JPH0514591B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION (Field of Industrial Application) The present invention relates to a device for controlling the amount of water removed in hemodialysis, and is used to save labor in hemodialysis.

(Prior art) Hemodialysis, which is performed using an artificial kidney device (dialysis device), is used to purify blood by eliminating waste products from the body or taking in what is needed instead of the kidneys when the human body suffers from kidney failure. It is widely used to carry out. The main function of the kidneys is to produce urine, and most of this urine is water, so in hemodialysis it is important to remove water from the blood, so-called water removal. It becomes a challenge. Water in the body moves into the blood via intracellular, intercellular, and blood vessels in this order, and it is necessary to remove water at a rate commensurate with this transfer rate.

FIG. 8 shows an example of a conventional dialysis device, which uses a positive pressure method. In Figure 8, cannulae 1a and 1 are inserted into the blood vessels of the limbs of body A.
Puncture b and use it as an entrance for extracorporeal circulation of blood. The blood pump 2 supplies a constant flow of blood flowing out from the cannula 1a to the dialyzer 3, and the constrictor 4 creates a stenosis in the tube 5 to generate positive blood pressure in the dialyzer 3. Air chamber 6 is installed at the blood inlet and outlet of the dialyzer.
a, 6b and pressure gauges 7a, 7b are provided as a guide for knowing the ultrafiltration pressure. A supply path 8a and a discharge path 8b are connected to the dialyzer 3, and a separately prepared dialysate is supplied thereto. To perform hemodialysis using this conventional dialysis device, after rotating the blood pump 2,
Squeeze the diaphragm 4 to generate positive pressure, and the pressure gauges 7a,
Check 7b and adjust the ultrafiltration pressure to an appropriate level.

Recently, however, dialysis membranes used in dialyzers have been improved, and the membrane thickness has become extremely thin, and at the same time, the filtration pores on the membrane surface have become larger, improving the efficiency of removing medium to large molecular weight wastes. This also greatly improves the ultrafiltration coefficient (UFR), which can cause water removal during dialysis to occur too quickly, which can cause patients to experience a drop in blood pressure. As a countermeasure in this case, or as a temporary stop operation during normal operation, the following operation is performed to stop water removal. That is,
In the positive pressure method, the restriction of the aforementioned restrictor 4 in the blood circuit is released, and in the negative pressure method, the negative pressure of the dialysate is reduced to near zero.

Now, the blood that comes out of the dialyzer returns to the patient's venous blood vessels, but in many patients, there is a complex intertwining of factors such as changes in the shunt of the blood vessel, deformation due to long-term puncture of the cannula, and lesions due to the underlying disease.
There are various problems in the vascular lumen, which increases venous vascular resistance, and when dialyzed blood returns to the venous blood vessel, a resistance force proportional to the amount of blood returned (generally called natural venous pressure) is applied. It is supposed to occur in venous blood vessels. Therefore, even when the above-mentioned operation to stop water removal is performed, this natural venous pressure is applied to the dialyzer as residual pressure, and in reality, a considerable amount of water is removed. For example, 150-200
Blood volume in ml/min (extracorporeally circulating blood volume during normal dialysis)
30-120mmHg depending on the patient, rarely 200mmHg
A natural venous pressure of more than g occurs and an effective UFR of 4
When using a dialysis machine with ml/mmHg/hr,
120-480ml/hr of body fluid is excessively removed.

In this way, in the conventional system, a considerable amount of water is being removed even when water removal is stopped, so the nurse must replenish the patient with replacement fluid commensurate with the amount of water removed while water removal is stopped. This work requires a great deal of effort, such as being busy with frequent blood pressure measurements, and most of this work relies on experience and knowledge, making it difficult to ensure the safety of patients undergoing dialysis. The current situation is that there are still problems with sexuality.

(Problem to be solved by the invention) Even when the above-mentioned operation to stop water removal is performed, a considerable amount of water is still removed because natural venous pressure is generated in the venous blood vessels. and
Therefore, the present invention applies a pressure that cancels out the water removal effect mainly due to natural venous pressure, and controls this pressure in advance, thereby eliminating the need for extra work during the water removal stop operation and making it safer. The purpose is to enable you to enhance your sexuality.

