JP5485757B2 - Method of operating hemodialysis apparatus and hemodialysis apparatus - Google Patents

Description

  The present invention relates to a method for operating a hemodialysis apparatus for dialysis of blood, and a hemodialysis apparatus.

  The hemodialysis apparatus has a blood circuit that allows blood to pass through the primary side of the membrane of the dialyzer, and a dialysate circuit that allows dialysate to pass through the secondary side of the membrane of the dialyzer. Dialysis is performed. For example, the dialysate circuit is connected to a metering container having two chambers formed therein and having a displaceable partition wall (see Patent Document 1). In the dialysis treatment of this hemodialyzer, in the state where blood is allowed to flow to the primary side of the dialyzer membrane in the blood circuit, the partition wall of the metering container is moved in the dialysate circuit, and the secondary of the dialyzer membrane is moved from the first chamber. The dialysate is supplied to the side, and the dialysate is returned from the secondary side of the dialyzer to the second chamber of the metering container. This type of hemodialysis apparatus is useful when strictly controlling the amount of dialysate supplied to the dialyzer and the amount of dialysate discharged from the dialyzer using a simple circuit.

JP-A-5-146506

  By the way, in the dialysis treatment using the hemodialysis apparatus as described above, a part of the dialysis fluid of the dialysis fluid circuit is supplied to the blood circuit side, and an equivalent amount of liquid is supplied to the blood circuit side through the membrane of the dialyzer. It is considered to flow to the dialysate circuit side. By doing so, the flow rate of the liquid passing through the membrane is increased, and for example, an unnecessary substance having a larger diameter in the blood passes through the membrane and is taken into the dialysate, thereby improving the dialysis ability for blood. However, in this case, a circuit that connects the dialysate circuit and the blood circuit, a pump that sends the dialysate from the dialysate circuit to the blood circuit, a device that opens and closes the circuit, and the like are required. For this reason, the configuration of the hemodialysis apparatus becomes complicated, the hemodialysis apparatus becomes larger, and the cost increases.

  The present invention has been made in view of such points, and with a simple apparatus configuration, the dialysate is supplied from the dialysate circuit side to the blood circuit side, and the dialysate circuit side is connected to the blood circuit side through the dialyzer membrane. It is an object of the present invention to provide a method for operating a hemodialysis apparatus and a hemodialysis apparatus that can discharge liquid into the apparatus.

  In order to achieve the above object, the present invention provides a hemodialysis apparatus for dialysis of blood through the membrane by flowing blood to the primary side of the membrane of the dialyzer and flowing dialysate to the secondary side of the membrane of the dialyzer. The hemodialysis apparatus comprises: a container having a partition wall that is displaceable inside a first chamber and a second chamber; and dialysate in the first chamber of the container in the dialyzer. A first expandable / contractible circuit for supplying, a second expandable / contractable circuit for discharging dialysate from the dialyzer to the second chamber of the container, and opening / closing the first circuit. And a second opening / closing device for opening and closing the second circuit, and the partition wall is provided on the first chamber side of the container filled with dialysate. The dialysis fluid in the first chamber is supplied to the dialysis machine through the first circuit, and the dialysis fluid from the dialysis machine is passed through the second circuit. When discharging into the second chamber, the first circuit is opened by the first opening and closing device, the second circuit is closed by the second opening and closing device, and then the second circuit is opened. The control device for opening the second circuit is operated by the opening / closing device.

  According to the present invention, when the partition wall of the container is moved and the dialysate is supplied from the container to the dialyzer and discharged from the dialyzer, the first circuit is opened and the second circuit is temporarily closed. As a result, the pressure on the secondary side of the membrane of the dialyzer increases, and a portion of the dialysate in the first circuit is supplied from the secondary side of the membrane to the primary side. At this time, the partition wall moves, and at least a section between the second opening / closing device and the container in the second circuit becomes negative pressure, so that the section of the second circuit that can be expanded and contracted contracts. Next, by opening the second circuit, the pressure is released, and the contraction of the above section of the second circuit is restored, and the pressure on the secondary side of the membrane of the dialyzer decreases due to the suction force at that time, A portion of the liquid on the primary side of the dialyzer membrane flows into the secondary side. Therefore, according to the present invention, the dialysate can be supplied from the dialysate circuit side to the blood circuit side and dialyzed from the blood circuit side through the membrane of the dialyzer with a simple device configuration without attaching a new device or member. The liquid can be discharged to the liquid circuit side.

  In the operation method of the hemodialysis apparatus, when the dialysate is supplied to the dialyzer, the dialysate may be pumped to the dialyzer side by a pump provided in the first circuit. In this case, since the dialysate is pumped to the dialyzer by the pump on the first circuit side, the negative pressure in the section between the second opening / closing device and the container in the second circuit can be appropriately generated.

