JP5968101B2 - Method for reducing liquid in circuit of blood purification apparatus, blood purification apparatus and program - Google Patents

Description

  The present invention relates to a method for reducing liquid in a circuit of a blood purification apparatus, a blood purification apparatus, and a program.

  A blood purification apparatus has been conventionally used for blood purification treatment such as continuous blood purification. A blood purification device generally supplies blood discharged from a patient to the primary side of the purification membrane of the blood purification device and returns it to the patient, and supplies and discharges dialysate to the secondary side of the purification membrane of the blood purification device. A dialysate circuit and a replacement fluid supply circuit for supplying replacement fluid to the blood circuit are provided.

  In the blood purification treatment using the blood purification device described above, the patient's blood is supplied to the primary side of the purification membrane of the blood purification device through the blood circuit, and dialyzed through the dialysate circuit while returning to the patient from the blood purification device. By supplying the liquid to the secondary side of the blood purifier and discharging it from the blood purifier, the pathogenic substance in the blood is taken into the dialysate through the purification membrane to purify the blood. Further, during blood purification treatment, a replacement fluid is supplied to the blood through a replacement fluid supply circuit in order to compensate for insufficient components of the blood.

  By the way, after the blood purification treatment described above is completed, liquid remains in the entire circuits of the blood purification apparatus. Specifically, the blood circuit mainly contains physiological saline substituted for blood to return blood to the patient, the dialysate circuit remains dialysate, and the replacement fluid supply circuit includes replacement fluid. Remains.

  Since most of the members such as the tube of the circuit used in the blood purification treatment are disposable, it is necessary to discard them after the blood purification treatment. At this time, if liquid remains in the circuit, the weight increases, handling becomes difficult, and the disposal cost increases. In addition, liquid may leak from the circuit, which is undesirable from a hygiene viewpoint.

  Therefore, a hemodialysis machine has been proposed in which air is supplied to a blood chamber, which is the primary side of a hemodialyzer, by means of ventilation means to empty at least the blood chamber (see Patent Document 1).

Special table 2009-529392

  However, in the hemodialysis machine, a ventilation means for emptying the blood chamber is required separately, so that the apparatus configuration becomes complicated and the apparatus cost increases. Moreover, the liquid in the replacement fluid supply circuit cannot be reduced, and the weight of the circuit cannot be reduced sufficiently. Furthermore, if the circuit is mistakenly connected to the patient, air in the circuit or an excessive amount of liquid may flow into the patient, and it is not possible to automate the operation of discharging the liquid from the viewpoint of safety. . For this reason, a medical worker is forced to work manually, and it takes time and effort to discard the circuit.

  The present invention has been made in view of such a point, and it is possible to discharge the liquid in the replacement fluid supply circuit without complicating the apparatus configuration, and also to ensure the safety of the patient and to automate the liquid discharge operation. An object of the present invention is to provide a method, a blood purification apparatus, and a program for reducing the liquid in the circuit of the blood purification apparatus.

To achieve the above object, the present invention provides a blood purifier having a purifying membrane, a blood collecting circuit for supplying blood collected from a patient to a primary side of the purifying membrane of the blood purifier, and purification by the blood purifier. A blood return circuit for returning the blood to the patient, the blood collection circuit and the blood return circuit each having a closing part capable of closing the circuit, and a secondary side of the purification membrane of the blood purifier A dialysis fluid supply circuit for supplying dialysis fluid to the dialysis fluid, a waste fluid circuit for draining the dialysis fluid on the secondary side of the purification membrane of the blood purifier to a waste fluid portion, the closed portion and the blood in the blood collection circuit A replacement fluid supply for supplying a replacement fluid to the blood collection circuit and / or the blood return circuit connected to the blood purification device and / or between the closed part of the blood return circuit and the blood purification device. possess a circuit, wherein the replacement fluid supply circuit, a replacement fluid supply source Which is connected between the replacement fluid supply source and said blood circuit and / or the blood return circuit, the blood purification device comprising a replacement fluid reservoir which is opened to the atmosphere to reduce the liquid remaining in the circuit after the blood purification treatment In the method, after the blood purification treatment, the remaining liquid in the dialysate supply circuit is caused to flow to the secondary side of the blood purifier, the secondary side liquid is caused to flow to the waste liquid circuit side, and the dialysate A first step of reducing the liquid in the supply circuit; and the liquid remaining in the replacement fluid supply circuit after the blood purification process in a state in which the closed portions of the blood collection circuit and the blood return circuit are closed in the blood circuit , pumped by the replacement fluid supply circuit is pumped connected to said blood circuit and / or the blood return circuit, and pumping the liquid of the blood circuit and / or blood return circuit to a primary side of the blood purifier, the Primary side liquid into the secondary Pumped to the side, further flowing a liquid of the secondary side to the waste liquid circuit side, a second step of reducing the liquid in the replacement fluid supplying the circuit, the secondary side and of the blood purifier after the blood purification treatment And a third step of reducing the liquid in the waste liquid circuit by flowing the liquid remaining in the waste liquid circuit to the waste liquid part.