(Means for Solving the Problems) In order to solve the above problems, the present invention provides a pressure device 10 on the downstream side of the dialyzer 3 in the dialysate circuit 9.
and a control device 21 for controlling the pressurizing device 10, and a pressurizing device 12 and a control device 22 for controlling the pressurizing device 12 on the downstream side of the dialyzer 3 in the blood circuit 11. Concerning the control device.

In this embodiment, a configuration is adopted in which the dialysate circuit side control device 21 and the blood circuit side control device 22 are arranged in close proximity to each other.

(Function) On the dialysate circuit 9 side, the dialysate is supplied to the dialyzer 3 from the supply path 7 by the pump P, and the dialysate in the dialyzer 3 is passed from the discharger 8 to the pressurizing device 10. On the other hand, on the blood circuit 11 side, the blood flowing out from the human body A is sent to the dialyzer 3 by the blood pump 2, and the blood that has been water-removed (dialyzed) here is passed through the pressurizing device. Blood is returned to the human body A via the blood circuit 12, but in this case, in order to remove a relatively large amount of water in general, the pressurizing device 12 on the blood circuit side must be connected to the patient by operating the control device 22. In addition to applying a pressure higher than the natural venous pressure, the pressurizing device 10 on the dialysate circuit side may be brought to zero pressure, ie, in an open state, by operating the control device 21.

Through the above operations, the blood circuit side becomes positive pressure in the dialyzer 3, and water is removed in proportion to the magnitude of the positive pressure, in other words, the differential pressure applied between the inside and outside of the dialysis membrane in the dialyzer 3. Become.

Next, a case in which water is removed within the range of natural venous pressure will be described.

For example, if the natural venous pressure is 140 mmHg, 140 mm
By adjusting the pressure so that a pressure lower than Hg, for example, a differential pressure of 110 mmHg, is applied to the dialysis membrane surface, the amount of water removed is within the amount of water removed by natural venous pressure, so as not to place an excessive burden on the patient. This is what I did.

This operation is performed by first operating the blood circuit side pressurizing device 12 using the control device 22 to increase the natural venous pressure (for example, 140 mm).
Hg) is adjusted so that it loads the blood circuit 11. Next, the dialysate circuit side pressure device 10 is connected to the control device 2.
1 to control and set a pressure of, for example, 30 mmHg to be applied to the membrane surface within the dialyzer. With this operation, the membrane surface of the dialyzer 3 has a natural venous pressure (140 mmH).
g) - Dialysate pressure (30mmHg) = A differential pressure of 110mmHg is applied, and the effective UFR of this dialysis membrane is 4ml/mmH
In the case of g/hr, it can be seen from the graph in Figure 4 that the amount of water removed is 440 ml/hr, which is lower than the amount of water removed (560 ml/hr) due to natural venous pressure (140 mmHg).

Furthermore, the case where water removal is stopped will be explained. In this operation, first, the blood circuit side pressurizing device 12 is set by operating the control device 22 so that the pressurizing force on the blood circuit 11 becomes zero. In this state, the dialyzer 3 is loaded with natural venous pressure (for example, 140 mmHg). Next, the dialysate circuit side pressure device 10
By operating the control device 21, the dialysate pressure in the dialysate circuit 9 before passing through the pressurizing device 10 is adjusted to natural venous pressure, for example, 140 mmHg.
By this operation, no differential pressure is applied to the membrane surface inside the dialyzer 3, and therefore water removal is not performed and the water removal is stopped.

As described above, in the present invention, the pressurizing device 10 provided downstream of the dialyzer 3 in the dialysate circuit 9, the control device 21 that controls the pressurizing device 10, and the downstream side of the dialyzer 3 in the blood circuit 11 are provided. By means of the pressurizing device 12 provided in the pressurizing device 12 and the control device 22 that controls the pressurizing device 12, the amount of water removed can be freely controlled without being influenced by natural venous pressure as described above.