  According to another aspect of the present invention, there is provided a method for operating a hemodialysis apparatus, wherein blood is flowed to a primary side of a membrane of a dialyzer, dialysate is flowed to a secondary side of the membrane of the dialyzer, and blood is dialyzed through the membrane. The hemodialysis apparatus is configured to supply a container having a partition wall that is displaceable between a first chamber and a second chamber, and a dialysate in the first chamber of the container to the dialyzer. A first circuit that can be expanded and contracted, a second circuit that can expand and contract to discharge the dialysate of the dialyzer to the second chamber of the container, and a first circuit that opens and closes the first circuit. A first opening and closing device and a second opening and closing device that opens and closes the second circuit, and displaces the partition wall toward the first chamber of the container filled with dialysate, The dialysate from the first chamber is supplied to the dialyzer through the first circuit, and the dialysate from the dialyzer is passed through the second circuit. When discharging to the second chamber, the second opening / closing device opens the second circuit, the first opening / closing device closes the first circuit, and then the first opening / closing device. Thus, the control device for opening the first circuit is activated.

  According to the present invention, when the dialysis fluid is supplied from the container to the dialyzer and discharged from the dialyzer to the container by moving the partition wall of the container, the second circuit is opened and the first circuit is temporarily closed. As a result, the pressure on the secondary side of the dialyzer membrane drops, and a portion of the liquid on the primary side of the dialyzer membrane flows into the secondary side. At this time, since the partition wall moves and at least a section between the first opening / closing device and the container in the first circuit becomes a positive pressure, the section of the first circuit that can be expanded and contracted expands. Next, by opening the first circuit, the pressure is released, the expansion of the section of the first circuit is restored, and the pressure at that time increases the pressure on the secondary side of the dialyzer membrane. Part of the dialysate of circuit 1 is supplied from the secondary side of the membrane to the primary side. Therefore, according to the present invention, the dialysate can be supplied from the dialysate circuit side to the blood circuit side and dialyzed from the blood circuit side through the membrane of the dialyzer with a simple device configuration without attaching a new device or member. The liquid can be discharged to the liquid circuit side.

  In the method of operating the hemodialysis apparatus, when the dialysate is supplied to the dialyzer, the dialysate may be pumped to the container side by a pump provided in the second circuit. In this case, since the dialysate is pumped to the container by the pump on the second circuit side, the positive pressure in the section between the first opening / closing device and the container in the first circuit can be appropriately generated.

  The hemodialysis apparatus further includes a bypass circuit that connects the first circuit and the second circuit, and a bypass opening / closing device that opens and closes the bypass circuit, the first circuit and the second circuit The circuit is provided with an opening / closing device on the container side and the dialyzer side from the branch portion with the bypass circuit, and the first opening / closing device is connected to the dialyzer from the branch portion of the first circuit. The second opening / closing device may be an opening / closing device provided on the dialyzer side with respect to the branch portion of the second circuit. In such a case, the dialysate that has flowed out of the first chamber of the container can be returned to the second chamber via the bypass circuit. For example, when the dialysate itself is defective, the dialysate is not supplied to the dialyzer. Can be returned to the second chamber. Moreover, since the switchgear close to the dialyzer side is used as the first switchgear and the second switchgear, the section between the second switchgear and the container in the second circuit, or in the first circuit The section between the first opening / closing device and the container becomes longer. Therefore, a sufficient pressure change due to expansion and contraction of the first circuit and the second circuit can be ensured, the dialysate supply from the dialysate circuit side to the blood circuit side, and the blood circuit side through the dialyzer membrane The fluid is properly discharged from the dialysis fluid circuit side.

  Another aspect of the present invention is a hemodialysis apparatus for dialysis of blood through the membrane by flowing blood to the primary side of the membrane of the dialyzer and flowing dialysate to the secondary side of the membrane of the dialyzer. A container having a partition wall that is displaceable by separating the interior into a first chamber and a second chamber, and a first circuit that can be expanded and contracted for supplying dialysate in the first chamber of the container to the dialyzer A second circuit that can be expanded and contracted to discharge the dialysate of the dialyzer to the second chamber of the container, a first opening / closing device that opens and closes the first circuit, and the second A second opening / closing device for opening and closing the circuit, and displacing the partition wall toward the first chamber of the container filled with dialysate, and passing the dialysate in the first chamber through the first circuit When the dialysate supplied to the dialyzer and discharged from the dialyzer through the second circuit to the second chamber, Ri opening the first circuit, and a control device for opening the second circuit by the second closed circuit, followed said second switching device by said second switching device.

