JP5707190B2 - Blood purification equipment - Google Patents

Description

  The present invention relates to a blood purification apparatus for performing blood purification treatment with a blood purifier connected to a blood circuit.

  Recently, in a dialysis machine as a blood purification apparatus, there is a technique for performing priming, blood return and replacement (emergency replacement) using dialysate for supplying to a dialyzer during dialysis treatment (particularly, on-line HDF or on-line HF). Has been proposed. For example, Patent Document 1 discloses a replacement fluid in which one end is connected to a sampling port formed in a predetermined part of the dialysate introduction line and the other end is connected to a blood circuit (arterial blood circuit or venous blood circuit). A dialysis apparatus including a line and a replacement fluid pump disposed in the replacement fluid line is disclosed. In order to perform priming, blood return or replacement fluid (emergency replacement fluid) with such a dialysis device, the dialysate introduction line dialysate is supplied to the blood circuit (arterial blood circuit or venous blood circuit) by driving the replacement fluid pump. It can be supplied.

JP 2004-313522 A

  However, in the conventional blood purification device, in the replacement fluid line priming process in which the replacement fluid pump is driven to fill the replacement fluid line with dialysis fluid to perform priming, the air in the replacement fluid line is arterial blood circuit or venous blood. Since the air reaches the inside of the circuit, there is a possibility that the air may be bubbled and flow into a blood purifier such as a dialyzer. If air bubbles enter the blood purifier as described above, there is a problem in that the air purifying operation in the blood purifier is required, and the working efficiency is remarkably deteriorated.

  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 capable of reliably preventing bubbles from entering the blood purification apparatus during the replacement fluid line priming step.

According to the first aspect of the present invention, there is provided a blood purifier that contains a blood purification membrane and purifies blood with the blood purification membrane, a proximal end is connected to the blood purification device, and a blood pump is disposed in the middle thereof. An arterial blood circuit, a venous blood circuit whose proximal end is connected to the blood purifier, a dialysate introduction line for introducing dialysate into the blood purifier, and discharging the dialysate from the blood purifier The dialysate discharge line and one end are connected to a sampling port formed in a predetermined part of the dialysate introduction line, and the other end is connected between the blood pump and the blood purifier in the arterial blood circuit. A fluid replacement line, a fluid replacement pump disposed in the middle of the fluid replacement line and capable of supplying the dialysate fluid in the dialysate introduction line to the arterial blood circuit, and the venous blood circuit. Liquid in the circuit Or an overflow line gas can was discharged to the outside, is arranged between the tip and the overflow line of the venous blood circuit in the venous blood circuit, and a bubble detector that can detect air bubbles in the flow path A blood purification apparatus comprising: in the course of a replacement fluid line priming step of filling the replacement fluid line with the dialysate in a state where the distal end of the arterial blood circuit and the distal end of the venous blood circuit are connected. Control that allows the blood pump and the replacement fluid pump to be driven at the same time while setting the driving speed of the blood pump to be larger than the driving speed of the replacement fluid pump, and allows the bubbles to be discharged from the overflow line on condition that the bubble detector detects the bubbles. Rutotomoni comprising means, said control means, the flow path of the overflow line with a closed, wherein A simultaneous driving step of simultaneously driving the blood pump and the replacement fluid pump while setting the driving speed of the fluid pump to be higher than the driving speed of the replacement fluid pump; and the overflow line is opened on condition that the bubble detector detects the bubbles And a bubble discharging step of discharging bubbles from the overflow line .

The invention according to claim 2 is the blood purification apparatus according to claim 1 , wherein one end is connected to a predetermined portion of the dialysate introduction line, and the other end is a tip of the artery side blood circuit in the artery side blood circuit. And a priming line connected between the blood pump and a dialysate supply means capable of supplying the dialysate from the dialysate introduction line to the arterial blood circuit via the priming line, and In the bubble discharging step, after the driving of the blood pump and the replacement fluid pump is stopped, the dialysate supply means supplies the dialysate in the dialysate introduction line via the priming line to discharge bubbles from the overflow line. It is characterized by making it.

According to a third aspect of the present invention, in the blood purification apparatus according to the second aspect , the dialysate supply means is disposed across the dialysate introduction line and the dialysate discharge line, and the dialysate is supplied to the blood purifier. And a double pump for discharging the dialysate from the blood purifier.

The invention of claim 4, wherein, in the blood purification apparatus according to claim 1, wherein the air bubble discharging process is characterized in that it is controlled to the driving speed of the replacement fluid pump increasing the driving speed of the blood pump.

The invention according to claim 5 is the blood purification apparatus according to any one of claims 1 to 4 , wherein the replacement fluid line priming is performed in a state in which the priming fluid is filled in the arterial blood circuit and the venous blood circuit. A process is performed.