(Example) Hereinafter, the present invention will be explained with reference to the drawings.

FIG. 1 shows an embodiment of a positive pressure method of a dialysis machine using the control device of the present invention. In the figure, 1a and 1b are cannulae, 2 is a blood pump, 3 is a dialyzer, 4 is a tube, 5a and 5b are air chambers, and 6a and 6b are pressure gauges.
Blood flowing out from the cannula 1a punctured in the human body A passes through the tube 4a, is sent into the dialyzer 3 from the tube 4b, and flows out from the tube 4c. The dialyzer 3 is connected to a dialysate supply path 7 and a dialysate discharge path 8 . The supply path 7 is provided with a pump P, and the downstream side of the dialyzer 3 in the discharge path 8, that is, the dialysate circuit 9, is provided with a pressurizing device 10, which will be described later, which is one of the essential parts of the present invention. There is. Therefore, the dialysate is supplied to the dialyzer 3 from the supply line 7 by the pump P.
The dialysate in the dialyzer 3 is discharged from a discharge path 8 via a pressurizing device 10 to a drainage tank or the like as indicated by an arrow. On the other hand, the blood that has flowed into the dialyzer 3 and has been dialyzed flows out from the tube 4c, that is, the blood circuit 1.
A pressurizing device 12, which is one of the essential parts of the present invention, is also provided on the downstream side of the dialyzer 3 in 1, and the blood passes through the tube 4d via this pressurizing device 12 and is delivered to the human body by the cannula 1b. Blood is now being returned to A.

Pressure device 10 or 12 used in this invention
Preferably, the structures shown in FIGS. 2a and 2b are preferred. That is, in the pressurizing devices 10 and 12, the inside of a sealed container 13 is divided by a diaphragm 13a into two chambers: a liquid chamber a through which dialysate or blood flows and an air chamber b through which pressurized air flows in and out. , the container 13 has an inlet 14a and an outlet 14b communicating with the liquid chamber a, and one connection port 15 communicating with the air chamber b.
is provided. The container 13 consists of a flat container member 13b and a curved container member 13c, and a diaphragm 13a having the same outer periphery is sandwiched between the brim portions of the container members 13b and 13c, and these are welded together and brought into close contact with each other. Then, diaphragm 13a
In the free state, the cylindrical member 13b extends substantially along the inner surface of the flat container member 13b. Container members 13b, 13c
is made of relatively hard polymeric material such as vinyl chloride, polycarbonate, or silicone rubber, and is integrally molded. Diaphragm 13a
have appropriate elasticity, and are made of the same material as the container members 13b and 13c to facilitate welding. It is convenient to make the container members 13b, 13c and the diaphragm 13a transparent so that the internal state can be monitored.

Referring also to FIG.
a, 17b, and a pressure gauge 19 via switching valves 18a, 18b provided in the tube 16.
It is also connected to a and 19b.

The switching valves 18a, 18b have openings a,
It is a three-way switching valve type having openings a, b, and c, respectively, as shown in the switching valve 18a connected to the pressurizing device 10 of the dialysate circuit 9 in FIG. When the pump 17a and the pressure gauge 19a are facing each other and in communication with each other (hereinafter referred to as the adjustment position), the air chamber b of the pressurizing device 10 is pressurized by manually operating the air pump 17a. to adjust the amount of deformation of the diaphragm 13a, and the measuring needle 20a of the pressure gauge 19a moves according to this adjusted pressure, and the adjusted pressure is transferred to the pressure gauge 1.
It can be read from 9a. When the desired regulation pressure value is set, the switching valve 18a is changed so that only the openings a and b face the air chamber b and the pressure gauge 19b, like the switching valve 18b connected to the pressurizing device 12 of the blood circuit 11. The communication state between the air chamber b and the pressure gauge 19b is maintained, but the communication state with the air pump 17b is cut off (hereinafter referred to as the set position).
For a and 17b, a syringe with the needle removed is used. As is clear from the above description, the pressure gauges 19a and 19b can be operated by air pressure, such as a Bourdon tube, bellows, or diaphragm pressure gauge. Convert to
The detection signal may be output by electrically comparing the electrically set value and the pressure signal value. Furthermore, the pressure gauges 19a and 19b are connected to the switching valve 18.
a, 18b, but it may be connected directly to the tubes 16, 16. In this case, the switching valves 18a, 18b
are air pumps 17a, 17b and tubes 16,1
6 may be used.