  According to the present invention, when the partition wall of the container is moved and the dialysate is supplied from the container to the dialyzer and discharged from the dialyzer, the first circuit is opened and the second circuit is temporarily closed. As a result, the pressure on the secondary side of the membrane of the dialyzer increases, and a portion of the dialysate in the first circuit is supplied from the secondary side of the membrane to the primary side. At this time, the partition wall moves, and at least a section between the second opening / closing device and the container in the second circuit becomes negative pressure, so that the section of the second circuit that can be expanded and contracted contracts. Next, by opening the second circuit, the pressure is released, and the contraction of the above section of the second circuit is restored, and the pressure on the secondary side of the membrane of the dialyzer decreases due to the suction force at that time, A portion of the liquid on the primary side of the dialyzer membrane flows into the secondary side. Therefore, according to the present invention, the dialysate can be supplied from the dialysate circuit side to the blood circuit side and dialyzed from the blood circuit side through the membrane of the dialyzer with a simple device configuration without attaching a new device or member. The liquid can be discharged to the liquid circuit side.

  In the hemodialysis apparatus, the first circuit may be provided with a pump for pumping dialysate to the dialyzer side.

  Another aspect of the present invention is a hemodialysis apparatus for dialysis of blood through the membrane by flowing blood to the primary side of the membrane of the dialyzer and flowing dialysate to the secondary side of the membrane of the dialyzer. A container having a partition wall that is displaceable by separating the interior into a first chamber and a second chamber, and a first circuit that can be expanded and contracted for supplying dialysate in the first chamber of the container to the dialyzer A second circuit that can be expanded and contracted to discharge the dialysate of the dialyzer to the second chamber of the container, a first opening / closing device that opens and closes the first circuit, and the second A second opening / closing device for opening and closing the circuit, and displacing the partition wall toward the first chamber of the container filled with dialysate, and passing the dialysate in the first chamber through the first circuit When the dialysate supplied to the dialyzer and discharged from the dialyzer through the second circuit to the second chamber, Ri opening the second circuit, and a control device for opening the first circuit by said first closed circuit, followed by the first switching device by said first switching device.

  According to the present invention, when the dialysis fluid is supplied from the container to the dialyzer and discharged from the dialyzer to the container by moving the partition wall of the container, the second circuit is opened and the first circuit is temporarily closed. As a result, the pressure on the secondary side of the dialyzer membrane drops, and a portion of the liquid on the primary side of the dialyzer membrane flows into the secondary side. At this time, since the partition wall moves and at least a section between the first opening / closing device and the container in the first circuit becomes a positive pressure, the section of the first circuit that can be expanded and contracted expands. Next, by opening the first circuit, the pressure is released, the expansion of the section of the first circuit is restored, and the pressure at that time increases the pressure on the secondary side of the dialyzer membrane. Part of the dialysate of circuit 1 is supplied from the secondary side of the membrane to the primary side. Therefore, according to the present invention, the dialysate can be supplied from the dialysate circuit side to the blood circuit side and dialyzed from the blood circuit side through the membrane of the dialyzer with a simple device configuration without attaching a new device or member. The liquid can be discharged to the liquid circuit side.

  In the hemodialysis apparatus, the second circuit may be provided with a pump for pumping dialysate to the container side.

  The hemodialysis apparatus further includes a bypass circuit that connects the first circuit and the second circuit, and a bypass opening and closing device that opens and closes the bypass circuit, and the first circuit and the second circuit The circuit is provided with an opening / closing device on the container side and the dialyzer side from the branch portion with the bypass circuit, and the first opening / closing device is connected to the dialyzer from the branch portion of the first circuit. The second opening / closing device may be an opening / closing device provided on the dialyzer side with respect to the branch portion of the second circuit.

  According to the present invention, with a simple apparatus configuration, the dialysate is supplied from the dialysate circuit side to the blood circuit side, and the liquid is discharged from the blood circuit side to the dialysate circuit side through the membrane of the dialyzer. Therefore, it is possible to improve the dialysis treatment capacity, prevent the apparatus from becoming complicated and large, and suppress an increase in cost.

It is a schematic diagram which shows the outline of a structure of the hemodialysis apparatus. It is explanatory drawing which shows the opening / closing timing of the on-off valve at the time of a dialysis process. It is explanatory drawing which shows the state of the hemodialysis apparatus of a 1st process. It is explanatory drawing which shows the state of the hemodialysis apparatus at the time of the start of a 2nd process. It is explanatory drawing which shows the state of the hemodialysis apparatus at the time of the dialysate circulation of a 2nd process. It is explanatory drawing which shows the state of the hemodialysis apparatus at the time of the start of another 2nd process. It is explanatory drawing which shows the opening / closing timing of the on-off valve at the time of the dialysis process which has another 2nd process. It is explanatory drawing which shows the state of the hemodialysis apparatus at the time of the dialysate circulation of another 2nd process.

Hereinafter, preferred embodiments of the present invention will be described with reference to the drawings. FIG. 1 is an explanatory diagram showing an outline of the configuration of a hemodialysis apparatus 1 according to the present embodiment.

 As shown in FIG. 1, the hemodialysis apparatus 1 includes, for example, a blood circuit 11 that circulates blood to the dialyzer 10 and a dialysate circuit 12 that supplies and discharges dialysate from the dialyzer 10.