  According to the first aspect of the present invention, in the course of the replacement fluid line priming process in which the replacement fluid line is filled with the dialysate while the distal end of the arterial blood circuit and the distal end of the venous blood circuit are connected, the blood pump is driven. Since the blood pump and the replacement fluid pump are simultaneously driven while the speed is set to be higher than the driving speed of the replacement fluid pump, and the control means that can discharge the bubbles from the overflow line, the bubbles are removed from the blood purifier during the replacement fluid line priming process. It can be surely prevented from entering.

In addition , since the control means discharges the bubbles from the overflow line on condition that the bubbles are detected by the bubble detector, the bubbles can be discharged from the overflow line more reliably and satisfactorily, and the bubbles used at the time of blood purification treatment The detector can be diverted.

Further , the control means closes the flow path of the overflow line, and simultaneously drives the blood pump and the replacement fluid pump while simultaneously setting the drive speed of the blood pump higher than the drive speed of the replacement fluid pump; Since the overflow line is opened under the condition that bubbles are detected by the bubble detector, and the bubble discharge process for discharging the bubbles from the overflow line is performed, the bubble detector used for blood purification treatment can be diverted from the overflow line. The bubbles can be discharged more reliably.

According to the invention of claim 2 , in the bubble discharging step, after the driving of the blood pump and the replacement fluid pump is stopped, the dialysate supply means supplies the dialysate in the dialysate introduction line via the priming line and overflows. Since the bubbles are discharged from the line, the bubbles can be discharged from the overflow line more smoothly and reliably.

According to the invention of claim 3 , the dialysate supply means is disposed across the dialysate introduction line and the dialysate discharge line, introduces the dialysate into the blood purifier and supplies the dialysate from the blood purifier. Since it comprises a dual pump to be discharged, the dual pump used at the time of blood purification treatment can be used as the dialysate supply means.

According to the invention of claim 4 , since the bubble discharging step is controlled so as to increase the driving speed of the replacement fluid pump above the driving speed of the blood pump, the bubbles are discharged from the overflow line with simpler control. Can be discharged.

According to the invention of claim 5 , since the replacement fluid line priming step is performed in a state where the arterial blood circuit and the venous blood circuit are filled with the priming fluid, the air in the replacement fluid line is blood during the replacement fluid priming step. It can prevent more reliably that it will reach a purifier.

The schematic diagram which shows the hemodialysis apparatus (blood purification apparatus) which concerns on 1st Embodiment of this invention. Schematic diagram showing the state at the end of priming of the blood circuit in the hemodialysis device Schematic showing the state during the simultaneous drive process in the hemodialysis machine Schematic diagram showing a state in which bubbles are detected during the simultaneous driving process in the hemodialysis device Schematic showing the state during the air bubble discharge process in the hemodialysis machine Flow chart showing control contents by control means in the hemodialysis apparatus FIG. 7 is a schematic view showing a state at the end of priming of a blood circuit, which is a hemodialysis apparatus (blood purification apparatus) according to a second embodiment of the present invention. Schematic showing the state during the simultaneous drive process in the hemodialysis machine Schematic diagram showing a state in which bubbles are detected during the simultaneous driving process in the hemodialysis device Schematic showing the state during the air bubble discharge process in the hemodialysis machine Flow chart showing control contents by control means in the hemodialysis apparatus

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 a hemodialysis apparatus. As shown in FIG. 1, an arterial blood circuit 2 and a venous blood circuit 3 are connected to a dialyzer 1 as a blood purification apparatus. Blood circuit, dialyzer body B having dialysate introduction line L1 and dialysate discharge line L2, duplex pump 7 as dialysate supply means, connection line L8 having replacement fluid line L8a and priming line L8b The hydraulic pressure measuring means 12 and the control means 16 are mainly configured.

  The dialyzer 1 includes a blood purification membrane (not shown) (in this embodiment, a hollow fiber type hemodiafiltration membrane, but includes a flat membrane type hemodialysis membrane or a blood filtration membrane) and introduces blood. The blood 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 dialysate is brought into contact with the blood introduced from the blood introduction port 1a through the hollow fiber membrane to purify the blood.

  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 blood vessel of the patient into the hollow fiber membrane of the dialyzer 1. A connector a to which an arterial puncture needle (not shown) can be attached is formed at the other end of the arterial blood circuit 2, and an arterial air trap chamber 5 for defoaming is connected in the middle. A blood pump 4 is provided. The blood pump 4 is a squeezing type pump (with a structure in which a flexible tube is squeezed to rotate the blood from the arterial puncture needle side toward the blood inlet 1a of the dialyzer 1 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 b to which a venous puncture needle (not shown) can be attached is formed, and a venous air trap chamber 6 for defoaming is connected midway. . That is, the blood of the patient collected by the arterial puncture needle reaches the dialyzer 1 via the arterial blood circuit 2, and after blood purification, flows through the venous blood circuit 3 and passes through the venous puncture needle. Thus, it is configured to return to the patient's body, thereby providing extracorporeal circulation.