As is clear from the above explanation, air pump 1
7b, switching valve 18a, 18b pressure gauge 19a, 19
Control device 2 of each pressurizing device 10, 12 by b etc.
1 and 22.

In FIG. 3, the control device 21 of the dialysate circuit 9 and the control device 22 of the blood circuit 11 are arranged close to each other as one controller 23 and are compactly integrated. That is, each operating section 24a, 24b has an air pump 17 connected to the dialysate circuit side pressurizing device 10 and the blood circuit side pressurizing device 12, respectively.
a, 17b are detachably attached via tubes 25a, 25b, and each air pump 17
Measure the pressure value by a, 17b with measuring needles 20a, 20b.
Dial plates 26a and 26b are provided for reading the switching valves 18a and 18b, and the switching valves 18a and 18b are moved from the adjustment position (indicated as "ADJUST" in the drawing) to the setting position (also indicated as "SET"). Operation levers 27a and 27b are provided for switching. There has not yet been a dialysis machine in which the control and operation parts are all integrated in one place, and this greatly improves work efficiency.

Next, a method of using the dialysis apparatus configured as described above will be explained.

In FIG. 1, the case where a normal water removal action is performed will first be described. On the dialysate circuit side, the dialysate is supplied to the dialyzer 3 from the supply path 7 by the pump P, and the dialysate in the dialyzer 3 is discharged to the outside from the discharge path 8 via the pressurizing device 10. On the other hand, on the blood circuit side, blood flowing out from the human body A is sent to a dialyzer 3 by a blood pump 2, and the blood that has been water-removed (dialyzed) here is sent to a pressurizing device 1.
In this case, in order to remove a relatively large amount of water in general, a pressure higher than the patient's natural venous pressure is applied to the pressurizing device 12 on the blood circuit side. In addition, the pressurizing device 1 on the dialysate circuit side
0 may be set to zero pressure, that is, an open state. The specific operation is performed by holding the operation lever 27b on the blood circuit side in the "adjustment" position in the operation section 24b of the controller 23, and controlling the air pressure of the blood circuit side pressurizing device 12 through the switching valve 18b linked thereto. The chamber b, the air pump 17b, and the pressure gauge 19b are maintained in communication with each other, and in this state, the air chamber b is pressurized by the air pump 17b, and the pressure is set to a predetermined pressure value by the pressure gauge 19b. After reading the operation lever 27
b to the "set" position, blocking the passage to air pump 17b. Similarly, the pressure in the air chamber b of the pressurizing device 10 on the dialysate circuit side is read and set to zero using the pressure gauge 19a.

Through the above operations, the blood chamber a of the pressurizing device 12 is
(FIG. 2) is pressurized via the diaphragm 13a, so it passes through the blood chamber a while pushing back the diaphragm 13a by a pressure greater than this pressurizing force. The blood circuit side becomes positive pressure, and the magnitude of the positive pressure is
In other words, water is removed in proportion to the differential pressure applied between the inside and outside of the dialysis membrane in the dialyzer 3.

