JPH0716294A - Dialyzing fluid changing device - Google Patents

Abstract

PURPOSE:To safely change a dialyzing fluid with a compact device, without any restriction due to a positional relationship with a patient. CONSTITUTION:A dialyzing fluid changing device 1A has dialyzing fluid bags 2a to 2e filled with a dialyzing fluid, a vessel 3 for temporarily storing the fluid, another vessel for temporarily storing the waste of the fluid, decompression and compression means 5 and 6 for keeping the atmosphere of both vessels 3 and 4 in decompressed and compressed state, waste fluid bags 7a to 7c for collecting the waste of the fluid, and a control means 30. The bags 2a to 2e and the vessel 3 are made to communicate with one another via the first fluid passage 31, and the passage 31 and a catheter placed in a patient's peritoneum are made to communicate with each other via the second flow passage 32. Also, the bags 7a to 7c and the vessel 4 are made to communicate with one another via the third flow passage 33. In addition, each of the passages 31 to 33 is provided with flow passage open/close means 35 to 39.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a dialysate exchange device used for peritoneal dialysis.

[0002]

2. Description of the Related Art In recent years, a treatment method using peritoneal dialysis is smaller and simpler in equipment and instruments than a dialysis method using an artificial kidney, the treatment cost is low, and it is possible to prevent peritoneal adhesion. Attention is paid to the reason that the burden on the patient is small.

Of these peritoneal dialysis methods, particularly continuous ambulatory peritoneal dialy
Sis (hereinafter, referred to as “CAPD”), which allows patients themselves to exchange the dialysate containers (bags) at home or at work, is easy to get back into the society and is receiving much attention.

In this CAPD, a catheter tube (peritoneal catheter) is placed in the abdominal cavity of a patient, a transfer tube is connected to the external end of the catheter tube, and a dialysate bag (injection bag) containing a dialysate therein.
Connect the bag tube of the above, inject the dialysate in the bag into the abdominal cavity through each tube, perform dialysis for a predetermined time, and then collect the dialysate drainage in the abdominal cavity into the drain bag through each tube. To do. The tubes are connected to each other aseptically by fitting male and female connectors mounted on the ends of both tubes.

In this CAPD, the dialysate is injected into the peritoneum by placing the dialysate bag at a position about 1 m higher than the patient's abdomen and transferring the dialysate from the dialysate bag into the peritoneum by the drop. is doing. Further, in collecting the dialysate drainage fluid from the peritoneum, the drainage bag is placed at a position about 1 m lower than the abdomen of the patient, and the dialysate is transferred from the peritoneal membrane to the drainage bag due to the drop.

However, injecting such a dialysate,
In the drainage method, for example, when the patient performs peritoneal dialysis while sleeping, the patient is put to a high position of about 70 to 100 cm from the floor using a bed, and a dialysate bag is set at a position about 1 m higher than the patient. Therefore, the height of the entire device is as large as about 2 m, which is difficult to handle and carry, and may cause the device to fall over by a sleeping patient or the like. Further, there is also a disadvantage that the sleeping position (height) of the patient cannot be freely selected in order to secure the necessary head for drainage.

Therefore, when collecting the drainage, there is known a method of collecting the drainage by sucking the dialysate in the peritoneum using a roller pump without transferring the drainage due to a drop. With this method, the roller pump rotates at a constant number of revolutions regardless of the amount of drainage, and the drainage is forcibly sucked,
When the remaining amount of drainage fluid in the peritoneum decreases, there is a possibility that the suction will be excessive and the inner wall of the peritoneum will be withdrawn, which is a safety problem.

[0008]

DISCLOSURE OF THE INVENTION An object of the present invention is to provide a dialysate exchange device capable of safely exchanging dialysate with a compact device without being restricted by the positional relationship with a patient. It is in.

[0009]

The above object is achieved by the present invention described in (1) below. Also, the following (2)-
It is preferably (11).

(1) At least one filled with dialysate
Dialysate container, at least one container capable of temporarily storing liquid, depressurizing / pressurizing means for bringing the atmosphere of the container into a depressurized state and a pressurized state, and at least one drainage solution for collecting dialysate A collection container, a first flow path having one end in communication with the dialysate container and the other end in communication with the container, and a first flow path having one end in communication with the container and the other end in a catheter placed in a patient. A second flow path communicating with the second flow path, a third flow path having one end communicating with the drainage recovery container and the other end communicating with the container, the first flow path, the second flow path, and the third flow path. Dialysis characterized by having flow path opening / closing means for opening / closing each of the flow paths, and control means for controlling opening / closing of each flow path by the flow path opening / closing means and operation of the pressure reducing / pressurizing means. Liquid exchange device.

(2) The dialysate according to the above (1), which has two containers, one of which temporarily stores the dialysate and the other of which temporarily stores the drainage of the dialysate. Exchange device.

(3) The dialysate exchange device according to the above (2), wherein the atmosphere of the two containers is brought into a depressurized state and a pressurized state by the same depressurizing / pressurizing means.

(4) The dialysate exchange device according to the above (2), wherein the atmospheres of the two containers are depressurized and pressurized by different depressurizing / pressurizing means.

(5) The dialysate exchange device according to any one of (1) to (4) above, wherein the container is in the form of a flexible bag.

(6) The depressurizing / pressurizing means has a depressurizing / pressurizing chamber for accommodating the container, and a supply / exhaust circuit for adjusting the pressure in the depressurizing / pressurizing chamber. The dialysate exchange device according to any one of (1) to (5).

(7) The first flow path, the second flow path and the third flow path are formed in a lumen of a flexible tube, and the flow path opening / closing means is a lumen of the tube. The dialysate exchange device according to any one of the above (1) to (6), which is capable of blocking the above.

(8) The dialysate exchange device according to any one of (1) to (7) above, which has a heating means for heating the dialysate.

(9) The dialysate exchange device according to (8), wherein the heating means heats the dialysate stored in the container.

(10) The dialysate exchange device according to any one of (1) to (9), which has a detection means for detecting the amount of liquid in the container.

(11) The dialysate exchange device according to (10), wherein the detection means is a weight detection means for detecting the weight of the container.

[0021]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS The dialysate exchange device of the present invention will be described in detail below with reference to the preferred embodiments shown in the accompanying drawings.

FIG. 1 is a front view schematically showing a configuration example of the dialysate exchange device of the present invention, and FIG. 2 is a circuit configuration diagram of the blood processing device shown in FIG. The dialysate exchange device 1A shown in these figures is a device for injecting dialysate into the peritoneum of a patient and collecting the drainage thereof when performing peritoneal dialysis, and a plurality of dialysate bags filled with dialysate. (Dialysate container) 2a, 2
b, 2c, 2d, 2e, a container 3 for temporarily storing dialysate, a container 4 for temporarily storing drainage of dialysate (hereinafter simply referred to as “drainage”), and both containers 3, 4 Depressurizing / pressurizing means 5 and 6 for respectively depressurizing and pressurizing the atmosphere, a plurality of drainage bags (dialysate recovery containers) 7a, 7b, 7c, and the bags and containers described above. 8 to 19 and connector 2 for connecting in a predetermined arrangement
0 and 21, the connection members 22 to 26, and flow path opening and closing means 35 to 3 that can open and close the flow paths formed in a predetermined tube.
9, a control unit 30, and an operation unit 44.

