15a is opened by a swing operation centered on the swing shaft 14a. . In this embodiment, the lid portion 16 is configured to be swingable. However, the lid portion 16 operates between a position where the concave portion 15a is covered in a sealed state by a slide operation and a position where the concave portion 15a is opened. You may comprise so that it may obtain.

  As shown in FIG. 12, the connecting means 14 is provided with a lock means 19 that is swingable about a swing shaft 17 formed on the lid portion 16 side. 19, an operated portion 19b that can be operated with a finger or the like and a claw portion 19a at the tip are formed. However, the claw portion 19a at the tip is locked or separated from the rod-shaped member 18 formed on the connecting means body 15 by pressing the operated portion 19b and swinging the lock means 19. . As a result, the lid 16 can be locked or unlocked in the closed state by the operation of the locking means 19.

  Further, as shown in FIG. 14, the bottom surface of the recess 15a in the connecting means 14 is inclined from the replacement fluid line connection port R1 toward the overflow line connection port R2, and the recess 15a extends from the replacement fluid line connection port R1. The dialysis fluid introduced into the inside is allowed to flow smoothly to the overflow line connection port R2 and can be prevented from staying in the recess 15a.

Next, a second embodiment of the present invention will be described.
As in the first embodiment, the blood purification apparatus according to this embodiment is applied to hemodiafiltration (online HDF), and as shown in FIG. Blood circuit A to which blood circuit 2 and venous blood circuit 3 are connected, blood purification apparatus body B having dialysate introduction line L1 and dialysate discharge line L2, overflow line L3, replacement fluid line L4, control It is mainly composed of the means 12.

  The replacement fluid line L4 according to the present embodiment is a part of the venous blood circuit 3 and a part (connecting part P1) different from the branch part of the overflow line L3 (specifically, the venous drip chamber 10) and dialysate This is connected to the introduction line L1 so that the dialysate in the dialysate introduction line L1 can be supplied to the venous blood circuit 3. The connecting portion between the replacement fluid line L4 and the venous blood circuit 3 is preferably provided with, for example, a T-shaped tube or the like, and is configured to connect the two with the T-shaped tube.

  With this configuration, the dialysate from the dialysate introduction line L1 can be mixed and diluted in the blood flowing through the venous blood circuit 3, and then returned to the patient. That is, in the first embodiment, the blood before being introduced into the dialyzer 1 is diluted by mixing dialysate (so-called pre-replacement fluid), whereas In the embodiment, the blood after being introduced into the dialyzer 1 is mixed with a dialysate and diluted (so-called post-replacement fluid).

The operation of the blood purification apparatus according to the second embodiment (the operation during blood purification treatment and a series of operations related to the treatment) will be described below. The gas purge process, blood removal process, replenishment process, drainage process, and washing process are not so different from the first embodiment in their operation, and thus their description is omitted.
(Priming process)
As in the first embodiment, as shown in FIG. 16, after the connectors 6a and 6b are connected to form a closed loop, the compound pump 5 and the pump 7 are driven under the control of the control means 12, and the blood pump 8 Is driven in reverse. At this time, under the control of the control means 12, the electromagnetic valves V1 and V2 are closed, the electromagnetic valves V3 to V8 and V10 and V11 are opened, and the dialysate supply speed (by driving the pump 7) The blood pump 8 is driven at a lower speed than the supply speed.

  As a result, the dialysate (dialysate that has been filtered and purified by the filtration filter 4) in the dialysate introduction line L1 can be supplied to the venous blood circuit 3 via the connection portion P1, and the supplied dialysis is performed. The liquid flows through the channel on the dialyzer 1 side and the channel on the venous drip chamber 10 side. The dialysate flowing through each flow path reaches the overflow line L3 via the venous drip chamber 10, and is guided to the dialysate discharge line L2 via the overflow line L3. Thereafter, as in the first embodiment, the dual pump 5 and the pump 7 are kept driven and the blood pump 8 is driven forward.

(Blood purification treatment process)
After the blood removal process (see the first embodiment), the dialysate filled in the arterial blood circuit 2 and the venous blood circuit 3 is all guided to the dialyzer 1 and replaced with blood. Will be performed. As shown in FIG. 17, in this blood purification treatment, the electromagnetic valves V1, V2, V7, V8, V10, V11 are opened and the electromagnetic valves V3, V4, V5, and V6 are controlled by the control means 12. Is closed, and the dual pump 5, the dewatering pump 11, the pump 7 and the blood pump 8 are driven (normal rotation driving in the blood pump 8).

