JP5931128B2 - Blood purification equipment - Google Patents

Description

  The present invention relates to a blood purification apparatus for purifying a patient's blood while circulating it outside the body.

  A dialysis device as a blood purification device includes an arterial blood circuit with an arterial puncture needle attached to the tip, a blood circuit comprising a venous blood circuit with a venous puncture needle attached to the tip, an arterial blood circuit, and a vein A dialyzer as a blood purification means for purifying blood flowing through the blood circuit interposed between the side blood circuit, a blood pump disposed in the artery side blood circuit, and defoaming disposed in the vein side blood circuit This is mainly composed of an air trap chamber and a dialyzer body capable of supplying dialysate to the dialyzer.

  In addition, a storage bag containing physiological saline is connected between the arterial puncture needle and the blood pump in the arterial blood circuit via a physiological saline supply line, and during priming before dialysis treatment, dialysis is performed. The physiological saline solution in the accommodation bag can be supplied into the blood circuit via the physiological saline supply line at the time of fluid replacement during treatment or when returning blood after dialysis treatment. For example, at the time of returning blood, physiological saline solution is supplied into the blood circuit as a replacement liquid, and blood can be returned by replacing the blood in the blood circuit with the replacement liquid (for example, Patent Document 1). reference).

  By the way, as disclosed in, for example, Patent Document 2, after the treatment, the blood pump is driven in the reverse direction so that the blood from the connection portion to the tip of the replacement fluid supply line in the arterial blood circuit is used as the replacement fluid. There has been proposed a blood purification device that replaces a physiological saline solution and returns blood to a patient. In addition, after the treatment, the blood pump is reversely driven and the dialysate is supplied to the dialyzer and reverse filtered to replace the blood in the arterial blood circuit with the dialysate as the replacement fluid and return the blood to the patient. Have also been proposed in various literatures.

JP 2006-280775 A Japanese Patent Laid-Open No. 6-261938

However, the conventional blood purification apparatus has the following problems.
When returning blood after treatment, when the blood pump is driven reversely to replace the blood in the arterial blood circuit with the replacement fluid and returned to the patient, for example, when the vicinity of the arterial puncture needle is blocked and a load occurs, the arterial side There is a possibility that a positive pressure is generated between the tip of the blood circuit and the position where the blood pump is disposed. Thus, there has been a problem that blood may leak out if blood return is terminated in the state where positive pressure is generated and the arterial puncture needle is removed from the patient.

  On the other hand, there is usually no sensor or the like for detecting positive pressure between the position of the blood pump in the artery side blood circuit and the tip of the artery side blood circuit, and the blood pump is driven in reverse. It was difficult to detect an excessive positive pressure. In order to solve this problem, if a new sensor or the like for detecting a positive pressure is to be provided separately, the cost will be increased by that amount, and the flow path may be branched to provide the sensors. A step or the like is required, which may hinder blood circulation during treatment. In addition, there is a possibility that such inconvenience may occur in another process different from blood return and also in other parts of the blood circuit (for example, the venous blood circuit side).

  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 detecting a positive pressure in a blood circuit without newly providing sensors.

The invention according to claim 1 is composed of an arterial blood circuit and a venous blood circuit, a blood circuit capable of extracorporeally circulating a patient's blood from the tip of the arterial blood circuit to the tip of the venous blood circuit, and the blood A blood purification means for purifying blood flowing between the arterial blood circuit and the venous blood circuit of the circuit and purifying the blood flowing through the blood circuit; a clamping means capable of clamping a part of the blood circuit; And an oscillating means capable of oscillating ultrasonic waves in the flow path, and a receiving means capable of receiving ultrasonic waves oscillated from the oscillating means and transmitted or reflected through the flow path, and the ultrasonic waves received by the receiving means And a bubble detection means capable of detecting bubbles in the liquid flowing through the flow path, the bubble detection means is held by the holding means according to the ultrasonic wave received by the reception means. Is capable of detecting the positive pressure of the flow path Rutotomoni, characterized in that the change in the detection value when the detected positive pressure changes and the flow path of the detected values when encountering a bubble is a reverse .