Dialysate bags 2a, 2b, 2c, 2d, 2
Each of e is formed by forming a resin sheet material such as soft polyvinyl chloride into a bag shape, to which a bag tube 8 communicating with the inside of the bag is connected. Each dialysate bag 2a, 2b, 2c, 2
d and 2e are hung on the hanger 29 with the side to which the bag tube 8 is connected facing downward.

The dialysate bags 2a, 2b, 2c and 2d are filled with dialysate of the same composition,
Inside the dialysate bag 2e are dialysate bags 2a, 2b, 2
A dialysate (final dialysate) having a composition or concentration different from the dialysate in c and 2d is filled.

One end of tubes 9 and 10 is detachably connected to each bag tube 8 via a connector 8, and the other end of each tube 9 is connected to one end of a tube 11 via a connecting member 22. Has been done. Tube 1
The other ends of 0 and 11 are connected to one ends of the tubes 12 and 13 via a connecting member 23. Tube 12
The other end of is connected to the container 3.

Each of the drainage bags 7a, 7b, 7c is formed by forming a resin sheet material such as soft polyvinyl chloride into a bag shape, and a bag tube communicating with the inside of the bag tube. 14 are connected to each other. The drainage bags 7a, 7b, 7c are stacked with the sides to which the bag tubes 14 are connected aligned in the same direction.

One end of a tube 15 is detachably connected to each bag tube 14 via a connector 21, and the other end of each tube 15 is connected to one end of a tube 16 via a connecting member 24. There is. Tube 16
The other end of the tubes 17 and 1 via the connecting member 25.
8 is connected to one end. The other end of the tube 17 is connected to the container 4.

The other ends of the tubes 13 and 18 are connected to one end of the tube 19 via a connecting member 26.
The other end of the tube 19 is connected to one end of a transfer tube 28 via a connector 27, and the other end of the transfer tube 28 is connected to a catheter tube (in the peritoneum of the patient 100 via a joint (not shown)). (Not shown) is connected to one end.

Each of the connecting members 22 to 26 is manufactured by, for example, resin molding, and a branch flow passage communicating with the flow passage in each tube to be connected is formed inside.

Each of the connectors 20, 21, and 27 has a structure (for example, a double structure) capable of aseptically holding the flow path inside the connector when the connector is attached or detached.

With the above-mentioned structure, each flow path through which the dialysate or the drainage fluid flows as shown in FIG. 2 is formed. That is, each bag tube 8, each connector 20, tubes 9, 10, 11, 12 and connecting members 22, 23 have one end communicating with the dialysate bags 2a to 2e and the other end communicating with the container 3. One channel 31 is formed, and one end of the first channel 3 is formed by the tubes 13 and 19, the connecting members 23 and 26, the connector 27, and the transfer tube 28.
A second flow path 32 is formed, which communicates with the inside of the container 3 through 0 and the other end communicates with a catheter tube (not shown) placed in the peritoneum of the patient 100.
4, each connector 21, the tubes 15, 16, 17 and the connecting members 24, 25 have one end at the drainage bags 7a to 7a.
The third flow path 33 that communicates with the inside of c and the other end communicates with the inside of the container 4.
The tube 18 and the connecting members 25 and 26 have one end communicating with the third flow passage 33 and the other end having the second flow passage 3
A fourth flow path (an extension flow path of the third flow path 33) 34 communicating with 2
Is formed.

Each of the containers 3 and 4 in this embodiment has a flexible bag-like shape. For example, the edges of a soft resin sheet material are fused to form a bag-like shape. It is formed.

The sheet material constituting the containers 3 and 4 is, for example, soft polyvinyl chloride, polyethylene, polypropylene, ethylene-vinyl acetate copolymer (EVA).
Polyolefin such as, polyethylene terephthalate (PET), polyester such as polybutylene terephthalate (PBT), polyamide, polyurethane series, polyester series, polyamide series, olefin series, various elastomers such as styrene series, or two or more of these And the like.

The containers 3 and 4 are not limited to be flexible as a whole, but may be flexible in part and deformed to change their volumes.

The capacity of the containers 3 and 4 is not particularly limited because it varies depending on the patient's case and various conditions such as the number (capacity) of the dialysate bag and the drainage bag. Is preferably about 100 to 10,000 ml, particularly about 100 to 3,000 ml, and the capacity of the container 4 is about 100 to 20,000 ml, particularly about 100 to 3,000 ml.

The tubes 8 to 19 are flexible.
It is preferable that the material has, for example, polyvinyl chloride, polyethylene, polypropylene, polyolefin such as EVA, PET, PB.
Polyester, polyurethane, polyamide, such as T,
Silicone, polyester elastomer, polyamide elastomer, thermoplastic elastomer such as styrene-butadiene-styrene copolymer, or 2 of these
A suitable combination of the above may be used.

As shown in FIG. 1, the tubes 11, 10,
In the middle of 13, 16 and 18, flow path opening / closing means 35, 36, 3 for closing / releasing the lumen of the tube, respectively.
7, 38 and 39 are provided. That is, FIG.
As shown in, the flow path opening / closing means 35 and 36 open / close the middle of the first flow path 31, the flow path opening / closing means 37 opens / closes the middle of the second flow path 32, and the flow path opening / closing means 38 opens the third path.
The middle of the flow path 33 is opened and closed, and the middle of the fourth flow path 34 is opened and closed by the flow path opening / closing means 39.

Each flow path opening / closing means 35-39 shown in FIG.
For example, it is composed of a solenoid pinch valve that closes the tube in a cut-off state by pressure.
The opening and closing of the flow path by 39 is controlled by the control means 30 described later.

As the flow path opening / closing means 35-39,
In addition to the above, for example, electromagnetic valves, valves that operate by air pressure or hydraulic pressure, valves and cocks that open and close manually, clamps that close the tube in the normal state and manually release it, etc. that can open and close each flow path Any material may be used as long as it is.

The depressurizing / pressurizing means 5 is for causing the dialysate to flow through a predetermined flow path of the circuit shown in FIG. 1, and includes a depressurizing / pressurizing chamber 51 for hermetically housing the container 3 and a depressurizing chamber.・ The air supply / exhaust circuit 52 for adjusting the pressure in the pressurizing chamber 51 and the decompression
It is composed of a pressure detecting means 57 for detecting the pressure of the pressurizing chamber 51.