Next, a case in which water is removed within the range of natural venous pressure will be described. As mentioned in the prior art section, human body A is always loaded with natural venous pressure.
Even if an operation is performed to stop water removal (opening the throttle of the diaphragm 4 in FIG. 8), there is a problem in that in reality, a considerable amount of water is removed due to natural venous pressure. In order to overcome this difficulty, the present applicant previously proposed in Japanese Patent Application Laid-Open No. 61-203971, a pressurizing device was installed on the downstream side of the dialyzer in the circuit where the dialysate flows out from the dialyzer, that is, in the dialysate circuit. On the other hand, a pressurizing device is also provided in the circuit from which blood flows out from the dialyzer, that is, on the downstream side of the dialyzer in the blood circuit, and the pressure loaded on the blood circuit, for example, natural venous pressure, is detected by the blood circuit side pressurizing device. By automatically applying this detected pressure to the pressure device on the dialysate circuit side, no differential pressure is applied to the dialysis membrane in the dialyzer. We proposed an innovative device that prevents water removal even under load, but in some patients, water removal does not completely stop, or on the other hand, the pressure exceeds the natural venous pressure. In cases where it is not desirable to remove a large amount of water using positive pressure, it may be desirable to remove water within the range of natural venous pressure. In other words, in physically weakened patients, removing a large amount of water at once can cause a drop in blood pressure, which can cause discomfort such as vomiting, as well as limb spasms that can last for a long time if left untreated, and in the worst case, can lead to death from shock. On the other hand, if water removal is stopped for a long time, harmful substances will naturally remain in the body, putting a heavy burden on the circulatory system.

Figure 4 shows that the effective ultrafiltration coefficient (UFR) is 4.
Venous pressure generated on the dialysis membrane surface and ultrafiltration amount (water removal amount) when using a dialysis machine with ml/mmHg/hr
For example, if the natural venous pressure is 140 mmHg, an excessive amount of body fluid of 560 ml/hr will be removed.

Therefore, in the present invention, a pressure less than 140 mmHg,
For example, by adjusting the differential pressure of 110 mmHg to be applied to the dialysis membrane surface, the amount of water removed was within the amount of water removed by natural venous pressure, so as not to place an excessive burden on the patient. It is something.

In this operation, first, the pressure in the air chamber b of the blood circuit side pressurizing device 12 is set to zero while being read by the pressure gauge 19b. Therefore, in this state, the blood circuit 11 is loaded with natural venous pressure (for example, 140 mmHg). Next, the air chamber b of the dialysate circuit side pressurizing device 10 is pressurized using the operating section 24a of the control device 21, and the dialysate chamber a is pressurized.
(Figure 2) is controlled and set so that a pressure of, for example, 30 mmHg is applied to the membrane surface within the dialyzer. With this operation, the membrane surface of the dialyzer 3 has a difference between natural venous pressure (140mmHg) - dialysate pressure (30mmHg).
Hg) = 110 mmHg differential pressure is loaded and the effective UFR of this dialysis membrane is 4 ml/mmHg/hr, the fourth
From the graph in the figure, it can be seen that the amount of water removed is 440 ml/hr, which is lower than the amount of water removed (560 ml/hr) due to natural venous pressure (140 mmHg).

One of the features of the present invention is that water can be removed freely within this natural venous pressure range.

Furthermore, the case where water removal is stopped will be explained. In this operation, first, the control device 22 is set so that the pressurizing force in the air chamber b of the blood circuit side pressurizing device 12 becomes zero. In this state, the inside of the dialyzer 3 is burdened by natural venous pressure. Next, the dialysate chamber a is pressurized via the diaphragm 13a by pressurizing the air chamber b of the dialysate circuit side pressurizing device 10 using the operating section 24a of the control device 21 (FIG. 2). As a result, the dialysate pressure in the dialysate circuit 9 before passing through the pressurizing device 10 is adjusted and set to natural venous pressure, for example, 140 mmHg. By this operation, no differential pressure is applied to the membrane surface inside the dialyzer 3, and therefore water removal is not performed and the water removal is stopped.

As described above, in the present invention, by controlling the dialysate circuit side operating section 24a and the blood circuit side operating section 24b in various ways in the controller 23, it is possible to remove the natural venous pressure without being affected by it as described above. Although the amount of water can be controlled freely, other operating methods than those described above are also possible.
That is, of the dialysate circuit side pressurizing device 10 and the blood circuit side pressurizing device 12, the latter blood circuit side pressurizing device 12
The pressure is always set to be higher than the natural venous pressure. Therefore, in this state, when the pressure on the dialysate circuit pressurizing device 10 is zero, venous pressure, ie, positive pressure, is applied to the inside of the dialyzer 3, and a general water removal effect can be exerted. Next, in the case of water removal within the range of natural venous pressure, pressure P ₁ to blood circuit side pressurizer 12 - pressure P ₂ to dialysate side pressurizer 10 =
It is sufficient to pressurize the dialysate circuit side pressurizing device 10 so that the pressure is within the natural venous pressure range, and in addition, when water removal is stopped, only the dialysate circuit side operating section 24a is pressed so that P ₁ = P ₂ . All you have to do is operate.

