JPH09173445A - Automatic peritoneum dialyzer - Google Patents

Abstract

PROBLEM TO BE SOLVED: To securely and automatically perform dialysis operation even while a patient is sleeping is forcedly containing drain by reducing pressure outside a drain containing container, supplying dialysis liquid into the abdominal cavity by head drop, and supplying drain after dialysis to the drain containing container. SOLUTION: Air in a container-containing chamber 3 contained in a drain containing container 2 is discharged by action of a positive displacement pump 28 to set the outer side of the drain containing container 2 in a reduced pressure condition. Drain after dialysis stored in the body of a patient is sent through a catheter 34, a part of a dialysis liquid flow passage 5, and a first branch tube 6 to the forcedly contained in the drain containing container 2. A first dialysis container 1 is disposed at a higher position than the patient, and the dialysis liquid heated to a specified temperature is supplied through the dialysis liquid flow passage 5 and a catheter 34 into the abdominal cavity. The dialysis liquid injected into the abdominal cavity is stored in the abdominal cavity for a specified time so that peritoneum dialysis is performed. Discharge operation of the dialyzed liquid after dialysis is performed similarly to the first dialysis operation. The whole device can thus be set compact, and need of keeping the patient laid of a bed can be eliminated.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an automatic peritoneal dialysis device, and more particularly, to an automatic peritoneal dialysis device capable of smoothly performing daily life by performing dialysis using the peritoneum while sleeping.

[0002]

2. Description of the Related Art Conventionally, a patient with renal failure has been subjected to artificial dialysis treatment using an artificial kidney. This artificial dialysis treatment
Since the patient is forced to visit the hospital frequently and the patient is restrained by the artificial dialysis device for a long time, there is a big drawback that the daily life of the patient is significantly restricted.

As a dialysis therapy that overcomes this drawback, in recent years, a peritoneal dialysis method in which dialysis is performed using the patient's own peritoneum,
In particular, continuous ambulatory peritoneal dialysis (Continuous A
mbulatory Peritoneal Dialysis, hereinafter sometimes referred to as "CAPD". ) Has come to the attention.

In this CAPD, a predetermined dialysate is usually injected into the abdominal cavity of a patient from a dialysate container through a catheter left in the abdominal cavity of the patient by a surgical operation, and the injected dialysate is stored in the abdominal cavity for a predetermined time. After dialysis, the drained liquid in the abdominal cavity is drained through the catheter and stored in a drainage container.

However, the patient needs to carry out such a series of operations about four times a day, and in addition, the work such as container replacement is complicated and time-consuming. . Such work has been a considerable labor and psychological burden for patients, especially those who have returned to society. Further, since the work of container replacement is complicated, a patient often performs a container replacement operation roughly, and as a result, a problem such as peritonitis caused by the contamination of bacteria may occur.

[0006] As a peritoneal dialysis method developed to avoid such drawbacks of CAPD, a continuous cycling peritoneal dialysis method (hereinafter, sometimes abbreviated as "CCPD") is particularly noted. ing.

This CCPD is a method for automatically performing the work such as the container replacement while the patient is sleeping at night by using an automatic peritoneal dialysis device.

In this CCPD, generally, an infusion phase of injecting a predetermined dialysate into a patient's abdominal cavity from a dialysate container through a catheter placed in the abdominal cavity of the patient by a surgical operation, and the infused dialysate into the abdominal cavity. It includes a storage phase in which the dialysate is stored for a predetermined time, and a drainage phase in which the dialysate is then drained from the catheter, and is typically performed during the sleep period of each day. For example, for 8 hours during sleep, 3 cycles are performed with the infusion phase, the storage phase and the drainage phase as 1 cycle, and the dialysate injected last is, for example, 16 hours in the abdominal cavity until the next treatment. Is stored and drained at the next bedtime.

According to the CCPD therapy using this automatic peritoneal dialysis device, the number of times of container replacement is reduced and the work that the patient should do is simplified, so that the patient can live a social life closer to a healthy person. The risk of bacterial contamination during the connection between the dialysis container and the dialysate flow tube, which induces peritonitis, and the connection between the catheter and the dialysate flow tube, is reduced, and the patient should work with relative caution. There is an advantage that you can come face to face.

Conventionally, in the automatic peritoneal dialysis apparatus used in CCPD, injection of dialysate into the abdominal cavity of a patient and discharge of dialysate from the abdominal cavity are often performed by CAPD.
It was done using natural heads as in therapy.

The drop required for the injection and drainage of this dialysate is usually 1,000-1500 mmA for injection depending on the patient.
It is said that it is about q and the drainage is about -400 to -1,000 mmAq. That is, 1,000m from the patient
A dialysate container containing a predetermined amount of dialysate is arranged at a position higher by about m to 1500 mm, and the dialysate is injected into the abdominal cavity of the patient by utilizing the drop, and 400 to 100
An empty drainage container was placed at a position as low as 0 mm, and the drop was used to drain the dialysate from the abdominal cavity.

[0012] However, in the injection drainage utilizing the natural head, since it is necessary to secure the natural head, the size of the entire apparatus becomes large. There was a problem that the use was forced. The above-mentioned problem is not a major problem in Europe and the United States where bed habits are used, but it is a serious problem in Japan where bed quilts are used.

There is known a device which does not require a head for drainage and can be used on a tatami mat. For example, JP-A-7
JP-A-24062 discloses a dialysate exchange device in which the dialysate is injected by a roller pump and the dialysate is discharged by utilizing the restoring force of a contracted bellows-shaped container.

However, since the roller pump is a pump which forcibly discharges the liquid, the dialysate flow pipe is bent or crushed due to the sleeping patient's turning over, etc., and the tube is clogged. If this happens, the pressure inside the tube will rise rapidly and the tube may be damaged. As a means for avoiding this, it is possible to consider a method such as monitoring the change in the injection amount with time or detecting the abnormality by monitoring the pressure change in the tube and issuing an alarm. When the tube is closed, the internal pressure of the tube rises instantaneously, so there is a high possibility that the tube has already been damaged by the pressure rise at the time of alarm output or when the roller pump is stopped. Further, it is not preferable to cut the tube to provide a pressure gauge to monitor the pressure from the viewpoint of preventing bacterial infection, and it is very difficult to detect the internal pressure from the outside of the tube without cutting the tube. Furthermore, it is virtually impossible to detect an abnormal sudden rise in internal pressure instantaneously.

On the other hand, the method for discharging the dialysate utilizing the restoring force of the bellows-shaped container has a problem that the restoring force for returning the contracted container to the original is not constant. That is, since the suction force due to this restoration depends on the degree of contraction similarly to the spring, it shows a strong suction force immediately after release, and the suction force decreases as it is restored, but the omentum is likely to be clogged in the catheter, for example. Depending on the patient, such as the patient, it may be required to discharge the dialysate with a weak suction force from the beginning, and it cannot be used for such a patient. In this case,
Although it is possible to appropriately change the degree of expansion and contraction, the material, and the like of the bellows-shaped container, there is a problem that it is difficult to make a delicate adjustment because the amount of liquid that can be discharged greatly changes accordingly.