The air supply / exhaust circuit 52 includes a vacuum pump 54, two 3-port valves 55a, in the middle of the air supply / exhaust pipe 53,
55b and a leak valve 56. The three-port valves 55a and 55b are in a ventilation state when they are on and in an atmosphere open state when they are off. Therefore, 3 port valve 55
When a is turned on and the 3-port valve 55b is turned off and the vacuum pump 54 is operated, the interior of the decompression / pressurization chamber 51 is depressurized (negative pressure state) by operating the vacuum pump 54, and conversely, the 3-port valve When 55a is turned off and the 3-port valve 55b is turned on to operate the vacuum pump 54, air is supplied and the inside of the decompression / pressurization chamber 51 is brought into a pressurized state (positive pressure state).

The leak valve 56 is closed when the inside of the depressurization / pressurization chamber 51 is in a depressurized state or a pressurized state, and when the depressurized state or the pressurized state is returned to the atmospheric pressure, the leak valve 56 is opened. To be in a state.

As the pressure detecting means 57, for example, a pressure sensor such as a diffusion type semiconductor pressure sensor is preferably used. The information obtained by the pressure detection means 57 is mainly used for controlling the air supply / exhaust in the air supply / exhaust circuit 52. For example, when the inside of the depressurization / pressurization chamber 51 is set to the depressurization state or the pressurization state, the pressure of the depressurization / pressurization chamber 51 is kept constant, for example, based on the information obtained by the pressure detection means 57 It is possible to control so as not to exceed a set limit (a lower limit value when depressurizing or an upper limit value when pressurizing).

On the other hand, the depressurizing / pressurizing means 6 is used for circulating the waste liquid in a predetermined flow path of the circuit shown in FIG. 1, and is provided with a depressurizing / pressurizing chamber 61 for hermetically containing the container 4. An air supply / exhaust circuit 62 for adjusting the pressure in the pressure reducing / pressurizing chamber 61,
The pressure reducing / pressurizing chamber 61 is constituted by a pressure detecting means 67.

The air supply / exhaust circuit 62 includes a vacuum pump 64, two three-port valves 65a, and a three-port valve 65a in the middle of the air supply / exhaust pipe 63.
The pressure reducing / pressurizing chamber 61 has a pressure reducing valve 65b and a leak valve 66, and operates in the same manner as the air supply / exhaust circuit 52 to bring the inside of the pressure reducing / pressurizing chamber 61 into a reduced pressure state or a pressurized state.

As the pressure detecting means 67, the same one as the pressure detecting means 57 can be used. Based on the information obtained by the pressure detecting means 67, the pressure in the decompression / pressurizing chamber 61 is kept constant, for example. It is possible to control so as to keep the above value or not to exceed a preset limit (a lower limit value during depressurization or an upper limit value during pressurization).

Depressurization / pressurization chamber 51 and depressurization / pressurization chamber 6
1 contains the weight of containers 3 and 4, respectively (total weight)
Weight detection means 40 and 41 for detecting the are installed. A weight sensor such as a load cell is preferably used as the weight detecting means 40 and 41. In addition,
The weight measurement of the container 3 by the weight detection unit 40 and the weight measurement of the container 4 by the weight detection unit 41 may be performed continuously (real time) or intermittently, that is, at a constant cycle.

A heating means 42 for heating the dialysate stored in the container 3 is installed in the depressurization / pressurization chamber 51. As the heating means 42, a heating element, particularly a plate-shaped heating element (for example, a panel heater) is preferably used.
In the illustrated example, a panel heater is installed on the floor surface of the decompression / pressurization chamber 51, and the container 3 is placed thereon. The operation of the heating means 42 is controlled by the control means 30 described later.

A temperature sensor 43 for detecting the temperature of the dialysate in the container 3 is installed in the container 3. In the illustrated example, the temperature sensor 43 is installed so as to contact the outer surface of the container 3. As the temperature sensor 43, for example, a thermistor, a thermocouple, a bimetal, a PT
Any type such as C and NTC may be used. Further, the temperature sensor 43 may be installed in the container 3.

When the dialysate in the container 3 is heated by the heating means 42, the temperature sensor 43 is controlled by the control means 30.
Based on the temperature information detected in, the temperature control is performed so that the temperature of the dialysate is maintained near the set temperature. For example, when the temperature of the dialysate detected by the temperature sensor 43 reaches the upper limit of the set temperature range while operating the heating means 42 to heat the dialysate in the container 3, The operation is stopped, and after a lapse of a predetermined time or when the temperature of the dialysate reaches the lower limit value of the set temperature range, control is performed to operate the heating means 42. The temperature range of the dialysate is set to a temperature slightly higher than the body temperature in consideration of the body temperature or a temperature decrease in the flow channel, for example, about 35 to 42 ° C.

By controlling the temperature of the dialysate in this manner, the dialysate at an appropriate temperature can be injected into the peritoneum of the patient 100, and the discomfort and other adverse effects due to the temperature difference from the body temperature do not occur.

The control means 30 is composed of, for example, a microcomputer (CPU), and the flow path opening / closing means 35-35.
39, weight detection means 40, 41, heating means 42, temperature sensor 43, vacuum pumps 54, 64, 3 port valve 5
5a, 55b, 65a, 65b, leak valves 56, 6
6 and the pressure detection means 57 and 67 are electrically connected to each other.

The control means 30 includes a weight detection means 40,
41, operation of each flow path opening / closing means 35-39 (switching operation) based on information from the pressure detecting means 57, 67
And the vacuum pumps 54, 64, 3 of the pressure reducing / pressurizing means 5, 6
While controlling the operation of the port valves 55a, 55b, 65a, 65b and the leak valves 56, 66, respectively, to set the liquid flow state in each flow path of the circuit as desired, based on the information from the temperature sensor 43, The operation of the heating means 42 is controlled to maintain the temperature of the dialysate in the container 3 near the set temperature.

The operation section 44 is for performing an operation for selecting a mode and setting various conditions when exchanging the dialysate. The control unit 30 performs sequence control for automatically performing each step described below according to the condition set by the operation unit 44. A warning lamp, a buzzer, and a display unit, which will be described later, may be installed in the operation unit 44.

Next, an example of the operation of injecting the dialysate and collecting the drainage when performing the peritoneal dialysis using the dialysate exchange device 1A will be described focusing on the control procedure by the control means 30. It should be noted that the pattern of steps to be executed, one injection amount of dialysate (target injection amount), one discharge amount (target discharge amount), dialysate and waste liquid flow rate in each step, and heating means 42. The set temperature and the like in can be set in advance by operating a switch, a dial, a key, etc. installed in the operation unit 44.

[1] Transfer of dialysate to container The flow path opening / closing means 35 to 39 are preliminarily set to the flow path opening / closing pattern 0 (basic pattern) shown in Table 1 below. The flow path opening / closing pattern 1 is set.

[0057]

[Table 1]

Next, in the pressure reducing / pressurizing means 5, the leak valve 56 is closed and the three-port valves 55a and 55 are provided.
b is turned on and off respectively, and the vacuum pump 5
By activating 4, the inside of the decompression / pressurization chamber 51 in which the container 3 is housed is depressurized. As a result, the pressure inside the container 3 is reduced, and the dialysate bags 2a, 2b, 2
The dialysate in c and 2d is introduced into the container 3 through the first flow path 31.