  According to the present invention, since it is not necessary to provide a separate ventilation means as in the prior art, the liquid in the circuit after the blood purification treatment can be reduced without complicating the apparatus configuration. In addition, the liquid in the replacement fluid supply circuit can be reduced, and the weight of the entire circuit can be greatly reduced. Furthermore, since the blood processing device, dialysate supply circuit, waste fluid circuit and replacement fluid supply circuit in which the liquid is reduced are shut off from the patient side by the closing part, even if the circuit remains connected to the patient, Excessive amount of liquid will not enter the patient. Therefore, since the patient's integrity is ensured, the liquid discharge operation can be automated.

  The first step may be performed prior to the second step. In such a case, the first step that does not allow the liquid to pass through the purification membrane is performed earlier than the second step that allows the liquid to pass through the purification membrane. Thereby, even if the clogging of the purification membrane after blood purification treatment is severe and the liquid does not pass, the liquid in the circuit can be surely reduced.

  In the second step, a liquid may flow from the primary side to the secondary side so that the pressure applied to the purification film does not exceed a predetermined threshold value. In such a case, when the purification membrane is clogged, the liquid can be discharged so that an excessive load is not applied to the purification membrane. As a result, even if the purification membrane is clogged, the liquid can be continuously discharged to the maximum and the liquid can be reduced to the maximum.

  The third step may be performed after the first step and the second step. In such a case, the liquid in the waste liquid circuit can finally be surely reduced.

  The dialysate supply circuit includes a dialysate supply source, and a dialysate reservoir connected between the dialysate supply source and the blood purifier, and in the first step, at least, You may make it empty the flow path between the said dialysate storage part and the said dialysate storage part, and the said blood purifier. In such a case, since the dialysate reservoir having a relatively large capacity is emptied, the weight of the liquid in the entire circuit can be greatly reduced.

  In the second step, at least the fluid replacement reservoir and the flow path between the fluid replacement reservoir and the blood collection circuit and / or the blood return circuit may be emptied. In such a case, the replacement fluid reservoir having a relatively large capacity is emptied, so that the weight of the liquid in the entire circuit can be greatly reduced.

  In the second step, a flow path between the blood purification device and a position where the replacement fluid supply circuit is connected in the blood collection circuit and / or the blood return circuit, and a primary side of the blood purification device are further provided. You may make it empty. In this case, since the primary side of the blood purifier is emptied, the weight of the liquid in the entire circuit can be greatly reduced.

  The waste liquid circuit may include a waste liquid storage part connected between the blood purifier and the waste liquid part, and at least the waste liquid storage part may be emptied in the third step. In such a case, since the waste liquid storage section having a relatively large capacity is emptied, the weight of the liquid in the entire circuit can be greatly reduced.

According to another aspect of the present invention, there is provided a blood purifier provided with a purification membrane, a blood collection circuit for supplying blood collected from a patient to a primary side of the purification membrane of the blood purification device, and blood purified by the blood purification device. A blood return circuit for returning the blood to the patient, the blood collection circuit and the blood return circuit each having a closing part capable of closing the circuit, and a dialysate on the secondary side of the purification membrane of the blood purifier A dialysis fluid supply circuit for supplying dialysis fluid, a waste fluid circuit for draining the dialysis fluid on the secondary side of the purification membrane of the blood purifier to a waste fluid portion, the closing portion in the blood collection circuit, and the blood purifier And / or a replacement fluid supply circuit for supplying a replacement fluid to the connected blood collection circuit and / or the blood return circuit, which is connected between the closed part of the blood return circuit and the blood purifier. have a, the replacement fluid supply circuit, a replacement fluid supply source, the replacement fluid Is connected between the sources and the blood circuit and / or the blood return circuit, a blood purification device including a replacement fluid reservoir which is opened to the atmosphere, and the remaining of the dialysis fluid supply in the circuit after the blood purification treatment A first liquid-feeding device that reduces the liquid in the dialysate supply circuit by flowing a liquid to the secondary side of the blood purifier and flowing the secondary-side liquid to the waste liquid circuit; and the blood circuit In the state where the closed portions of the blood collection circuit and the blood return circuit in the closed state, the blood remaining in the replacement fluid supply circuit after the blood purification treatment by the pump, the blood collection circuit to which the replacement fluid supply circuit is connected, and / or pumped into the blood return circuit, the liquid of the blood circuit and / or blood return circuit is pumped to the primary side of the blood purifier, and pumping the liquid of the primary side to the secondary side, further said two Let the next liquid flow to the waste liquid circuit side, A second liquid feeding device for reducing the liquid in the replacement fluid supply circuit; and the liquid remaining on the secondary side of the blood purifier and in the waste liquid circuit after the blood purification treatment is caused to flow to the waste liquid part, and the waste liquid circuit And a third liquid delivery device for reducing the liquid in the blood purification device.