Further, since the bellows-shaped container is provided separately from the drainage container, there is a problem that the piping system for connecting the containers is complicated, and furthermore, the flow of the dialysate in the piping system is controlled. Therefore, there is also a problem that the number of valves increases and noise increases. As a typical example of such a valve,
A valve similar to a solenoid pinch valve can be mentioned, but this pinch valve produces a considerable amount of noise due to the force exerted on the outside of the tube to crush it. Therefore, the number of such valves should be as small as possible. Furthermore, increasing the number of disposable containers such as shrinkable containers causes an increase in the cost required for treatment.

As an example of another device that does not require a drop in drainage, a dialysate is injected and drained into the abdominal cavity using a pump that alternately changes the volumes of multiple chambers,
Moreover, a device is known in which the pressure applied to the dialysate by the pump is controlled by a computer. In this device, by adjusting the pressure applied to the dialysate by the pump to the pressure due to the conventional free fall, the tube is unlikely to be damaged as in the case of the roller pump.

However, since this conventional device is provided with a plurality of chambers, it requires a valve that is interlocked with the movement of the chambers. As a result, the circuit of the device becomes complicated, and there is a problem that noise is generated because the valve is opened / closed in conjunction with the movement of the chamber. This noise is a serious problem considering that it is installed at the patient's bedside and operates while the patient is sleeping, even if the noise level is not a problem during the day.

Moreover, in this apparatus, the thin film is deformed under the control of a computer, thereby changing the volume in the chamber. That is, the thin film is provided in contact with the dialysate. In the peritoneal dialysis device used for CCPD, in order to prevent bacterial infection and the like, the flow passage that connects the dialysate container filled with the dialysate and the catheter is a closed system so that it does not come into contact with the outside. It is important that the tube forming the flow passage is disposable in principle.

However, the membrane in the pump is very fragile and can cause life-threatening problems for the patient if ruptured during dialysis. Further, since the chamber itself having such a thin film is made disposable, there is a problem that treatment cost is inevitably increased.

[0021]

SUMMARY OF THE INVENTION An object of the present invention is to provide an automatic peritoneal dialysis device which can perform a dialysis operation reliably and automatically even while a patient is sleeping.

Another object of the present invention is to provide an automatic peritoneal dialysis device which is capable of performing a dialysis operation without causing contamination by bacteria even when operated by the patient himself.

Another object of the present invention is to automatically and safely perform peritoneal dialysis regardless of whether a patient is sleeping on a futon bed or sleeping on a bed, that is, regardless of the patient's lying position. It is to provide a peritoneal dialysis device.

[0024] Another object of the present invention is to provide an automatic peritoneal dialysis device which does not generate noise and does not interfere with the sleep of the patient, and can safely and surely perform automatic peritoneal dialysis.

Another object of the present invention is to provide an automatic peritoneal dialysis device that can achieve any or all of the above objects without the need for complex circuit routing and special disposable components. .

[0026]

The invention according to claim 1 for solving the above-mentioned problems comprises a dialysate container containing a dialysate and a drainage container containing a drainage solution after dialysis. , A drainage suction means for forcibly storing the drainage liquid in the drainage liquid storage container by depressurizing the outside of the drainage liquid storage container, and a dialysate liquid in the dialysate liquid container due to a drop through the catheter to the abdominal cavity of the patient. A first circulation means for supplying the inside of the drainage container and a second circulation means for supplying the drainage liquid after dialysis into the drainage container.
An automatic peritoneal dialysis device comprising: a control means for controlling the operations of the first circulation means and the second circulation means, wherein the invention according to claim 2 is a main dialysis containing a dialysate. A liquid container and a drainage storage container for storing drainage liquid after dialysis, and drainage suction means for forcibly storing the drainage liquid in the drainage storage container by reducing the pressure outside the drainage storage container. A preliminary dialysate container containing a dialysate, a first flow means for supplying the dialysate in the main dialysate container into the abdominal cavity of a patient through a catheter by a drop, and a drained liquid after dialysis is contained in the drainage container. A second circulation means for supplying the inside of the container, a third circulation means for supplying the dialysate in the preliminary dialysate container into the empty main dialysis container by a drop, the first circulation means, the second circulation means and the third circulation means. And a control unit for controlling the operation of the distribution unit. In the invention according to claim 3, the drainage suction means stores a storage container for storing the drainage storage container, a depressurizing means for depressurizing the inside of the storage container, and the depressurization. The automatic peritoneal dialysis device according to claim 1 or 2, further comprising a decompression control means for controlling the means.

[0027]

BEST MODE FOR CARRYING OUT THE INVENTION The automatic peritoneal dialysis device of the present invention comprises:
A dialysate container, a drainage container, a drainage suction means, a first
It has a distribution means, a second distribution means, and a control means.

The dialysate container is formed so as to accommodate a predetermined amount of dialysate and to discharge the accommodated dialysate by a drop. A suitable dialysate container is a container that can store a predetermined amount of dialysate, is formed into a flat shape by a flexible member, and has a dialysate outlet. One or more dialysate containers can be used depending on the amount of dialysate used.

The drainage container is formed so as to be able to store the drainage liquid after dialysis. As a suitable drainage container, a container which stores the drainage solution after dialysis and is formed in a bag shape can be mentioned. As a more preferable drainage container, a flat bag-like container that contains the drained liquid after dialysis and is easily deformed, for example, formed of a synthetic resin such as polyvinyl chloride can be used.

The drainage suction means is a means for sucking and storing the dialyzed fluid after dialysis as drainage in the drainage container, and includes a drainage container accommodating chamber, a decompression means, and a decompression control means. Have.

The drainage container accommodating chamber is formed so as to accommodate the drainage container.

A suitable drainage container accommodating chamber is capable of accommodating the drainage container and is formed of a hard material to withstand pressure. Preferable examples of the material include acrylic resin, polycarbonate resin and the like from the viewpoints of lightness, ease of production, pressure resistance and the like.

The depressurizing means is means for depressurizing the drainage container accommodating chamber. Suitable depressurizing means has a positive displacement pump capable of depressurizing the inside of the drainage container and pressure releasing means for preventing the inside of the drainage container from being excessively depressurized.

Examples of the positive displacement pump include an air compressor, an air pump, a roller pump, a syringe pump, a finger pump, a tubing pump and the like. Among these, low noise roller pumps and low noise air pumps are preferable.

The pressure releasing means is formed so as to prevent the inside of the drainage container from being excessively depressurized, and examples thereof include a solenoid valve.

The operation of the depressurizing means is controlled by the depressurizing control means so that the depressurized state inside the drainage storage container is optimized.

The decompression control means inputs pressure measuring means for measuring the pressure in the drainage container accommodating chamber and pressure measurement data output from the pressure measuring means, and the drainage container is based on the pressure measurement data. It has a control calculation unit for issuing a pressure control signal to the pressure reducing means, in particular, the positive displacement pump, so that the pressure in the storage chamber becomes a predetermined value.