When introducing the dialysate into the container 3, the flow rate of the dialysate can be controlled as follows, for example. The weight detection means 40 detects the total weight of the container 3 for each unit time, obtains the dialysate inflow amount into the container 3 per unit time from the rate of increase, and this inflow amount is equal to a preset set inflow amount. The pressure in the decompression / pressurization chamber 51 is adjusted so that In this case, the pressure in the decompression / pressurization chamber 51 can be controlled so as not to exceed a preset lower limit value based on the detection value of the pressure detection means 57. Further, when the inflow of the dialysate into the container 3 reaches a steady state, the pressure in the decompression / pressurization chamber 51 is kept constant based on the detection value of the pressure detection means 57 as described above. It can also be adjusted. Such pressure adjustment is performed by opening and closing the leak valve 56, for example.

Container 3 detected by weight detecting means 40
The total weight of the dialysate has reached the weight (set weight) at the time when the preset single injection amount of dialysate (target injection amount) was introduced. The passage opening / closing means 35 to 39 are set again to the passage opening / closing pattern 0 shown in Table 1, the vacuum pump 54 is stopped, and the leak valve 56 is opened. As a result, the inside of the decompression / pressurization chamber 51 is returned to the atmospheric pressure.

In the peritoneal dialysis while the patient is sleeping, the target injection amount of dialysate is, for example, four (1 to 4 arbitrarily set) dialysate bags 2a, 2b, 2c,
It is about 1/10 to 1/1 times the total amount of dialysate in 2d.

[2] Warming of dialysate The warming means 42 is operated to warm the dialysate in the container 3 to an appropriate temperature. At this time, as described above, the temperature sensor 43
On / off control or output (heat generation amount) control of the heating means 42 is carried out so that the temperature of the dialysate in the container 3 is maintained near the preset temperature based on the temperature information detected in step 3. To do.

[3] Injection of dialysate into a patient The flow passage opening / closing pattern 2 shown in Table 1 is used for each flow passage opening / closing means 35 to 39 which has the flow passage opening / closing pattern 0 shown in Table 1 in advance.
Set to.

Next, in the pressure reducing / pressurizing means 5, the leak valve 56 is closed and the three-port valves 55a and 55 are used.
b is turned off and on respectively, and the vacuum pump 5
By activating 4, the inside of the decompression / pressurization chamber 51 in which the container 3 is housed is put in a pressurized state. As a result, the pressure in the container 3 rises, and the heated dialysate in the container 3 passes through the second flow path 32 and the indwelling catheter to allow the patient 1
00 intraperitoneally.

When injecting the dialysate into the patient 100,
For example, the flow rate of dialysate can be controlled as follows. The total weight of the container 3 is detected by the weight detection means 40 at every unit time, the dialysate outflow amount (= dialysate injection amount) from the container 3 per unit time is calculated from the reduction rate, and this outflow amount is preset. The pressure in the decompression / pressurization chamber 51 is adjusted so as to be equal to the set outflow amount. In this case, the pressure in the decompression / pressurization chamber 51 can be controlled so as not to exceed a preset upper limit value based on the detection value of the pressure detection unit 57. Further, when the outflow of the dialysate from the container 3 reaches a steady state, the pressure in the decompression / pressurization chamber 51 is kept constant based on the detection value of the pressure detection means 57 as described above. It can also be adjusted. Such pressure adjustment is performed by opening and closing the leak valve 56, for example.

Container 3 detected by weight detecting means 40
It is judged whether the total weight has reached a weight corresponding to a preset dialysate remaining amount (for example, the dialysate remaining amount in the container 3 is 0). Means 35-
39 is set again to the flow path opening / closing pattern 0 shown in Table 1, the vacuum pump 54 is stopped, and the leak valve 56 is opened. As a result, the inside of the decompression / pressurization chamber 51 is returned to the atmospheric pressure.

As a result of the weight detection of the container 3, when the outflow amount of the dialysate from the container 3 sharply decreases or after a predetermined time elapses, the dialysate in the container 3 has a preset dialysate remaining amount. If it does not reach the flow path opening / closing pattern, it is judged that an abnormal situation such as blockage of the tube 19 or the transfer tube 28 has occurred, and the flow path opening / closing means 35 to 39 are set to the flow path opening / closing pattern 0 shown in Table 1. Decompression / pressurization chamber 5
The inside of 1 is returned to atmospheric pressure. In addition, a warning is issued to inform of this abnormal situation. Examples of the warning method include lighting of a warning lamp, a buzzer and a sound, and a display on a display unit (for example, a liquid crystal display, a CRT), which is performed by the dialysate exchange device 1A itself. Alternatively, it may be performed by communication with a nurse station in a hospital or the like.

[4] Implementation of dialysis After the injection of the dialysate into the peritoneum of the patient 100 is completed and the flow path opening / closing means 35 to 39 are set to the flow path opening / closing pattern 0 shown in Table 1, a predetermined time ( For example, about 30 to 600 minutes) elapse. Thereby, peritoneal dialysis is performed.

[5] Discharge of dialysate drainage into a container After dialysis is completed, the flow path opening / closing means 35 to 39 having the flow path opening / closing pattern 0 shown in Table 1 are opened and closed as shown in Table 1. Set to pattern 3.

Next, in the pressure reducing / pressurizing means 6, the leak valve 66 is closed, and the three-port valves 65a and 65 are used.
b is turned on and off respectively, and the vacuum pump 6
By activating 4, the inside of the decompression / pressurization chamber 61 in which the container 4 is housed is depressurized. As a result, the pressure in the container 4 is lowered, and the dialyzed drainage liquid in the peritoneum of the patient 100 is transferred to the indwelling catheter, the second flow path 32, and the fourth flow path 34.
And is introduced into the container 4 through the third flow path 33.

When introducing the drainage into the container 4, the flow rate of the drainage can be controlled as follows, for example.
The weight detection means 41 detects the total weight of the container 4 for each unit time, and from the rate of increase thereof, the inflow amount of the drainage liquid into the container 4 per unit time is obtained, and this inflow amount is equal to the preset inflow amount. The pressure in the pressure reducing / pressurizing chamber 61 is adjusted so that In this case, the pressure in the decompression / pressurization chamber 61 can be controlled so as not to exceed a preset lower limit value based on the detection value of the pressure detection means 67. Further, when the drainage of liquid into the container 4 reaches a steady state, the pressure in the decompression / pressurization chamber 61 is kept constant based on the detection value of the pressure detection means 67 as described above. It can also be adjusted. Such pressure adjustment is performed by, for example, the leak valve 6
Open and close 6

The set pressure (holding pressure) in the decompression / pressurization chamber 61 or its lower limit is usually lower than atmospheric pressure by a pressure corresponding to a head difference of about 0.7 to 1.3 mH ₂ O. (About 0.07 to 0.13 kgf / cm ² ) is preferable. As a result, drainage from the peritoneum can be performed smoothly and safely without causing the inner wall of the peritoneum to be withdrawn due to excessive suction.

