JP6462076B1 - Blood purification apparatus and priming method thereof - Google Patents

Abstract

A blood purification apparatus and a priming method thereof that can more reliably prevent bubbles from flowing into a blood purification means during priming.
When liquid is present in an outlet side flow path D between a dialyzer 3 and an air trap chamber 5 in a venous blood circuit 2, the blood pump 4 is driven to rotate in a forward direction with the electromagnetic valves V3 and V4 opened. By doing so, the priming liquid is applied to both the flow path from the connection portion J of the priming liquid supply line Ld to the tip of the arterial blood circuit 1 and the flow path from the connection portion J of the priming liquid supply line Ld to the dialyzer 3. , And a bubble removal step that allows the bubbles contained in the liquid in the outlet side channel D to be discharged from the overflow line Le is performed.
[Selection] Figure 7

Description

  The present invention relates to a blood purification apparatus for purifying a patient's blood while circulating outside the body, such as dialysis treatment using a dialyzer, and a priming method thereof.

  Generally, at the time of dialysis treatment, a blood circuit for circulating the collected patient's blood extracorporeally and returning it to the body is used. Such a blood circuit is, for example, a dialyzer (blood purification means) having a hollow fiber membrane. It is mainly composed of an arterial blood circuit and a venous blood circuit that can be connected to each other. An arterial puncture needle and a venous puncture needle are attached to the tips of the arterial blood circuit and the venous blood circuit, respectively, and are punctured by the patient to perform extracorporeal circulation of blood in dialysis treatment.

  Among these, an ironing tube is connected to the arterial blood circuit, and an ironing type blood pump capable of feeding liquid by rubbing the ironing tube with a roller. By driving such a blood pump, the patient's blood can be circulated extracorporeally in the blood circuit, so that blood purification treatment using a dialyzer is performed on the extracorporeally circulated blood.

  The arterial blood circuit is connected to a priming fluid supply line for supplying priming fluid to the blood circuit. Then, at the time of priming before dialysis treatment, the priming solution is supplied from the priming solution supply line to the air trap chamber and discharged from the overflow line, and the priming solution supplied in the overflow step is caused to flow in the blood circuit. By repeatedly performing the liquid process (circulation process), air bubbles in the blood circuit are discharged from the overflow line, and the flow path of the blood circuit is filled with a priming liquid (see, for example, Patent Document 1). ).

JP 2010-273893 A

  However, in the conventional blood purification apparatus, when the priming liquid is supplied from the priming liquid supply line and discharged from the overflow line to discharge the bubbles in the blood circuit in the overflow process, the bubbles moved to the air trap chamber There was a possibility of flowing to the dialyzer side without being discharged from the overflow line. As described above, when bubbles flow into the dialyzer, a large amount of priming liquid having a high flow rate may be required to discharge the bubbles.

  In the above conventional blood purification apparatus, the flow path between the dialyzer and the air trap chamber (in the present invention, the “outlet side flow” is defined by driving the blood pump forwardly after the overflow process and before the liquid feeding process. Although the priming liquid is flowing through the channel, the bubbles remaining in the outlet-side flow path may remain in the air trap chamber or the like, and may not be sufficiently discharged from the overflow line. In particular, when the air trap chamber is filled with the priming liquid and the air layer is not formed at the end of priming, it is highly possible that the air bubbles flow to the dialyzer side because the air trap chambers cannot store the air bubbles. It has become.

  The present invention has been made in view of such circumstances, and provides a blood purification apparatus and a priming method thereof that can more reliably prevent bubbles from flowing into the blood purification means during priming. It is in.

  The invention according to claim 1 includes a blood circuit that has an arterial blood circuit and a venous blood circuit, and can circulate a patient's blood extracorporeally from the distal end of the arterial blood circuit to the distal end of the venous blood circuit, and the artery Blood purification means connected to the proximal end of the side blood circuit and the proximal end of the venous side blood circuit and capable of purifying the blood flowing through the blood circuit; and disposed in the artery side blood circuit, A blood pump capable of feeding from the tip of the blood circuit toward the blood purification means, and capable of feeding from the blood purification means toward the tip of the artery side blood circuit by reverse rotation driving; and the arterial side A priming fluid supply line connected to a blood circuit and capable of supplying a priming fluid into the blood circuit; a first valve means capable of optionally closing or opening the priming fluid supply line; An air trap chamber connected to the venous blood circuit, an overflow line extending from the air trap chamber and allowing the priming liquid overflowing the air trap chamber to be discharged to the outside, and optionally closing or opening the overflow line And a control means capable of controlling the blood pump, the first valve means, and the second valve means, and the blood purifying means is disposed above the arterial blood circuit. A state in which the connection portion with the venous blood circuit is directed downward, and the distal end of the arterial blood circuit and the distal end of the venous blood circuit are connected to each other to communicate with each other. The priming is performed as a blood purification device, and at the time of priming, the control means stops the blood pump while the blood pump is stopped. An overflow step of opening priming liquid from the priming liquid supply line to the air trap chamber and discharging the priming liquid from the overflow line by opening the first valve means and the second valve means; and the first valve means and the second valve The blood pump is reversely driven in a state where the means is closed, so that a priming solution supplied in the overflow step is sequentially flowed in the blood circuit, and the blood circuit and the blood circuit When the overflow process and the liquid feeding process are repeated until the air trap chamber is filled with the priming liquid, and there is liquid in the outlet-side flow path between the blood purification means and the air trap chamber in the venous blood circuit The first valve means and the second valve means are opened in the state described above. By driving the blood pump to rotate forward, a flow path from the connection part of the priming liquid supply line to the tip of the arterial blood circuit, and a flow path from the connection part of the priming liquid supply line to the blood purification means, The priming liquid is supplied to both of the above, and a bubble removal step is performed in which bubbles contained in the liquid in the outlet side flow path can be discharged from the overflow line.