  As a result, when the pump 5 is driven, the dialysate prepared to a predetermined concentration is supplied to the dialyzer 1 via the dialysate introduction line L1, and the blood pump 8 is driven forward so that the artery side blood circuit 2 Blood is circulated extracorporeally to the side blood circuit 3. In the process, dialysis using the dialyzer 1 is performed. In addition, when the pump 7 is driven, dialysate is supplied to the venous blood circuit 3 via the replacement fluid line L4, and the dialysate is mixed and diluted in the blood after reaching the dialyzer 1. .

(Blood return process)
After the blood purification treatment process is completed, a blood return process is performed to return the blood in the dialyzer 1, the arterial blood circuit 2 and the venous blood circuit 3 to the patient's body. As shown in FIG. 18, the blood return step is performed by controlling the control means 12 so that the electromagnetic valves V1 and V2 are closed and the electromagnetic valves V3 and V4 are opened. Keep driving. The blood pump 8 is driven in the reverse direction, and its driving speed is set lower than the dialysate supply speed (dialyte supply speed by the pump 7) (see the first embodiment).

  As can be seen from the first and second embodiments, the replacement fluid line L4 is a part of the arterial blood circuit 2 or the venous blood circuit 3 and is a part different from the branch of the overflow line L3. Either the side blood circuit 2 or the venous side blood circuit 3 may be connected. In the first and second embodiments, the overflow line L3 is connected to the venous drip chamber 10, but may be connected to any part of the venous blood circuit 3, or the arterial side. You may comprise so that it may connect to any site | part of the blood circuit 2. FIG.

  Thus, according to the first and second embodiments, the arterial blood circuit is branched from a part of the arterial blood circuit 2 or the venous blood circuit 3 and extends to the dialysate discharge line L2. 2 or an overflow line L3 capable of guiding a fluid (dialysate) flowing through the venous blood circuit 3 to the dialysate discharge line L2, and an electromagnetic valve capable of arbitrarily opening and closing the flow path of the overflow line L3 V5, V6 (overflow line opening / closing valve means) and the control means 12 for controlling the blood pump 8 and the electromagnetic valves V5, V6 at a preset timing are provided, so that a series of operations related to blood purification treatment is automated. Can be further enhanced.

  Further, a portion of the arterial blood circuit 2 or the venous blood circuit 3 that is different from the branch portion of the overflow line L3 is connected to the dialysate introduction line L1, and the dialysate in the dialysate introduction line L1 is connected. Is provided to the arterial blood circuit 2 or the venous blood circuit 3, for example, from the dialysate introduction line L1 via the blood purification membrane of the dialyzer 1 (blood purifier) to the arterial side. Compared with what is called reverse filtration which supplies the dialysate to the blood circuit 2 and the venous blood circuit 3, the dialysate can be supplied reliably and smoothly.

  Further, a pump 7 (fluid feeding means) for feeding the dialysate from the dialysate introduction line L1 to the arterial blood circuit 2 or the venous blood circuit 3 is connected to the replacement fluid line L4. Since it is disposed, the dialysate can be supplied more reliably and smoothly by the replacement fluid line L4. Further, in a state where the distal end of the arterial blood circuit 2 and the distal end of the venous blood circuit 3 are connected, the dialysate in the dialysate introduction line L1 is supplied to the arterial blood circuit 2 and the venous blood circuit 3, Since the priming process is performed by overflowing the dialysate through the overflow line L3, the priming process can be automated.

  Furthermore, since the control means 12 drives the blood pump 8 at a speed lower than the dialysate supply speed during the priming step, more dialysate is supplied to the arterial blood circuit 2 and the venous blood circuit 3 before blood purification treatment. Fills reliably and quickly, and can overflow through the overflow line L3. That is, by driving the blood pump 8 at a speed lower than the supply speed of the dialysate, the dialysate flows through two flow paths (for example, a flow path that passes through the dialyzer 1 and a flow path that does not pass through), respectively. This ensures reliable and quick filling of the dialysate.

  However, the overflow line L3 and the replacement fluid line L4 have internal flow paths (L3a, L4a) inside the blood purification apparatus main body B and external flow paths (L3b, L4b) outside the blood purification apparatus main body B, respectively. An overflow line connection port R2 that connects the internal flow path L3a and the external flow path L3b of the overflow line L3, and a replacement fluid line connection port R1 that connects the internal flow path L4a and the external flow path L4b of the replacement liquid line L4. Since each is formed in the blood purification apparatus main body B, the internal flow paths (L3a, L4a) inside the blood purification apparatus main body B and the external flow paths (L3b, L4b) outside the blood purification apparatus main body B can be easily connected. Can be done.