Container 4 detected by weight detecting means 41
It is judged whether the total weight has reached the weight (set weight) at the time when the preset one-time drainage amount (target drainage amount) was introduced. Opening and closing means 35
~ 39 is again set to the flow path opening / closing pattern 0 shown in Table 1,
The vacuum pump 64 is stopped and the leak valve 66 is opened. As a result, the inside of the decompression / pressurization chamber 61 is returned to the atmospheric pressure.

In peritoneal dialysis while the patient is asleep, the target drainage amount of dialysate drainage is the target infusion amount plus the dewatering amount, for example, three (or four) drainage bags. It is about 1/20 to 1/1 times the total capacity of 7a, 7b and 7c (the drainage bag is set with an allowable amount).

As a result of the weight detection of the container 4, when the inflow amount of the drainage into the container 4 sharply decreases, or even after a predetermined time elapses, the drainage in the container 4 has a preset target drainage amount. If it does not reach the flow path opening / closing pattern, it is judged that an abnormal situation such as blockage of the tube 19 or the transfer tube 28 has occurred, and the flow path opening / closing means 35 to 39 are set to the flow path opening / closing pattern 0 shown in Table 1. , The inside of the decompression / pressurization chamber 61 is returned to the atmospheric pressure state. Further, in order to notify this abnormal situation, the above-mentioned warning is issued.

[6] Collection of drainage into drainage bag The flow path opening / closing pattern 4 shown in Table 1 is used for each flow path opening / closing means 35 to 39 having the flow path opening / closing pattern 0 shown in Table 1 in advance.
Set to.

Next, in the pressure reducing / pressurizing means 6, the leak valve 66 is closed, and the three-port valves 56a and 56a.
b is turned off and on respectively, and the vacuum pump 6
By activating 4, the inside of the decompression / pressurization chamber 61 in which the container 4 is housed is put in a pressurized state. As a result, the pressure in the container 4 rises, and the drainage liquid in the container 4 is discharged to the third flow path 3
3 is introduced into the drainage bags 7a, 7b, 7c,
Be recovered.

When collecting the drainage in the drainage bags 7a, 7b, 7c, the flow rate of the drainage can be controlled as follows, for example. The weight detection means 41 detects the total weight of the container 4 for each unit time, obtains the drainage outflow amount from the container 4 per unit time from the reduction rate, and this outflow amount is equal to a preset set outflow amount. The pressure in the pressure reducing / pressurizing chamber 61 is adjusted so that In this case, the pressure in the decompression / pressurization chamber 61 can be controlled so as not to exceed a preset upper limit value based on the detection value of the pressure detection means 67. When the outflow of the drainage liquid from the container 4 reaches a steady state, the pressure in the decompression / pressurization chamber 61 is kept constant based on the detection value of the pressure detection means 67 as described above. It can also be adjusted. Such pressure adjustment is performed by opening and closing the leak valve 66, for example.

Container 4 detected by weight detecting means 41
The total weight of the
It is judged whether or not the remaining amount of the drainage liquid has reached the weight corresponding to 0), and when it reaches this, the flow path opening / closing means 35 to 39
Is set again to the flow path opening / closing pattern 0 shown in Table 1, the vacuum pump 64 is stopped, and the leak valve 66 is opened.
As a result, the inside of the decompression / pressurization chamber 61 is returned to the atmospheric pressure.

The step [6] is the same as the above step [1].
You may carry out after performing- [5] several times.

The steps [1] to [6] (or [1] to [5]) described above are defined as one cycle, and one cycle or two or more cycles are repeated. The number of cycles is appropriately determined according to the case of 100 patients who undergo peritoneal dialysis. In this case, even if the number of cycles stored in advance in the memory built in the control unit 30 is executed, the accumulated drainage amount (in the drainage bags 7a to 7c) obtained from the change in weight detected by the weight detection unit 41 is executed. The cycle may be repeated until the amount of collected drainage) reaches a predetermined value.

In the dialysate exchange device 1A, the depressurizing / pressurizing means 5 for depressurizing / pressurizing the container 3 and the depressurizing / pressurizing means 6 for depressurizing / pressurizing the container 4 are independent of each other. Therefore, when performing the steps [1] to [6] (or [1] to [5]) for two cycles or more, the steps in the next cycle are performed while performing the step [5] and subsequent steps. [1] and [2] can be performed, and steps [1] to [3] in the next cycle can be performed while performing step [6]. This makes it possible to shorten the time from the collection of the drainage fluid from the peritoneum of the patient 100 to the next injection of the dialysate.

The above steps [1] to [6] (or [1] to
After performing [5]) for at least one cycle, injection of the final dialysate stored in the dialysate bag 2e as described below or injection of the final dialysate and recovery of its drainage are performed as necessary. Be seen.

[7] Transfer of Final Dialysate to Container Each flow path opening / closing means 35 to 39 having the flow path opening / closing pattern 0 shown in Table 1 is set to the flow path opening / closing pattern 5 shown in Table 1.

Next, in the pressure reducing / pressurizing means 5, the leak valve 56 is closed and the three-port valves 55a and 55 are used.
b is turned on and off respectively, and the vacuum pump 5
By activating 4, the inside of the decompression / pressurization chamber 51 in which the container 3 is housed is depressurized. As a result, the pressure in the container 3 is lowered, and the final dialysate in the dialysate bag 2e is introduced into the container 3 through the first flow path 31.

When introducing the final dialysate into the container 3,
The flow rate of the dialysate can be controlled in the same manner as in the step [1]. Further, in peritoneal dialysis while the patient is sleeping, the target injection amount of the final dialysate is, for example, about 1/5 to 1/1 times the dialysate amount in the dialysate bag 2e.

[8] Heating of final dialysate As in the above step [2], the final dialysate in the container 3 is heated to an appropriate temperature.

[9] Injection of final dialysate into patient In the same manner as in the above step [3], the warmed final dialysate in the container 3 is injected into the peritoneum of the patient 100.

The steps [7] and [8] can be carried out while the steps [5] and [6] of the last cycle are carried out, and the step [6] of the last cycle can be carried out. While performing, steps [7] to [9] can be performed. As a result, it is possible to shorten the time required to inject the final dialysate after collecting the drainage fluid from the peritoneum of the patient 100.

[10] Implementation of final dialysis Dialysis is performed with the final dialysate in the same manner as in the above step [4].

[11] Discharging the final dialysate drainage into the container As in the above step [5], the dialyzed drainage in the peritoneum of the patient 100 is introduced into the container 4.

[12] Collection of drainage into drainage container In the same manner as in the above step [6], drainage in the container 4 is collected into drainage bags 7a, 7b, 7c.