  In addition, a bubble detector 17 capable of detecting bubbles in the flow path is disposed in the vicinity of the distal end of the venous blood circuit 3 (in the present embodiment, the portion where the electromagnetic valve V11 is disposed). Such bubble detector 17 can detect bubbles in blood circulating outside the body during blood purification treatment. Note that the bubble detector 17 according to the present embodiment is formed at the site where the electromagnetic valve V11 is disposed, but the tip of the venous blood circuit 3 and the venous air trap chamber 6 in the venous blood circuit 3 are connected. You may make it arrange | position in any site | part between the site | parts (specifically site | part in which the overflow line L10 in the venous blood circuit 3 was formed).

  An electromagnetic valve V10 is connected to the distal side of the arterial blood circuit 2 (between the connector a and the blood pump 4 and in the vicinity of the connector a), and the distal side of the venous blood circuit 3 (connector b and A solenoid valve V11 is connected to the vein-side air trap chamber 6 and in the vicinity of the connector b). An overflow line L10 that can discharge liquid or gas to the outside is extended from the upper part of the venous air trap chamber 6 formed in the middle of the venous blood circuit 3, and in the middle of the overflow line L10. Is connected to a solenoid valve V8.

  Before the dialysis treatment, as shown in FIG. 1, by connecting the connector a and the connector b, the tip of the arterial blood circuit 2 and the tip of the venous blood circuit 3 are connected to each other. A closed circuit on the blood circuit side can be formed by the side blood circuit 2 and the venous side blood circuit 3 (including a flow path through which blood in the dialyzer 1 flows). Then, by supplying dialysate into the closed circuit via the connection line L8 (specifically, the priming line L8b), the blood circuit (the arterial blood circuit 2 and the venous blood circuit 3) and the connection line are supplied. Priming work is possible by filling L8 with dialysate. In the course of the priming operation, the dialysate can overflow from the overflow line L10 to wash the closed circuit on the blood circuit side.

  End portions of a dialysate introduction line L1 and a dialysate discharge line L2 are respectively connected to the dialysate introduction port 1c and the dialysate discharge port 1d of the dialyzer 1, and are connected to the dialyzer 1 through the dialysate introduction line L1. The introduced dialysate passes through the outside of the hollow fiber membrane and is discharged from the dialysate discharge line L2. In addition, a dual pump 7 for introducing the dialysate into the dialyzer 1 through the dialysate introduction line L1 and discharging the dialysate from the dialyzer 1 is disposed in the dialyzer body B.

  The dialyzer main body B has a dialysate introduction line L1 and a dialysate discharge line L2, and has a dual pump 7, bypass lines L3 to L6, and electromagnetic valves V1 to V7. Among these, the duplex pump 7 is disposed across the dialysate introduction line L1 and the dialysate discharge line L2, and introduces dialysate prepared to a predetermined concentration into the dialyzer 1 and dialysates after dialyzing from the dialyzer 1 Are to be discharged. The dual pump 7 according to the present embodiment constitutes a dialysate supply means used in a bubble discharge process described later.

  An electromagnetic valve V1 is connected to the middle of the dialysate introduction line L1 (downstream side of the dialysate introduction line L1 connected to the connection line L8 (dialyzer 1 side)), and the middle of the dialysate discharge line L2 ( An electromagnetic valve V2 is connected to the upstream side (dialyzer 1 side) of the dialysate discharge line L2 connected to the bypass line L3. In addition, filtration filters 8 and 9 are connected between the dual pump 7 and the solenoid valve V1 in the dialysate introduction line L1.

  The filtration filters 8 and 9 are for filtering and purifying the dialysate flowing through the dialysate introduction line L1, and the filtration filters 8 and 9 bypass the dialysate discharge line L2 to guide the dialysate. Bypass lines L3 and L4 are connected to each other. Solenoid valves V3 and V4 are connected to the bypass lines L3 and L4, respectively. Note that an electromagnetic valve V6 and an atmospheric introduction line L7 are connected between the filtration filter 8 and the filtration filter 9 in the dialysate introduction line L1, and an electromagnetic valve V12 is connected to the atmospheric introduction line L7. .

  On the other hand, a fluid pressure measuring means 12 capable of measuring the fluid pressure of the dialysate is connected between the connecting portion with the bypass line L3 and the connecting portion with the bypass line L4 in the dialysate discharge line L2. Furthermore, the dialysate discharge line L2 is connected to bypass lines L5 and L6 that bypass the duplex pump 7, and the bypass line L5 is a filter for removing water from the blood of the patient flowing in the dialyzer 1. A water pump 10 is disposed, and an electromagnetic valve V5 that can open and close the flow path is connected to the bypass line L6.