  According to a second aspect of the present invention, in the blood purification apparatus according to the first aspect, in the bubble removal step, the blood pump is configured such that a priming liquid directed to the blood purification means has a flow rate equal to or less than a capacity of the outlet side flow path. Are driven to rotate forward.

  According to a third aspect of the present invention, in the blood purification apparatus according to the first or second aspect, the bubble removal step is performed between the overflow step and the liquid feeding step after the second time. .

  According to a fourth aspect of the present invention, in the blood purification apparatus according to any one of the first to third aspects, when the blood purification unit is prefilled with a filling liquid, the control unit is Before the overflow step, the blood pump is driven to rotate in the forward direction to perform a flow step of flowing the filling liquid into the air trap chamber.

  According to a fifth aspect of the present invention, there is provided a blood circuit that has an arterial blood circuit and a venous blood circuit, and can circulate a patient's blood extracorporeally from the distal end of the arterial blood circuit to the distal end of the venous blood circuit; Blood purification means connected to the proximal end of the side blood circuit and the proximal end of the venous side blood circuit and capable of purifying the blood flowing through the blood circuit; and disposed in the artery side blood circuit, A blood pump capable of feeding from the tip of the blood circuit toward the blood purification means, and capable of feeding from the blood purification means toward the tip of the artery side blood circuit by reverse rotation driving; and the arterial side A priming fluid supply line connected to a blood circuit and capable of supplying a priming fluid into the blood circuit; a first valve means capable of optionally closing or opening the priming fluid supply line; An air trap chamber connected to the venous blood circuit, an overflow line extending from the air trap chamber and allowing the priming liquid overflowing the air trap chamber to be discharged to the outside, and optionally closing or opening the overflow line Second blood valve means, and the blood purification means, with the connection portion with the arterial blood circuit facing upward and the connection portion with the venous blood circuit facing downward, and A priming method using a blood purification apparatus in which priming is performed by connecting a distal end of the arterial blood circuit and a distal end of the venous blood circuit and communicating with each other, and the blood pump is stopped. The priming liquid supply line is opened by opening the first valve means and the second valve means. An overflow process for supplying a priming solution from the air trap chamber to the air trap chamber and discharging it from the overflow line; and driving the blood pump in a reverse rotation state while closing the first valve means and the second valve means, A priming solution supplied in an overflow step is sequentially flown in the blood circuit, and the overflow step and the liquid feeding step are repeated until the blood circuit and the air trap chamber are filled with the priming solution. And when there is liquid in the outlet-side flow path between the blood purification means and the air trap chamber in the venous blood circuit, the blood is in a state where the first valve means and the second valve means are opened. Connecting the priming liquid supply line by driving the pump forward Priming liquid is supplied to both the flow path from the section toward the tip of the arterial blood circuit and the flow path from the connection section of the priming liquid supply line to the blood purification means, It is characterized in that a bubble removing step is performed in which bubbles contained therein can be discharged from the overflow line.

  According to a sixth aspect of the present invention, in the priming method by the blood purification apparatus according to the fifth aspect, in the bubble removal step, the priming liquid directed to the blood purification means has a flow rate equal to or lower than the capacity of the outlet side flow path. The blood pump is driven to rotate forward.

  A seventh aspect of the present invention is the priming method by the blood purification apparatus according to the fifth or sixth aspect, wherein the bubble removal step is performed between the second and subsequent overflow steps and the liquid feeding step. Features.

  The invention according to claim 8 is the priming method by the blood purification apparatus according to any one of claims 5 to 7, wherein when the pre-filled filling liquid is used as the blood purification means, the first time Before the overflow process, the blood pump is driven to rotate forward to perform a flow process of flowing the filling liquid into the air trap chamber.

  According to the first and fifth aspects of the present invention, the overflow process and the liquid feeding process are sequentially performed during priming, and the overflow process and the liquid feeding process are repeatedly performed until the blood circuit and the air trap chamber are filled with the priming liquid. In addition, when there is liquid in the outlet side flow path between the blood purification means and the air trap chamber in the venous side blood circuit, the blood pump is driven to rotate in the forward direction with the first valve means and the second valve means opened. By supplying the priming liquid to both the flow path from the connection part of the priming liquid supply line to the tip of the arterial blood circuit and the flow path from the connection part of the priming liquid supply line to the blood purification means, Since the bubble removal process that allows the bubbles contained in the liquid in the outlet side channel to be discharged from the overflow line is performed, When, it is possible to more reliably prevent the air bubbles would flow to the blood purification means.

  According to the second and sixth aspects of the invention, the bubble removing step drives the blood pump to rotate forward so that the priming liquid directed to the blood purification means has a flow rate equal to or less than the capacity of the outlet side flow path. Bubbles contained in the liquid in the outlet side channel can be discharged from the overflow line by the priming liquid.

  According to the third and seventh aspects of the present invention, since the bubble removal step is performed between the second and subsequent overflow steps and the liquid feeding step, the bubble removal step is performed with no liquid in the outlet side flow path. It is possible to avoid the occurrence of a wasteful bubble removal process.

  According to the fourth and eighth aspects of the present invention, when the pre-filled filling liquid is used as the blood purification means, the filling liquid is put into the air trap chamber by driving the blood pump forward before the first overflow process. Since the fluidizing process is performed, even if the filling liquid of the blood purification means contains bubbles, the bubbles can flow into the air trap chamber and be discharged from the overflow line in the overflow process.