Depending on the case, the above step [11]
In some cases, the final dialysate may be left in the peritoneum of the patient 100 without performing [12] and [12].

According to the dialysate exchange device 1A as described above, the liquid transfer at the time of injecting the dialysate to the patient 100 and collecting the drainage is performed by pressurizing the atmosphere of the container 3 and the container 4, respectively. Since it is performed by reducing the pressure of the atmosphere, it is not necessary to secure a head for obtaining liquid circulation, and the patient's sleeping position (height)
Can be freely selected. In particular, when collecting the drainage liquid, the atmosphere in the container 4 is decompressed so that the head difference from the atmospheric pressure is approximately the same as the drop between the conventional patient and the drainage bag, so that the inner wall of the peritoneum is pulled in. The drainage is slowly aspirated and discharged without being generated.

Further, since it is not necessary to secure a drop from the sleeping position of the patient in both the dialysate bag and the drainage bag, the device can be downsized, and the accident of accidentally tipping the device during sleep can be prevented. it can.

From the start to the end of peritoneal dialysis (eg, steps [1] to [6] or steps [1] to [12])
Since it can be automatically performed, it does not take time and effort for the patient to wake up and switch the flow path while sleeping.

FIG. 3 is a circuit diagram showing another configuration example of the dialysate exchange device of the present invention. Hereinafter, the configuration of the dialysate exchange device 1B shown in the same figure will be described regarding the differences from the dialysate exchange device 1A, and the description of the same items will be omitted.

The dialysate exchange device 1B is for depressurizing / pressurizing the container 3 for temporarily storing dialysate and the container 4 for temporarily storing drainage by the same depressurizing / pressurizing means 5. is there. That is, decompression in the dialysate exchange device 1B
The pressurizing means 5 includes a depressurizing / pressurizing chamber 58, an air supply / exhaust circuit 52 similar to the above, and a pressure detecting means 57 similar to the above, and a container is provided in the depressurizing / pressurizing chamber 58. 3 and container 4
And are stored airtight.

In the decompression / pressurization chamber 58, the same weight detection means 40 and 41 as described above for detecting the weight (total weight) of the containers 3 and 4 are installed. Also,
In the vicinity of the container 3 in the depressurization / pressurization chamber 58, the heating means 42 and the temperature sensor 43 similar to those described above are installed to control the temperature of the dialysate as desired.

The inside of the container 4 and the inside of each of the drainage bags 7a to 7c are connected by a third flow path 33, and the third flow path 33 is also in communication with the second flow path 32. Third flow path 33
The same flow path opening / closing means 38 as described above is installed between the communication part with the second flow path 32 and each of the drainage bags 7a to 7c.
Between the communication part of the third flow path 33 with the second flow path 32 and the container 4, the same flow path opening / closing means 39 as described above is installed.

In the dialysate exchange device 1B having such a structure, the same effect as that of the dialysate exchange device 1A described above can be obtained, and since the pressure reducing / pressurizing means is used for both the containers 3 and 4, The structure of the device is simplified and the size can be further reduced.

When performing peritoneal dialysis using the dialysate exchange device 1B as described above, the operation of injecting dialysate and collecting the drainage is performed by discharging the dialysate drainage into the container in the above step [5] and the above steps. Collect the drainage of [6] in the drainage bag under reduced pressure /
The steps are the same as the above steps [1] to [12] except that depressurization of the pressurizing means 5 and depressurization and pressurization in the pressurizing chamber 58 are performed.

In this case, the steps [1], [2], [3],
[4], [5], [6], [7], [8], [9],
The opening / closing patterns of the flow path opening / closing means 35 to 39 in [10], [11] and [12] are shown in Table 2 below.
Flow channel opening / closing patterns 1, 0, 2, 0, 3, 4, 5,
0, 2, 0, 3 and 4.

[0104]

[Table 2]

In the dialysate exchange device 1B, when the steps [1] to [6] (or [1] to [5]) are performed for two cycles or more, the following steps are performed during the step [5]. Steps [1] and [2] in the cycle can be performed, and step [2] in the next cycle can be performed while performing step [6]. This allows
After collecting the drainage fluid from the peritoneum of the patient 100, the time until the next infusion of the dialysate can be shortened.

Also, steps [7] and [8] can be carried out while step [5] of the last cycle is carried out, and while step [6] of the last cycle can be carried out. , Step [8] can be performed. As a result, it is possible to shorten the time required to inject the final dialysate after collecting the drainage fluid from the peritoneum of the patient 100.

FIG. 4 is a circuit configuration diagram showing another configuration example of the dialysate exchange device of the present invention. Hereinafter, the configuration of the dialysate exchange device 1C shown in the figure will be described regarding the differences from the dialysate exchange device 1A, and the description of the same items will be omitted.

The dialysate exchange device 1C includes a container for temporarily storing dialysate and a container for temporarily storing drainage.
One container 3 is also used. This dialysate exchange device 1C has one depressurizing / pressurizing means 5 as described above,
The container 3 is hermetically housed in the depressurizing / pressurizing chamber 51.

The heating means 42 and the temperature sensor 43 installed near the container 3 in the depressurization / pressurization chamber 51 operate only when the dialysate is introduced into the container 3 and manage the temperature thereof. Has been done.

The inside of the container 3 and the inside of the drainage bags 7a to 7c are connected by the first flow path 31 and the third flow path 33. In the middle of the second flow path 32 and in the middle of the third flow path 33, the same flow path opening / closing means 37 and 38 as described above are installed, respectively.

In the dialysate exchange device 1C having such a configuration, the same effects as those of the dialysate exchange device 1A described above can be obtained, and since the container and the pressure reducing / pressurizing means are combined, the configuration of the device is further simplified. It is possible to achieve further miniaturization.

When performing peritoneal dialysis using the dialysate exchange device 1C as described above, the operation of injecting the dialysate and collecting the drainage is performed by discharging the dialysate drainage into the container and in the above step [5]. Collect the drainage of [6] in the drainage bag under reduced pressure /
The steps are the same as the above steps [1] to [12], except that the depressurization of the pressurizing unit 5 and the depressurization and pressurization in the pressurizing chamber 51 are performed.

In this case, the steps [1], [2], [3],
[4], [5], [6], [7], [8], [9],
The opening / closing patterns of the flow path opening / closing means 35 to 39 in [10], [11] and [12] are shown in Table 3 below.
Flow path opening / closing patterns 1, 0, 2, 0, 2, 3, 4,
0, 2, 0, 2 and 3.

[0114]

[Table 3]

The dialysate exchange device of the present invention has been described above with reference to the configuration examples shown in the drawings, but the present invention is not limited to these. For example, 2 sharing the air supply and exhaust circuit
It is also possible to have one depressurizing / pressurizing chamber and to store the containers 3 and 4 in both depressurizing / pressurizing chambers.