  Further, on the upstream side of the dual pump 7 in the dialysate discharge line L <b> 2 (between the connecting portion with the bypass line L <b> 5 and the dual pump 7), a pump 14 for adjusting the fluid pressure on the drain side in the dual pump 7. Is arranged. Further, a chamber 15 is connected to the upstream side (between the pump 14 and the duplex pump 7) of the dialysate discharge line L2 (between the pump 14 and the duplex pump 7), and the chamber 15 is connected to the atmosphere open line via a check valve or the like. L9 is connected, and an electromagnetic valve V7 is connected to the atmosphere release line L9.

  Here, the electromagnetic valves V1 to V12 constitute an on-off valve that can open and close the dialysate or blood flow path. In the present embodiment, the electromagnetic valves V1 to V12 are turned on in the course of the replacement fluid line priming step. A desired flow path can be formed by optionally opening and closing. Specifically, at the end of priming and before the replacement fluid line priming step, as shown in FIG. 2, the solenoid valves V3, V5 and V6 on the dialyzer body B side and the solenoid valves V10 and V11 on the blood circuit side are respectively set. While the other solenoid valves (solenoid valves V 1, V 2, V 4, V 7, V 8, V 9, V 12) are closed, the dialysate in the dialysate introduction line L 1 is supplied to the arterial blood circuit 2. It can be in a state where it can be supplied.

  One end of the connection line L8 is connected to the sampling port 11 formed at a predetermined portion of the dialysate introduction line L1 (in this embodiment, the tip of the branch line L1a branched from the dialysate introduction line L1). The end is connected to the arterial blood circuit 2 (or may be the venous blood circuit 3), and the dialysate from the dialysate introduction line L1 is supplied to the arterial blood circuit 2 (or venous blood circuit 3). It consists of a flow channel to obtain.

  In the middle of the connection line L8 according to the present embodiment, the replacement fluid pump 13 is disposed and the distal end of the connection line L8 is connected to the upper portion of the artery side air trap chamber 5, and the distal end of the connection line L8 is connected to the artery side blood circuit 2. A priming line L8b is connected between the electromagnetic valve V10 and the blood pump 4 (if it is between the distal end of the arterial blood circuit 2 and the blood pump 4) and the electromagnetic valve V9 is disposed on the distal end side. And a flow path having This connection line L8 is discarded together with the arterial blood circuit 2 and the venous blood circuit 3 after the completion of one blood purification treatment, and like the arterial blood circuit 2 and the venous blood circuit 3, For example, it consists of a flexible tube. In the present embodiment, the replacement fluid line L8a and the priming line L8b are flow paths branched in the middle of one connection line L8. However, separate replacement fluid lines and priming lines composed of separate flow paths may be used. Good.

  The replacement fluid pump 13 is disposed in the middle of the replacement fluid line L8a in the connection line L8, and can supply the dialysate from the dialysate introduction line L1 to the blood circuit (arterial blood circuit 2 or venous blood circuit 3). . Like the blood pump 4, the replacement fluid pump 13 is a squeezing type pump (with a configuration in which the dialysis fluid can flow by squeezing a flexible tube constituting the replacement fluid line L 8 a when driven).

  However, at the time of priming, the dialysate can be supplied to the arterial blood circuit 2 via the priming line L8b, and the replacement fluid pump 13 is driven during the blood purification treatment, so that the replacement fluid line L8a is used. A dialysate can be supplied into the arterial blood circuit 2 to perform a replacement fluid during blood purification treatment. Although the replacement fluid line L8a of the connection line L8 according to the present embodiment is connected to the upper part of the artery side air trap chamber 5, any replacement is possible between the blood pump 4 and the dialyzer 1 in the artery side blood circuit 2. It may be connected to a position.

  The priming line L8b is composed of a flow path in which an actuator or the like such as the replacement fluid pump 13 is not provided, and an electromagnetic valve V9 serving as an opening / closing means in the vicinity of the connection with the arterial blood circuit 2 (or venous blood circuit 3). When the electromagnetic valve V9 is opened, the dialysate introduction line L1 and the arterial blood circuit 2 are in communication with each other. The tip of the priming line L8b may be connected to any position in the artery side blood circuit 2 between the tip of the artery side blood circuit 2 and the blood pump 4.

  The control means 16 can perform control related to opening / closing of arbitrary solenoid valves V1 to V12, driving or stopping of arbitrary actuators such as the dual pump 7 (dialysate supply means), blood pump 4 and replacement fluid pump 13, for example from a microcomputer It consists of. In particular, the control means 16 according to the present embodiment performs a replacement fluid line priming process in which the replacement fluid line L8a is filled with dialysate 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 blood pump 4 and the replacement fluid pump 13 are simultaneously driven while the driving speed of the blood pump 4 is set to be higher than the driving speed of the replacement fluid pump 13, and the bubbles can be discharged from the overflow line L10.