  The dialyzer 10 is, for example, a hollow fiber module including a hollow fiber membrane 20, and dialyzes blood by taking unnecessary substances of blood passing through the primary side 10 a of the membrane 20 into the dialysate on the secondary side 10 b through the membrane 20. be able to.

  The blood circuit 11 includes, for example, a blood collection circuit 31 connected to the inlet end 10c of the primary side 10a of the dialyzer 10 from the needle portion 30 punctured by the patient, and another needle from the outlet end 10d of the primary side 10a of the dialyzer 10. A blood return circuit 33 connected to the unit 32 is provided. For example, the blood collection circuit 31 is provided with a pump 34.

  The dialysate circuit 12 includes, for example, a metering container 40, a first circuit 41, a second circuit 42, a third circuit 43, and a fourth circuit 44. The first circuit 41 to the fourth circuit 44 are made of, for example, an inflatable / contractible tube. An example of the tube material is a silicon tube.

  The fixed-quantity container 40 has a displaceable partition wall 52 that divides the inside of a constant volume into a first chamber 50 and a second chamber 51, for example. The partition wall 52 is made of, for example, a rubber diaphragm. In the metering container 40, the partition wall 52 is displaced due to fluctuations in the internal pressure of the chambers 50 and 51 to change the volumes of the chambers 50 and 51. When the volume of one chamber increases, the volume of the other chamber decreases accordingly. . Accordingly, when the partition 52 moves and the dialysate flows out from the first chamber 50 to the dialyzer 10 side, the corresponding amount of dialysate flows into the second chamber 51 from the dialyzer 10 side.

  The first circuit 41 is for supplying the dialysate in the first chamber 50 to the dialyzer 10, and from the first chamber 50 to the inlet end 10 e on the secondary side 10 b of the membrane 20 of the dialyzer 10. Communicates. The first circuit 41 includes an on-off valve 60 that can open and close the flow path to the dialyzer 10, a pump 61 that pumps dialysate from the first circuit 41 to the dialyzer 10, and a flow to the dialyzer 10. An opening / closing valve 62 is provided as a first opening / closing device capable of opening and closing the path. The on-off valve 60, the pump 61, and the on-off valve 62 are provided in this order from the first chamber 50 side to the dialyzer 10 side.

  The second circuit 42 is for discharging the dialysate from the dialyzer 10 to the second chamber 51, and communicates with the second chamber 51 from the outlet end 10 f of the secondary side 10 b of the dialyzer 10. . In the second circuit 42, an opening / closing valve 70 as a second opening / closing device for opening / closing a flow path to the second chamber 51 and an opening / closing valve 71 are directed from the dialyzer 10 side toward the second chamber 51 side. They are provided in this order.

  The first circuit 41 and the second circuit 42 are connected by a bypass circuit 80. The bypass circuit 80 is connected between the pump 61 and the on-off valve 62 of the first circuit 41 and between the on-off valve 70 and the on-off valve 71 of the second circuit 42. The bypass circuit 80 is provided with a bypass opening / closing valve 81. With this bypass circuit 80, the dialysate flowing out from the first chamber 50 of the metering container 40 can be returned to the second chamber 51 without being supplied to the dialyzer 10. Thereby, for example, when an abnormality occurs in the dialysate itself or the supply of the dialysate, the supply of the dialysate to the dialyzer 10 can be stopped.

  The third circuit 43 is for supplying dialysate to the first chamber 50 of the metering container 40, and communicates from the dialysate supply source 90 to the first chamber 50, for example. The third circuit 43 is provided with, for example, a pump 91 and an on-off valve 92 that opens and closes a flow path to the first chamber 50.

  The fourth circuit 44 is for discharging the dialysate in the second chamber 51 to the outside of the device 1, and communicates from the second chamber 51 to the outside of the device 1. The fourth circuit 44 is provided with an on-off valve 100.

  The operation of the hemodialysis apparatus 1 is executed by the control device 120. The control device 120 is, for example, a computer, and controls operations of the pumps 34, 61, 91, the on-off valves 60, 62, 70, 71, 81, 92, 100, and the like by executing a program stored in the memory. Thus, the operation method of the hemodialysis apparatus 1 described later can be executed.

  Next, an operation method of the hemodialysis apparatus 1 configured as described above will be described together with a dialysis process. FIG. 2 is an explanatory view showing the opening / closing operation of the opening / closing valves 60, 71, 92, 100, 70 in each step of the dialysis treatment.

  First, on the blood circuit 11 side, the pump 34 is operated, and the patient's blood is supplied to the dialyzer 10 through the blood collection circuit 31. The blood passes through the primary side 10 a of the dialyzer 10 and is returned to the patient through the blood return circuit 33.