  According to a second aspect of the present invention, in the blood purification apparatus according to the first aspect, the bubble detecting means is disposed at a distal end portion of the arterial blood circuit, and the bubble detecting means in the arterial blood circuit A blood pump capable of flowing blood from the tip of the arterial blood circuit to the tip of the venous blood circuit by forward rotation is disposed between the blood purification means, and the blood pump is driven in reverse to drive the blood. The blood in the circuit can be returned to the patient, and the air bubble detecting means can detect the air bubble and the positive pressure on the tip side from the position of the blood pump in the arterial blood circuit when returning blood. It is characterized by that.

  According to a third aspect of the present invention, in the blood purification apparatus according to the second aspect, the blood pump is driven to rotate forward on the condition that a positive pressure of a predetermined value or more is detected by the bubble detecting means when returning blood. It is characterized by comprising control means for obtaining.

  According to the first aspect of the present invention, since the bubble detecting means can detect the positive pressure of the flow path held by the holding means according to the ultrasonic wave received by the receiving means, In addition, the positive pressure can be detected, and the positive pressure in the blood circuit can be detected without providing a separate sensor.

  According to the invention of claim 2, the bubble detection means is disposed at the tip of the arterial blood circuit, and is driven forward between the bubble detection means and the blood purification means in the arterial blood circuit. Is provided with a blood pump capable of flowing blood from the tip of the arterial blood circuit to the tip of the venous blood circuit, and configured to return the blood in the blood circuit to the patient by driving the blood pump in reverse. The bubble detection means is capable of detecting the bubble and positive pressure on the tip side from the position of the blood pump in the arterial blood circuit when returning blood, and is generated when the blood pump is driven in reverse to return blood. Positive pressure can be detected.

  According to the invention of claim 3, since the blood circuit is provided with the control means that can drive the blood pump in a forward direction on condition that a positive pressure of a predetermined value or more is detected by the bubble detection means when returning blood, The generated positive pressure can be automatically released.

The schematic diagram which shows the blood purification apparatus which concerns on embodiment of this invention. Side view showing bubble detecting means in the blood purification apparatus Front view showing the bubble detection means IV-IV line sectional view in FIG. Sectional drawing which shows the blood discrimination means arrange | positioned at the clamping means in the bubble detection means (VV sectional view taken on the line in FIG. 2) Sectional drawing which shows the bubble detection means (The state by which the clamping means is not made) (VI-VI sectional view taken on the line in FIG. 2) Sectional drawing which shows the bubble detection means (state clamped by the clamping means) Schematic diagram showing a flow path (a state in which no positive pressure is generated) clamped by the clamping means of the bubble detection means Schematic diagram showing a channel (a state in which a positive pressure is generated) clamped by the clamping means of the bubble detection means Graph showing the detection value (when a bubble is detected) by the bubble detection means Graph showing the detection value (when positive pressure is detected) by the bubble detection means The graph which shows the relationship between the detected value by the bubble detection means and the pressure in the flow path (internal pressure)

Hereinafter, embodiments of the present invention will be specifically described with reference to the drawings.
The blood purification apparatus according to this embodiment includes a dialysis apparatus for performing dialysis treatment. As shown in FIG. 1, a blood circuit including an arterial blood circuit 1 and a venous blood circuit 2, and an arterial blood circuit 1. And a dialyzer 3 (blood purification means) interposed between the venous blood circuit 2 and purifying blood flowing through the blood circuit, a blood pump 4, and an air trap chamber 5 disposed in the venous blood circuit 2. The dialyzer body 6 capable of supplying dialysate 3 to the dialyzer 3, the bubble detecting means 7, the blood discriminating means 8, and the physiological saline supply line L3 (substitution) capable of supplying a physiological saline as a replacement fluid to the blood circuit. Liquid supply line) and a storage means 10 that stores a physiological saline solution as a replacement liquid.

  An arterial puncture needle a can be connected to the distal end of the arterial blood circuit 1 via a connector, and an iron-type blood pump 4 is disposed in the middle. The venous puncture needle b can be connected to the tip thereof via a connector, and the air trap chamber 5 is connected in the middle. The air trap chamber 5 is formed with an air layer, which can capture bubbles in the liquid and is provided with a filtration network (not shown) so that, for example, blood clots can be captured when returning blood. It has become.