The above explanation is about the configuration of a dialysis apparatus using the so-called positive pressure method, but the configuration and operation are the same in the negative pressure method described below.

Figure 5 shows a dialysis machine using the negative pressure method.
To mention only the differences with the positive pressure method, the suction pump 2
8 and the restrictor 29 to generate a negative pressure of the pressure indicated by the pressure gauge 30 on the dialysate circuit side, and the dialyzer 3 in this dialysate circuit 9
The above-mentioned pressurizing device 10 and a control device 21 for controlling and operating the pressurizing device 10 are provided on the downstream side of the pressurizing device 10. Note that the blood circuit 11 does not need to be provided with a pressurizing device as in the positive pressure method described above, or even if it is provided, it may be kept open at all times, or in any case, the blood circuit 11 is always loaded with natural venous pressure. That means you are doing it.

This operation using the negative pressure method is performed by adjusting and setting the operating section 24a of the control device 21 so that the pressurizing force applied to the pressurizing device 10 becomes zero. Depending on the pressure, a general water removal effect greater than that achieved by natural venous pressure can be achieved. In addition, when removing water within the range of natural venous pressure, it is sufficient to apply a pressure within the natural venous pressure to the pressurizing device 10, and when water removal is stopped, apply the same pressure as the natural venous pressure to the pressurizing device 10.
There is no difference from the positive pressure method in that all you have to do is perform a control operation on the operating section 24a to apply the pressure.

Figure 6 shows that the applicant has previously
This shows an example in which the present invention is applied to the intermittent dialysis method proposed as No. 103969. The configuration is basically the same as the positive pressure method shown in Figure 1, but the dialysate circuit has been significantly modified. Therefore, the difference is that the dialysate supply path 7 is provided with a supply on/off valve 31, and the dialysate discharge path 8 is provided with a metering flow path 8a and a washing flow path 8b. A metering on-off valve 32 is provided in the metering channel 8a, and a measuring device 33 for measuring the outflowing dialysate is attached to the tip thereof, and a washing on-off valve 34 is provided in the washing channel 8b. The discharge path 35 of the meter 33 merges with the cleaning flow path 8b and is connected to a drainage tank or the like.

In this embodiment, the blood circuit side pressure device 12 is provided on the downstream side of the dialyzer 3 in the blood circuit 11, which is the same as the above-mentioned positive pressure method, but the dialysate circuit side pressure device 10 is Of course, it is the same as the positive pressure method in that it is placed downstream of the dialyzer 3 in the circuit, but
More specifically, the pressure devices 10 and 12 are interposed in the metering flow path 8a, and the respective pressure devices 10 and 12 are connected to the control device 2.
1 and 22. The details of this intermittent dialysis method are explained in Japanese Patent Application Laid-Open No. 103969/1982, but in order to explain the operation and operation of this embodiment, its structure (function) will be briefly explained.
The supply opening/closing valve 31 is opened intermittently at a constant cycle, and the metering opening/closing valve 32 and the cleaning opening/closing valve 34 are respectively closed or opened approximately in synchronization with this. In other words, a relatively short period of /cycle time tc
At the same time as the supply opening/closing valve 31 is opened only in tw, the metering opening/closing valve 32 is closed and the washing opening/closing valve 34 is opened, and for the remaining relatively long time td, the respective operating states are reversed. Therefore, during time tw,
The dialysate flows into the dialyzer 3 by the pump P through the supply path 7 and the supply opening/closing valve 31, and the dialysate flows into the dialyzer 3 through the discharge path 8,
It is discharged through the cleaning channel 8b and the cleaning on/off valve 34. Further, during time td, the supply of dialysate to the dialyzer 3 is not performed, and the increased amount of dialysate as a result of water removal in the dialyzer 3 is supplied to the discharge path 8 and the metering flow path 8.
The water flows into the meter 33 through the metering valve 32 and the metering valve 32, and the amount of water removed is measured.