1 is a schematic diagram showing a dialysis device (blood purification device) according to a first embodiment of the present invention. A perspective view showing a blood pump applied to the dialysis machine The top view which shows the state which attached the covering tube to the blood pump Schematic diagram showing venous pressure measuring means applied to the dialysis machine Schematic diagram showing the state where the priming process (overflow process) is performed by the dialysis machine Schematic diagram showing the state where the priming process (liquid feeding process) is performed by the dialysis machine Schematic diagram showing the state in which the air bubble removal process is performed by the dialysis machine Flow chart showing control contents by control means of the dialysis machine It is a figure which shows the dialysis apparatus (blood purification apparatus) which concerns on the 2nd Embodiment of this invention, Comprising: The schematic diagram which shows the state in which the flow process is performed Flow chart showing control contents by control means of the dialysis machine

Hereinafter, embodiments of the present invention will be specifically described with reference to the drawings.
The blood purification apparatus according to the first 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. A dialyzer 3 (blood purification means) connected to the base end of the circuit 1 and the base end of the venous blood circuit 2 to purify blood flowing in the blood circuit; an air trap chamber 5 connected to the venous blood circuit 2; A priming liquid supply line Ld that is connected to the arterial blood circuit 1 and can supply a priming liquid into the blood circuit, and an overflow line that can discharge the priming liquid supplied into the blood circuit through the priming liquid supply line Ld. Le (discharge section), electromagnetic valve V4 as first valve means capable of arbitrarily closing or opening the priming liquid supply line Ld, and overflow line Le An electromagnetic valve V3 of a second valve means which can be closed or open, is mainly composed of a controllable control means E the blood pump 4 and the solenoid valve (V1-V4) or the like.

  An arterial puncture needle a is connected to the distal end of the arterial blood circuit 1 via a connector c, and an iron blood pump 4 is disposed midway. A vein side puncture needle b is connected to the distal end of the vein side blood circuit 2 via a connector d, and an air trap chamber 5 is connected in the middle. Furthermore, solenoid valves V1 and V2 that can close or open the flow paths are connected to the distal end side (near connector c) of arterial blood circuit 1 and the distal end side (near connector d) of venous blood circuit 2, respectively. ing.

  Then, when the blood pump 4 is driven with the patient punctured with the arterial puncture needle a and the venous puncture needle b, the patient's blood passes through the arterial blood circuit 1 and reaches the dialyzer 3, Blood purification is performed by the dialyzer 3, and air bubbles are removed in the air trap chamber 5, and then returned to the patient's body through the venous blood circuit 2. That is, the blood purification treatment is performed by purifying the patient's blood by the dialyzer 3 while circulating it extracorporeally from the tip of the arterial blood circuit 1 to the tip of the venous blood circuit 2 of the blood circuit. In this specification, the side of the puncture needle that removes blood (collects blood) is referred to as the “arterial side”, and the side of the puncture needle that returns the blood is referred to as the “venous side”. "Venous side" is not defined by whether the blood vessel to be punctured is an artery or a vein.

  In addition, an iron tube H is connected in the middle of the arterial blood circuit 1 (between the connection portion of the priming fluid supply line Ld and the dialyzer 3), and the iron tube H is connected to the blood pump 4 (specifically, In FIG. 2, it is possible to attach to the mounting recess 12a) formed in the stator 12 of the blood pump 4, which will be described in detail later. The ironing tube H can be compressed in the longitudinal direction while being compressed in the radial direction by the roller 14 (ironing part) of the blood pump 4 (ironing type pump), and the liquid inside can flow in the rotational direction of the rotor 13. It consists of a flexible tube that is softer and larger in diameter than the other flexible tubes that make up the arterial blood circuit 1.

  As shown in FIGS. 2 and 3, the blood pump 4 according to the present embodiment includes a stator 12, a rotor 13 that can be driven to rotate within the stator 12, a roller 14 formed on the rotor 13, and a pair of upper and lower guides. It is mainly comprised from the pin 15 and the holding part 16 which hold | grips and fixes the ironing tube H. FIG. In the figure, the cover that covers the upper portion of the stator 12 in the blood pump 4 is omitted.

  The stator 12 is formed with an attachment recess 12a to which the ironing tube H is attached. As shown in FIGS. 2 and 3, the ironing tube H is attached along the inner peripheral wall surface forming the attachment recess 12a. It is configured as follows. In addition, a rotor 13 that can be driven to rotate by a motor is disposed substantially at the center of the mounting recess 12a. A pair (two) of rollers 14 and guide pins 15 are disposed on the side surface of the rotor 13 (the surface facing the inner peripheral wall surface of the mounting recess 12a).

  The roller 14 is rotatable about a rotation axis M (see FIG. 3) formed on the outer edge side of the rotor 13, and compresses the iron tube H attached to the attachment recess 12a in the radial direction. By squeezing in the longitudinal direction (blood flow direction) as the rotor 13 rotates, blood can flow in the arterial blood circuit 1. That is, when the ironing tube H is attached in the mounting recess 12a and the rotor 13 is driven to rotate, the ironing tube H is compressed between the roller 14 and the inner peripheral wall surface of the mounting recess 12a, and the rotor 13 It can be ironed in the rotational direction (longitudinal direction of the ironing tube H) with the rotational drive. With this ironing action, blood in the arterial blood circuit 1 is fed in the direction of rotation of the rotor 13, so that it can be circulated extracorporeally in the arterial blood circuit 1.

  Furthermore, in the blood pump 4 according to the present embodiment, the rotor 13 is driven to rotate in the forward direction to rotate the roller 14 in the same direction (the direction indicated by the symbol α in FIG. 3) along the longitudinal direction of the ironing tube H. By rolling, liquid can be fed from the distal end of the arterial blood circuit 1 toward the dialyzer 3 (blood purification means), and the rotor 13 is driven to rotate in the reverse direction to move the roller 14 in the same direction (reference numeral β in FIG. 3). The liquid can be fed from the dialyzer 3 (blood purification means) toward the distal end of the arterial blood circuit 1 by rolling along the longitudinal direction of the ironing tube H while rotating in the direction indicated by.

  As shown in FIG. 2, the guide pin 15 is composed of a pair of upper and lower pin-shaped members that are formed to protrude from the upper end side and the lower end side of the rotor 13 toward the inner peripheral wall surface of the mounting recess 12 a. The ironing tube H is held between the pair of guide pins 15. That is, when the rotor 13 is driven, the ironing tube H is held at a normal position by the pair of upper and lower guide pins 15 so that the ironing tube H is not detached upward or downward from the mounting recess 12a.