The predetermined pressure is -1,000 to -400.
[MmAq], preferably -800 to -600.
It is [mmAq].

When the pressure in the drainage container storage chamber deviates from a predetermined value due to some abnormality, the control calculation unit issues an opening command signal to the pressure release means to open the drainage container storage chamber. To do.

The first circulation means is formed so that the dialysate in the dialysate container can be supplied into the abdominal cavity of the patient. A preferred first circulation means comprises a supply pipe capable of supplying the dialysate in the dialysate container into the abdominal cavity of the patient.
A more preferred first circulation means comprises a supply pipe capable of supplying the dialysate in the dialysate container into the abdominal cavity of a patient, and one or more valves for blocking or communicating the supply pipe. .

When a plurality of dialysate container is accommodated in the dialysate container accommodating chamber, a suitable first circulation means is a branch pipe connectable to each branch pipe connected to each dialysate container. It has a supply pipe provided, a switching valve for circulating the dialysate into the supply pipe for each dialysate container, and one or a plurality of valves for adjusting the flow rate of the dialysate flowing through the supply pipe.

The second circulation means is formed so that the drainage liquid after dialysis can be sucked into the drainage container. A preferred second circulation means has a drain pipe capable of supplying the drainage liquid after the dialysis to the drainage container. A more preferable second circulation means includes a discharge pipe capable of supplying the drainage liquid after the dialysis to the drainage container, and one or a plurality of valves for blocking or connecting the discharge pipe. .

It is preferable that a part of the supply pipe in the first circulation means and a part of the discharge pipe in the second circulation means are shared. That is, it is branched in the middle of the supply pipe in the first circulation means, the pipe from the branch point to the drainage container is connected, and a part of the supply pipe in the first circulation means and from the branch point to the drainage container are connected. It is preferable that the tubular body is the discharge pipe in the second circulation means. As described above, when a part of the supply pipe in the first circulation means is to be a part of the discharge pipe in the second circulation means, a switching valve is provided in the middle of the supply pipe so that the flow path can be switched. good.

The control means is formed so as to control the operations of the first circulation means and the second circulation means. A preferred control means has a control calculation section for controlling the operation of the valves in the first circulation means and the second circulation means.

In the automatic peritoneal dialysis device of the present invention,
The control calculation unit in the control unit and the control calculation unit in the pressure reduction control unit can be substituted by one control calculation unit, or a control calculation unit can be installed for each.

A preferred automatic peritoneal dialysis apparatus of the present invention comprises a main dialysate container, a spare dialysate container, a drainage storage container, a drainage suction means, a first circulation means, and a second circulation means. Third
It has a distribution means and a control means.

The main dialysate container in a suitable automatic peritoneal dialysis device is formed so as to contain a predetermined amount of dialysate and to discharge the contained dialysate by a drop.
A suitable dialysate container is a container that can store a predetermined amount of dialysate, is formed into a flat shape by a flexible member, and has a dialysate outlet. One or more main dialysate containers can be used depending on the amount of dialysate used. In the present invention, it is preferable to use one.

The preparatory dialysate container in the preferred automatic peritoneal dialysis device is formed so as to contain a predetermined amount of dialysate and to discharge the contained dialysate into the main dialysis container by a drop. A suitable dialysate container is a container that can store a predetermined amount of dialysate, is formed into a flat shape by a flexible member, and has a dialysate outlet. One or more main dialysate containers can be used depending on the amount of dialysate used. In the present invention, it is preferable to use a plurality.

The drainage container, drainage suction means, first circulation means, and second circulation means in a suitable automatic peritoneal dialysis device are the same as those described above.

The third circulation means in the preferred automatic peritoneal dialysis device is formed so that the dialysate in the preliminary dialysate container can be fed into the main dialysate container. A preferred third circulation means has a supply pipe capable of supplying the dialysate in the preliminary dialysate container into the main dialysate container. A more preferred third circulation means has a supply pipe capable of supplying the dialysate in the preliminary dialysate container to the main dialysate volume, and one or more valves for blocking or communicating the supply pipe. It becomes.

It is preferable that a part of the supply pipe in the first circulation means and a part of the supply pipe in the third circulation means are shared. That is, it is branched in the middle of the supply pipe in the first circulation means, the pipe from the branch point to the drainage container is connected, and a part of the supply pipe in the first circulation means is connected to the supply pipe in the third circulation means. Preferably. In this way, when a part of the supply pipe in the first circulation means is made to be a part of the supply pipe in the third circulation means, a switching valve is provided in the middle of the supply pipe so that the flow path can be switched. good.

The control means in the preferred automatic peritoneal dialysis device is formed so as to control the operations of the first circulation means, the second circulation means and the third circulation means. A preferred control means has a control calculation section for controlling the operation of the valves in the first circulation means, the second circulation means and the third circulation means.

In the preferred automatic peritoneal dialysis apparatus of the present invention, one control calculation section may be substituted for the control calculation section in the control means and the control calculation section in the decompression control means, or a control calculation section may be provided for each. It can be done.

The operation of the peritoneal dialysis device of the present invention will be described.

The main dialysate container containing a fixed volume of dialysate is housed in the dialysate container housing chamber, and the main dialysate container is connected to the first circulating means. Further, the preliminary dialysate container containing a fixed volume of dialysate is connected to the first circulation means. More specifically, the main dialysate container and the spare dialysate container are connected to the supply pipe in the first circulation means. When accommodating a plurality of dialysate containers in the dialysate container accommodating chamber, each branch pipe provided in the supply pipe is connected to each dialysate container.

The empty drainage container is housed in the drainage container housing chamber, and the drainage container and the second circulation means are connected. More specifically, the drainage container is connected to the drainage pipe in the second circulation means.

The tips of the first circulating means and the second circulating means are placed in the peritoneum. When a part of the supply pipe in the first circulation means is also used as a part of the discharge pipe in the second circulation means, the tip of the supply pipe in the first supply means is installed in the peritoneum. The tip of the first distribution means and the second
When the tip of the circulation means or a part of the supply pipe in the first circulation means is also used as the discharge pipe of the second circulation means,
A catheter is preferably provided at the tip of the supply tube.

After the connection work is completed, the control calculation unit is activated. After the operation of the control operation unit, a command signal is output from the control operation unit to open the on-off valve and the valve provided in the middle of the supply pipe, so that the dialysate in the dialysate container is transferred to the first circulation means. It is supplied into the abdominal cavity of the patient through the supply tube.

On the other hand, the control calculation section outputs a pressure reduction control signal to the pressure control means. The pressure control means drives the depressurizing means to bring the drainage container accommodating chamber into a predetermined depressurized state.

After the peritoneal dialysis treatment for a predetermined time, the valve is opened by the decompression control means which has received the command signal output from the control calculation section, and the discharge pipe is brought into communication with the peritoneum through the discharge pipe. The drainage inside is sucked into the drainage container. The power of this suction is due to the decompression of the drainage container accommodating chamber.

