JPH07299133A - Dialysis filtering device - Google Patents

Abstract

PURPOSE:To provide a dialysis filtering device easily handled and maintained which can be constituted simply and in a small size by eliminating the need for a drive source with respect to a mechanism other than an ultrafiltration volume control mechanism, while effecting an injection and a withdrawing of a dialysis liquid in a dailyzer, and can be manufactured at a lower cost with a sufficient strength. CONSTITUTION:In this dialysis filter which is provided with a dialyzer 60 which is partitioned to humor systems 61 and 62 such as blood systems and dialysis liquid systems 63 and 64 through a semi-permeable membrane while being provided with an ultrafiltration volume control mechanism 66 for controlling the supply and the discharge of a dialysis liquid with respect to the dialyzer 60 to perform a dialysis filtration of a humor, the ultrafiltration volume control mechanism has pump devices 72a and 72b arranged and connected to a dialysis liquid supplying system 63 and a dialysis liquid discharging system 64 connected to the dialyzer 60 being penetrated thereinto to accomplish an equal capacity change. The pump devices 72a and 72b are connected to a drive source 74 to carry out a pumping action in different phases.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a diafiltration device for dialysis or filtration of body fluid such as blood, and particularly to pushing the dialysate into the body fluid through a semipermeable membrane, and then drawing water from the body fluid (filtration). The present invention relates to a dialysis filtration device capable of easily performing an operation in which steps are alternately repeated with a compact device.

[0002]

2. Description of the Related Art Conventionally, particularly in dialysis and purification of body fluid such as blood, pushing the dialysate from the dialysate side to the body fluid side and conversely drawing water from the body fluid side to the dialysate side has been repeated. By performing hemofiltration (HF) effect and hemodialysis (HD)
Various dialysis filtration devices have been proposed that have both an effect and a high efficiency and enable easy dialysis, and that do not require a replacement liquid introduction mechanism that is indispensable for conventional HF operation devices. ing.

For example, Japanese Patent Application Laid-Open No. 57-173062 discloses a dialysis filtration device which enables highly efficient dialysis and filtration, is easy to operate, and is inexpensive. That is, FIG. 6 shows the configuration of this diafiltration device.
By the alternating operation of the first pump means 10 and the second pump means 12, the amount of dialysate supplied to the dialyzer 14 through the supply passage 13 or the discharge passage 1 from the dialyzer 14.
5, the amount of dialysate discharged into the dialyzer 5 is increased or decreased, whereby the difference (per unit time) between the inflow of dialysate into the dialyzer 14 and the outflow of dialysate from the dialyzer 14 is changed from positive to negative. In addition, it is possible to repeatedly change from negative to positive, and therefore, it is possible to repeatedly perform the operation of pushing the dialysate into the body fluid through the semipermeable membrane in the dialyzer 14 and drawing the water out of the body fluid. It was done.

According to the dialysis filtration apparatus having such a configuration, the amount of dialysate taken out from the dialysate flow path by the first pump 10 to the outside of the system and the amount of dialysate flowed by the second pump 12 to the dialysate flow path. Since the amount of the liquid pushed from the outside of the system is equal, the amount of the liquid drawn from the body and the amount of the liquid pushed into the body are subtracted from the body fluid determined by the inflow and outflow amount adjusting mechanism 16 to the outside of the body. It becomes equal to the amount of water. By repeating these two types of operations alternately, conventional HF operations can be performed with the same device.
The HD operation can also be performed. In FIG. 6, reference numeral 18 denotes a dialysate tank,
Reference numeral 0 is a control device for detecting the dialysate level in the tank 12 to control the first pump 10 and the second pump 12, and 21 and 22 are dialysate discharge passages 1.
To detect the pressure in the first pump 10 and the second pump 10.
The respective control devices for controlling the pump 12 are shown.