  On the dialysate circuit 12 side, first, new dialysate is replenished into the first chamber 50 of the metering container 40, and dialysate is discharged from the second chamber 51 to the outside (the first dial shown in FIG. 2). Step S1). Specifically, as shown in FIG. 3, the on-off valves 60 and 71 are closed, the on-off valves 92 and 100 are opened, and dialysate is supplied from the dialysate supply source 90 to the first chamber 50 through the third circuit 43. Supplied. At this time, the on-off valve 70 is opened. Except for special cases such as when the supply of dialysate to the dialyzer 10 is stopped due to a malfunction, the on-off valve 62 is opened and the bypass on-off valve 81 is closed.

  Thus, the inside of the first chamber 50 is filled with the new dialysate, and the partition wall 52 of the metering container 40 moves to the second chamber 51 side. In addition, the partition 52 moves to the second chamber 51 side, and the dialysate previously stored in the second chamber 51 is discharged to the outside of the apparatus 1 through the fourth circuit 44.

  Next, the dialysate is supplied from the first chamber 50 to the dialyzer 10, and the dialysate is discharged from the dialyzer 10 to the second chamber 51 (second step S2 shown in FIG. 2). As shown in FIG. 4, first, the on-off valves 92 and 100 are closed, the on-off valves 60 and 71 are opened, and the pump 61 is activated. At this time, the on-off valve 70 is temporarily closed. For example, the pressure from the first chamber 50 side to the dialyzer 10 side is applied by the operation of the pump 61, the partition wall 52 of the metering container 40 moves to the first chamber 50 side, and the dialysate in the first circuit 41 flows. It is pumped to the dialyzer 10 side. Since the on-off valve 70 is closed, the dialysate that has moved to the dialyzer 10 side loses its destination, the pressure on the secondary side 10b of the dialyzer 10 rises, and partly flows out to the primary side 10a through the membrane 20. At this time, the partition wall 52 moves, and at least the section 42a between the on-off valve 70 of the second circuit 42 and the second chamber 51 becomes negative pressure, the tube contracts, and the pipe volume is reduced. Get smaller.

  Immediately after that, as shown in FIG. 5, the on-off valve 70 is opened, and the dialysate is caused to flow through the second circuit 42. At this time, the tube of the contracted section 42a between the on-off valve 70 of the second circuit 42 and the second chamber 51 returns to the original state, and the secondary side 10b of the dialyzer 10 is generated by the suction force generated at this time. And the liquid containing unnecessary substances in the blood on the primary side 10a of the membrane 20 flows into the secondary side 10b. At this time, substantially the same amount of dialysate that has flowed from the secondary side 10b to the primary side 10a is discharged from the primary side 10a to the secondary side 10b. Thereby, since the flow rate of the liquid passing through the membrane 20 becomes higher than usual, for example, an unnecessary substance having a larger diameter in the blood passes through the membrane 20 and is taken into the dialysate, thereby increasing the dialysis ability. The time for which the on-off valve 70 is closed is appropriately set according to the target discharge amount of the liquid containing unnecessary substances, the length of the section 42a of the second circuit 42, and the like.

  After the opening / closing valve 70 is opened, the partition wall 52 is continuously moved to the first chamber 50 side by the pump 61, and the dialysate in the first chamber 50 passes through the second circuit 42 to the secondary side 10 b of the dialyzer 10. To be supplied. The dialysate that has passed through the secondary side 10 b is returned to the second chamber 51 through the second circuit 42. During circulation of the dialysate, unnecessary substances in the blood on the primary side 10a pass through the membrane 20 and are taken into the dialysate on the secondary side 10b. Since the volume of the first chamber 50 is decreased by the movement of the partition wall 52, the volume of the second chamber 51 is increased. Therefore, the amount of dialysate supplied from the first chamber 50 and the second chamber 51 are increased. The amount of dialysate discharged in the same is the same. Further, the dialysate corresponding to the unnecessary substances increased by being taken in by the dialyzer 10 is discharged to the outside from a branch path (not shown) connected to the second circuit 42, for example.

  After that, as shown in FIG. 3 again, the on-off valves 60 and 71 are closed, the on-off valves 92 and 100 are opened, and the dialysate is supplied from the dialysate supply source 90 to the first chamber 50 as described above. The dialysate in the second chamber 51 is discharged to the outside (first step S1). After that, as shown in FIGS. 4 and 5, the dialysate is supplied from the first chamber 50 to the dialyzer 10 and the dialysate is discharged from the dialyzer 10 to the second chamber 51 (the second chamber 51). Step S2). At the start, the on-off valve 70 is temporarily closed, so that the dialysate is supplied from the secondary side 10b to the primary side 10a through the membrane 20 of the dialyzer 10 and the liquid is discharged from the primary side 10a to the secondary side 10b. Done.

  Thus, the first step S1 and the second step S2 are alternately repeated, and the patient is dialyzed. In the second step S2, it is not necessary to perform the step of closing the on-off valve 70 at the start, and the number of times is set as appropriate.