[0061]

The present invention will be described in detail below with reference to examples. Needless to say, the present invention is not limited to the embodiments described below. Device Configuration FIG. 1 schematically shows the configuration of an automatic peritoneal dialysis device that is an embodiment of the present invention. This automatic peritoneal dialysis device includes a first dialysate container 1, a drainage container 2, a container chamber 3, a decompression unit 4, a dialysate flow pipe 5, a first branch pipe 6, and a second branch pipe 6.
Branch pipe 7, three branch pipes 7a, 7b, 7c, first to sixth normally closed valves 9, 10, 11, 12, 13, 14 and 3
Second dialysate container 8a, 8b, 8c of the base, and control calculation unit 1
5, an alarm means 16, an input means 17, and an output display means 18.

The first dialysate container 1 is a container capable of containing a predetermined amount of dialysate. Usually, the first dialysate container 1 is formed in a flat bag shape. The first dialysate container 1 is arranged at a predetermined height higher than the position where the patient is arranged. By arranging the first dialysate container 1 at a position higher than the patient, the dialysate can be supplied to the patient of the first dialysate container 1 by using the natural head without applying excessive pressure.
The first dialysate container 1 is provided with a lead-out pipe 20 having a first dialysate container side connector 19 at its tip.

The first dialysate container 1 is arranged so as to be sandwiched by two panel heaters 21 which are dialysate heating means. The panel heater 21 has the control calculation unit 15
In response to the operation command signal output from the panel heater 2,
The amount of current that is supplied to 1 is controlled, and the first
The dialysate in the dialysate container 1 is heated or the heating is stopped. The heating temperature of the dialysate is preferably close to the patient's body temperature, for example, 35 to 39.
It is preferable that the temperature is about ° C. In order to accurately control the heating temperature, temperature measuring means 22 capable of detecting the temperature of the dialysate is provided.

The temperature measuring means 22 is not particularly limited as long as it can convert the temperature into an electric signal, and for example, a thermistor or a thermocouple can be preferably used.
In the apparatus of this embodiment, a temperature measuring means insertion hole (not shown) is provided on one wall surface of the panel heater 21, and the temperature measuring means 22 is inserted from the outside.
The temperature detecting section is located in contact with the first dialysate container 1.

The temperature measuring means 22 accurately measures the temperature of the dialysate inside the first dialysate container 1 and outputs the temperature measurement data to the control calculator 15.

The control calculation unit 15 inputs the temperature measurement data and calculates the optimum heating conditions for the first dialysate container 1,
The supply of electric power to the panel heater 21 is controlled based on the result.

Further, the apparatus of this embodiment is provided with the first weight measuring means 23a for measuring the weight of the first dialysate container 1 and outputting the weight measurement data to the control calculation section 15. ing.

The control calculation section 15 analyzes whether or not the dialysate is continuously drawn out from the first dialysate container 1 by analyzing the weight measurement data output by the first weight measuring means 23a. Calculate the amount of dialysate derived from the first dialysate container 1 or the second dialysate container 8a, 8b, 8c
The amount of dialysate transferred to the first dialysate container 1 from is calculated. Further, when it is determined that the change in the dialysate volume is abnormal, an operation command signal for issuing an alarm is output to the alarm means 16.

The first dialysate container 1 in this embodiment is
It corresponds to the dialysate container or the main dialysate container in the present invention.

The drainage container 2 is a bag-shaped container. The material and shape of the drainage container 2 in the present invention are not particularly limited as long as they can be deformed to increase the internal volume in accordance with external depressurization, but a soft material such as polyvinyl chloride that can be easily deformed. It is preferable that the bag is made of a material such as a flat bag.

The maximum liquid storage amount of the drainage storage container can be appropriately determined according to the number of times dialysis is performed, the amount of dialysate used for one dialysis, the amount of water removed, and the like. It is usually 13 to 20 liters, preferably 15 to 17 liters.

The drainage storage container 2 is provided with a drainage introduction pipe 25 having a drainage storage container side connector 24 at its tip. In addition, a sealing member (not shown) made of a hard member, which is not easily deformed even when a pressing force is applied from the outer periphery, between the drainage container side connector 24 and the drainage container 2 in the drainage introduction pipe 25. .) Is installed. The drainage storage container 2 is stored in the container storage chamber 3.

The container storage chamber 3 is a container for hermetically storing the drainage storage container 2 therein. An opening for accommodating the drainage container 2 is formed in the container chamber 3 (not shown), and an opening is formed after the drainage container 2 is housed through the opening. The portion is airtightly covered with a lid member (not shown). At this time, the drainage introducing pipe 25 is sealed by the sealing mechanism while the tip of the drainage introducing pipe 25 is projected to the outside. That is, an airtight seal is provided between the sealing member provided in the introduction pipe 25 and the seal portion provided in the container storage chamber 3, and the airtightness inside the container storage chamber 3 is ensured.

The container accommodating chamber 3 is preferably made of a hard material and formed to withstand pressure. If the container itself is not easily deformed, the container storage chamber 3 is prevented from being deformed or destroyed even if the space for storing the drainage storage container 2 is maintained at a predetermined depressurized state.

The material of the container chamber 3 is preferably transparent. When the container storage chamber 3 is formed of a transparent material, the pressure deformation of the drainage storage container 2 stored inside and the amount of drainage stored in the drainage storage container 2 can be observed from the outside. External drainage container 2
If the pressure deformation of the device can be observed, the patient and family can visually confirm the normal operation of the device in addition to the device display, etc., and receive dialysis therapy in a mentally stable state. There is an advantage that can be. Further, instead of forming the container accommodating chamber 3 with a transparent material, a transparent window may be formed in a part of the wall surface of the container accommodating chamber 3 so that the container can be observed from the outside.

Suitable examples of the material of the container housing chamber 3 include acrylic resin and polycarbonate resin.

The decompression means 4 has a function of decompressing the internal space 26 in which the drainage storage container 2 in the container storage chamber 3 is stored. The decompression means 4 in this embodiment has an exhaust pipe 27 communicating with the internal space 26 and a positive displacement pump 28 provided in the exhaust pipe 27. The positive displacement pump 28 is not particularly limited as long as it can reduce the pressure inside the internal space that accommodates the drainage storage container, and is a positive displacement pump such as an air compressor or an air pump.
Roller pump, syringe pump, finger pump,
A tubing pump or the like can be preferably adopted.
Among these, it is desirable to adopt one having a low operating noise, considering that it is arranged near the patient.
From this point of view, among the various pressure reducing means, a roller pump, a finger pump, etc. can be particularly preferably adopted.

The operation of the decompression means 4 is controlled by the decompression control means so that the decompression state in the container accommodating chamber 3 becomes optimum.

The pressure reducing control means is a pressure measuring means 29 for measuring the pressure in the internal space 26 in the container accommodating chamber 3.
And pressure measurement data output from the pressure measurement means 29 are input, and the internal space 26 is based on the pressure measurement data.
It has the control calculation unit 15 which issues a pressure control signal to the decompression unit 4, in particular, the positive displacement pump 28, so that the internal pressure becomes a predetermined value.