Another aspect of the present invention provides a blood purifier provided with a purification membrane, a blood collection circuit that supplies blood collected from a patient to the primary side of the purification membrane of the blood purification device, and the blood purification device. A blood return circuit for returning the blood to the patient, the blood collection circuit and the blood return circuit each having a closing part capable of closing the circuit, and a blood circuit on the secondary side of the purification membrane of the blood purifier A dialysate supply circuit for supplying dialysate, a waste liquid circuit for draining dialysate on the secondary side of the purification membrane of the blood purifier to a waste liquid section, the closing section in the blood collection circuit, and the blood purification And / or a replacement fluid supply circuit for supplying a replacement fluid to the connected blood collection circuit and / or the blood return circuit, which is connected between the closed part of the blood return circuit and the blood purifier. If, have a, the replacement fluid supply circuit, a replacement fluid supply source, before Is connected between the replacement fluid supply source and the blood circuit and / or the blood return circuit, the blood purification device comprising a replacement fluid reservoir which is opened to the atmosphere, and the remaining of the dialysis fluid supply in the circuit after the blood purification treatment A first step of reducing the liquid in the dialysate supply circuit by flowing a liquid to a secondary side of the blood purifier by a pump and flowing the liquid on the secondary side to the waste liquid circuit; In the circuit, the blood collection circuit in which the replacement fluid supply circuit is connected to the liquid remaining in the replacement fluid supply circuit after the blood purification process with the closed portions of the blood collection circuit and the blood return circuit closed. and / or pumped into the blood return circuit, the liquid of the blood circuit and / or blood return circuit is pumped to the primary side of the blood purifier, and pumping the liquid of the primary side to the secondary side, further the The secondary side of the waste liquid circuit A second step of reducing the liquid in the replacement fluid supply circuit by flowing to the side, and the liquid remaining in the secondary side of the blood purifier and the waste liquid circuit after the blood purification treatment by the pump And a third step of reducing the liquid in the waste liquid circuit, and causing the computer to execute the third step.

  According to the present invention, since the circuit liquid can be discharged without complicating the apparatus configuration, an increase in apparatus cost can be prevented. In addition, since the liquid in the replacement fluid supply circuit can be discharged, the weight of the circuit can be greatly reduced, and the cost of discarding the circuit can be reduced. Furthermore, since the safety of the patient can be ensured, the operation of draining the circuit liquid can be automated, and the labor and time of the circuit discarding operation can be greatly reduced.

It is explanatory drawing which shows the outline of the circuit structure of a blood purification apparatus. It is explanatory drawing which shows the state of the 1st process of a circuit. It is explanatory drawing which shows a state at the time of completion | finish of the 1st process of a circuit. It is explanatory drawing which shows the state of the 2nd process of a circuit. It is explanatory drawing which shows a state at the time of completion | finish of the 2nd process of a circuit. It is explanatory drawing which shows the state of the 3rd process of a circuit. It is explanatory drawing which shows the state of the 3rd process of a circuit. It is explanatory drawing which shows a state at the time of completion | finish of the 3rd process of a circuit.

  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 blood purification apparatus 1 according to the present embodiment.

  The blood purification apparatus 1 is an apparatus for performing blood purification treatment of, for example, continuous renal function replacement therapy (CRRT).

  The blood purification apparatus 1 includes, for example, a blood purification device 11 having a purification membrane 10, a blood circuit 12 for supplying blood collected from a patient to the blood purification device 11 and returning it to the patient, and supplying dialysate to the blood purification device 11. The operation of the blood purifier 1, the waste fluid circuit 14 for discharging the dialysate from the blood purifier 11, the replacement fluid supply circuit 15 for supplying a replacement fluid to the blood circuit 12, and the blood purifier 1. A control device 16 and the like for controlling are provided.

  The blood circuit 12, the dialysate supply circuit 13, the waste liquid circuit 14 and the replacement fluid supply circuit 15 each have a flow path made of a soft tube through which the liquid flows.

  The blood purifier 11 is a cylindrical module that incorporates a purification membrane 10 such as a hollow fiber membrane, for example. The blood purification device 11 flows blood to the primary side 10a of the purification membrane 10 and flows dialysate to the secondary side 10b, Unnecessary components in the blood 10a are taken into the dialysate on the secondary side 10b through the purification membrane 10 to purify the blood.

  The blood circuit 12 is supplied to the patient from, for example, a blood collection circuit 20 connected to the inlet of the primary side 10a of the purification membrane 10 of the blood purifier 11 from a needle punctured by the patient and an outlet of the primary side 10a of the dialyzer 10. It has a blood return circuit 21 connected to the needle to be punctured. For example, the blood collection circuit 20 is provided with a tube pump 30 that pumps blood. The tube pump 30 handles the tube of the flow path of the blood collection circuit 20 and pumps blood, and functions as a closing portion that closes the flow path when stopped. Further, on the patient side of the tube pump 30 of the blood circuit 12, a saline supply circuit that supplies a liquid, for example, physiological saline, to the blood circuit 12 in order to return the blood in the blood circuit 12 to the patient after blood purification treatment. 31 is connected. The salt solution supply circuit 31 includes, for example, a valve 32 and a salt solution supply source 33. Further, a valve 34 is provided on the patient side of the merging portion of the saline supply circuit 31 of the blood collection circuit 20.