  More specifically, the control means 16 is controlled to discharge the bubbles from the overflow line L10 on condition that the bubbles are detected by the bubble detector 17, and the flow path of the overflow line L10 is closed, Overflow line L10 on the condition that the blood pump 4 and the replacement fluid pump 13 are simultaneously driven while the driving speed of the blood pump 4 is set higher than the driving speed of the replacement fluid pump 13 and the detection of bubbles by the bubble detector 17 Is opened, and a bubble discharging step of discharging bubbles from the overflow line L10 can be performed.

  Here, in the bubble discharging step according to the present embodiment, after the driving of the blood pump 4 and the replacement fluid pump 13 is stopped, the dialysate in the dialysate introduction line L1 is supplied to the priming line L8b by the dual pump 7 (dialysate supply means). And the air bubbles are discharged from the overflow line L10. That is, by driving the dual pump 7, the dialysate in the dialysate introduction line L1 is supplied to the arterial blood circuit 2 via the priming line L8b, and the air bubbles are venous-aired by the fluid pressure of the supplied dialysate. It can flow to the trap chamber 6 side and be discharged from the overflow line L10.

Hereinafter, the control contents of the control means 16 according to the present embodiment will be described with reference to the flowchart of FIG. 6 and FIGS.
First, before dialysis treatment (before priming), as shown in FIG. 2, by connecting the connector a and the connector b, the tip of the arterial blood circuit 2 and the tip of the venous blood circuit 3 are connected, A closed circuit on the blood circuit side is formed by the arterial blood circuit 2 and the venous blood circuit 3 (including a flow path through which blood in the dialyzer 1 flows). Then, the solenoid valves V3, V5, V6 on the dialyzer body B side and the solenoid valves V10, V11 on the blood circuit side are opened, and the other solenoid valves (solenoid valves V1, V2, V4, V7, V9) are opened. , V12) is closed and priming is performed.

  The priming of the blood circuit is performed by supplying the dialysate (priming fluid) from the dialysate introduction line L1 to the blood circuit side (arterial blood circuit 2) via the priming line L8b by driving the compound pump 7. In the cleaning process, the electromagnetic valve V8 is opened and the dialysate as the priming liquid is discharged from the overflow line L10. In the subsequent filling process, the electromagnetic valve V8 is closed. FIG. 2 shows a state after the priming of the blood circuit is performed, and the electromagnetic valve V8 is in a closed state.

  When the priming of the blood circuit is completed, the control unit 16 performs priming of the replacement fluid line L8a (replacement fluid line priming step). In this replacement fluid line priming step, as shown in FIG. 3, the control means 16 maintains the closed state of the electromagnetic valve V8 to close the flow path of the overflow line L10 and to control the driving speed of the blood pump 4. The blood pump 4 and the replacement fluid pump 13 are simultaneously driven while being set to be larger than the driving speed of the replacement fluid pump 13 (simultaneous driving step S1), and then it is determined whether or not bubbles are detected by the bubble detector 17 ( S2) As shown in FIG. 4, when bubbles are detected by the bubble detector 17, bubble discharge steps (S3 to S5) are sequentially performed.

  This bubble discharging step is a step of opening the overflow line L10 on the condition that bubbles are detected by the bubble detector 17, and discharging the bubbles from the overflow line L10. As shown in FIG. The step of stopping the driving of the pump 13 (S3), the solenoid valve V8 is opened, the overflow line L10 is opened, and the solenoid valve V9 is opened, so that the priming line L8b is opened. The step (S4) of performing and the step (S5) of driving the dual pump 7 are sequentially performed.

  Thus, the dialysate (priming) in the blood circuit (the arterial blood circuit 2 and the venous blood circuit 3) is detected when the bubble detector 17 detects the bubbles through the bubble discharging step (S3 to S5). The flow of the liquid) is once stopped, and then the bubbles are caused to flow toward the venous air trap chamber 6 by driving the dual pump 7 so that the bubbles can be reliably discharged from the overflow line L10. On the other hand, if no bubbles are detected for a predetermined time in S2, it can be recognized that all the air in the replacement fluid line L8a has been exhausted from the overflow line L10, so that the next step (the next step of priming, usually the blood purification treatment step). Will be migrated.

  According to the present embodiment, the blood pump 4 is driven in the replacement fluid line priming process in which the replacement fluid line L8a is filled with the dialysate while the distal end of the arterial blood circuit 2 and the distal end of the venous blood circuit 3 are connected. Since the blood pump 4 and the replacement fluid pump 13 are simultaneously driven while the speed is set to be higher than the drive speed of the replacement fluid pump 13 and the control means 16 is provided that can discharge bubbles from the overflow line L10, the replacement fluid line priming step is performed. Air bubbles can be reliably prevented from entering the dialyzer 1.