By the decompression control means, the pressure inside the container accommodating chamber 3 is usually controlled to a pressure that produces a suction force approximately the same as the suction force of the drain head used in CAPD. Specifically, the pressure in the container housing chamber 3 is usually −
1,500 to -400 mmAq, preferably -800 to
It is controlled to -600 mmAq. By controlling the pressure in the container accommodating chamber 3 within such a range, it is possible to perform automatic peritoneal dialysis with peace of mind even for a patient or the like in whom the omentum is easily clogged with the catheter.

The pressure measuring means 29 is not particularly limited as long as it has a function of converting pressure into an electric signal, but a conventionally known measuring means such as a pressure transducer can be adopted.

The control calculation section 15 inputs the pressure measurement data output from the pressure measurement means 29 and performs arithmetic processing, and according to the result, controls the on-off of the pressure reduction means 4 or controls the rotation speed. It outputs a pressure control signal for controlling. The output of this pressure control signal may be intermittent or continuous.

The container accommodating chamber 3 further has a pressure release means 30 for emergency pressure release. The pressure release means 3
0 is an air flow pipe 31 communicating with the internal space of the storage container, and a valve 32 attached to the air flow pipe 31.
And a control calculation unit 15 that controls the opening and closing of the valve 32. The valve 32 is a normally closed valve, but when the pressure in the container storage chamber 3 falls below a predetermined value due to some abnormality, it is opened by inputting an opening command signal from the control calculation unit 15. It becomes a state.

By providing the pressure releasing means 30 as described above, it is possible to prevent an accident in which the inside of the container accommodating chamber 3 becomes abnormally decompressed. The valve is not particularly limited as long as it can be activated or opened / closed by an electric signal, and a solenoid valve can be preferably used.

In this automatic peritoneal dialysis device, the second weight measuring means 2 for measuring the weight of the drainage storage container 2 and outputting the weight measurement data to the control calculation section 15.
3b is provided. The control calculation unit 15 monitors whether the drained liquid after dialysis is continuously introduced into the drainage storage container 2 from the abdominal cavity of the patient based on the input weight measurement data, and the drainage storage container 2 It is monitored whether there is any liquid leakage from the patient, and the amount of dialysate discharged from the abdominal cavity of the patient is calculated. When the control calculation unit 15 determines that the change in the measured weight is abnormal, the alarm calculation unit 16
An operation command signal is output to.

The container accommodating chamber 3 and the decompression means 4 in this embodiment constitute the main part of the drainage suction means in the present invention.

The dialysate flow tube 5 is provided with a first connector 33 which can be connected to the first dialysate container side connector 19 at one end thereof and is surgically placed in the abdominal cavity of the patient at the other end. A second connector 36 connectable to the catheter-side connector 35 of the catheter 34 is provided, and two normally closed valves, that is, the first normally-closed end on the one end side, are provided in the middle of the one end and the other end. A closing valve 9 and a second normally closed valve 10 on the other end side are mounted. The dialysate flow pipe 5, the first normally closed valve 9 and the second normally closed valve 1
0 constitutes a main part of the first distribution means in the present invention.

The dialysate flow pipe 5 is provided with the first normally closed valve 9 described above.
Has a branch point A at which the first branch pipe 6 branches between the second normally closed valve 10 and the second normally closed valve 10, and a branch point B at which the second branch pipe 7 branches between the one end and the first valve 9. Have.

The first branch pipe 6 has at its tip a third connector 3 which can be connected to the drainage storage container side connector 24.
Seven. The second branch pipe 7 is the dialysate flow pipe 5
After branching from 3 branch pipes 3 at branch point C
It branches to a, 7b, and 7c. A fourth connector 38 is provided at each of the tips of the branch pipes 7a, 7b, 7c.

A third normally closed valve 11 is mounted between the branch point A and the third connector 37 in the first branch pipe 6.

Three second dialysate containers 8a, 8b, 8c
Is a bag-shaped container in which the dialysate is housed, and a lead-out pipe 39 having a second dialysate container-side connector 40 that can be coupled to the fourth connector 38 at the tip end thereof.
a, 39b, 39c. Second dialysate container 8a, 8
b, 8c each of the outlet pipes 39a, 3 connected to
In the middle of 9b and 39c, the fourth to sixth normally closed valves 12,
13 and 14 are provided respectively.

These second dialysate containers 8a to 8c are normally placed at 30 relative to the position where the first dialysate container 1 is arranged.
0 to 800 mm higher position, preferably 300
It is placed at a position about 500 mm higher. When the positions where the second dialysate containers 8a, 8b, 8c are arranged are within this range, the second dialysate containers 8a, 8b, 8c and the first dialysate container 1 are connected to each other. Therefore, the dialysate in the second dialysate container 8a, 8b, 8c can be easily transferred into the first dialysate container 1.

In this embodiment, the second dialysate containers 8a, 8b and 8c contain dialysate having the same concentration. These second dialysate containers 8a, 8
b and 8c correspond to the preliminary dialysate container in this invention.

The first to sixth normally closed valves 9, 10, 1
Although 1, 12, 13, and 14 are normally in a closed state, they are brought into an open state by inputting an operation control signal from the control calculation section 15.

The first to sixth normally closed valves 9, 10, 11, 12, 13, 14 in this embodiment are all solenoid pinch valves that cut off the flow passage by sandwiching the tube from the outside. As a valve for controlling the opening and closing of the flow path, if a valve that can open and close the flow path without contacting the internal dialysate is adopted, such as this solenoid pinch valve, the risk of bacterial contamination is significantly reduced. be able to. Among them, a valve having a low operation noise is preferable, and for example, a rotary type pinch valve can be particularly preferably adopted.

The catheter 34, a part of the dialysate flow passage 5, the first branch pipe 6, the first normally closed valve 9, the second normally closed valve 10 and the third normally closed valve 11 serve as the second flow passage in the present invention. It constitutes the main part of the means. The second branch pipe 7, 3
Three branch pipes 7a, 7b, 7c, three outlet pipes 39a, 39
b, 39c, fourth to sixth normally closed valves 12, 13, 14
Constitutes a main part of the third distribution means in the present invention.

The control calculation unit 15 outputs the weight measurement data of the first dialysate container 1 output from the first weight measuring means 23a and the weight measurement data of the drainage container 2 output from the second weight measuring means 23b. , Temperature measurement data output from the temperature measurement means 22 and pressure measurement data output from the pressure measurement means 29 are input, and various calculations based on these various data, calculation results and the internal storage device are stored. Various determinations are made by comparison with the information that is displayed, or the operating state of each unit is monitored. Also, according to a certain flow,
Alternatively, based on the result of the determination or the monitoring, the first
-The operation control signal is output to the sixth normally closed valves 9, 10, 11, 12, 13, and 14, the operation command signal is output to the panel heater 21, and the pressure control signal is output to the pressure reducing means 4.
These controls are performed. Further, when it is determined that a predetermined abnormal state has occurred, an opening command signal is output to the pressure releasing means 30 to avoid an abnormal depressurized state, and / or an operation instruction signal is output to the alarm means 16 to issue an alarm. To be issued.