Further, unlike the above-mentioned respective constitutional examples, the introduction of the dialysate from the dialysate bags 2a to 2e into the container 3 may be carried out by positioning the dialysate bags 2a to 2e at a high place and dropping them.

As means for detecting the amount of liquid in the containers 3 and 4, instead of the weight detecting means 40 and 41, the flow rate of the liquid flowing into or out of the containers 3 and 4 ( A means for detecting the (flow velocity) or the integrated flow rate may be used. Examples of such means include a flow rate sensor that optically, electrically or magnetically detect the flow rate, and a flow meter having an impeller.

The heating means and the temperature sensor for heating the dialysate are respectively located at positions other than those shown in the drawing, for example,
It may be provided in the middle of the dialysate bag 2a to 2e or the tube.

In the present invention, the means for detecting the amount of liquid in the containers 3, 4 such as the weight detecting means, the heating means, and the temperature sensor may be omitted if necessary.

Further, the forms of the dialysate container and the drainage recovery container are not limited to the dialysate bag and the drainage bag as described above, and other shape containers such as bottles may be used. The number and capacity of the dialysate container and the drainage collection container installed are not particularly limited.

[0121]

As described above, according to the dialysate exchange device of the present invention, the liquid transfer at the time of exchanging the dialysate is performed by depressurizing and pressurizing the atmosphere of the container, thereby obtaining the liquid flow. It is not necessary to secure the head of the patient, and the recumbent position (height) of the patient and the installation position of the device can be freely selected.

In particular, when collecting the drainage liquid, it is possible to prevent the inner wall of the peritoneum from being pulled in by adjusting the depressurized state of the atmosphere in the container to a desired level, which is extremely safe. Further, the structure of the device is simple, and the device can be downsized. In particular, it is possible to prevent an accident in which the device is accidentally overturned due to the high height of the device as in the conventional case.

Further, since the peritoneal dialysis can be automatically performed from the start to the end, it is not necessary to wake up the patient during bedtime and switch the flow path, thereby reducing the burden on the patient. In particular, when the heating means and the liquid amount detection means are provided, peritoneal dialysis can be easily performed under more appropriate conditions.

[Brief description of drawings]

FIG. 1 is a front view schematically showing a configuration example of a dialysate exchange device of the present invention.

FIG. 2 is a circuit configuration diagram of the dialysate exchange device shown in FIG.

FIG. 3 is a circuit configuration diagram showing another configuration example of the dialysate exchange device of the present invention.

FIG. 4 is a circuit configuration diagram showing another configuration example of the dialysate exchange device of the present invention.

[Explanation of symbols]

 1A, 1B, 1C Dialysate exchange device 2a, 2b, 2c, 2d, 2e Dialysate bag 3, 4 Container 5 Pressure reducing / pressurizing means 51 Pressure reducing / pressurizing chamber 52 Air supply / exhaust circuit 53 Air supply / exhaust pipe 54 Vacuum pump 55a, 55b 3 port valve 56 Leak valve 57 Pressure detecting means 58 Pressure reducing / pressurizing chamber 6 Pressure reducing / pressurizing means 61 Pressure reducing / pressurizing chamber 62 Air supply / exhaust circuit 63 Air supply / exhaust pipe 64 Vacuum pump 65a, 65b 3 port valve 66 Leak valve 67 Pressure detection means 7a, 7b, 7c Drainage bag 8 Bag tube 9 to 13 tube 14 Bag tube 15 to 19 tube 20, 21 Connector 22 to 26 Connection member 27 Connector 28 Transfer tube 29 Hanger 30 Control means 31 First flow path 32 2nd flow path 33 3rd flow path 34 4th flow path 35-39 Flow path opening and closing Stage 40, 41 weight detection means 42 heating means 43 temperature sensor 44 operating section 100 patients

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[Procedure amendment]

[Submission date] September 16, 1994

[Procedure Amendment 1]

[Document name to be amended] Statement

[Correction target item name] 0047

[Correction method] Change

[Correction content]

Depressurization / pressurization chamber 51 and depressurization / pressurization chamber 6
1 contains the weight of containers 3 and 4, respectively (total weight)
Weight detection means 40 and 41 for detecting the are installed. A weight sensor such as a load cell is preferably used as the weight detecting means 40 and 41. In addition,
The weight measurement of the container 3 by the weight detection unit 40 and the weight measurement of the container 4 by the weight detection unit 41 may be performed continuously (real time) or intermittently, that is, at a constant cycle. In the case of the method using the pressure of air like the depressurizing / pressurizing means 5 and 6, since the atmosphere equivalent to the drop pressure is created by the air supply / exhaust circuits 52 and 62, the position (height) relationship with the patient 100 Is greatly affected by. As the correction means, the weight detection means 40, 4
Although the amount of outflow per unit time when injecting or draining is controlled by the weight measurement using 1, when the patient suddenly changes position, the drop pressure acts on the patient as it is and There may be a temporary burden. In such a case, the intra-abdominal pressure of the patient 100 may be present between the pressure reducing / pressurizing means 5 or 6 and the transfer tube 28, that is, in the middle of the second flow path 32 or the fourth flow path 34 in FIG. The abdominal pressure detecting means 80 for detecting the pressure is installed, and when the abdominal pressure detecting means 80 detects a pressure exceeding a set value, the pressure reduction / pressurization is immediately stopped and at least the flow path opening / closing means 37 and 39. The above-mentioned problem can be solved by adopting a configuration in which the is closed. In addition, the pressure reducing / pressurizing means 5, 6
In the depressurization / pressurization method according to (1), since the pressure can be increased / decreased only up to a preset limit for safety, the installation location of the device may be restricted to some extent, but the intra-abdominal pressure detection means 80 is installed. As a result, it is possible to control the pressurization and depressurization so that the pressure in the abdominal cavity is kept substantially constant, and it is possible to use it even if the drop between the patient 100 and the dialysate exchange device 1A is at least about 1 m. An example of the configuration of the abdominal pressure detection means 80 is shown in FIGS. 5 and 6. The intra-abdominal pressure detecting means 80 shown in these figures adopts a system in which an operating transformer is used as a sensor, and its configuration will be described in detail below. A soft container (pillow) 81 made of a soft vinyl chloride resin or the like, which is deformable by a change in internal pressure, is installed in the middle of the tube forming the fourth flow path 34. The soft container 81 is hard. It is housed in a casing (guide) 82. A sensor 84 is installed and fixed to the lower portion of the casing 82 by a support member 88. The sensor 84 includes a coil 85, a core 86 of the coil 85, and a spring 87 that biases the core 86. The tip of the core 86 is inside the casing 82 through an opening 83 formed in the lower surface of the casing 82. Has been inserted into. The upper surface of the soft container 81 in FIG.
The inner end of the core 86 contacts the upper inner surface of the core, and the tip of the core 86 contacts the lower surface of the soft container 81 in FIG. The output terminal of the coil 85 is electrically connected to the control means 30 via a signal conversion circuit (not shown). For example, when the pressure in the abdominal cavity of the patient 100 increases, the soft container 81 expands accordingly, the lower surface of the soft container 81 displaces downward, and when the pressure in the abdominal cavity decreases, the soft container 81 contracts accordingly. Then, the lower surface of the soft container 81 is displaced upward. This soft container 81
Due to the displacement of the lower surface of the core 86, the core 86 moves, an electromotive force is generated in the coil 85, and the abdominal pressure is detected by monitoring the electromotive force. The sensor used in the abdominal pressure detecting means 80 is not limited to the actuating transformer as shown in the figure, but for example, an optical sensor for distance measurement using infrared light, laser light or the like as a light source, an ultrasonic sensor or a hall element is used. The same action and effect can be obtained by using these. In FIG. 2, the abdominal pressure detection means 80
Is provided in the middle of the fourth flow path 34, but the second flow path 32
It may be provided on the way or at another position. Further, such an intraperitoneal pressure detecting means 80 is used in the dialysate exchange device 1 described later.
It can be installed in the same manner for B and 1C, and the same action and effect can be obtained.