  In addition, since the control means 16 discharges the bubbles from the overflow line L10 on condition that the bubbles are detected by the bubble detector 17, it is possible to discharge the bubbles from the overflow line L10 more reliably and satisfactorily and at the time of blood purification treatment. The bubble detector 17 used can be diverted. Further, the control means 16 closes the flow path of the overflow line L10 and simultaneously drives the blood pump 4 and the replacement fluid pump 13 while setting the driving speed of the blood pump 4 to be higher than the driving speed of the replacement fluid pump 13. Air bubbles used during blood purification treatment because the simultaneous driving step and the bubble discharge step of opening the overflow line L10 and discharging the bubbles from the overflow line L10 are performed on condition that the bubble detector 17 detects the bubbles. It is possible to more reliably discharge bubbles from the overflow line L10 while diverting the detector 17.

  In particular, in the present embodiment, in the bubble discharging step, after the driving of the blood pump 4 and the replacement fluid pump 13 is stopped, the dialysate in the dialysate introduction line L1 is supplied to the priming line L8b by the dual pump 7 (dialysate supply means). Since the air bubbles are discharged from the overflow line L10 through the air flow, the air bubbles can be discharged from the overflow line L10 more smoothly and reliably.

  The dialysate supply means according to the present embodiment is disposed across the dialysate introduction line and the dialysate discharge line, and introduces the dialysate into the blood purifier and discharges the dialysate from the blood purifier. Since it consists of the duplex pump 7, the duplex pump 7 used at the time of blood purification treatment can be used as dialysate supply means. Instead of the compound pump 7, other means (water removal pump 10 or other liquid feeding means) may be used.

  In the present embodiment, since the replacement fluid line priming process is performed in a state where the priming fluid (dialysate) is filled in the arterial blood circuit 2 and the venous blood circuit 3, the replacement fluid line is used during the replacement fluid priming process. It can prevent more reliably that the air in L8a will reach the dialyzer 1. However, the replacement fluid line priming step may be performed in a state where the priming fluid (dialysis fluid) is not filled in the arterial blood circuit 2 and the venous blood circuit 3.

Next, a second embodiment according to the present invention will be described.
As in the first embodiment, the blood purification apparatus according to the second embodiment is applied to a hemodialysis apparatus. As shown in FIG. 7, an arterial blood circuit 2 and a dialyzer 1 as a blood purification apparatus are provided. A blood circuit to which the venous blood circuit 3 is connected, a dialyzer body B having a dialysate introduction line L1 and a dialysate discharge line L2, a dual pump 7 as dialysate supply means, a replacement fluid line L8a, and a priming line The connecting line L8 having L8b, the hydraulic pressure measuring means 12, and the control means 16 are mainly configured. In addition, the same code | symbol is attached | subjected to the component similar to 1st Embodiment, and those detailed description is abbreviate | omitted.

  As in the first embodiment, the control means 16 closes the flow path of the overflow line L10 and sets the driving speed of the blood pump 4 higher than the driving speed of the replacement fluid pump 13 in the replacement fluid line priming step. A simultaneous driving step of simultaneously driving the blood pump 4 and the replacement fluid pump 13 and a bubble discharging step of opening the overflow line L10 on the condition that bubbles are detected by the bubble detector 17 and discharging the bubbles from the overflow line L10. It can be done.

  Here, the control means 16 according to the present embodiment controls the driving speed of the replacement fluid pump 13 to be higher than the driving speed of the blood pump 4 during the bubble discharging process. That is, in the first embodiment, when bubbles are detected by the bubble detector 17 in the simultaneous driving process, the blood pump 4 and the replacement fluid pump 13 are stopped. In the present embodiment, the replacement fluid pump 13 is stopped. Is controlled to be higher than the driving speed of the blood pump 4.

Hereinafter, the control contents of the control means 16 according to the present embodiment will be described based on the flowchart of FIG. 11 and FIGS. 7 to 10.
First, before dialysis treatment (before priming), as shown in FIG. 7, by connecting the connector a and the connector b, the tip of the arterial blood circuit 2 and the tip of the venous blood circuit 3 are connected, A closed circuit on the blood circuit side is formed by the arterial blood circuit 2 and the venous blood circuit 3 (including a flow path through which blood in the dialyzer 1 flows). Then, the solenoid valves V3, V5, V6 on the dialyzer body B side and the solenoid valves V10, V11 on the blood circuit side are opened, and the other solenoid valves (solenoid valves V1, V2, V4, V7, V9) are opened. , V12) is closed and priming is performed.

  The priming of the blood circuit is performed by supplying the dialysate (priming fluid) from the dialysate introduction line L1 to the blood circuit side (arterial blood circuit 2) via the priming line L8b by driving the compound pump 7. In the cleaning process, the electromagnetic valve V8 is opened and the dialysate as the priming liquid is discharged from the overflow line L10. In the subsequent filling process, the electromagnetic valve V8 is closed. FIG. 7 shows a state after the priming of the blood circuit is performed, and the electromagnetic valve V8 is in a closed state.