The alarm means 16 issues an alarm in response to an operation command signal from the control calculation section 15 when an abnormal condition occurs. The alarm is given by a visual or audible signal, and in some cases both visual and audible alarms are performed. For example, the alarm means includes a red lamp that can blink to indicate an abnormality in the flow passage, an alarm sound generator that can generate an alarm sound indicating an abnormality in the flow passage, and a voice synthesizer that issues an abnormality in the flow passage by a synthetic voice. A combination with a speaker capable of generating synthetic voice is included.

The input means 17 is, for example, a keyboard which can input various conditions necessary for dialysis such as the injection amount of dialysate, the number of dialysis, the dialysis time, etc. to the control calculation section 15.

The output display means 18 includes a control calculation section 15
The dialysis state and various instruction contents are displayed under the control of, for example, a CRT device, a liquid crystal display device, various lamps, and a combination thereof.

Operation and Operation of Device The automatic peritoneal dialysis device having the above-described configuration is operated and operates as follows.

Using this automatic peritoneal dialysis device, dialysis is performed three times while the patient is asleep, and after the third dialysis is completed,
A case will be described in which the fourth dialysate is injected into the abdominal cavity of a patient and the dialysate is retained in the abdominal cavity until the next bedtime.

(1) Connection of dialysate container, connection of drainage container, etc. (preparation) In order to carry out CCPD using this automatic peritoneal dialysis device, first, the number of dialysis and Various data necessary for the dialysis operation such as the injection amount are input to the control calculation means 15.

Next, the first dialysate container 1 filled with the dialysate, the second dialysate containers 8a, 8b, 8c and the empty drainage container 2 are attached to this apparatus. That is, the first dialysate container 1 filled with the dialysate is the panel heater 21.
The first dialysate container side connector 19 is connected to the first connector 33. The three second dialysate containers 8a, 8b, 8c are arranged at a position higher than the position where the first dialysate container 1 is arranged, and the second dialysate container side connector 40 has the fourth connector 38. Connected to. The drainage storage container 2 is arranged inside the container storage chamber 3, and the drainage storage container side connector 24 is the third connector 3
7 is connected. At the time of this connection, the first to sixth normally closed valves 9, 10, 11, 12, 13, 14 are all closed.

When these connections are completed, the first weight measuring means 23a and the second weight measuring means 23b perform the first weight measurement.
The measurement of the weight of the dialysate container 1 and the drainage container 2 is started. The first weight measuring means 23a and the second weight measuring means 23b continuously output weight measurement data to the control calculation section 15. The control calculation unit 15 uses the input weight measurement data to calculate the amount of change in the weight of the first dialysate container 1 and the drainage storage container 2 over time.

Then, the first to sixth normally closed valves 9, 10,
It is confirmed that the weights of the first dialysate container 1 and the drainage container 2 have not changed in the state where all 11, 12, 13, and 14 are in the closed state. When a change in weight is recognized even after a predetermined time has elapsed after the connection, the control calculation unit 15 causes the dialysate to leak, or the first to sixth normally closed valves 9, 10, 11, 12, and 13. , 1
It is determined that the flow path is not completely closed by 4, and the output display means 18 is caused to display an indication that the connection is not good, and / or the operation means signal is output to the alarm means 16 to issue an alarm. On the other hand, when the control calculation unit 15 determines that the connection is good and there is no abnormality such as liquid leakage, it outputs an operation command signal to the output display unit 18 to display the connection completion or the like. Output.

(2) First Washing Operation and Priming Operation The temperature of the dialysate contained in the first dialysate container 1 is monitored by the heater unit including the panel heater 21 and the temperature measuring means 22 and the control calculator 15. Also, the temperature is maintained at a preset temperature.

That is, the temperature measurement data output from the temperature measurement means 22 is input to the control calculation section 15, and in the control calculation section 15, the measurement based on the set temperature previously input by the input means 17 and the temperature measurement data. The temperature is compared to determine whether the measured temperature is maintained within a predetermined range or is outside the predetermined temperature range.

When it is determined that the measured temperature is within the predetermined set temperature range, the control calculation unit 15 causes the output display means to turn on, for example, a green lamp to determine the temperature of the dialysate in the first dialysate container 1. Indicates that it is managed within a proper range. On the other hand, when it is determined that the measured temperature is not within the predetermined set temperature range, for example, by blinking a red lamp on the output display means, the temperature of the dialysate in the first dialysate container 1 is kept at the predetermined temperature. When it is determined that the temperature of the dialysate in the first dialysate container 1 is higher than a preset temperature, the heating by the panel heater 21 is stopped, or the panel heater 21 The temperature of the dialysate is lowered by reducing the amount of electricity,
When it is determined that the temperature of the dialysate in the first dialysate container 1 is lower than the preset temperature, the amount of electricity supplied to the panel heater 21 is increased or the duration of electricity is further extended to determine whether the dialysate is to be supplied. Is further heated.

By performing such determination and control based on the result of the determination, the dialysate in the first dialysate container 1 is maintained at a predetermined temperature. Further, in this automatic peritoneal dialysis device, when the dialysate is present in the first dialysate container 1, the dialysate is transferred to the second dialysate bags 8a, 8b, 8
Even if the dialysate is transferred from any one of c, the dialysate in the first dialysate container 1 is maintained at a predetermined temperature by the panel heater 21, the temperature measuring means 22, and the control calculation unit 15 as described above. To be done.

Further, as a result of the temperature of the dialysate in the first dialysate container 1 exceeding the predetermined temperature range, the control calculation section 15 outputs a signal to stop heating, and when a predetermined time has elapsed, Regardless, when an abnormal situation such as a further temperature rise occurs, an operation command signal is output to the alarm means 16. The alarm means 16 inputs the operation command signal and outputs an alarm sound or a sound alarm.

When performing CCPD with this automatic peritoneal dialysis device, the connector part is washed and the priming operation is performed as follows.

That is, by inputting the operation control signal from the control calculation unit 15, the other normally closed valves 9, 11, 12, 13, while keeping the second normally closed valve 10 in the closed state,
14 is opened.

In the apparatus of this embodiment, since both the first dialysate container 1 and the second dialysate containers 8a, 8b, 8c are arranged at a position higher than the drainage storage container 2, there is a drop. The dialysate in the first dialysate container 1 and the second dialysate containers 8a, 8b, 8c is the dialysate flow pipe 5, the first dialysate.
Through the branch pipe 6, the second branch pipe 7 and the branch pipes 7a, 7b, 7c, they fall into the drainage storage container 2 and flow. By the flow of the dialysate, the connecting portion between the first dialysate container side connector 19 and the first connector 33, the second dialysate container side connector 40.
Bacteria and contaminants are washed away at the connection between the third connector 37 and the fourth connector 38 and the connection between the drainage container inside connector 24 and the third connector 37.

During this washing operation, the dialysate is discharged from any of the first dialysate container 1 and the second dialysate containers 8a, 8b, 8c.