  The blood return circuit 21 has, for example, a drip chamber 40 for removing bubbles mixed in the liquid and a valve 41 as a closing portion.

  The dialysate supply circuit 13 includes, for example, a dialysate supply source 50, a dialysate reservoir 51, and a first flow path connected from the dialysate reservoir 51 to the secondary side 10b of the purification membrane 10 of the blood purifier 11. 52 and a second flow path 53 connected from the dialysate supply source 50 to the first circuit 52. A tube pump 54 is provided in the first flow path 52. The dialysate reservoir 51 is open to the atmosphere. The dialysate supply source 50 is provided at a position higher than the dialysate reservoir 51, and the dialysate reservoir 51 can be filled with the dialysate from the dialysate supply source 50 by free fall. A valve 55 is provided in the second flow path 53. In the dialysate supply circuit 13, a predetermined amount of dialysate from the dialysate supply source 50 is sent in advance to the dialysate reservoir 51, and the dialysate reservoir 51 and the dialysate supply source 50 dialysate are driven by the tube pump 54. Is supplied to the blood purifier 11 through the first flow path 52 and the second flow path 53.

  The waste liquid circuit 14 is connected to the waste liquid section 60, the waste liquid storage section 61, the third flow path 62 connected to the secondary side 10b of the blood purifier 11, and the waste liquid storage section 61. And a fifth channel 64 connected to the waste liquid unit 60 from a junction of the third channel 62 and the fourth channel 63. A tube pump 65 and a pressure sensor 66 are provided in the third flow path 62. The pressure sensor 66 can detect the pressure on the secondary side 10 b of the blood purifier 11, and the detection result can be output to the control device 16 described later. A valve 67 is provided in the fifth flow path 64. The waste liquid storage unit 61 is provided with a pump 68 that pumps outside air into the waste liquid storage unit 61. In the waste liquid circuit 14, the dialysate waste liquid on the secondary side 10 b of the blood purifier 11 can be supplied to the waste liquid storage part 61 or discharged to the waste liquid part 60.

  The replacement fluid supply circuit 15 includes a replacement fluid supply source 70, a replacement fluid reservoir 71, and a sixth flow path 72 connected from the replacement fluid reservoir 71 to the blood return circuit 21 between the blood purifier 11 and the drip chamber 40. The seventh flow path 73 is connected to the sixth circuit 72 from the replacement fluid supply source 70. A tube pump 74 is provided in the sixth flow path 72. Further, the replacement fluid reservoir 71 is open to the atmosphere. The replacement fluid supply source 70 is provided at a position higher than the replacement fluid reservoir 71, and the replacement fluid reservoir 71 can be filled with the replacement fluid from the replacement fluid supply source 70 by free fall. A valve 75 is provided in the seventh flow path 73. In the replacement fluid supply circuit 15, a predetermined amount of replacement fluid from the replacement fluid supply source 70 is sent in advance to the replacement fluid storage unit 71, and the replacement fluid storage unit 71 and the replacement fluid from the replacement fluid supply source 70 are driven by the tube pump 74. Or is supplied to the blood return circuit 21 through the seventh flow path 73.

  The control device 16 is, for example, a computer, and controls operations of the pumps 30, 54, 65, 68, 74, valves 32, 34, 41, 55, 67, 75, and the like by executing a program stored in the memory. Thus, blood purification processing and processing for reducing the liquid in the circuit of the blood purification device 1 described later can be executed.

  The dialysate reservoir 51, the waste fluid reservoir 61, and the replacement fluid reservoir 71 are supported by a weigh scale 80, and their total weight can be measured. With this weigh scale 80, in the process of measuring the water removal rate during the blood purification process, liquid is supplied to the blood purifier 11 and the blood circuit 10 only from the dialysate reservoir 51 and the replacement fluid reservoir 71 for a predetermined time. 11 is supplied to the waste liquid reservoir 61, and the total weight of the dialysate reservoir 51, the replacement fluid reservoir 71, and the waste liquid reservoir 61 is measured. Thereby, the fluctuation amount of the total weight of the dialysate reservoir 51, the replacement fluid reservoir 71, and the waste liquid reservoir 61 can be measured, and the fluctuation amount of the total weight is the amount of water removed from the blood. The water removal rate can be calculated from the amount. Thereby, the water removal rate at the time of blood purification treatment can be monitored, and the water removal rate can be adjusted as necessary.

  In this embodiment, for example, the tube pump 54 and the tube pump 65 constitute a first liquid feeding device, and the tube pump 74 and the tube pump 65 constitute a second liquid feeding device, and the tube pump 54 and the tube The pump 65 and the pump 68 constitute a third liquid feeding device.

  Next, in the blood purification apparatus 1 configured as described above, a process for reducing the liquid in the circuit after the blood purification process will be described together with the blood purification process.