  In addition, since it includes the connecting means 14 for connecting the overflow line connection port R2 and the replacement fluid line connection port R1 in a state where the external flow path L3b of the overflow line L3 and the external flow path L4b of the replacement fluid line L4 are removed, In the connected state by the connecting means 14, the internal flow paths (L3a, L4a) in the blood purification apparatus main body B in the overflow line L3 and the replacement fluid line L4 can be easily washed or disinfected.

  Further, the connecting means 14 includes a recess 15a formed on the blood purification device main body B side including the overflow line connection port R2 and the replacement fluid line connection port R1, and a lid capable of covering the recess 15a in a sealed state. Therefore, the overflow line connection port R2 and the replacement fluid line connection port R1 can be coupled with a relatively simple structure such as covering the recess 15a with the lid portion 16, and the overflow line L3 and the replacement fluid line can be connected. The internal flow path (L3a, L4a) inside the blood purification apparatus main body B at L4 can be cleaned or disinfected.

  Furthermore, the lid portion 16 can operate between a position where the recess 15a is covered in a sealed state by a swinging operation (or a slide operation) and a position where the recess 15a is opened, so that the overflow line can be made more easily and smoothly. The internal flow paths (L3a, L4a) inside the blood purification apparatus main body B in L3 and the replacement fluid line L4 can be cleaned or disinfected. The lid portion 16 is a separate body, and when the overflow line connection port R2 and the replacement fluid line connection port R1 are connected, the lid portion 16 is mounted on the concave portion 15a to seal the concave portion 15a. Also good.

  As another embodiment, as shown in FIG. 19, when the overflow line connection port R2 and the replacement fluid line connection port R1 are released from the state of being connected by the connection means 14, the connection portion (recess 15a) is hidden. Negative pressure generating means 21 that can be in a pressure state may be provided. In this case, the usage is as follows. That is, after the internal flow path inside the blood purification apparatus is cleaned or disinfected in a state where the connection port R2 for the overflow line and the connection port R1 for the replacement fluid line are connected by the connecting means 14, preparation for the next blood purification treatment is performed. To do this, the connected state is released and a new external flow path is connected. At this time, the cleaning or disinfecting liquid remains in the connection part, and if the connection part is opened without performing anything, the liquid may leak to the outside. In order to prevent this, a negative pressure generating means 21 (comprising a pump) for the connecting portion is provided.

  Instead of providing the negative pressure generating means 21 as described above, the following configuration can be adopted. That is, the pump 7 as the liquid feeding means is stopped before the connection is released. The connecting means 14 is disposed at a position higher in the vertical direction than the dialysate discharge line L2, and uses the potential energy due to the drop. The stop of the pump 7 as the liquid feeding means and the control of the negative pressure generating means 21 are preferably performed by the control means 12 so as to interlock with the opening and closing of the connecting means 14.

Having described the present embodiment, the present invention is not name limited thereto.

  In the present embodiment, solenoid valves V5 and V6 (overflow line opening / closing valve means) are disposed in the internal flow path L3a and the external flow path L3b of the overflow line L3, but only one of them is provided. It may be arranged. Similarly, in the present embodiment, the electromagnetic valves V7 and V8 are disposed in the internal flow path L4a and the external flow path L4b of the replacement fluid line L4, respectively, but only one of them may be disposed. Good.

It is possible to branch from a part of the arterial blood circuit or the venous blood circuit to the dialysate discharge line and guide the fluid flowing through the arterial blood circuit or the venous blood circuit to the dialysate discharge line. Overflow line, overflow line opening / closing valve means capable of arbitrarily opening and closing the flow path of the overflow line, control means for controlling the blood pump and the overflow line opening / closing valve means at preset timing, and an artery A portion of the side blood circuit or vein side blood circuit that is different from the branch of the overflow line is connected to the dialysate introduction line, and the dialysate in the dialysate introduction line is connected to the artery side blood circuit or vein It is configured to include a replacement fluid line that is capable of supplying to the side blood circuit, overflow line and replacement fluid line, a blood purification apparatus body The internal flow path of the blood purification device main body and the external flow path outside the blood purification apparatus main body, the overflow line connection port for connecting the internal flow path of the overflow line and the external flow path, and the internal flow of the replacement fluid line A connection port for a replacement fluid line that connects the passage and the external flow channel is formed in the blood purification device main body, and the connection for the overflow line in a state where the external flow channel of the overflow line and the external flow channel of the replacement fluid line are removed. As long as the blood purification device includes a connecting means for connecting the port and the connection port for the replacement fluid line, the blood purification device can be applied to devices to which other configurations and functions are added.