  The air trap chamber 5 is provided with an overflow line Le (exhaust part) extending from the top and having a tip opened to the atmosphere, and discharges the liquid (priming liquid) overflowing the air trap chamber 5 to the outside. Configured to get. The overflow line Le is provided with a solenoid valve V3 (second valve means), and the flow path of the overflow line Le can be closed or opened at an arbitrary timing.

  The dialyzer 3 includes a blood inlet 3a (blood inlet port), a blood outlet 3b (blood outlet port), a dialysate inlet 3c (dialysate channel inlet: dialysate inlet port) and a dialysate in its casing. A lead-out port 3d (dialysate flow path outlet: dialysate lead-out port) is formed, of which the blood introduction port 3a has the proximal end of the arterial blood circuit 1 and the blood lead-out port 3b has the venous blood circuit 2. Are connected to each other. The dialysate inlet 3c and dialysate outlet 3d are respectively connected to a dialysate inlet line La and a dialysate outlet line Lb extending from the dialyzer body.

  A plurality of hollow fibers (not shown) are accommodated in the dialyzer 3, and these hollow fibers constitute a blood purification membrane for purifying blood. Thus, in the dialyzer 3, a blood flow path (flow path between the blood inlet 3a and the blood outlet 3b) through which the patient's blood flows through the blood purification membrane and a dialysate flow path through which the dialysate flows. (A flow path between the dialysate inlet 3c and the dialysate outlet 3d) is formed. The hollow fiber constituting the blood purification membrane is formed with a large number of minute holes (pores) penetrating the outer peripheral surface and the inner peripheral surface to form a hollow fiber membrane, and blood is passed through the membrane. It is configured so that impurities therein can permeate into the dialysate.

  The dual pump 10 is disposed in the main body of the dialyzer so as to straddle the dialysate introduction line La and the dialysate discharge line Lb, and the bypass line Lc that bypasses the dual pump 10 in the dialysate discharge line Lb has a dialyzer. A water removal pump 11 is provided for removing water from the blood of the patient flowing through the blood. One end of the dialysate introduction line La 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 dialysate having a predetermined concentration. . One end of the dialysate discharge line Lb is connected to the dialyzer 3 (dialysate outlet 3d), and the other end is connected to a drain means (not shown), and the dialysate supplied from the dialysate supply device After passing through the dialysate introduction line La to the dialyzer 3, it is sent to the drainage means through the dialysate discharge line Lb.

  One end of the priming fluid supply line Ld is connected to the connection portion J at a predetermined position between the dual pump 10 and the dialyzer 3 in the dialysate introduction line La, and the other end is a blood pump in the arterial blood circuit 1. 4 and the artery side bubble detection means 6 are connected to a predetermined position. The priming liquid supply line Ld is provided with an electromagnetic valve V4 (first valve means) that can close or open the flow path at an arbitrary timing. By opening the electromagnetic valve V4, dialysis is performed. The dialysis fluid (priming fluid) in the fluid introduction line La can be supplied to the arterial blood circuit 1.

  On the other hand, an arterial side bubble detecting means 6 capable of detecting bubbles in the liquid flowing through the site is disposed on the distal end side of the arterial blood circuit 1, and on the distal side of the venous blood circuit 2, A venous-side bubble detection means 7 capable of detecting bubbles in the liquid flowing through the part is provided. In the figure, reference numerals 8 and 9 denote blood discriminators disposed on the distal end side of the arterial blood circuit 1 and the distal end side of the venous blood circuit 2, respectively.

  In the venous blood circuit 2 in the present embodiment, venous pressure measuring means P capable of measuring venous pressure is formed. This venous pressure measuring means P is formed at a position between the dialyzer 3 and the air trap chamber 5 in the venous blood circuit 2, and by measuring the fluid pressure of the blood flowing through the venous blood circuit 2, The venous pressure of the patient undergoing purification treatment can be measured over time.

  The venous pressure measuring means P according to the present embodiment includes, for example, a chamber connected to the venous blood circuit 2 and a sensor that can measure the fluid pressure in the chamber. The chamber portion is filled with a priming solution before blood purification treatment and with blood during blood purification treatment, so that an air layer is not formed. Accordingly, the fluid pressure of the fluid (blood) flowing through the vein pressure measuring means P is directly measured by a sensor, and the vein pressure of the patient during blood purification treatment can be monitored over time.

  Specifically, the venous pressure measuring means P according to this embodiment has a chamber part m1 connected to the venous blood circuit 2, as shown in FIG. 4A, and a liquid is contained in the chamber part m1. A film m2 that does not permeate is formed, and a liquid phase Q1 that can be filled with a liquid and a gas phase Q2 that can be filled with air can be formed in the chamber portion m1. Furthermore, an air release line Lf is extended from the gas phase Q2 side, and a level adjusting pump 17 composed of an iron pump similar to the blood pump 4 is attached to the air release line Lf. Then, as shown in FIG. 5B, the liquid level in the chamber m1 can be adjusted by driving the level adjusting pump 17 to discharge the air in the gas phase Q2 to the outside (this book). In the embodiment, all the air in the chamber part m1 is not discharged to form an air layer).

  The electromagnetic valves V1 to V4 are capable of closing and opening the flow paths in the respective portions provided by the opening / closing operation as described above, and the opening / closing operation is performed by the control means E configured by a microcomputer or the like. To be controlled. In particular, the control means E in the present embodiment can receive a detection signal from the venous-side bubble detection means 7 and can control the blood pump 4 and each of the electromagnetic valves V1 to V4, and is electrically connected to these components. Has been.