  In the blood purification process, the patient's blood is sent to the blood purifier 11 through the blood collection circuit 20 by the tube pump 30, passes through the primary side 10 a of the purification film 10, and is returned to the patient through the blood return circuit 21. . Further, the dialysate in the dialysate supply source 50 or the dialysate reservoir 51 is sent to the blood purifier 11 through the first flow path 52 and the second flow path 53 by the tube pump 54, so It passes through the secondary side 10 b, passes through the third flow path 62 of the waste liquid circuit 14, and is sent to the waste liquid part 60 or the waste liquid storage part 61. In this blood purification process, the water removal rate is intermittently measured using the weight meter 80. At this time, the waste fluid reservoir 61 is temporarily emptied, and the dialysate reservoir 51 and the replacement fluid reservoir 71 are filled with the dialysate and the replacement fluid, respectively. From this state, the dialysate reservoir 51, the waste fluid reservoir 61, and the replacement fluid reservoir While measuring the total weight of 71, the dialysate in the dialysate reservoir 51 is supplied to the blood purifier 11, and the replacement fluid in the replacement fluid reservoir 71 is sent to the blood circuit 12. The dialysate discharged from the blood purifier 11 is sent to the waste liquid storage unit 61. The water removal amount is determined from the change in the total weight at this time, and the water removal rate is determined from the water removal amount. When the water removal rate is not measured, for example, the dialysate from the dialysate supply source 50 and the dialysate reservoir 51 is supplied to the blood purifier 11, and the replacement fluid from the replacement fluid supply source 70 and the replacement fluid reservoir 71 is supplied. The blood is supplied to the blood circuit 12 and the dialysate is discharged from the blood purifier 11 to the waste liquid portion 60.

  In this blood purification process, in the blood purifier 11, water containing unnecessary components in the blood on the primary side 10a of the purification membrane 10 flows out to the secondary side 10b through the purification membrane 10 and is taken into the dialysate. Thus, the blood is purified and returned to the patient.

  Also, the replacement fluid is sent to the blood return circuit 21 to replenish moisture in the patient's blood.

  Such blood purification processing is performed for a predetermined time, and blood in the patient's body is purified. After a predetermined time elapses, each pump is stopped, and the blood purification process ends.

  When the blood purification process ends, for example, the valve 34 is closed, the tube pump 30 is driven, the physiological saline in the saline supply circuit 31 is supplied into the blood circuit 12, and the inside of the blood circuit 12 is replaced with physiological saline. Thus, the blood in the blood circuit 12 is returned to the patient.

  Next, a process for reducing the liquid remaining in the circuit after the blood purification process is started. First, as shown in FIG. 2, with the tube pumps 74, 30, and the pump 68 stopped, the valve 67 is opened, the tube pump 54 and the tube pump 65 are driven, and the dialysate reservoir 51 and the first flow The residual dialysate in the passage 52 is sent to the secondary side 10 b of the blood purifier 11, the dialysate on the secondary side 10 b is discharged to the third flow path 62, and the dialysate in the third flow path 62 Is discharged to the waste liquid part 60 (first step). And, for example, as shown in FIG. 3, when the dialysate in the dialysate reservoir 51 and the first flow path 52 becomes empty and the water level of the dialysate on the secondary side 10b of the blood purifier 11 decreases, the tube The pump 54 and the tube pump 65 are stopped, and the first step is completed. In the first step, the valves 55, 75, 41, 34, and 32 are closed.

  Next, as shown in FIG. 4, in a state where the valve 41 of the blood circuit 12 is closed and the tube pump 30 is stopped, the tube pump 74 and the tube pump 65 are driven, and the replacement fluid reservoir 71 and the sixth flow path 72 are driven. Of the blood return circuit 21 is sent to a section (hereinafter referred to as “blood return flow path 21a”) between the junction with the sixth flow path 72 of the blood return circuit 21 and the blood purifier 11. The replacement fluid 21a and physiological saline 21a are sent to the primary side 10a of the blood purifier 11. The liquid on the primary side 10a passes through the purification film 10 and flows out to the secondary side 10b. The liquid on the secondary side 10b (including the remaining dialysate and liquid that has entered from the primary side 10a) is discharged to the third flow path 62, and the liquid in the third flow path 62 flows into the fifth flow path. It is sent to the waste liquid part 60 through the path 64 (second step).

  In this second step, the pressure gauge 66 continuously or sequentially measures the pressure in the third flow path 62 (secondary side 10b) so that the pressure does not drop below a predetermined threshold value. The pumping flow rates of the pump 74 and the tube pump 65 are adjusted. For example, when the pressure measured by the pressure gauge 66 decreases, the pumping flow rates of the tube pump 74 and the tube pump 65 are decreased. In this way, even when the purification film 10 is clogged, the liquid on the primary side 10a is passed to the secondary side 10b so that excessive pressure exceeding a predetermined threshold is not applied to the purification film 10. In addition, even when the pumping flow rate of the tube pump 74 and the tube pump 65 is adjusted, the pressure on the secondary side 10b falls below a predetermined threshold value, and a pressure exceeding the predetermined threshold value is applied to the purification film 10. The tube pump 74 and the tube pump 65 are stopped.