  According to the above embodiment, when the partition wall 52 of the metering container 40 is moved and the dialysate is supplied from the first chamber 50 to the dialyzer 10 and discharged from the dialyzer 10 to the second chamber 51, the first Therefore, the pressure on the secondary side 10b of the membrane 20 of the dialyzer 10 is increased, and a part of the dialysate in the first circuit 41 is part of the membrane 20. From the secondary side 10b to the primary side 10a. At this time, since the partition wall 52 moves and at least the section 42a between the opening / closing valve 70 of the second circuit 42 and the metering container 40 becomes negative pressure, the section 42a of the second circuit 42 that can be expanded and contracted contracts. To do. At this time, there is a possibility that the section between the pump 61 of the first circuit 41 and the first chamber 50 also becomes negative pressure and contracts, but this may be any. Next, by opening the second circuit 42, the pressure is released, and the contraction of the section 42a of the second circuit 42 is restored, and the secondary side 10b of the membrane 20 of the dialyzer 10 is restored by the suction force at that time. , And a part of the liquid on the primary side 10a of the membrane 20 of the dialyzer 10 flows into the secondary side 10b. Therefore, according to the present embodiment, the dialysate is supplied from the dialysate circuit 12 side to the blood circuit 11 side through the membrane 20 of the dialyzer 10 with a simple device configuration without attaching new devices or members. The liquid can be discharged from the blood circuit 11 side to the dialysate circuit 12 side. Thereby, while improving the dialysis processing capability, the complication and enlargement of the apparatus can be prevented, and an increase in cost can be suppressed.

  In the above embodiment, during the second step S2 in which the dialysate is supplied to the dialyzer 10, the dialysate is pumped to the dialyzer 10 side by the pump 61 provided in the first circuit 41. Yes. Thus, since the dialysate is pumped by the pump 61 on the first circuit 41 side, a negative pressure is appropriately generated in the section 42 a between the on-off valve 70 of the second circuit 42 and the second chamber 51. .

  Further, in the above embodiment, the dialysate circuit 12 is provided with the bypass circuit 80 and the bypass opening / closing valve 81, and the first circuit 41 and the second circuit 42 are connected to the dialyzer 10 side from the branch portion of the bypass circuit 80. Since the on / off valves 70 and 62 are provided, the dialysate discharged from the first chamber 50 is returned to the second chamber 51 without being supplied to the dialyzer 10 when the dialysate is defective. be able to. At the start of the second step S2, the dialysate is supplied from the dialysate circuit 12 side to the blood circuit 11 side, and the liquid from the blood circuit 11 side through the membrane 20 of the dialyzer 10 to the dialysate circuit 12 side is supplied. Since the on-off valve 70 close to the dialyzer 10 side is temporarily closed when discharging the gas, the section 42a between the on-off valve 70 of the second circuit 42 to be closed and the second chamber 51 is long. Become. Therefore, a sufficient pressure change due to expansion and contraction of the section 42a of the second circuit 42 can be secured, and the dialysate supply from the dialysate circuit 12 side to the blood circuit 11 side and the membrane 20 of the dialyzer 10 are communicated. The liquid is properly discharged from the blood circuit 11 side to the dialysate circuit 12 side.

  In the above embodiment, the opening / closing valve 70 on the second circuit 42 side is temporarily closed at the start of the second step S2, but the opening / closing valve 62 of the first circuit 41 is temporarily closed. May be. In such a case, for example, as shown in FIG. 6, it is preferable to provide a pump 61 on the second circuit 42 side. The pump 61 is provided between the on-off valve 70 and the on-off valve 71, for example. In addition, since the other structure of the hemodialysis apparatus 1 in this Embodiment is the same as that of the said embodiment, it abbreviate | omits description using the same code | symbol. FIG. 7 is an explanatory diagram showing the opening / closing operation of the on-off valves 60, 71, 92, 100, 62 in each step of the dialysis treatment in this embodiment.

  At the start of the second step S2, as shown in FIG. 6, the on-off valve 62 is closed and the on-off valves 60, 70, 71 are opened, and the pump 61 operates. The pressure from the dialyzer 10 side to the second chamber 51 side is applied by the operation of the pump 61, the partition wall 52 of the metering container 40 moves to the first chamber 50 side, and the dialysate in the second circuit 42 is changed to the first one. 2 is pumped to the chamber 51 side. At this time, since the on-off valve 62 is closed, the pressure on the secondary side 10b of the dialyzer 10 decreases, and a liquid containing unnecessary blood substances on the primary side 10a of the membrane 20 flows into the secondary side 10b. Thereby, since the flow rate of the liquid passing through the membrane 20 becomes higher than usual, for example, an unnecessary substance having a larger diameter in the blood passes through the membrane 20 and is taken into the dialysate, thereby increasing the dialysis ability. At this time, the partition wall 52 moves, at least the section 41a between the on-off valve 62 of the first circuit 41 and the first chamber 50 becomes positive pressure, the tube expands, and the pipe volume is increased. growing. The section between the pump 61 of the second circuit 42 on the outlet side of the pump 61 and the second chamber 51 may be positive pressure and expand, but this may be any. .