  The blood pump 4 is composed of a squeezing type pump disposed in the arterial blood circuit 1 and is capable of normal rotation and reverse rotation, and can flow the liquid in the blood circuit in the driving direction. That is, a corrugated tube that is softer and larger in diameter than other flexible tubes constituting the arterial blood circuit 1 is connected to the arterial blood circuit 1, and the corrugated tube is connected to the blood pump 4. A roller for squeezing in the liquid feeding direction is provided. When the blood pump 4 is driven in this manner, the roller rotates to squeeze the ironing tube (part of the blood circuit), and the liquid inside can flow in the driving direction (rotating direction of the roller). .

  Thus, when the blood pump 4 is driven to rotate forward (left rotation in the figure) with the artery side puncture needle a and the vein side puncture needle b being punctured into the patient, the patient's blood passes through the artery side blood circuit 1. After reaching the dialyzer 3, blood purification is performed by the dialyzer 3, and air bubbles are removed in the air trap chamber 5 and returned to the patient's body through the venous blood circuit 2. That is, the blood of the patient is purified by the dialyzer 3 while circulating externally from the tip of the arterial blood circuit 1 to the tip of the venous blood circuit 2 of the blood circuit. Further, when the blood pump 4 is driven in the reverse direction (right rotation in the figure), the blood in the blood circuit (between the distal end of the arterial blood circuit 1 and the position where the blood pump 4 is disposed) can be returned to the patient. .

  The dialyzer 3 is formed with a blood introduction port 3a, a blood outlet port 3b, a dialysate inlet port 3c, and a dialysate outlet port 3d in the casing. Among these, the blood inlet port 3a includes the arterial blood circuit 1. However, the venous blood circuit 2 is connected to the blood outlet port 3b. The dialysate introduction port 3c and the dialysate lead-out port 3d are connected to a dialysate introduction line L1 and a dialysate discharge line L2 extending from the dialyzer body 6, respectively.

  A plurality of hollow fibers are accommodated in the dialyzer 3, the inside of the hollow fibers is used as a blood flow path, and the flow of dialysate is between the hollow fiber outer peripheral surface and the inner peripheral surface of the housing. It is considered a road. A hollow fiber membrane is formed in the hollow fiber by forming a large number of minute holes (pores) penetrating the outer circumferential surface and the inner circumferential surface, and impurities in the blood are passed through the membrane in the dialysate. It is comprised so that it can permeate | transmit.

  On the other hand, the dialyzer body 6 is provided with liquid feeding means such as a dual pump over the dialysate introduction line L1 and the dialysate discharge line L2, and a bypass line that bypasses the liquid feeding means has a dialyzer. 3 is provided with a water removal pump for removing water from the blood of the patient flowing through the body 3. Furthermore, one end of the dialysate introduction line L1 is connected to the dialyzer 3 (dialyte introduction port 3c), and the other end is connected to a dialysate supply device (not shown) for preparing a predetermined concentration of dialysate. One end of the dialysate discharge line L2 is connected to the dialyzer 3 (dialysate outlet port 3d), and the other end is connected to a drain means (not shown). The dialysate supplied from the dialysate supply device After reaching the dialyzer 3 through the dialysate introduction line L1, it is sent to the drainage means through the dialysate discharge line L2.

  A pressure sensor is connected to the air trap chamber 5 via a monitor tube so that the fluid pressure (venous pressure) in the air trap chamber 5 can be measured. An overflow line is extended from the upper part (air layer side) of the air trap chamber 5, and clamping means such as a solenoid valve is disposed in the middle of the overflow line. Then, by opening the clamping means such as the electromagnetic valve, the liquid (priming liquid or the like) flowing in the blood circuit can overflow through the overflow line.

  One end of the physiological saline supply line L3 (replacement fluid supply line) is connected by a T-shaped tube or the like between the position of the blood pump 4 in the artery-side blood circuit 1 and the tip of the artery-side blood circuit 1. The flow path (for example, flexible tube etc.) which can supply the physiological saline (substitution liquid) for replacing with the blood in the blood circuit to the artery side blood circuit 1. The other end of the physiological saline supply line L3 is connected to a storage means 10 (so-called “saline bag”) that stores a predetermined amount of physiological saline, and an air trap chamber 14 is connected in the middle. ing.