  For example, as shown in FIG. 5, when the liquid replacement reservoir 71 and the sixth channel 72, the blood return channel 21 a and the primary side 10 a of the blood purifier 11 become empty, the tube pump 74 and the tube The pump 65 is stopped and the second step is completed.

  Next, as shown in FIG. 6, the tube pump 54, the tube pump 65, and the pump 68 are driven, and the liquid remaining on the secondary side 10b of the blood purifier 11 is sent to the third flow path 62, and the third The liquid in the flow path 62 is discharged to the waste liquid portion 60 through the fifth flow path 64. At the same time, the liquid in the waste liquid storage part 61 is discharged to the waste liquid part 60 through the fourth flow path 63 and the fifth flow path 64. Then, as shown in FIG. 7, after the waste liquid storage portion 61 is emptied, the driving of the pump 68 is stopped, and the remaining liquid in the third flow path 62 passes through the fifth flow path 64 to reach the waste liquid section. It is discharged to 60 (third step).

  Then, as shown in FIG. 8, when the secondary side 10b of the blood purifier 11, the third channel 62, the waste liquid reservoir 61, the fourth channel 63, and the fifth channel 64 are emptied. The tube pump 54 and the tube pump 65 are stopped, and the third step is completed.

  According to the present embodiment, there is no need to provide a separate ventilation means as in the prior art, so that the liquid in the circuit after processing can be reduced without complicating the apparatus configuration. Also, the liquid in the replacement fluid supply circuit 15 can be reduced, and the weight of the entire circuit can be greatly reduced. Furthermore, since it is cut off from the patient side by the tube pump 30 of the blood collection circuit 20 and the valve 41 of the blood return circuit 21, etc., the blood purifier can reduce the liquid even if the blood circuit 12 remains connected to the patient. 11. The air and liquid of the dialysate supply circuit 13, the replacement fluid supply circuit 15, and the waste liquid circuit 14 do not enter the patient. Thus, since the patient's integrity is ensured, the process of reducing the liquid in the circuit can be automated.

  According to the present embodiment, the first step of not allowing the liquid to pass through the purification membrane 10 is performed earlier than the second step of allowing the liquid to pass through the purification membrane 10, so that the purification membrane 10 after the blood purification treatment is performed. Even when the clogging is severe and the liquid does not pass, at least the liquid of the dialysate supply circuit 13 can be discharged to reliably reduce the weight of the circuit of the blood purification apparatus 1.

  Further, in the second step, since the liquid flows from the primary side 10a to the secondary side 10b of the blood purifier 11 so that the pressure applied to the purification membrane 10 does not exceed a predetermined threshold value, the purification membrane 10 is clogged. In such a case, the liquid can be discharged so that an excessive load is not applied to the purification film 10. Thereby, even if the purification film 10 is clogged, the liquid can be continuously discharged to the maximum and the liquid can be reduced to the maximum.

  Since the third step is performed last, no liquid remains in the waste liquid circuit 14, and the weight of the blood purification apparatus 1 can be sufficiently reduced.

  In the present embodiment, the dialysate reservoir 51 and the first flow path 52 having a relatively large volume are emptied in the first process, and the relatively large volume of the replacement fluid reservoir 71 and the second process are used. Since the sixth flow path 72 is emptied and the waste liquid storage unit 61 having a relatively large volume is emptied in the third step, the weight of the liquid in the entire circuit can be greatly reduced.

  In the second step, the blood return channel 21a and the primary side 10a of the blood purifier 11 are further emptied, so that the weight of the liquid in the entire circuit can be further reduced.

  In the above embodiment, the process of reducing the liquid in the circuit after the blood purification treatment is performed in the order of the first step, the second step, and the third step. However, this order is arbitrary. You may rearrange.

  For example, the first step may be performed after the second step. In this case, in the second step, the replacement fluid reservoir 71, the sixth channel 72, the blood return channel 21a, and the primary side 10a of the blood purifier 11 are emptied, and then the dialysate reservoir in the first step. 51, the first flow path 52 and the secondary side 10b of the blood purifier 11 may be emptied. Then, following the first step, the pump 68 may be driven to empty the waste liquid storage unit 61, the fourth channel 63, and the fifth channel 64.

  In the third step, the liquid in the waste liquid storage unit 61 and the fourth flow path 63 is discharged and the liquid in the secondary side 10b of the blood purifier 11 and the third flow path 62 is discharged at the same time. Or it may be done in order.

  Furthermore, after performing either the first step or the second step, the third step may be performed, and finally the remaining first step or second step may be performed.

  Further, the circuit configuration of the blood purification apparatus 1 according to the present invention is not limited to the above-described embodiment, and may be a blood purification apparatus having another circuit configuration. For example, there is no dialysate reservoir 51, waste fluid reservoir 61, and replacement fluid reservoir 71, and dialysate or replacement fluid is directly supplied from the dialysate supply source 50 and the replacement fluid supply source 70 to the blood purifier 11. The liquid may be discharged directly to the waste liquid part 60.