Further, JP-A-61-146781 discloses that backwashing of a membrane in a dialyzer or a filter can be effectively and efficiently achieved with a relatively simple structure and a simple operation can be performed on a living body. However, an artificial kidney device that can be safely handled is disclosed. That is, FIG. 7 shows the configuration of this artificial kidney device, which is a dialyzer (filter) 28 that defines a blood system 24 and a dialysate (filtrate) system 26 via a semipermeable membrane (filtration membrane). The blood supply system 24 and the dialysate (filtrate) system 26 are connected to reservoirs 34 and 36 respectively equipped with load cells 30 and 32 via reversible liquid transfer means P1 and P2, respectively, to provide the reversible liquid transfer. The pressure condition in the dialyzer (filter) 28 is changed by switching back and forth between the means P1 and P2, and the semipermeable membrane is subjected to diafiltration and backwashing.

According to the artificial kidney device thus constructed, the backwashing of the membrane can be achieved while the amount of the liquid returned to the body through the dialyzer 28 of the blood system 24 is always kept constant. Therefore, even if the dialysis or filtration operation is rapidly switched to the reverse operation, for example, there is no disconnection of the system and no impact on the living body, and safe and effective backwashing can be realized.

Further, in Japanese Patent Laid-Open No. 5-245195, the conventional diafiltration apparatus has a large physical burden on the patient because the blood flow on the venous side greatly changes when the dialysate is taken in and out of the filtration dialyzer. Also, if the blood flow changes significantly, the load on the shunt will increase and the life of the shunt will be shortened.Because it is difficult to confirm whether the extracorporeal circulation of blood is normal because the blood volume is not stable, In order to reduce the change in blood flow on the venous side, a hemofiltration and dialysis device with a function of preventing deterioration of the performance of the membrane is disclosed. That is, FIG. 8 shows the configuration of the hemodiafiltration apparatus, which includes a filtration dialyzer 40, and a blood inlet side (arterial side) 41 and an outlet side (venous side) 4 of the filtration dialyzer.
3, the blood chambers 42 and 44 respectively provided in FIG. 3, an ultrafiltration amount control mechanism 46 for controlling the volume difference between the fresh dialysate flowing into the filter dialyzer and the used dialysate flowing out from the filter dialyzer as the water removal amount. The inside of the cylinder sandwiches the piston 47 between the dialysate outlet 45 of the filtration dialyzer 40 and the venous blood chamber 44, and the buffer air chamber 4 is formed.
Reciprocating pump 4 defined by 7a and dialysate chamber 47b
8, the dialysate outlet 45 of the filter dialyzer 40 and the dialysate chamber 47b of the reciprocating pump 48, and the air chamber 44a of the venous blood chamber 44 and the buffer air chamber 47a of the reciprocating pump 48. Are connected to each other.

According to the hemofiltration / dialysis apparatus having such a structure, the blood flow on the venous side can be stabilized, so that the burden on the circulatory system of the patient can be reduced and the extracorporeal circulation of blood can be prevented. It becomes easy to confirm whether or not the operation is performed normally.

[0009]

However, in the above-mentioned various conventional apparatuses, for example, according to the configurations shown in FIGS. 6 and 7, the pumps for injecting and withdrawing the dialysate into and from the dialyzer are provided. Power for driving is required, and also in the configuration shown in FIG. 8, power for driving the piston is required for changing the volume of the cylinder, which makes it difficult to miniaturize the device and requires maintenance. Work is troublesome.

Further, as shown in FIG. 7, in a device which requires a reservoir, there is a drawback that the reservoir cannot be sufficiently cleaned and disinfected.

However, in the conventional normal dialysis apparatus, as shown in FIG. 9, in the dialyzer 50 which is divided into a blood chamber and a dialysate chamber through a semipermeable membrane, the inlet of the blood chamber And outlet to arterial blood system 51 and venous blood system 5
2 are connected in communication with each other, and a dialysate supply system 53 and a dialysate discharge system 5 are provided to the inlet and outlet of the dialysate chamber.
4 has a configuration in which they are connected in communication with each other. However, the dialysate system is provided with an ultrafiltration amount control mechanism 56, and the ultrafiltration amount control mechanism 56 is, for example, a pump having a single plunger and two identical volumes which alternately perform suction and discharge operations. It is configured by a reciprocating pump provided with a section, and is configured to simultaneously supply the dialysate to the dialysate supply system 53 and discharge the dialysate from the dialysate discharge system 54 at a constant ratio. A dewatering system 59 having a dewatering pump 58 is branched and connected to the dialysate discharge system 54.