  Here, the control means E according to this embodiment is configured such that the solenoid valve V4 (first valve means) and the solenoid valve V3 (first valve means) with the blood pump 4 stopped during priming before dialysis treatment (before blood purification treatment). The two-valve means) are opened to supply the priming liquid from the priming liquid supply line Ld to the air trap chamber 5 and discharge it from the overflow line Le, and the solenoid valve V4 (first valve means) and the solenoid valve V3. The blood pump 4 is reversely driven while the (second valve means) is closed, thereby sequentially performing a liquid feeding step for causing the priming liquid supplied in the overflow step to flow in the blood circuit. And the overflow process and the liquid feeding process are repeated until the air trap chamber 5 is filled with the priming liquid, It is adapted to perform the bubble removal process.

  In the air bubble removal process, an outlet side flow path D (part of the venous blood circuit 2 between the dialyzer 3 (blood purification means) and the air trap chamber 5 in the venous blood circuit 2 constitutes a blood guide of the dialyzer 3. When there is liquid in the flow path made of a flexible tube connecting the outlet 3b and the air trap chamber 5, the solenoid valve V4 (first valve means) and the solenoid valve V3 (second valve means) are opened. Then, the blood pump 4 is driven to rotate in the forward direction, whereby the flow path from the connection portion J of the priming fluid supply line Ld to the tip of the arterial blood circuit 1 and the flow from the connection portion J of the priming fluid supply line to the dialyzer 3 In this step, the priming liquid is supplied to both the passage and the bubbles contained in the liquid in the outlet side passage D can be discharged from the overflow line Le.

Hereinafter, the control content by the control means E according to the present embodiment will be described based on the flowchart of FIG.
In priming before blood purification treatment, as shown in FIGS. 5 and 6, the blood introduction port 3a of the dialyzer 3 is faced upward (fixed by a fixing means not shown), and the connector c and the connector d are connected. Then, after making the flow paths communicate with each other, the priming process (the overflow process S1 and the liquid feeding process S2) is performed. The priming process is a process of discharging the priming liquid supplied from the priming liquid supply line Ld from the overflow line Le (discharge section) and filling the flow path of the blood circuit. In the present embodiment, the overflow process S1 is performed. (FIG. 5) and liquid feeding process S2 (FIG. 6) are performed repeatedly.

  As shown in FIG. 5, in the overflow step S1, the priming solution (dialysis solution) supplied from the priming solution supply line Ld is opened by opening the solenoid valves (V1 to V4) while stopping the blood pump 4. In this step, the priming liquid that has flowed to the air trap chamber 5 and overflowed the air trap chamber 5 is discharged to the outside through the overflow line Le. As a result, the priming fluid (dialysis fluid) supplied through the priming fluid supply line Ld is connected to the priming fluid supply line Ld in the arterial blood circuit 1 from the connection portion J with the distal end portion and the vein side. The flow path to the air trap chamber 5 and the air trap chamber 5 are filled through the connection portion with the distal end portion of the blood circuit 2.

  And if predetermined time passes after overflow process S1 is started, liquid feeding process S2 will be performed. In the liquid feeding step S2, as shown in FIG. 6, the solenoid valves (V1, V2) are opened while the blood pump 4 is driven to rotate in the reverse direction (rotation drive in the β direction in FIG. 6), and the solenoid valve (V3 , V4) are closed to send (circulate) the priming solution (dialysate) filled in the overflow step S1 in the blood circuit. As a result, the priming liquid flows from the lower side to the upper side of the blood flow path in the dialyzer 3, and the bubbles smoothly move upward to be removed.

  After the liquid feeding step S2 as described above, an overflow step S3 (second overflow step S3) similar to the overflow step S1 is performed again, and as shown in FIG. 5, the solenoid valve (V1 ˜V4) is opened, the priming solution (dialysis solution) supplied from the priming solution supply line Ld is caused to flow to the air trap chamber 5, and the priming solution overflowed from the air trap chamber 5 is passed through the overflow line Le. Through the outside.

  Then, after the second overflow step S3 is performed, the bubble removal step S4 is performed. The bubble removal step S4 is performed when there is liquid in the outlet side flow path D in the venous blood circuit 2 (that is, between the second and subsequent overflow steps S3 and the liquid feeding step S5 in the present embodiment). As shown in FIG. 7, the solenoid valves (V1, V2) are opened and the solenoid valves (V4, V3) are opened while the blood pump 4 is driven to rotate in the forward direction (rotation drive in the direction α in FIG. 7). By opening the (first valve means and second valve means) (open state), the flow path from the connection portion J of the priming fluid supply line Ld toward the distal end of the arterial blood circuit 1, and the priming The priming liquid is supplied to both the flow path from the connection portion J of the liquid supply line Ld to the dialyzer 3, the bubbles contained in the liquid in the outlet side flow path D are moved to the air trap chamber 5, and the overflow line So that the can is discharged from e.

  Thus, in the bubble removal step S4, the priming fluid is supplied from the connection portion J of the priming fluid supply line Ld to the flow path toward the dialyzer 3, and at the same time from the connection portion J to the distal end of the arterial blood circuit 1. Since the priming liquid is supplied to the flow path to which the air flows, the bubbles in the outlet-side flow path D flow into the air trap chamber 5 and then flow to the distal end side of the venous blood circuit 2 without being discharged from the overflow line Le. Can be prevented, and the bubbles in the outlet-side channel D can be more reliably discharged to the outside. Further, in the present embodiment, the blood pump 4 is driven to rotate forward so that the priming liquid directed to the dialyzer 3 has a flow rate equal to or less than the capacity of the outlet side flow path D.

  After the bubble removal step S4, the same liquid feeding step S5 as the liquid feeding step S2 (second liquid feeding step S5) is performed again, and as shown in FIG. The priming solution (dialysis solution) filled in the overflow step S3 by opening the solenoid valves (V1, V2) and closing the solenoid valves (V3, V4) while being rotated in the β direction. Is sent (circulated) in the blood circuit.