  In the above embodiment, the closed part of the blood collection circuit 20 of the blood purification apparatus 1 is the tube pump 30 and the closed part of the blood return circuit 21 is the valve 41. However, other parts may be used. . Moreover, the 1st liquid feeding apparatus, the 2nd liquid feeding apparatus, and the 3rd liquid feeding apparatus may have another structure.

  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 replacement fluid supply circuit 15 is connected between the valve 41 and the blood purifier 11 in the blood return circuit 21, but the tube pump 30 serving as a closing part in the blood collection circuit 20 and the blood purification are included. It may be connected between the container 11. In such a case, in the second step, the liquid remaining in the replacement fluid supply circuit 15 after the blood purification treatment is caused to flow to the blood collection circuit 20, and the liquid in the blood collection circuit 20 is caused to flow to the primary side 10 a of the blood purification device 11. The liquid in the replacement fluid supply circuit 15 may be reduced by flowing the liquid on the side 10a to the secondary side 10b and further flowing the liquid on the secondary side 10b to the waste liquid circuit 14 side. At that time, the position of the replacement fluid storage circuit 71 of the replacement fluid supply circuit 15 and the flow path between the replacement fluid storage unit 71 and the blood collection circuit 20 are emptied, and the replacement fluid supply circuit 15 is connected to the blood collection circuit 20. The flow path between the blood purifier 11 and the primary side 10a of the blood purifier 11 may be emptied. Note that the replacement fluid supply circuit 15 may be connected to not only one of the blood return circuit 21 and the blood collection circuit 20 but also both as described above. In such a case, as described in the above embodiment, the remaining liquid in the blood return circuit 21 and the blood collection circuit 20 is reduced in the second step.

  The present invention reduces the liquid in the circuit of the blood purification apparatus that can discharge the liquid in the replacement fluid supply circuit without complicating the apparatus configuration, and can automate the liquid discharge operation while ensuring the safety of the patient. Useful in providing a method.

DESCRIPTION OF SYMBOLS 1 Hemodialysis apparatus 10 Purification membrane 10a Primary side 10b Secondary side 11 Blood purifier 12 Blood circuit 13 Dialysate supply circuit 14 Waste liquid circuit 15 Replacement fluid supply circuit 16 Controller 20 Blood collection circuit 21 Blood return circuit

Claims (10)