The conventional dialysis machine thus constructed is
Due to the structure of the reciprocating pump applied to the ultrafiltration rate control mechanism 56, the phases of pump operation with respect to the dialysate supply system 53 and the dialysate discharge system 54 are synchronized as shown in FIG. Therefore, since the amount of dialysate delivered to the dialyzer 50 and the amount of dialysate drained from the dialyzer 50 are always equal, the dialysate 50 should be properly injected and withdrawn. I can't.

Therefore, an object of the present invention is that the mechanism other than the ultrafiltration amount control mechanism does not require a drive source, can be constructed in a simple and small size, and can inject and withdraw dialysate in a dialyzer. The object of the present invention is to provide a dialysis filtration device which can be smoothly manufactured, has sufficient strength, can be manufactured at low cost, and is easy to maintain and easy to handle.

[0014]

In order to achieve the above-mentioned object, a diafiltration apparatus according to the present invention is provided with a dialyzer that defines a body fluid system such as blood and a dialysate system through a semipermeable membrane. In the diafiltration device that performs diafiltration of body fluid by providing an ultrafiltration amount control mechanism that controls the supply amount and the discharge amount of the dialysate to the dialyzer, the ultrafiltration amount control mechanism,
A dialysate supply system and a dialysate discharge system, which are connected to the dialyzer in communication, are connected to a pump device that performs the same volume change, and these pump devices are used as drive sources so that the pump devices operate in different phases. It is characterized by being configured to be connected.

In the above dialysis filtration device, the pump device may be configured so as to be coupled to the common drive source with a phase shift.

Further, the pump device may be configured to be coupled to independent drive sources, and to drive the drive sources so that the opposing pump devices perform pumping operations at different phases.

Further, for the venous blood system connected to the dialyzer, a bag is provided so as to communicate directly or with the upper part of the venous blood chamber, and the venous pressure fluctuation is automatically absorbed. You can In this case, the bag provided so as to communicate with the venous blood system directly or in the upper part of the venous blood chamber is provided with a pressure urging device for applying pressure from the outside to force fluctuation of the venous pressure. It can also be configured to absorb.

[0018]

According to the dialysis filtration apparatus of the present invention, a dialysis machine that defines a body fluid system such as blood and a dialysis fluid system via a semipermeable membrane is provided, and the dialysis fluid is supplied to the dialysis machine. In the dialysis filtration device for diafiltration of a body fluid by providing an ultrafiltration amount control mechanism for controlling the discharge amount, the ultrafiltration amount control mechanism comprises a dialysate supply system connected in communication with the dialyzer and The ultrafiltration amount control mechanism is configured by connecting and arranging pump devices that perform the same volume change to the dialysate discharge system and connecting the pump devices to the drive source so that the pump devices operate in different phases. The injecting and withdrawing of the dialysate in contact with the body fluid through the semipermeable membrane in the dialyzer can be effectively achieved only by the operation of supplying and discharging the dialysate by the. In this case, the phase of the pump operation can be easily adjusted, and along with this, the withdrawal amount / injection amount of water and dialysate in the dialyzer can be easily adjusted.

[0019]

Embodiments of the dialysis filtration apparatus according to the present invention will now be described in detail with reference to the accompanying drawings.

FIG. 1 shows an embodiment of the diafiltration apparatus according to the present invention, in which reference numeral 60 indicates a dialyzer, and inside the dialyzer 60, a blood chamber is provided through a semipermeable membrane. And a dialysate chamber are defined. In the blood chamber, an arterial blood system 61 and a venous blood system 62 are provided with respect to the inlet and the outlet thereof.
And the dialysate supply system 63 and the dialysate discharge system 64 are connected to the inlet and the outlet of the dialysate chamber, respectively. Therefore, the dialysate system is provided with an ultrafiltration amount control mechanism 66. The ultrafiltration amount control mechanism 66 supplies the dialysate to the dialysate supply system 63 and the dialysate from the dialysate discharge system 64. The liquid is discharged at a constant ratio at the same time.