  After the second liquid feeding step S5 as described above, it is determined whether or not the venous-side bubble detection means 7 has detected a bubble (S6). If it is determined that the bubble detection has been detected, the overflow step S3 (third time) An overflow step S3) will be performed. Then, after the overflow process S3 is performed for a predetermined time, the bubble removal process S4 and the liquid feeding process S5 are performed, and it is determined again whether or not there is a bubble detection in S6. Thus, the priming solution is filled in the blood circuit and the air trap chamber 5 by repeatedly performing the overflow step S3, the bubble removal step S4, and the liquid feeding step S5 until the bubble detection by the vein-side bubble detection means 7 is eliminated. It becomes.

  When it is determined in S6 that there is no bubble detection by the venous-side bubble detection means 7 and the priming process (overflow process S3, bubble removal process S4 and liquid feeding process S5) is completed, the arterial blood circuit 1 and the venous blood are circulated. The flow path of the circuit 2 and the blood flow path of the dialyzer 3 are filled with the priming liquid (filled state), and the air trap chamber 5 and the chamber portion of the venous pressure measuring means P are also filled with the priming liquid. In this state, the air layer is not formed.

  According to this embodiment, at the time of priming, the overflow process (S1, S3) and the liquid feeding process (S2, S5) are sequentially performed, and the overflow process is performed until the blood circuit and the air trap chamber 5 are filled with the priming liquid. When S3 and the liquid feeding step S5 are repeatedly performed and there is liquid in the outlet-side flow path D between the dialyzer 3 and the air trap chamber 5 in the venous blood circuit 2, the electromagnetic valve V4 and the electromagnetic valve V3 (first valve) By opening the blood pump 4 in a forward rotation state with the valve means and the second valve means open, and a flow path from the connection portion J of the priming fluid supply line Ld toward the tip of the arterial blood circuit 1, and the priming The priming liquid is supplied to both the flow path from the connection portion J of the liquid supply line Ld to the dialyzer 3 and is contained in the liquid in the outlet-side flow path D. Since causes the debubbling step S4, the bubble can was discharged from the overflow line Le to be, it is possible to prevent the priming, air bubbles dialyzer 3 from being flowed more reliably.

  Further, in the bubble removal step S4 according to the present embodiment, the blood pump 4 is driven to rotate forward so that the priming liquid directed to the dialyzer 3 has a flow rate equal to or lower than the capacity of the outlet-side flow path D. The bubbles contained in the liquid in the outlet side flow path D can be discharged from the overflow line Le. The blood pump 4 may be driven to rotate forward so that the priming liquid toward the dialyzer 3 has a flow rate equal to or greater than the capacity of the outlet side flow path D.

  Furthermore, since the bubble removal step S4 according to the present embodiment is performed between the second and subsequent overflow steps S3 and the liquid feeding step S5, the bubble removal step S4 is performed in a state where there is no liquid in the outlet side flow path D. It is possible to avoid breakage, and it is possible to prevent a useless bubble removal process from being performed. Note that the bubble removal step may be performed between the first overflow step S1 and the liquid feeding step S2, or the bubble removal step S4 is performed between the fourth overflow step S3 and the liquid feeding step S5. You may make it perform.

Next, a second embodiment according to the present invention will be described.
As in the first embodiment, the blood purification apparatus according to the present embodiment includes a dialysis apparatus for performing dialysis treatment. As illustrated in FIG. 1, the blood includes an arterial blood circuit 1 and a venous blood circuit 2. The circuit is connected to the proximal end of the arterial blood circuit 1 and the proximal end of the venous blood circuit 2, and is connected to the dialyzer 3 (blood purification means) for purifying blood flowing through the blood circuit, and to the venous blood circuit 2. A priming fluid supply line Ld connected to the air trap chamber 5 and the arterial blood circuit 1 and capable of supplying a priming fluid into the blood circuit, and a priming fluid supplied into the blood circuit through the priming fluid supply line Ld An overflow line Le (discharge portion) that can be discharged to the inside, a solenoid valve V4 as a first valve means that can arbitrarily close or open the priming liquid supply line Ld, an overflow An electromagnetic valve V3 of the line Le as optionally closed or openable second valve means is mainly composed blood pump 4 and the solenoid valve (V1-V4) or the like and a controllable control means E. Note that the same components as those in the first embodiment are denoted by the same reference numerals, and detailed description thereof is omitted.

  As in the first embodiment, the control means E according to this embodiment is configured such that the solenoid valve V4 (first valve means) and the blood pump 4 are stopped during priming before dialysis treatment (before blood purification treatment). By opening the electromagnetic valve V3 (second valve means), an overflow step of supplying the priming liquid from the priming liquid supply line Ld to the air trap chamber 5 and discharging it from the overflow line Le; and the electromagnetic valve V4 (first valve means) ) And the liquid feeding step for causing the priming solution supplied in the overflow step to flow in the blood circuit by driving the blood pump 4 in the reverse rotation state with the electromagnetic valve V3 (second valve means) closed. The overflow process and the liquid feeding process are repeated until the blood circuit and the air trap chamber 5 are filled with the priming liquid. Rutotomoni, so as to perform the bubble purging process.

  In addition, as in the first embodiment, the bubble removal step is performed by using the outlet side flow path D (one of the venous side blood circuit 2) between the dialyzer 3 (blood purification means) and the air trap chamber 5 in the venous side blood circuit 2. When there is liquid in the flow path comprising a flexible tube connecting the blood outlet 3b of the dialyzer 3 and the air trap chamber 5), the electromagnetic valve V4 (first valve means) and the electromagnetic valve V3 ( When the blood pump 4 is driven to rotate forward with the second valve means) open, the flow path from the connecting portion J of the priming fluid supply line Ld toward the tip of the arterial blood circuit 1 and the priming fluid supply line The priming liquid is supplied to both the flow path from the connecting portion J to the dialyzer 3, and the bubbles contained in the liquid in the outlet-side flow path D can be discharged from the overflow line Le.