  When the priming of the blood circuit is completed, the control unit 16 performs priming of the replacement fluid line L8a (replacement fluid line priming step). In this replacement fluid line priming step, as shown in FIG. 8, the control means 16 maintains the electromagnetic valve 8 in the closed state to close the flow path of the overflow line L <b> 10 and the driving speed of the blood pump 4. The blood pump 4 and the replacement fluid pump 13 are simultaneously driven while being set to be larger than the driving speed of the replacement fluid pump 13 (simultaneous driving step S1), and then it is determined whether or not bubbles are detected by the bubble detector 17 ( S2) As shown in FIG. 9, when a bubble is detected by the bubble detector 17, the bubble discharge step (S3, S4) is sequentially performed.

  This bubble discharging step is a step of opening the overflow line L10 under the condition that bubbles are detected by the bubble detector 17, and discharging the bubbles from the overflow line L10. As shown in FIG. 10, the electromagnetic valve V8 is opened. The step of opening the overflow line L10 by setting the state (S3) and the step of controlling the driving speed of the replacement fluid pump 13 to be higher than the driving speed of the blood pump 4 (S4) are sequentially performed.

  Thus, the dialysate (priming) in the blood circuit (arterial blood circuit 2 and venous blood circuit 3) is detected when the bubble detector 17 detects the bubbles through the bubble discharging step (S3, S4). The flow rate of the liquid is reduced, and the bubbles can be reliably discharged from the overflow line L10. On the other hand, if no bubbles are detected for a predetermined time in S2, it can be recognized that all the air in the replacement fluid line L8a has been exhausted from the overflow line L10, so that the next step (the next step of priming, usually the blood purification treatment step). Will be migrated.

  Thus, according to the bubble discharging step (S3, S4) according to the present embodiment, the driving speed of the replacement fluid pump 13 is increased from the driving speed of the blood pump 4 (that is, the flow rate by driving the replacement fluid pump 13 is increased. The flow rate of the dialysate from the replacement fluid pump 13 to the artery-side air trap chamber 5 is divided into a flow path that passes through the blood pump 4 and a flow path that passes through the dialyzer 1. Each reaches the vein-side air trap chamber 6 and air bubbles are removed. Therefore, the bubbles moved by the reverse drive of the blood pump 4 are surely released from the overflow line L10, and the bubbles accumulated in the venous air trap chamber 6 are prevented from moving to the dialyzer 1, and the dialyzer 1 It is possible to prevent air bubbles from being taken into the vein-side header.

  According to the present embodiment, as in the first embodiment, the replacement fluid line priming step of filling the replacement fluid line L8a with the dialysate while the distal end of the arterial blood circuit 2 and the distal end of the venous blood circuit 3 are connected. The control means 16 is provided which can drive the blood pump 4 and the replacement fluid pump 13 at the same time while discharging the air bubbles from the overflow line L10 while setting the drive speed of the blood pump 4 higher than the drive speed of the replacement fluid pump 13. During the replacement fluid line priming step, bubbles can be reliably prevented from entering the dialyzer 1.

  In addition, since the control means 16 discharges the bubbles from the overflow line L10 on condition that the bubbles are detected by the bubble detector 17, it is possible to discharge the bubbles from the overflow line L10 more reliably and satisfactorily and at the time of blood purification treatment. The bubble detector 17 used can be diverted. Further, the control means 16 closes the flow path of the overflow line L10 and simultaneously drives the blood pump 4 and the replacement fluid pump 13 while setting the driving speed of the blood pump 4 to be higher than the driving speed of the replacement fluid pump 13. Air bubbles used during blood purification treatment because the simultaneous driving step and the bubble discharge step of opening the overflow line L10 and discharging the bubbles from the overflow line L10 are performed on condition that the bubble detector 17 detects the bubbles. It is possible to more reliably discharge bubbles from the overflow line L10 while diverting the detector 17.

  In particular, in the present embodiment, the bubble discharging step is controlled so that the driving speed of the replacement fluid pump 13 is higher than the driving speed of the blood pump 4. Therefore, during the replacement fluid line priming step, There is no need to drive separate dialysate supply means, and bubbles can be discharged from the overflow line with simpler control.

  In the present embodiment, since the replacement fluid line priming process is performed in a state where the priming fluid (dialysate) is filled in the arterial blood circuit 2 and the venous blood circuit 3, the replacement fluid line is used during the replacement fluid priming process. It can prevent more reliably that the air in L8a will reach the dialyzer 1. However, the replacement fluid line priming step may be performed in a state where the priming fluid (dialysis fluid) is not filled in the arterial blood circuit 2 and the venous blood circuit 3.