  Immediately after that, as shown in FIG. 7, the on-off valve 62 is opened, and the dialysate is caused to flow through the first circuit 41. At this time, the tube in the section 41a that has been expanded returns to the original state, and the pressure generated at this time increases the pressure on the secondary side 10b of the dialyzer 10, and a part of the dialysate flows out to the primary side 10a through the membrane 20. . At this time, approximately the same amount of dialysate as the liquid flowing from the primary side 10a to the secondary side 10b flows out from the secondary side 10b to the primary side 10a.

  After the opening / closing valve 62 is opened, the dialysate is supplied from the first chamber 50 to the dialyzer 10 and the dialysate is discharged from the dialyzer 10 to the second chamber 51 in the same manner as in the above embodiment. Done.

  In this embodiment, the dialysate supply from the dialysate circuit 12 side to the blood circuit 11 side and the blood circuit through the membrane 20 of the dialyzer 10 can be performed with a simple device configuration without attaching new devices or members. The liquid can be discharged from the 11 side to the dialysate circuit 12 side. Thereby, while improving the dialysis processing capability, the complication and enlargement of the apparatus can be prevented, and an increase in cost can be suppressed.

  Further, during the second step S2 in which the dialysate is supplied to the dialyzer 10, the dialysate is pumped to the metering container 40 side by the pump 61 provided in the second circuit 42. Thus, since the dialysate is pumped by the pump 61 on the second circuit 42 side, a positive pressure is appropriately generated in the section 41 a between the on-off valve 62 of the first circuit 41 and the first chamber 50. .

  The preferred embodiments of the present invention have been described above with reference to the accompanying drawings, but the present invention is not limited to such examples. It is obvious for those skilled in the art that various modifications or modifications can be conceived within the scope of the idea described in the claims, and these naturally belong to the technical scope of the present invention. It is understood.

  For example, in the above embodiment, the on-off valve 70 of the second circuit 42 or the on-off valve 62 of the first circuit 41 is temporarily closed at the start of the second step S2, but instead the second step S2 is performed. As an opening / closing device, the opening / closing valve 71 of the second circuit 42 may be closed, and as the first opening / closing device, the opening / closing valve 60 of the first circuit 41 may be closed. Moreover, although the above embodiment was an example in which each of the first circuit 41 and the second circuit 42 is provided with two on-off valves, the present invention can be applied to cases where the number is other than two. Applicable. Further, the opening / closing valve is not limited, and other opening / closing devices may be used.

  In the above embodiment, the dialysate is pumped by the pump 61. However, the present invention can also be applied when the dialysate is pumped by other means. For example, the partition wall 52 of the metering container 40 is driven by another driving source, or the partition chamber 52 is given a biasing force toward the first chamber 50 to automatically fill the first chamber 50 with dialysate. The partition wall 52 may move to the first chamber 50 side.

  Further, in the above embodiment, there is one quantitative container 40, but the present invention can also be applied to the case where there are two quantitative containers. In such a case, each metering container 40 may be connected in parallel to the dialyzer 10 by the respective first circuit 41 and second circuit 42.

  The present invention is useful for supplying dialysate from the dialysate circuit side to the blood circuit side and discharging the liquid from the blood circuit side to the dialysate circuit side through the dialyzer membrane with a simple apparatus configuration. It is.

DESCRIPTION OF SYMBOLS 1 Hemodialysis apparatus 10 Dialyzer 10a Primary side 10b Secondary side 20 Membrane 11 Blood circuit 12 Dialysate circuit 40 Metering container 41 First circuit 42 Second circuit 43 Third circuit 44 Fourth circuit 50 First Chamber 51 Second chamber 52 Bulkhead 60, 62, 70, 71, 92, 100 On-off valve 34, 61, 91 Pump 80 Bypass circuit 81 Bypass on-off valve 120 Controller

Claims (10)