  Here, in the dialyzer 3 (blood purification means) according to the present embodiment, the purification membrane (in this embodiment, the hollow fiber membrane) is preliminarily filled with the filling liquid, and the filling liquid is discharged together with the priming liquid at the time of priming. It is comprised so that. That is, a so-called wet type blood purification means is used. Then, on the premise that such a dialyzer 3 prefilled with the filling liquid is used, the blood pump 4 is driven to rotate forward to flow the filling liquid into the air trap chamber 5 before the first overflow step. The flow process is performed.

Hereinafter, the control content by the control means E according to the present embodiment will be described based on the flowchart of FIG.
In the priming before the blood purification treatment, as shown in FIG. 9, the blood inlet 3a of the dialyzer 3 is faced upward (fixed by a fixing means not shown), and the connector c and the connector d are connected. After the mutual flow paths are communicated, the flow process S1 according to the present embodiment is performed before the first overflow process S2.

  The flow step S1 is a step of causing the blood pump 4 to rotate forward to cause the filling liquid to flow into the air trap chamber 5. As shown in FIG. 9, the blood pump 4 is driven to rotate forward (direction α in FIG. 9). The electromagnetic valve V1 is closed, the electromagnetic valve V2 is opened, the electromagnetic valve V3 (second valve means) is closed, and the electromagnetic valve V4 (first valve means) is opened. Thus, the filling liquid in the dialyzer 3 and the filling liquid reaching the outlet-side flow path D from the dialyzer 3 due to its own weight are caused to flow into the air trap chamber 5.

  After the flow step S1 is performed, the same priming steps (overflow step S2, bubble removal step S3 and liquid feeding step S4) as in the first embodiment are performed. These overflow step S2 (see FIG. 5), bubble removal step S3 (see FIG. 7) and liquid feeding step S4 (see FIG. 6) are the same steps as in the first embodiment. Thus, the priming solution is filled into the blood circuit and the air trap chamber 5 by repeatedly performing the overflow step S2, the bubble removal step S3, and the liquid feeding step S4 until the bubble detection by the vein-side bubble detection means 7 is eliminated. It will be.

  Then, when it is determined in S5 that there is no bubble detection by the venous-side bubble detection means 7, and the priming steps (overflow step S2, bubble removal step S3 and liquid feeding step S4) are completed, the arterial blood circuit 1 and venous blood The flow path of the circuit 2 and the blood flow path of the dialyzer 3 are filled with the priming liquid (filled state), and the air trap chamber 5 and the chamber portion of the venous pressure measuring means P are also filled with the priming liquid. In this state, the air layer is not formed.

  According to the present embodiment, as in the first embodiment, during the priming, the overflow process S2 and the liquid feeding process S4 are sequentially performed, and the overflow process is performed until the blood circuit and the air trap chamber 5 are filled with the priming liquid. When S2 and the liquid feeding step S4 are repeatedly performed and there is liquid in the outlet-side flow path D between the dialyzer 3 and the air trap chamber 5 in the venous blood circuit 2, the electromagnetic valve V4 and the electromagnetic valve V3 (first valve) By opening the blood pump 4 in a forward rotation state with the valve means and the second valve means open, and a flow path from the connection portion J of the priming fluid supply line Ld toward the tip of the arterial blood circuit 1, and the priming The priming liquid is supplied to both the flow path from the connection portion J of the liquid supply line Ld to the dialyzer 3, and the liquid in the outlet-side flow path D is supplied. Since causes the debubbling step S4, may the Murrell bubble is discharged from the overflow line Le, it is possible to prevent the priming, air bubbles dialyzer 3 from being flowed more reliably.

  In particular, according to the present embodiment, when a dialyzer (blood purification means) that has been filled with a filling liquid in advance is used, before the first overflow step S2, the blood pump 4 is driven to rotate in the forward direction to air the filling liquid. Since the flow step S1 for flowing into the trap chamber 5 is performed, even if bubbles are contained in the filling liquid of the dialyzer, the bubbles are caused to flow into the air trap chamber 5 and discharged from the overflow line Le in the overflow step S2. Can do.

  Although the present embodiment has been described above, the present invention is not limited to this, and another process for removing bubbles in priming may be performed. Further, the priming liquid supply line Ld according to the present embodiment has one end connected to the dialysate introduction line La, and opens the electromagnetic valve V4 (first valve means) as a priming liquid for the blood circuit. For example, one end of a priming solution supply line Ld is connected to a storage bag containing a physiological saline solution, and a physiological saline solution as a priming solution is supplied to the blood circuit. It may be a thing.

  In addition, it is good also as what uses other liquids different from a dialysate and a physiological saline as a priming liquid. In this embodiment, the present invention is applied to a dialysis apparatus used at the time of dialysis treatment, but is used in other apparatuses 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.

  When there is liquid in the outlet side flow path between the blood purification means and the air trap chamber in the venous blood circuit, the blood pump is driven to rotate in the forward direction with the first valve means and the second valve means opened. The priming liquid is supplied to both the flow path from the connection part of the priming liquid supply line to the tip of the arterial blood circuit and the flow path from the connection part of the priming liquid supply line to the blood purification means, The blood purification apparatus and the priming method thereof can be applied to other forms and uses as long as the blood purification apparatus and the priming method thereof perform a bubble removal process capable of discharging bubbles contained in the liquid in the passage from the overflow line.