1 Dialyzer (blood purifier)
2 Arterial blood circuit 3 Venous blood circuit 4 Filtration filter 5 Duplex pump 6a, 6b Connector 7 Pump (liquid feeding means)
8 Blood pump 9 Arterial drip chamber 10 Venous drip chamber 11 Dewatering pump 12 Control means 13 Short-circuit means 14 Connection means 15 Connection means body 15a Recess 16 Lid 17 Oscillating shaft 18 Rod-shaped member 19 Locking means 20 Sealing material R1 Fluid replacement Line connection port R2 Overflow line connection port L1 Dialysate introduction line L2 Dialysate discharge line L3 Overflow line L3a Internal flow path L3b External flow path L4 Replacement fluid line L4a Internal flow path L4b External flow paths V5, V6 Solenoid valves (overflow line) On-off valve means)
A Blood circuit B Blood purification device body

Claims (8)

A blood purification membrane is provided, and a blood introduction port for introducing blood and a blood outlet for extracting introduced blood are formed, and a dialysate introduction port for introducing dialysate and a dialysate discharge for discharging the introduced dialysate A blood purifier in which an outlet is formed and purifies the blood by bringing the dialysate into contact with the blood through the blood purification membrane;
One end is connected to the blood inlet of the blood purifier, and an arterial blood circuit in which a blood pump is disposed in the middle,
A venous blood circuit having one end connected to the blood outlet of the blood purifier,
A dialysate introduction line connected to the dialysate inlet of the blood purifier and for introducing dialysate into the blood purifier;
A dialysate discharge line connected to the dialysate discharge port of the blood purifier and discharging dialysate from the blood purifier;
A blood purification apparatus configured to supply the dialysate in the dialysate introduction line to the arterial blood circuit and the venous blood circuit,
Branching from a portion of the arterial blood circuit or venous blood circuit and extending to the dialysate drain line, and leading the fluid flowing through the arterial blood circuit or venous blood circuit to the dialysate drain line An overflow line enabled, and
An overflow line opening / closing valve means capable of arbitrarily opening and closing the flow path of the overflow line;
Control means for controlling the blood pump and the on-off valve means for the overflow line at a preset timing;
A portion of the arterial blood circuit or venous blood circuit that is different from the branch portion of the overflow line is connected to the dialysate introduction line, and the dialysate in the dialysate introduction line is connected to the artery side. A fluid replacement line that can be supplied to the blood circuit or the venous blood circuit;
The overflow line and the replacement fluid line each have an internal flow path inside the blood purification apparatus main body and an external flow path outside the blood purification apparatus main body, and the internal flow path and external flow of the overflow line. An overflow line connection port for connecting to the passage, and a replacement fluid line connection port for connecting the internal flow path and the external flow path of the replacement fluid line, respectively, are formed in the blood purification device main body, and outside the overflow line. A blood purification apparatus comprising a connecting means for connecting the overflow line connection port and the replacement fluid line connection port in a state in which the flow path and the external flow path of the replacement fluid line are removed . Controlled by the control means, and liquid supply means for supplying dialysate from the dialysate introduction line to the arterial blood circuit or venous blood circuit is provided in the replacement fluid line. The blood purification apparatus according to claim 1 . In a state where the tip of the artery side blood circuit and the tip of the vein side blood circuit are connected, the dialysate in the dialysate introduction line is supplied to the artery side blood circuit and the vein side blood circuit, and the dialysate is overflowed 3. The blood purification apparatus according to claim 1, wherein the priming process is performed by overflowing the line. 4. The blood purification apparatus according to claim 3 , wherein the control means drives the blood pump at a speed lower than a dialysate supply speed during the priming step. When the blood purifier is pre-filled with a filling liquid, the blood pump is driven to fill the filling liquid up to the connection portion of the replacement fluid line with the arterial blood circuit or the venous blood circuit. The blood purification apparatus according to any one of claims 1 to 4 , wherein control is performed by the control means so as to supply dialysate from the replacement fluid line. The coupling means includes a recess formed on the blood purification apparatus main body side including the overflow line connection port and a replacement fluid line connection port, and a lid that can cover the recess in a sealed state. The blood purification apparatus according to any one of claims 1 to 5, wherein The blood purification apparatus according to claim 6 , wherein the lid portion can operate between a position where the recess is covered in a sealed state by a swing operation or a slide operation and a position where the recess is opened. When releasing the replacement fluid line connection port and the overflow line connection port from the state of being connected by the connecting means, according to claim 1, characterized by comprising a negative pressure generating means capable of the connecting portion and the negative pressure state The blood purification apparatus as described in any one of -7 .

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