  In addition, a clamping means 15 (for example, an electromagnetic valve) is disposed in the physiological saline supply line L3 according to the present embodiment. The clamp means 15 is provided so that the physiological saline supply line L3 can be opened and closed, and can close and open the flow path. By opening and closing the clamp means 15, the flow of the physiological saline supply line L3 is made. It is possible to arbitrarily switch between a closed state in which the path is closed and a flowing state in which a physiological saline solution (substitution solution) can flow. The clamping means 15 is configured such that the opening / closing operation when returning blood is controlled by the control means 12 described in detail later. Instead of such clamping means, general-purpose means such as forceps capable of closing and opening the flow path of the physiological saline supply line L3 by manual operation may be used.

  Further, in the vicinity of the arterial puncture needle a in the arterial blood circuit 1 (near the tip of the arterial blood circuit 1 and the connection portion of the physiological saline supply line L3 (position of the T-shaped tube), the arterial puncture needle a, Between the venous puncture needle b in the venous blood circuit 2 (near the tip of the venous blood circuit 2 and between the air trap chamber 5 and the venous puncture needle b). 7, a blood discriminating means 8 and a clamping means 9 (for example, an electromagnetic valve) are provided.

  These bubble detection means 7, blood discrimination means 8 and clamp means 9 are provided with a common clamping means H. The clamping means H is composed of a unit disposed at each of the distal end portion of the arterial blood circuit 1 and the distal end portion of the venous blood circuit 2, and includes a main body portion Ha and a lid portion Hb. In addition, a fitting groove Haa into which a flexible tube constituting the artery side blood circuit 1 or the vein side blood circuit 2 can be fitted is formed in the main body Ha. The lid Hb is swingably attached to the main body Ha via a swing shaft L, and can be opened and closed by swinging about the swing shaft L.

  Then, by closing the lid portion Hb with the flexible tube fitted in the fitting groove Haa, the flexible portion is caused by the main body portion Ha and the lid portion Hb as shown in FIGS. A tube (part of the blood circuit) can be sandwiched from above and below. Further, a switch f is formed at a predetermined position of the fitting groove Haa, and the switch f is turned on when the flexible tube is normally clamped by the fitting groove Haa. Thereby, it is possible to detect whether or not the flexible tube is normally held in the fitting groove Haa.

  Further, the lid portion Hb is formed with a lock portion Hba that can be engaged with the main body portion Ha in the closed state, and the state in which the flexible tube is sandwiched is securely held by the lock by the lock portion Hba. The The bubble detecting means 7, the blood discriminating means 8 and the clamping means 9 are arranged along the extending direction of the fitting groove Haa in the main body portion Ha, and a part of the blood circuit held by the holding means H. On the other hand, the bubble detection means 7 can detect the bubbles, the blood determination means 8 can determine the blood, and the clamp means 9 can open and close the flow path.

  The clamp means 9 can close and open the flow path (that is, the flow path at the distal end portion of the arterial blood circuit 1 or the distal end portion of the venous blood circuit 2) in each of the disposed portions by opening and closing operations. In particular, the opening / closing operation at the time of returning blood is controlled by the control means 12 described in detail later. 4 indicates a push rod disposed in the clamp means 9, and the push rod R is moved forward and backward with respect to the fitting groove Haa to close and open the flow path at a predetermined position. It has come to be able to do.

  The blood discriminating means 8 is for discriminating whether or not blood is circulating in the flow path at the distal end of the arterial blood circuit 1 or the distal end of the venous blood circuit 2, as shown in FIG. For example, it includes a light emitting element A1 made of LEDs and a light receiving element A2. The light emitting element A1 and the light receiving element A2 are respectively disposed on the left and right sides of the fitting groove Haa, and constitute the arterial blood circuit 1 and the venous blood circuit 2 fitted in the fitting groove Haa. Light can be emitted from the light emitting element A1 toward the flexible tube, and the light can be received by the light receiving element A2.