However, in the present embodiment, the dialyzing fluid supply system 63 is used as the ultrafiltration amount control mechanism 66.
Pump devices 72a and 72b having independent plunger mechanisms 70a and 70b for performing the same volume change are symmetrically provided in a part of the dialysate discharge system 64 and the plunger mechanisms 70a and 70b of the pump devices 72a and 72b.
Is coupled to the common rotary drive source 74 with a phase shift (a phase shift of 180 ° in the illustrated example). Note that reference numeral 69 indicates a water removal system including a water removal pump 68 that is branched from the dialysate discharge system 64.

According to the dialysis / filtration apparatus of this embodiment having the above-described structure, the pump operation phases of the respective pump apparatuses 72a, 72b constituting the ultrafiltration amount control mechanism 66 are arranged as shown in FIG. There will be a phase difference. Therefore, in the first half-cycle operation of the rotary drive source 74, when dialysate is supplied from one pump device 72a to the dialysate supply system 63, the other pump device 72b discharges dialysate on the dialyzer 60 side. Since the dialysate is not sucked from the system 64, the dialysate in the dialysate supply system 63 including the dialyzer 60 is in a stagnant state, and the amount of dialysate in the dialysate supply system 63 temporarily becomes excessive. The pressure also rises, and as a result, the dialysate is injected into the blood side through the semipermeable membrane. In the next half-cycle operation, since the dialysate is not supplied from the one pump device 72a to the dialysate supply system 63, the other pump device 72b draws out the dialysate in the dialyzer 60. Water on the blood side is drawn to the dialysate side via the semipermeable membrane.

FIG. 3 shows another embodiment of the diafiltration device according to the present invention. That is, in this embodiment, in the embodiment shown in FIG. 1, the plunger mechanisms 70a and 70b of the pump devices 72a and 72b which are provided independently for the dialysate supply system 63 and the dialysate discharge system 64, respectively.
Are coupled to independent drive sources 74a and 74b, respectively. In this way, the drive sources 74a, 7
In 4b, if the phase of the pump operation is set to be shifted, the diafiltration action in the dialyzer 60 can be easily achieved in exactly the same manner as in the above-mentioned embodiment.

In the embodiment shown in FIGS. 1 and 3, by appropriately adjusting the phase shift of the pump operation of the opposing pump devices 72a and 72b, the withdrawal amount / injection of water and dialysate in the dialyzer 60 can be achieved. Amount adjustments can be made.

Further, when the dialysis filtration device according to the present invention is applied, when dialysate is injected / withdrawn in the dialyzer 60, the return blood flow to the patient repeatedly increases and decreases, so that the resistance of the needle tip of the venous needle is increased. Causes the venous pressure to fluctuate. Therefore, if the fluctuation of the venous pressure is suppressed, the physical burden on the patient will be further reduced. Therefore, for example, in the step of injecting the dialysate, the filling amount in the blood tube can be increased, and in the drawing step, the filling amount in the blood tube can be reduced so that the return blood flow can be averaged. preferable.

FIG. 4 shows an embodiment of the diafiltration apparatus according to the present invention which is constructed so as to suppress the fluctuation of the venous pressure without external power. That is, in the present embodiment, the venous blood system 62 of the embodiment shown in FIG.
A soft bag 82 is arranged so as to communicate with the upper part of 0. The bag 82 is preferably made of a material having elasticity. With such a configuration, when the return blood flow increases and the venous pressure rises, the volume of the bag 82 increases, and the action of reducing the return blood flow works to prevent the venous pressure from becoming excessive. be able to. Further, when the return blood flow volume decreases and the venous pressure decreases during the drawing process, the volume of the bag 82 decreases and the action of increasing the return blood flow volume works, so that the venous pressure is prevented from becoming too small. be able to.

FIG. 5 shows an embodiment of the dialysis filtration device according to the present invention which is constructed so as to suppress the fluctuation of the venous pressure by using external power. That is, in the present embodiment, the bag 82 provided in the embodiment shown in FIG. 4 is pressured from the outside by an appropriate pressure urging device 84 to forcibly form the blood forming the venous side blood system 62. By changing the blood filling amount in the tube, it is possible to prevent the venous pressure from becoming excessive and prevent the venous pressure from becoming excessively low as in the above-described embodiment.

Although the preferred embodiments of the present invention have been described above, the present invention can be used not only in combination with these embodiments, but also variously within the scope of the present invention. It goes without saying that the design can be changed.