In this automatic peritoneal dialysis device, the first weight measuring means 23a continuously measures the weight change of the first dialysate container 1 accompanying the discharge of the dialysate, and the second weight measuring means 23.
In b, the weight change of the drainage container is continuously measured, and the measured data is continuously output to the control calculation unit 15, respectively.

In the control calculation section 15, the first weight measuring means 2
The amount of dialysate discharged from the first dialysate container 1 is calculated based on the measurement data input from 3a, and the amount of dialysate discharged from the first dialysate container 1 and the first weight. The amount of dialysate discharged from the second dialysate containers 8a, 8b, 8c is calculated based on the measurement data input from the measuring means 23a.

Then, the amount of dialysate discharged from the first dialysate container 1 is compared with the amount of dialysate discharged from the second dialysate containers 8a, 8b, 8c, and the ratio thereof is set to a predetermined value. If the amount of dialysate discharged from the second dialysate container 8a, 8b, 8c is excessive, the operation control signal is output and the cleaning operation is continued. ~ Close the sixth normally closed valves 12-14,
The dialysate is discharged only from the first dialysate container 1. On the other hand, when the amount of dialysate discharged from the first dialysate container 1 is excessive, an operation control signal is output to close the first normally closed valve 9 and the fourth to sixth normally closed valves 12 to 14. At the same time, an operation command signal is output to the alarm means 16 so as to output an alarm indicating that the second dialysate containers 8a, 8b, 8c are not properly arranged.

The control calculation unit 15 uses the weight measurement data respectively input from the second weight measurement means 23b and the first weight measurement means 23a so that an excessive amount of dialysate is not used for this cleaning operation. Based on a predetermined calculation based on the above, a predetermined amount of dialysate is discharged from the first dialysate container 1,
When it is determined that the preset amount of dialysate has been discharged from the second dialysate containers 8a, 8b, 8c, all the first to fifth normally closed valves 14a to 14d are closed.

(3) First dialysis operation (3-1) Drainage of drainage When starting dialysis, the dialysate after removal of water retained in the abdominal cavity of the patient for the last dialysis (“ After dialysis, it may be referred to as "dialysis fluid" or "drainage fluid". Therefore, the dialysate after removing the water in the abdominal cavity is stored in the drainage storage container 2 before newly starting dialysis.

That is, the control calculation section 15 includes the pressure reducing means 4
The operation control signal is output to operate the positive displacement pump 28. By the operation of the positive displacement pump 28, the air in the container storage chamber 3 in which the drainage storage container 2 is stored is discharged, and the outside of the drainage storage container 2 is depressurized.

At this time, the pressure outside the drainage container 2 is controlled within an appropriate pressure range as follows. That is, the pressure measuring means 29 in this automatic peritoneal dialysis device
Measures the pressure in the internal space 26 inside the container storage chamber 3 and outside the drainage storage container 2, and
The pressure measurement data is output to. Control calculator 15
Performs a predetermined calculation based on this pressure measurement data to determine whether the pressure in the internal space 26 is within the set pressure range. As a result, when it is determined that the pressure is higher than the predetermined pressure range, that is, when the predetermined pressure reduction is not achieved, a pressure reduction control signal is output to the pressure reducing means 4 to exhaust the gas. Let it continue,
Alternatively, increase the exhaust speed. On the other hand, when it is determined that the pressure is within the predetermined range, the pressure reducing control signal is output to the pressure reducing means 4 to stop the exhaust or reduce the exhaust speed.

By the determination and control being continuously performed by the control calculation unit 15, the drainage container 2
The external environment is maintained at a predetermined reduced pressure.

Further, the pressure in the container storage chamber 3 in which the drainage storage container 2 is stored is excessively lower than the pressure within the preset allowable range, and the control calculation unit 15 causes the pressure reducing means 4 to operate. If an abnormal situation occurs in which the exhaust by the decompression unit 4 does not stop despite outputting the decompression control signal for stopping the exhaust by the control calculation unit 15, the control calculation unit 15 inputs the pressure measurement data input from the pressure measurement unit 29. Based on the above, the occurrence of the abnormal situation is detected, and an operation command signal for outputting an alarm to the alarm means 16 is output, and at the same time, the pressure releasing means 3
An open command signal is output to 0. The pressure release means 30 receiving this release command signal opens the valve 32 and introduces air into the container housing chamber 3. In this way, further depressurization in the container accommodating chamber 3 can be avoided, and damage caused by the occurrence of this abnormal depressurized state can be minimized. For example, in the worst case where the inner wall of the abdominal cavity of the patient is damaged. Can be avoided.

As described above, the dialysate stored in the abdominal cavity of the patient is discharged while the outside of the drainage container 2 is maintained at a predetermined depressurized state.

The operation control signal output from the control calculation unit 15 is input to the first normally closed valve 9 and the fourth to sixth normally closed valves 1.
2 to 14 are closed, while the second normally closed valve 1
0 and the third normally closed valve 11 are opened. Then, since the outside of the drainage storage container 2 is in a decompressed state, the drained fluid stored in the patient's body after dialysis is part of the catheter 34 and the dialysate flow passage 5 due to the pressing force by the atmospheric pressure. , And the first branch pipe 6, and is forcibly stored in the drainage storage container 2.

The effluent after the dialysis flows through the connecting portion of the catheter side connector 35 and the second connector 36, and the bacteria adhering to these connectors are washed away.

The discharge of the dialysate after the dialysis is continued until the total amount of the dialysate after the dialysis stored in the abdominal cavity, that is, the drainage is discharged into the drainage storage container 2. During this period, the external environment of the drainage container 2 is maintained at a predetermined depressurized state as described above.

The determination that the total amount of dialysate has been discharged from the patient's abdominal cavity after dialysis is performed as follows.

That is, when dialysis is performed in the abdominal cavity, the body fluid is drained, and the dialyzed fluid after dialysis is stored in the abdominal cavity in an amount equal to or larger than the injected amount. The amount of water removed varies depending on the age, weight, and degree of kidney function of the patient, but the amount of water removed for each patient can be estimated from medical experience. Therefore, the estimated water removal amount of the patient is stored in advance in the storage device in the control calculation unit 15 via the input means 17. Alternatively, by preliminarily inputting the age, sex, medical history, etc. of the patient via the input means 17, the water removal amount of the patient is calculated as an estimated value in the control calculation unit 15, and the storage unit in the control calculation unit 15 is calculated. Store the estimated water removal amount in. The dialysate amount actually injected into the abdominal cavity is calculated from the measurement data output from the first weight measuring means 23a, and is stored in the storage device in the control calculation unit 15 as the infused dialysate amount.

On the other hand, the amount of dialyzed fluid after dialysis that is stored in the drainage storage container 2 from the abdominal cavity is monitored by the second weight measuring means 23b and the control calculation section 15, and the control calculation section 15 uses the input measurement data. When it is determined that the amount of fluid stored in the drainage storage container 2 is substantially equal to the sum of the water removal amount of the patient and the stored infusion dialysate amount, the total amount of dialysate (drainage liquid) after dialysis is collected. I judge that I did. Then, an operation control signal is output to the second normally closed valve 10 and the third normally closed valve, and the second normally closed valve 10 and the third normally closed valve 1 are output.
1 is closed.