  The light receiving element A2 is configured such that the voltage changes according to the amount of light received, and is configured to be able to determine the presence or absence of blood flowing through the arterial blood circuit 1 and the venous blood circuit 2 based on the detected voltage. ing. That is, the transmittance of light emitted from the light emitting element A1 is different between blood and the replacement fluid (in this embodiment, physiological saline) (the replacement fluid such as physiological saline has a light transmittance higher than that of blood). Therefore, when the voltage detected by the light receiving element A2 exceeds a predetermined threshold value, it is detected that the flowing liquid is replaced with the replacement liquid from the blood.

  The bubble detection means 7 is composed of a sensor capable of detecting bubbles (air) flowing through the arterial blood circuit 1 and the venous blood circuit 2 at a portion (predetermined position) held by the holding means H, as shown in FIG. In addition, for example, an ultrasonic vibration element A3 (oscillation means) made of a piezoelectric element and an ultrasonic reception element A4 (reception means) made of a piezoelectric element are provided. The ultrasonic vibration element A3 (oscillating means) is disposed below the fitting groove Haa in the main body portion Ha, and can oscillate ultrasonic waves in the flow path sandwiched by the sandwiching means H. The ultrasonic receiving element A4 (receiving means) is disposed in a predetermined part of the lid Hb (a part facing the ultrasonic vibration element A3 when the lid Hb is closed), and the ultrasonic receiving element The ultrasonic wave oscillated from A4 and transmitted through the flow path can be received.

  Then, ultrasonic waves can be irradiated from the ultrasonic vibration element A3 toward the flexible tubes constituting the arterial blood circuit 1 and the venous blood circuit 2 that are fitted in the fitting groove Haa, and the vibration is superfluous. It can be received by the sound wave receiving element A4. The ultrasonic receiving element A4 is configured such that the voltage changes in accordance with the received vibration. When the detected voltage exceeds a predetermined threshold, the arterial blood circuit 1 and the venous blood circuit 2 It is comprised so that it can detect that a bubble flowed.

  That is, the detection value by the bubble detection means 7 (voltage according to the vibration received by the ultrasonic receiving element A4) is configured to change within a certain range as shown in FIG. 10, and when the bubble flows, Since bubbles have a higher attenuation rate of ultrasonic waves than blood or replacement liquid, the voltage detected by the ultrasonic receiving element A4 is lowered as shown in FIG. Then, when the voltage detected by the ultrasonic receiving element A4 falls below a predetermined threshold, it is detected that the bubble has flowed.

  The bubble detection means 7 configured as described above can detect bubbles in the liquid flowing through the flow path based on the ultrasonic waves received by the ultrasonic reception element A4 (reception means). Thus, according to the present embodiment, blood purification treatment is performed by the dialyzer 3 while circulating the patient's blood extracorporeally in the arterial blood circuit 1 and the venous blood circuit 2, and the blood discriminating means 8 performs predetermined processing. When it is detected that the fluid flowing through the position has been replaced with the replacement liquid from the blood, or when the bubble detection means 7 detects the flow of the bubbles, the clamp means 9 is closed to terminate or interrupt the dialysis treatment or blood return. Can do.

  Further, in the dialysis apparatus main body 6 according to the present embodiment, a monitoring unit 11 and a control unit 12 and a notification unit 13 made of, for example, a microcomputer are disposed. The monitoring means 11 can monitor the detection values of the blood discrimination means 8 and the bubble detection means 7 in real time. For example, the detection of bubbles by the bubble detection means 7 or the replacement of blood with a replacement fluid by the blood discrimination means 8 can be performed. When the detection is performed, the notification unit 13 can output a predetermined alarm or notification.

  Here, the bubble detection means 7 according to the present embodiment detects the positive pressure of the flow path held by the holding means H in accordance with the ultrasonic wave received by the ultrasonic receiving element A4 (reception means) in addition to the detection of the bubbles. It is possible. That is, when a positive pressure (positive pressure) is applied to the flow path in the flexible tube at the portion clamped by the clamping means H, the flow path expands in the radial direction, so that the clamping is performed as shown in FIG. The flow path (the tip of the arterial blood circuit 1 in the figure) is deformed as shown in FIG. 9, and the flexible tube, the ultrasonic vibration element A3 (oscillating means), and the super The contact area with the acoustic wave receiving element A4 (receiving means) increases.