Here, if time tw is called a washing process and time td is called a steady process, in the washing process, the dialysate flows into the dialyzer 3 and the inside of the dialyzer 3 is washed. , in the steady process, the translucent device 3
The flow of dialysate to the dialyzer 3 is stopped and
Dialysis is performed inside the chamber, and the dialysate that has increased due to water removal flows into the meter 33. These cleaning steps and regular steps are repeated.

That is, in this intermittent dialysis method, the water removal action is carried out in the above-mentioned steady process. Therefore, in this embodiment, the above-mentioned pressure devices 10 and 12 are controlled by the control device 21, The control operation is performed at 22. This operation is the same as that in the positive pressure method described above, and when removing water at a level higher than the natural venous pressure, the control device 22 is operated to load the blood circuit side pressure device 12 with a pressure higher than the natural venous pressure. The pressurization is controlled in the section 24b, while the dialysate circuit side pressurizing device 10 is left open so that the pressurizing force becomes zero. In addition, when the water removal amount is to be within the natural venous pressure, the pressurizing force of the blood circuit side pressurizing device 12 is released to zero, and the pressure within the natural venous pressure is applied to the dialysate circuit side pressurizing device 10. When water removal is to be stopped, the pressurizing force of the blood circuit pressurizing device 12 is released, and the same pressure as the natural venous pressure is applied to the dialysate circuit pressurizing device 10.

In FIG. 7, in order to protect the above-mentioned pressurizing devices 10 and 12, they are housed in a cylindrical casing 36, and connecting ports 37a and 37b at both ends of the pressurizing devices 10 and 12 are connected to tubes 8 and 9. A quick adapter 38 is attached to facilitate attachment to and detachment from the dialyzer 3. Note that 39 is a tube connection port for introducing pressurized air into the air chambers b of the pressurizing devices 10 and 12.

(Effects) According to the present invention, it is possible to obtain the desired amount of water removal with a simple operation, and also to reliably stop water removal even if the natural venous pressure loads the dialyzer. It becomes possible to finely adjust the amount of water removed to be lower than the amount of water removed when the pressure is applied, and the burden on patients and nurses can be significantly reduced.

[Brief explanation of the drawing]

Fig. 1 is a schematic explanatory diagram of a dialysis machine using a positive pressure method according to an embodiment of the present invention, Fig. 2 is a longitudinal cross-sectional view of the main parts, Fig. 3 is an external view of the main parts, and Fig. 4 is , a graph showing the proportional relationship between the venous pressure and the ultrafiltration amount in a dialyzer, FIG. 5 is a schematic explanatory diagram of a dialysis device using a negative pressure method, which is another embodiment of the present invention
The figure is a schematic explanatory diagram of a dialysis apparatus using an intermittent dialysis method, which is another embodiment of the present invention, FIG. 7 is an external view of accessories for carrying out the present invention, and FIG. 8 is a schematic diagram of a conventional example. This is an explanation. 3... Dialyzer, 9... Dialysate circuit, 10... Dialysate circuit side pressure device, 11... Blood circuit, 12...
... Blood circuit side pressurizing device, 21... Dialysate side pressurizing device, 22... Blood circuit side pressurizing device.

Claims (1)

[Claims] 1. A pressurizing device and a control device for controlling the pressurizing device are provided downstream of the dialyzer in the dialysate circuit, and a pressurizing device and the pressurizing device are also provided downstream of the dialyzer in the blood circuit. A hemodialysis control device comprising a control device for controlling the device. 2. The hemodialysis control device according to claim 1, wherein the dialysis circuit side control device and the blood circuit side control device are arranged in close proximity to each other.