  As mentioned above, although this embodiment was described, this invention is not limited to these, For example, although the overflow line 10 is extended from the upper part of the vein side air trap line 6 in the vein side blood circuit 3, It is good also as what can be extended from the other site | part in the said venous side blood circuit 3, and can discharge a liquid or gas outside. The connection line L8 is sufficient if the replacement fluid line L8a is formed, and in the second embodiment, a connection line L8 in which the priming line L8b is not formed may be used. Note that the priming solution used for priming the arterial blood circuit 2 and the venous blood circuit 3 performed before the replacement fluid line priming step is not limited to dialysate, and for example, other priming solution (such as physiological saline). There may be.

In the course of the replacement fluid line priming process in which the fluid replacement line is filled with the dialysate while the tip of the arterial blood circuit and the distal end of the venous blood circuit are connected, the driving speed of the blood pump is set higher than the driving speed of the replacement fluid pump. large set simultaneously driven the blood pump and the replacement fluid pump while, Rutotomoni a control unit capable of discharging the air bubbles from the overflow line bubble detection by bubble detector as a condition, the control means, the flow path of the overflow line In the closed state, overflowing on condition that the blood pump and the replacement fluid pump are simultaneously driven while the blood pump drive speed is set higher than that of the replacement fluid pump and the detection of bubbles by the bubble detector Open the line and remove air bubbles from the overflow line. If the blood purification apparatus capable of performing the steps, can be applied to such as those other functions are added.

1 ... Dializer (blood purifier)
DESCRIPTION OF SYMBOLS 2 ... Arterial side blood circuit 3 ... Vein side blood circuit 4 ... Blood pump 5 ... Arterial side air trap chamber 6 ... Vein side air trap chamber 7 ... Duplex pump 8, 9 ... Filtration filter 10 ... Dewatering pump 11 ... Collection port 12 ... Hydraulic pressure measuring means 13 ... Replacement pump 14 ... Pump 15 ... Chamber 16 ... Control means 17 ... Bubble detector L1 ... Dialysate introduction line L2 ... Dialysate discharge line L8 ... Connection line L8a ... Replacement line L8b ... Priming line V1 V12 ... Solenoid valve

Claims (5)

A blood purifier that contains a blood purification membrane and purifies the blood with the blood purification membrane;
An arterial blood circuit in which a proximal end is connected to the blood purifier and a blood pump is disposed in the middle thereof;
A venous blood circuit having a proximal end connected to the blood purifier;
A dialysate introduction line for introducing dialysate into the blood purifier,
A dialysate discharge line for discharging dialysate from the blood purifier,
One end is connected to a sampling port formed in a predetermined part of the dialysate introduction line, and the other end is connected to the blood replacement line between the blood pump and the blood purifier in the arterial blood circuit,
A fluid replacement pump disposed in the middle of the fluid replacement line and capable of supplying dialysate from the dialysate introduction line to the arterial blood circuit;
An overflow line connected to the venous blood circuit and capable of discharging the liquid or gas in the venous blood circuit to the outside;
A bubble detector disposed between the distal end of the venous blood circuit and the overflow line in the venous blood circuit, and capable of detecting bubbles in the flow path;
A blood purification apparatus comprising:
In the course of the replacement fluid line priming process in which the replacement fluid line is filled with the dialysate in a state where the distal end of the arterial blood circuit and the distal end of the venous blood circuit are connected, the driving speed of the blood pump is changed to the replacement fluid pump. driving speed simultaneously driven the blood pump and the replacement fluid pump with greater than, Rutotomoni a control means capable of discharging bubbles from the overflow line detection of bubbles by the bubble detector as a condition,
The control means includes
A simultaneous driving step of simultaneously driving the blood pump and the replacement fluid pump while closing the flow path of the overflow line and setting the drive speed of the blood pump to be higher than the drive speed of the replacement fluid pump;
A bubble discharging step of opening the overflow line under the condition that bubbles are detected by the bubble detector, and discharging bubbles from the overflow line;
The blood purification apparatus characterized by being able to perform . A priming line having one end connected to a predetermined portion of the dialysate introduction line and the other end connected between a tip of the arterial blood circuit in the arterial blood circuit and the blood pump;
Dialysate supply means capable of supplying dialysate in the dialysate introduction line to the arterial blood circuit via the priming line;
And the bubble discharging step stops the driving of the blood pump and the replacement fluid pump, and then supplies the dialysate in the dialysate introduction line through the priming line by the dialysate supply means. blood purification apparatus according to claim 1, wherein the discharging the air bubbles from the overflow line. The dialysate supply means is disposed across the dialysate introduction line and the dialysate discharge line, and includes a dual pump for introducing the dialysate into the blood purifier and discharging the dialysate from the blood purifier. The blood purification apparatus according to claim 2 . The bubble discharge step, the replacement fluid blood purification apparatus according to claim 1, wherein the controlled is possible to the driving speed increase than the driving speed of the blood pump of the pump. The blood purification device according to any one of claims 1 to 4 , wherein the replacement fluid line priming step is performed in a state where the priming fluid is filled in the arterial blood circuit and the venous blood circuit.

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