  In this way, when a positive pressure (positive pressure) is applied to the flow path in the flexible tube and the internal pressure increases, the flexible tube, the ultrasonic vibration element A3 (oscillation means), and the ultrasonic wave that constitute the flow path. Since the contact area with the receiving element A4 (receiving means) increases, as shown in FIG. 12, the detection value (specifically, the ultrasonic receiving element A4 ( The output voltage) by the receiving means) will increase. FIG. 12 shows the relationship between the pressure (internal pressure) applied to the flow path in the flexible tube and the detection value of the bubble detection means 7, and it can be seen that the two are approximately proportional.

  Then, the monitoring unit 11 monitors the detection value of the bubble detection unit 7 in real time. As shown in FIG. 11, when the detection value rises as shown in FIG. It can be determined that pressure has been applied. When excessive positive pressure is detected by the monitoring means 11 in this way, an alarm is output by the notification means 13 and control by the control means 12 is performed. However, as shown in FIGS. 10 and 11, the change in the detection value when the bubble is detected and the change in the detection value when the positive pressure is detected are in opposite directions. You can avoid being broken.

  The control means 12 can control the actuator such as the blood pump 4 and the clamp means 9, 15, etc. In this embodiment, the blood pump 4 is driven to rotate forward to drive the vein from the distal end of the arterial blood circuit 1. The blood is flowed to the tip of the side blood circuit 2, and the blood pump 4 is driven in reverse while supplying the physiological saline as a replacement liquid by opening the clamp means 15, thereby the blood circuit (arterial blood circuit). 1 is configured so that the blood in the flow path between the site where the blood pump 4 is disposed and the tip of the blood pump 4 can be returned to the patient. It is assumed that the blood pump 4 can be driven to rotate forward on the condition that the pressure is detected.

  As described above, according to the present embodiment, the control unit 12 that can drive the blood pump 4 to rotate forward is provided on the condition that a positive pressure of a predetermined value or more is detected by the bubble detection unit 7 when returning blood. Therefore, when the blood pump 4 is driven reversely to return blood, a positive pressure is generated in the blood circuit (the flow path from the site where the blood pump 4 is disposed in the artery side blood circuit 1 to the tip). Even if it exists, the generated positive pressure can be automatically released.

  According to the above embodiment, the bubble detecting means 7 can detect the positive pressure of the flow path held by the holding means H in accordance with the ultrasonic wave received by the ultrasonic receiving element A4 (receiving means). The detection means 7 can be used to detect the positive pressure in addition to the bubbles, and the positive pressure in the blood circuit can be detected without providing a separate sensor. Therefore, since the positive pressure can be detected in addition to the bubbles by the bubble detection means 7 provided in the blood purification apparatus, it is not necessary to provide a separate sensor for detecting the positive pressure.

  In particular, the bubble detection means 7 according to the present embodiment is disposed at the distal end portion of the arterial blood circuit 1 and between the bubble detection means 7 and the dialyzer 3 (blood purification means) in the arterial blood circuit 1. Is provided with a blood pump 4 capable of flowing blood from the tip of the arterial blood circuit 1 to the tip of the venous blood circuit 2 by forward rotation, and the blood in the blood circuit is driven in reverse. The air bubble detection means 7 can detect the air bubble and the positive pressure on the tip side from the position of the blood pump 4 in the arterial blood circuit 1 when returning blood. The positive pressure generated when the blood pump 4 is driven in reverse to return blood can be detected.

  As mentioned above, although this embodiment was described, this invention is not limited to this, For example, it replaced with what uses a physiological saline as a substitution liquid at the time of blood return, and was introduce | transduced into the dialyzer 3 from the dialyzer main body 6. The dialysate may be reverse filtered to reach a blood circuit (arterial blood circuit 1 and venous blood circuit 2), and applied to a blood purification device that returns blood by replacing the dialysate and blood. Further, instead of using a physiological saline as a replacement liquid at the time of returning blood, the replacement liquid supply line L3 is connected to the dialysate introduction line L1, and the dialysate is supplied from the dialyzer body 6 so that the dialysate and blood are supplied. And may be applied to a blood purification device that returns blood by replacing.