A blood purifier with a purification membrane;
A blood collection circuit that supplies blood collected from a patient to the primary side of the purification membrane of the blood purifier, and a blood return circuit that returns the blood purified by the blood purifier to the patient, the blood collection circuit and the return Blood circuits each having a closure that can close the circuit;
A dialysate supply circuit for supplying dialysate to the secondary side of the purification membrane of the blood purifier;
A waste liquid circuit for draining the dialysate on the secondary side of the purification membrane of the blood purifier into a waste liquid part;
Connected between the closed part and the blood purifier in the blood collection circuit and / or between the closed part and the blood purifier in the blood return circuit, the connected blood collection circuit and / or blood return possess a replacement fluid supply circuit for supplying a replacement fluid to the circuit, and
In the blood purification apparatus, the blood replacement device includes a replacement fluid supply source, a replacement fluid reservoir connected between the replacement fluid supply source and the blood collection circuit and / or the blood return circuit, and opened to the atmosphere. A method of reducing liquid remaining in a circuit after purification treatment,
The remaining liquid in the dialysate supply circuit after blood purification treatment is caused to flow to the secondary side of the blood purifier, the secondary side liquid is allowed to flow to the waste liquid circuit side, and the liquid in the dialysate supply circuit A first step of reducing
In the blood circuit, with the closed portions of the blood collection circuit and the blood return circuit closed, the liquid remaining in the replacement fluid supply circuit after the blood purification process is connected to the replacement fluid supply circuit by a pump. It was pumped into blood circuit and / or the blood return circuit, the liquid of the blood circuit and / or blood return circuit is pumped to the primary side of the blood purifier, and pumping the liquid of the primary side to the secondary side, A second step of reducing the liquid in the replacement fluid supply circuit by flowing the liquid on the secondary side toward the waste liquid circuit;
A third step of reducing the liquid in the waste circuit by flowing the liquid remaining in the secondary side of the blood purifier and the waste circuit after the blood purification process to the waste unit. A method of reducing liquid in the circuit of a device.   The method of reducing the liquid in the circuit of the blood purification apparatus according to claim 1, wherein the first step is performed before the second step.   3. In the second step, the liquid is allowed to flow from the primary side to the secondary side so that the pressure applied to the purification membrane does not exceed a predetermined threshold value. How to reduce liquid.   The method of reducing the liquid in the circuit of the blood purification apparatus in any one of Claims 1-3 by which the said 3rd process is performed after the said 1st process and the said 2nd process. The dialysate supply circuit has a dialysate supply source, and a dialysate reservoir connected between the dialysate supply source and the blood purifier,
The blood purification according to any one of claims 1 to 4, wherein in the first step, at least the dialysate reservoir and a flow path between the dialysate reservoir and the blood purifier are emptied. A method of reducing liquid in the circuit of a device.   In the second step, at least the fluid replacement reservoir and the flow path between the fluid replacement reservoir and the blood collection circuit and / or the blood return circuit are emptied. A method for reducing fluid in the circuit of the described blood purification apparatus. In the second step, a flow path between the blood purification device and a position where the replacement fluid supply circuit is connected in the blood collection circuit and / or the blood return circuit, and a primary side of the blood purification device are further provided. The method of reducing the liquid in the circuit of the blood purification apparatus of Claims 1-6 made empty. The waste liquid circuit has a waste liquid storage part connected between the blood purifier and the waste liquid part,
The method of reducing the liquid in the circuit of the blood purification apparatus in any one of Claims 1-7 which empty | empties at least the said waste liquid storage part in a said 3rd process. A blood purifier with a purification membrane;
A blood collection circuit that supplies blood collected from a patient to the primary side of the purification membrane of the blood purifier, and a blood return circuit that returns the blood purified by the blood purifier to the patient, the blood collection circuit and the return Blood circuits each having a closure that can close the circuit;
A dialysate supply circuit for supplying dialysate to the secondary side of the purification membrane of the blood purifier;
A waste liquid circuit for draining the dialysate on the secondary side of the purification membrane of the blood purifier into a waste liquid part;
Connected between the closed part and the blood purifier in the blood collection circuit and / or between the closed part and the blood purifier in the blood return circuit, the connected blood collection circuit and / or blood return possess a replacement fluid supply circuit for supplying a replacement fluid to the circuit, and
The replacement fluid supply circuit is a blood purification device having a replacement fluid supply source, and a replacement fluid reservoir connected between the replacement fluid supply source and the blood collection circuit and / or the blood return circuit and opened to the atmosphere. ,
The remaining liquid in the dialysate supply circuit after blood purification treatment is caused to flow to the secondary side of the blood purifier, the secondary side liquid is allowed to flow to the waste liquid circuit side, and the liquid in the dialysate supply circuit A first liquid delivery device for reducing
In the blood circuit, with the closed portions of the blood collection circuit and the blood return circuit being closed, the liquid remaining in the replacement fluid supply circuit after the blood purification process is connected to the replacement fluid supply circuit by a pump. It was pumped into blood circuit and / or the blood return circuit, the liquid of the blood circuit and / or blood return circuit is pumped to the primary side of the blood purifier, and pumping the liquid of the primary side to the secondary side, Furthermore, the second liquid feeding device for flowing the secondary liquid to the waste liquid circuit side and reducing the liquid in the replacement liquid supply circuit;
A third liquid feeding device for reducing the liquid in the waste liquid circuit by flowing the liquid remaining in the secondary side of the blood purifier and the waste liquid circuit after the blood purification treatment to the waste liquid part; Blood purification device. A blood purifier with a purification membrane;
A blood collection circuit that supplies blood collected from a patient to the primary side of the purification membrane of the blood purifier, and a blood return circuit that returns the blood purified by the blood purifier to the patient, the blood collection circuit and the return Blood circuits each having a closure that can close the circuit;
A dialysate supply circuit for supplying dialysate to the secondary side of the purification membrane of the blood purifier;
A waste liquid circuit for draining the dialysate on the secondary side of the purification membrane of the blood purifier into a waste liquid part;
Connected between the closed part and the blood purifier in the blood collection circuit and / or between the closed part and the blood purifier in the blood return circuit, the connected blood collection circuit and / or blood return possess a replacement fluid supply circuit for supplying a replacement fluid to the circuit, and
In the blood purification apparatus, the replacement fluid supply circuit includes a replacement fluid supply source, and a replacement fluid storage unit connected between the replacement fluid supply source and the blood collection circuit and / or the blood return circuit and opened to the atmosphere .
The remaining liquid in the dialysate supply circuit after blood purification treatment is caused to flow by a pump to the secondary side of the blood purifier, and the secondary side liquid is caused to flow to the waste liquid circuit side, thereby the dialysate supply circuit. A first step of reducing the liquid in the interior;
In the blood circuit, with the closed portions of the blood collection circuit and the blood return circuit closed, the liquid remaining in the replacement fluid supply circuit after the blood purification process is connected to the replacement fluid supply circuit by a pump. It was pumped into blood circuit and / or the blood return circuit, the liquid of the blood circuit and / or blood return circuit is pumped to the primary side of the blood purifier, and pumping the liquid of the primary side to the secondary side, A second step of reducing the liquid in the replacement fluid supply circuit by flowing the liquid on the secondary side toward the waste liquid circuit;
A third step of reducing the liquid in the waste liquid circuit by flowing the liquid remaining in the secondary side of the blood purifier and the waste liquid circuit to the waste liquid part by a pump after the blood purification process; A program to make it run.

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