A method of operating a hemodialysis apparatus for flowing blood to a primary side of a membrane of a dialyzer, flowing dialysate to a secondary side of the membrane of the dialyzer, and dialyzing blood through the membrane;
The hemodialyzer is
A container having a partition wall that is displaceable by separating the interior into a first chamber and a second chamber;
A first expandable / contractible circuit for supplying dialysate from the first chamber of the container to the dialyzer;
A second expandable / contractible circuit for discharging the dialysate of the dialyzer to the second chamber of the container;
A first switching device for opening and closing the first circuit;
A second opening / closing device for opening and closing the second circuit,
The partition is displaced to the first chamber side of the container filled with dialysate, and the dialysate in the first chamber is supplied to the dialyzer through the first circuit, and the dialysate in the dialyzer is supplied. When discharging to the second chamber through the second circuit, the first circuit is opened by the first switch, the second circuit is closed by the second switch, and then A method for operating a hemodialysis apparatus, wherein a control device for opening the second circuit is operated by the second opening / closing device.   The method of operating a hemodialysis apparatus according to claim 1, wherein when the dialysate is supplied to the dialyzer, the dialysate is pumped to the dialyzer side by a pump provided in the first circuit. A method of operating a hemodialysis apparatus for flowing blood to a primary side of a membrane of a dialyzer, flowing dialysate to a secondary side of the membrane of the dialyzer, and dialyzing blood through the membrane;
The hemodialyzer is
A container having a partition wall that is displaceable by separating the interior into a first chamber and a second chamber;
A first expandable / contractible circuit for supplying dialysate from the first chamber of the container to the dialyzer;
A second expandable / contractible circuit for discharging the dialysate of the dialyzer to the second chamber of the container;
A first switching device for opening and closing the first circuit;
A second opening / closing device for opening and closing the second circuit,
The partition is displaced to the first chamber side of the container filled with dialysate, and the dialysate in the first chamber is supplied to the dialyzer through the first circuit, and the dialysate in the dialyzer is supplied. When discharging to the second chamber through the second circuit, the second circuit is opened by the second switching device, the first circuit is closed by the first switching device, and then A method for operating a hemodialysis apparatus, wherein a control device for opening the first circuit is operated by the first opening / closing device.   The method of operating a hemodialysis apparatus according to claim 3, wherein when the dialysate is supplied to the dialyzer, the dialysate is pumped to the container side by a pump provided in the second circuit. The hemodialyzer is
A bypass circuit connecting the first circuit and the second circuit;
A bypass opening and closing device for opening and closing the bypass circuit,
The first circuit and the second circuit are each provided with an opening / closing device on the container side and the dialyzer side from a branch portion with the bypass circuit,
The first switchgear is a switchgear provided on the dialyzer side from the branch portion of the first circuit,
The method for operating a hemodialysis apparatus according to any one of claims 1 to 4, wherein the second switchgear is a switchgear provided on the dialyzer side with respect to the branch portion of the second circuit. A hemodialyzer for dialysis of blood through the membrane by flowing blood to the primary side of the membrane of the dialyzer, flowing dialysate to the secondary side of the membrane of the dialyzer,
A container having a partition wall that is displaceable by separating the interior into a first chamber and a second chamber;
A first expandable / contractible circuit for supplying dialysate from the first chamber of the container to the dialyzer;
A second expandable / contractible circuit for discharging the dialysate of the dialyzer to the second chamber of the container;
A first switching device for opening and closing the first circuit;
A second switching device for opening and closing the second circuit;
The partition is displaced to the first chamber side of the container filled with dialysate, and the dialysate in the first chamber is supplied to the dialyzer through the first circuit, and the dialysate in the dialyzer is supplied. When discharging to the second chamber through the second circuit, the first circuit is opened by the first switch, the second circuit is closed by the second switch, and then And a control device for opening the second circuit by the second opening / closing device.   The hemodialyzer according to claim 6, wherein the first circuit is provided with a pump for pumping dialysate to the dialyzer side. A hemodialyzer for dialysis of blood through the membrane by flowing blood to the primary side of the membrane of the dialyzer, flowing dialysate to the secondary side of the membrane of the dialyzer,
A container having a partition wall that is displaceable by separating the interior into a first chamber and a second chamber;
A first expandable / contractible circuit for supplying dialysate from the first chamber of the container to the dialyzer;
A second expandable / contractible circuit for discharging the dialysate of the dialyzer to the second chamber of the container;
A first switching device for opening and closing the first circuit;
A second switching device for opening and closing the second circuit;
The partition is displaced to the first chamber side of the container filled with dialysate, and the dialysate in the first chamber is supplied to the dialyzer through the first circuit, and the dialysate in the dialyzer is supplied. When discharging to the second chamber through the second circuit, the second circuit is opened by the second switching device, the first circuit is closed by the first switching device, and then And a control device that opens the first circuit by the first opening and closing device.   The hemodialysis apparatus according to claim 8, wherein the second circuit is provided with a pump for pumping dialysate to the container side. A bypass circuit connecting the first circuit and the second circuit;
A bypass opening and closing device for opening and closing the bypass circuit,
The first circuit and the second circuit are each provided with an opening / closing device on the container side and the dialyzer side from a branch portion with the bypass circuit,
The first switchgear is a switchgear provided on the dialyzer side from the branch portion of the first circuit,
The hemodialysis apparatus according to any one of claims 6 to 9, wherein the second switchgear is a switchgear provided on the dialyzer side with respect to the branch portion of the second circuit.

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