  In the present embodiment, the blood pump 4 is driven in the reverse direction so that the blood in the blood circuit can be returned to the patient, and the bubble detection means 7 is used for the blood pump in the arterial blood circuit 1 when returning blood. Although it is supposed that the bubble and the positive pressure on the distal end side can be detected from the arrangement position 4, for example, when the blood pump 4 is driven to rotate forward at the time of treatment, it is disposed at the distal end portion of the venous blood circuit 2. It is also possible to detect bubbles and positive pressure in the liquid by the bubble detection means 7 that has been made.

  Furthermore, the bubble detection means 7 according to the present embodiment receives the ultrasonic wave oscillated from the ultrasonic vibration element A3 (oscillation means) and transmitted through the flow path by receiving the ultrasonic wave at the ultrasonic reception element A4 (reception means). It is supposed that the bubbles and the positive pressure inside can be detected, but instead, the ultrasonic wave oscillated from the ultrasonic vibration element A3 (oscillating means) and reflected from the flow path is received by the ultrasonic wave reception element A4 (reception). It is also possible to detect the bubbles and the positive pressure in the liquid.

  Furthermore, the bubble detection means 7 according to the present embodiment includes the clamping means H common to the blood discrimination means 8 and the clamp means 9, but may be a clamping means shared with other sensors and actuators, Alternatively, the bubble detection means 7 alone may be provided with a clamping means. In this embodiment, the present invention is applied to a dialysis apparatus used at the time of dialysis treatment, but is used in another apparatus that can purify the patient's blood while circulating it outside the body (for example, blood filtration dialysis, blood filtration, AFBF). The present invention may be applied to blood purification devices, plasma adsorption devices, and the like.

Detection when detecting the positive pressure changes and the flow path of the detection value when detecting the detectable and is Rutotomoni, bubbles positive pressure flow path is sandwiched by the clamping means in accordance with the ultrasonic wave received by the receiving means As long as the blood purification device is provided with the bubble detection means whose value change is in the opposite direction, the blood purification device can be applied to devices to which other functions are added.

1 Arterial blood circuit 2 Venous blood circuit 3 Dialyzer (blood purification means)
4 Blood Pump 5 Air Trap Chamber 6 Dialyzer Main Body 7 Bubble Detection Unit 8 Blood Discriminating Unit 9 Clamping Unit 10 Storage Unit 11 Monitoring Unit 12 Control Unit 13 Notification Unit H Clamping Unit

Claims (3)

A blood circuit comprising an arterial blood circuit and a venous blood circuit, and capable of extracorporeally circulating the patient's blood from the distal end of the arterial blood circuit to the distal end of the venous blood circuit;
A blood purification means for purifying blood flowing between the arterial blood circuit and the venous blood circuit of the blood circuit and flowing through the blood circuit;
Clamping means capable of clamping a part of the blood circuit, oscillation means capable of oscillating ultrasonic waves in the flow path sandwiched by the clamping means, and ultrasonic waves oscillated from the oscillation means and transmitted or reflected through the flow path A bubble detecting means having a receiving means capable of receiving, and capable of detecting bubbles in the liquid flowing through the flow path based on the ultrasonic wave received by the receiving means;
In the blood purification apparatus comprising
The bubble detection means is capable of detecting the positive pressure flow path sandwiched by the clamping means in accordance with the ultrasonic wave received by said receiving means Rutotomoni, the detection value when encountering a bubble changes and the flow path of the A blood purification apparatus, wherein a change in a detected value when a positive pressure is detected is in a reverse direction .   The bubble detection means is disposed at a distal end portion of the arterial blood circuit, and between the bubble detection means and the blood purification means in the arterial blood circuit, the arterial blood circuit is driven forward. A blood pump capable of flowing blood from the distal end of the blood circuit to the distal end of the venous blood circuit is configured to reversely drive the blood pump to return the blood in the blood circuit to the patient; 2. The blood purification apparatus according to claim 1, wherein the means is capable of detecting a bubble and a positive pressure on the tip side from a position where the blood pump is disposed in the arterial blood circuit when returning blood.   3. The blood purification apparatus according to claim 2, further comprising a control unit capable of driving the blood pump to rotate forward on the condition that a positive pressure of a predetermined value or more is detected by the bubble detection unit when returning blood. apparatus.

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