[0029]

As is apparent from the above-described embodiments, according to the present invention, a dialyzer for defining a body fluid system such as blood and a dialysate system through a semipermeable membrane is provided, and the dialyzer is provided with respect to the dialyzer. In a diafiltration device for diafiltration of body fluid by providing an ultrafiltration amount control mechanism for controlling the supply amount and the discharge amount of dialysate, the ultrafiltration amount control mechanism is connected in communication with the dialyzer. The dialysate supply system and the dialysate discharge system are connected to a pump device that performs the same volume change, and the pump device is connected to the drive source so that the pump devices operate in different phases. Only by the operation of supplying and discharging the dialysate by the ultrafiltration amount control mechanism, the injection and withdrawal of the dialysate in contact with the body fluid through the semipermeable membrane in the dialyzer can be effectively achieved.

In particular, according to the present invention, the phases of the pump operation can be easily adjusted for the opposing pump devices, and the withdrawal amount / injection amount of water and dialysate in the dialyzer can be easily adjusted accordingly. Can be done.

Further, since it can be operated only by driving the pump device, it has the advantages that the structure is simple, the durability is excellent, and the maintenance work is easy. Further, the device can be downsized, and not only the manufacturing cost can be reduced, but also the operating cost can be maintained as in the case of a normal dialysis device. Furthermore, since the structure is simple, cleaning and disinfection operations can be performed easily and sufficiently.

[Brief description of drawings]

FIG. 1 is a main part systematic diagram showing an embodiment of a diafiltration device according to the present invention.

FIG. 2 is a waveform diagram showing the delivery and discharge characteristics of dialysate in the dialysis filtration apparatus shown in FIG.

FIG. 3 is a main part systematic diagram showing another embodiment of the dialysis filtration device according to the present invention.

FIG. 4 is a main part systematic diagram showing another embodiment of the dialysis filtration device according to the present invention.

5 is a main part system diagram showing a modified example of the dialysis filtration device shown in FIG. 4. FIG.

FIG. 6 is a system diagram showing a configuration of a conventional diafiltration device.

FIG. 7 is a system diagram showing a configuration of a conventional artificial kidney device for performing diafiltration.

FIG. 8 is a system diagram showing the configuration of a conventional hemodiafiltration apparatus for performing diafiltration.

FIG. 9 is a system diagram showing a configuration of a conventional normal dialysis device.

10 is a waveform diagram showing the delivery and discharge characteristics of the dialysate in the dialyzer shown in FIG.

[Explanation of symbols]

 60 dialyzer 61 arterial blood system 62 venous blood system 63 dialysate supply system 64 dialysate discharge system 66 ultrafiltration amount control mechanism 68 water removal pump 69 water removal system 70a, 70b plunger mechanism 72a, 72b pump device 74 rotational drive Source 74a, 74b drive source 80 venous blood chamber 82 bag 84 pressure biasing device

Claims (5)

[Claims] 1. An ultrafiltration system which is provided with a dialyzer that defines a body fluid system such as blood and a dialysate system via a semipermeable membrane, and controls the supply amount and the discharge amount of the dialysate to the dialyzer. In a diafiltration device for diafiltration of a body fluid by providing a volume control mechanism, the ultrafiltration volume control mechanism has the same volume for a dialysate supply system and a dialysate discharge system connected in communication with the dialyzer. 2. A diafiltration device, characterized in that pump devices that perform changes are connected and arranged, and these pump devices are connected to a drive source so as to perform pump operations in different phases. 2. The diafiltration device according to claim 1, wherein the pump devices are connected to a common drive source with a phase shift. 3. The diafiltration device according to claim 1, wherein the pump devices are respectively coupled to independent driving sources, and are configured to drive the driving sources so that the opposing pump devices operate in different phases. . 4. A venous blood system connected to a dialyzer is provided with a bag so as to communicate with the venous blood system directly or in the upper part of the venous blood chamber, and configured to automatically absorb fluctuations in venous pressure. The diafiltration device according to any one of claims 1 to 3. 5. A bag provided so as to communicate with the venous blood system directly or at an upper portion of the venous blood chamber,
The diafiltration device according to claim 4, wherein a pressure urging device for applying a pressure from the outside is provided to forcibly absorb the fluctuation of the venous pressure.