1 Arterial blood circuit 2 Venous blood circuit 3 Dialyzer (blood purification means)
DESCRIPTION OF SYMBOLS 4 Blood pump 5 Air trap chamber 6 Arterial side bubble detection means 7 Venous side bubble detection means 8, 9 Blood discriminator 10 Duplex pump 11 Dewatering pump 12 Stator 12a Mounting recess 13 Rotor 14 Roller
15 Guide pin 16 Grasping part 17 Level adjusting pump P Venous pressure measuring means H Corrosion tube E Control means La Dialysate introduction line Lb Dialysate discharge line Lc Bypass line Ld Priming liquid supply line Le Overflow line Lf Atmospheric release line V3 No. 1 2 valve means V4 1st valve means J Connection part D Outlet side flow path

Claims (8)

A blood circuit having 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;
Blood purification means connected to the proximal end of the arterial blood circuit and the proximal end of the venous blood circuit and capable of purifying blood flowing through the blood circuit;
The arterial blood circuit is disposed in the arterial blood circuit, and can be fed from the tip of the arterial blood circuit toward the blood purification means by forward rotation, and from the blood purification means by the reverse rotation drive. A blood pump capable of feeding toward the tip of the circuit;
A priming fluid supply line connected to the arterial blood circuit and capable of supplying a priming fluid into the blood circuit;
First valve means capable of arbitrarily closing or opening the priming liquid supply line;
An air trap chamber connected to the venous blood circuit;
An overflow line extending from the air trap chamber and capable of discharging priming liquid overflowing the air trap chamber to the outside;
Second valve means capable of arbitrarily closing or opening the overflow line;
Control means capable of controlling the blood pump, the first valve means and the second valve means;
And the blood purification means is in a state in which the connecting portion with the arterial blood circuit is directed upward and the connecting portion with the venous blood circuit is directed downward, and the arterial blood circuit A blood purification device in which priming is performed in a state in which the distal end and the distal end of the venous blood circuit are connected to communicate with each other,
During priming, the control means
An overflow step of supplying priming liquid from the priming liquid supply line to the air trap chamber and discharging it from the overflow line by opening the first valve means and the second valve means in a state where the blood pump is stopped. When,
A liquid feeding step for causing the priming liquid supplied in the overflow step to flow in the blood circuit by driving the blood pump in a reverse rotation state in a state where the first valve means and the second valve means are closed;
The overflow process and the liquid feeding process are repeated until the blood circuit and the air trap chamber are filled with the priming liquid, and the blood purification means and the air trap chamber in the venous blood circuit are When there is liquid in the outlet side flow path, the blood pump is driven to rotate in the forward direction with the first valve means and the second valve means opened, so that the arterial side is connected to the priming liquid supply line. Priming liquid is supplied to both the flow path toward the tip of the blood circuit and the flow path from the connection portion of the priming liquid supply line to the blood purification means, and the bubbles contained in the liquid in the outlet-side flow path are A blood purification apparatus characterized by performing a bubble removal step that can be discharged from an overflow line.   2. The blood purification apparatus according to claim 1, wherein in the air bubble removing step, the blood pump is driven to rotate forward so that a priming liquid directed to the blood purification means has a flow rate equal to or less than a capacity of the outlet-side flow path. .   The blood purification apparatus according to claim 1 or 2, wherein the bubble removal step is performed between the overflow step and the liquid feeding step after the second time.   In the case where a pre-filled filling liquid is used as the blood purification means, the control means causes the blood pump to flow forward into the air trap chamber by driving the blood pump forward before the first overflow step. The blood purification apparatus according to any one of claims 1 to 3, wherein a flow process is performed. A blood circuit having 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;
Blood purification means connected to the proximal end of the arterial blood circuit and the proximal end of the venous blood circuit and capable of purifying blood flowing through the blood circuit;
The arterial blood circuit is disposed in the arterial blood circuit, and can be fed from the tip of the arterial blood circuit toward the blood purification means by forward rotation, and from the blood purification means by the reverse rotation drive. A blood pump capable of feeding toward the tip of the circuit;
A priming fluid supply line connected to the arterial blood circuit and capable of supplying a priming fluid into the blood circuit;
First valve means capable of arbitrarily closing or opening the priming liquid supply line;
An air trap chamber connected to the venous blood circuit;
An overflow line extending from the air trap chamber and capable of discharging priming liquid overflowing the air trap chamber to the outside;
Second valve means capable of arbitrarily closing or opening the overflow line;
And the blood purification means is in a state in which the connecting portion with the arterial blood circuit is directed upward and the connecting portion with the venous blood circuit is directed downward, and the arterial blood circuit A priming method by a blood purification apparatus in which priming is performed in a state in which the distal end and the distal end of the venous blood circuit are connected to communicate with each other,
An overflow step of supplying priming liquid from the priming liquid supply line to the air trap chamber and discharging it from the overflow line by opening the first valve means and the second valve means in a state where the blood pump is stopped. When,
A liquid feeding step for causing the priming liquid supplied in the overflow step to flow in the blood circuit by driving the blood pump in a reverse rotation state in a state where the first valve means and the second valve means are closed;
The overflow process and the liquid feeding process are repeated until the blood circuit and the air trap chamber are filled with the priming liquid, and the blood purification means and the air trap chamber in the venous blood circuit are When there is liquid in the outlet side flow path, the blood pump is driven to rotate in the forward direction with the first valve means and the second valve means opened, so that the arterial side is connected to the priming liquid supply line. Priming liquid is supplied to both the flow path toward the tip of the blood circuit and the flow path from the connection portion of the priming liquid supply line to the blood purification means, and the bubbles contained in the liquid in the outlet-side flow path are A priming method using a blood purification device characterized by performing a bubble removal process that can be discharged from an overflow line .   6. The blood purification apparatus according to claim 5, wherein, in the bubble removal step, the blood pump is driven to rotate forward so that a priming solution directed to the blood purification means has a flow rate equal to or less than a capacity of the outlet side flow path. Priming method by.   The priming method by the blood purification apparatus according to claim 5 or 6, wherein the bubble removing step is performed between the overflow step and the liquid feeding step after the second time.   In the case of using a pre-filled filling liquid as the blood purification means, before the first overflow process, a flow process is performed in which the blood pump is driven to rotate forward to flow the filling liquid into the air trap chamber. The priming method by the blood purification apparatus as described in any one of Claims 5-7 characterized by the above-mentioned.

Images