[Procedure Amendment 2]

[Document name to be amended] Statement

[Correction target item name] 0052

[Correction method] Change

[Correction content]

The control means 30 is composed of, for example, a microcomputer (CPU), and the flow path opening / closing means 35-35.
39, weight detection means 40, 41, heating means 42, temperature sensor 43, vacuum pumps 54, 64, 3 port valve 5
5a, 55b, 65a, 65b, leak valves 56, 6
6, pressure detecting means 57, 67 and intra-abdominal pressure detecting means 8
0 and each of them are electrically connected.

[Procedure 3]

[Document name to be amended] Statement

[Correction target item name] 0053

[Correction method] Change

[Correction content]

The control means 30 includes a weight detection means 40,
41, pressure detecting means 57, 67, intra-abdominal pressure detecting means 80
Based on the information from the above, etc., the operation (switching operation) of each flow path opening / closing means 35-39 and the vacuum pumps 54, 64 of the pressure reducing / pressurizing means 5, 6 and the three-port valves 55a, 55b, 6
5a, 65b and the operation of the leak valves 56, 66 are respectively controlled to set the liquid flow state in each flow path of the circuit to a desired state, and the operation of the heating means 42 is performed based on the information from the temperature sensor 43. Is controlled to maintain the temperature of the dialysate in the container 3 near the set temperature.

[Procedure amendment 4]

[Document name to be amended] Statement

[Correction target item name] 0075

[Correction method] Change

[Correction content]

As a result of the weight detection of the container 4, when the inflow amount of the drainage into the container 4 sharply decreases, or even after a predetermined time elapses, the drainage in the container 4 has a preset target drainage amount. If it does not reach the flow path opening / closing pattern, it is judged that an abnormal situation such as blockage of the tube 19 or the transfer tube 28 has occurred, and the flow path opening / closing means 35 to 39 are set to the flow path opening / closing pattern 0 shown in Table 1. , The inside of the decompression / pressurization chamber 61 is returned to the atmospheric pressure state. Further, in order to notify this abnormal situation, the above-mentioned warning is issued. Further, as a result of the pressure detection by the intra-abdominal pressure detection means 80, when it exceeds a preset set value, each flow path opening / closing means 3
5 to 39 are set to the flow path opening / closing pattern 0 shown in Table 1 and the pressure reducing / pressurizing chamber 61 is returned to the atmospheric pressure state, or the pressure reducing / pressurizing chamber is maintained so that the abdominal pressure is maintained within the set range. The control for adjusting the pressure in 61 is performed. In these cases, the warning as described above can be accompanied.

[Procedure Amendment 5]

[Document name to be amended] Statement

[Name of item to be corrected] Brief description of the drawing

[Correction method] Change

[Correction content]

[Brief description of drawings]

FIG. 1 is a front view schematically showing a configuration example of a dialysate exchange device of the present invention.

FIG. 2 is a circuit configuration diagram of the transparent liquid exchange device shown in FIG.

FIG. 3 is a circuit configuration diagram showing another configuration example of the dialysate exchange device of the present invention.

FIG. 4 is a circuit configuration diagram showing another configuration example of the dialysate exchange device of the present invention.

FIG. 5 is a partial cross-sectional plan view showing a configuration example of intra-abdominal pressure detection means.

FIG. 6 is a partial cross-sectional side view showing a configuration example of an abdominal pressure detection unit.

[Explanation of reference numerals] 1A, 1B, 1C dialysate exchange device 2a, 2b, 2c, 2d, 2e dialysate bag 3, 4 container 5 pressure reducing / pressurizing means 51 pressure reducing / pressurizing chamber 52 air supply / exhaust circuit 53 air supply / exhaust pipe 54 vacuum pumps 55a, 55b 3 port valves 56 leak valve 57 pressure detection means 58 depressurization / pressurization chamber 6 depressurization / pressurization means 61 depressurization / pressurization chamber 62 air supply / exhaust circuit 63 air supply / exhaust pipe 64 vacuum pumps 65a, 65b 3 ports Valve 66 Leak valve 67 Pressure detecting means 7a, 7b, 7c Drainage bag 8 Bag tube 9-13 tube 14 Bag tube 15-19 Tube 20, 21 Connector 22-26 Connecting member 27 Connector 28 Transfer tube 29 Hanger 30 Control means 31 First flow path 32 Second flow path 33 Third flow path 34 Fourth flow path 35 39 the flow path opening and closing means 40, 41 weight detection means 42 heating means 43 temperature sensor 44 operation unit 80 intraabdominal pressure detecting means 81 flexible container 82 housing 83 opening 84 sensor 85 coil 86 core 87 spring 88 support member 100 patients

[Procedure correction 6]

[Document name to be corrected] Drawing

[Name of item to be corrected] Figure 2

[Correction method] Change

[Correction content]

[Fig. 2]

[Procedure Amendment 7]

[Document name to be corrected] Drawing

[Name of item to be corrected] Figure 5

[Correction method] Added

[Correction content]

[Figure 5]

[Procedure Amendment 8]

[Document name to be corrected] Drawing

[Name of item to be corrected] Figure 6

[Correction method] Added

[Correction content]

[Figure 6]

Claims (1)

[Claims] 1. At least one dialysate container filled with dialysate, at least one container capable of temporarily storing liquid, and decompression / pressurization for making the atmosphere of the container decompressed and pressurized. Means, at least one drainage recovery container for collecting dialysate, a first flow path having one end communicating with the dialysate container and the other end communicating with the container, and one end communicating with the container A second flow path having the other end communicating with a catheter placed in the patient; a third flow path having one end communicating with the drainage recovery container and the other end communicating with the container; A flow path opening / closing means for opening / closing each of the one flow path, the second flow path and the third flow path, and opening / closing of each flow path by the flow path opening / closing means and operation of the pressure reducing / pressurizing means. A dialysate exchange device comprising: a control means for controlling.