As described above, the drainage is discharged, and at the same time, the washing operation and the priming operation of the portion where there is a risk of contamination by bacteria or the like are achieved.

(3-2) Injection of dialysate The dialysate in the first dialysate container 1 is injected into the abdominal cavity as follows.

That is, an operation control signal is output from the control calculation unit 15 to the first normally closed valve 9 and the second normally closed valve 10, so that the first normally closed valve 9 and the second normally closed valve 10 are opened. . At this time, the third normally closed valve 11 and the fourth to sixth normally closed valves 12 to 14 remain in the closed state.

This state is a state in which the first circulation means in the present invention is operated. That is, the outlet pipe 20 of the first dialysate container 1 and the catheter 34 of the patient are connected by one flow path.

Since the first dialysate container 1 is arranged at a position higher than the position of the patient, the dialysate heated to a predetermined temperature from the inside of the first dialysate container 1 is supplied to the dialysate flow passage 5 And delivered intraperitoneally via catheter 34.

Also at this time, the first weight measuring means 2
3a continuously measures the weight of the first dialysate container 1, and outputs the measured data to the control calculation unit 15.
Then, the control calculation unit 15 calculates the weight reduction rate of the dialysate in the first dialysate container 1 in the same manner as described above, and the weight reduction rate becomes equal to or less than a predetermined threshold value or more than a threshold value, Alternatively, it is determined whether or not it is 0. Then, when it is determined that the dialysate is being supplied into the abdominal cavity at the normal weight reduction rate, an operation command signal is output and, for example, a "green lamp" indicating normal operation in the output display means 17 is turned on.

If the amount of dialysate delivered from the first dialysate container 1 does not reach the amount of dialysate to be injected into the abdominal cavity, the predetermined weight reduction rate is less than or equal to the predetermined threshold value or the threshold value. When it becomes the above or becomes 0, the control calculation part 15 which has detected it outputs an operation command signal to the alarm means 16 to alert the patient. Upon receipt of this alarm, the patient checks whether the dialysate flow passage is not bent, or whether the amount remaining in the first dialysate container 1 and the infusion amount displayed by the output display means match, If possible, eliminate the cause of the abnormality.

When the disconnected state is resolved, the control calculation unit 15 recognizes that the disconnected state has been resolved based on the weight measurement data output from the first weight measuring means 23a, and stops the alarm or injects the dialysate. The output display means displays a display indicating that the operation is normally performed.

The control / calculation unit 15 includes the first weight measuring means 23.
With the weight measurement data continuously input from a, the first
It is judged that the injection of the dialysate is completed by confirming that the dialysate in the dialysate container 1 has been completely discharged or a predetermined amount of the dialysate has been discharged. Control calculation unit 1 that determines that the injection of dialysate is completed
5 causes the output display means 18 to display the completion of injection,
An operation control signal is output to the first normally closed valve 9 and the second normally closed valve 10 to switch these normally closed valves to the closed state.

As described above, the injection of the dialysate in the first dialysate container 1 into the abdominal cavity is completed.

The dialysate injected into the abdominal cavity is stored in the abdominal cavity as it is for a predetermined time, and peritoneal dialysis is performed.

(3-3) Replenishment of the first dialysate container 1 with the dialysate As described above, while the peritoneal dialysis is performed by storing the dialysate in the abdominal cavity of the patient, three second dialysates are used. Of the dialysate containers 8a, 8b, 8c, for example, the dialysate in the second dialysate container 8a is transferred into the first dialysate container 1.

By inputting the operation command signal from the control calculation section 15, the fourth normally closed valve 12 is opened,
The first to third normally closed valves 9 to 11, the fifth normally closed valve 13 and the sixth normally closed valve 14 are closed. Then, the dialysate in the second dialysate container 8a is transferred into the first dialysate container 1 by a natural drop.

From the second dialysate container 8a to the first dialysate container 1
The transfer of the dialysate to is monitored by the first weight measuring means 23a.

The first weight measuring means 23a measures the weight of the first dialysate container 1 even while the dialysate in the second dialysate container 8a is being transferred into the first dialysate container 1. .
Then, the measured measurement data is output to the control calculation unit 15, and the control calculation unit 15 based on the input measurement data,
The weight increase rate of the first dialysate container 1 is calculated. And
By the same method as described above, the second dialysate container 8a
From the second branch pipe 7 to the first dialysate container 1 is monitored for a disconnection state, and when it is determined that a disconnection state has occurred, the control calculation unit 15 causes the alarm unit 1 to operate.
An alarm is issued by outputting an operation command signal to 6.
Alternatively, the output display means 18 is caused to display a warning.

The control calculation unit 15 which inputs the measurement data output from the first weight measuring means 23a calculates the amount of dialysate contained in the first dialysate container 1 by integrating the weight measurement data, When the set dialysate amount and the calculated dialysate amount match, it is determined that a predetermined amount of dialysate has been transferred into the first dialysate container 1, and an operation command signal is output to output the fourth normally closed valve 12 Switch to the closed state.

Further, the control calculator 15 which inputs the measurement data output from the first weight measuring means 23a calculates the amount of dialysate contained in the first dialysate container 1 by integrating the weight measurement data. If the calculated dialysate volume is insufficient for the preset dialysate volume, the second dialysate container 8
When all the dialysate in a is transferred to the first dialysate container 1 and judged, an operation command signal is output to open the fifth normally closed valve 8b and / or the sixth normally closed valve 8c. After switching, the fourth normally closed valve 8a is switched to the closed state, and the dialysate is transferred from the second dialysate container 8b and / or the second dialysate container 8c to the first dialysate container 1.

The dialysate stored in the first dialysate container 1 at the beginning of dialysis and the second dialysate container 8a,
The components of the dialysate in 8b and 8c may be the same or different. The composition of the dialysate in the second dialysate container 8a, 8b, 8c may be different from the composition of the dialysate in the first dialysate container 1 depending on the purpose of dialysis, the condition of the patient, and the like.

As described above, the panel heater 2 also applies to the dialysate thus transferred to the first dialysate container 1.
1, temperature control is performed by the temperature measuring means 22 and the control calculation section 15.

(4) Second and subsequent dialysis When the transfer of the dialysate from the second dialysate container 8a into the first dialysate container 1 is completed and the peritoneal dialysis for a predetermined time is completed, the second dialysate is completed. Dialysis is performed.

Even in the case of performing the second dialysis operation, it is necessary to discharge the dialyzed dialysate stored in the abdominal cavity by the first dialysis operation into the drainage storage container 2. The operation of discharging the dialyzed solution after dialysis, the confirmation of the discharge of the total amount of dialyzed solution after dialysis, the monitoring of the depressurized state during discharging, etc. are performed in the same manner as in the first dialysis operation.

After the dialysis, after the dialysate is completely discharged into the drainage container 2, the dialysate in the first dialysate container 1 heated to a predetermined temperature is injected into the abdominal cavity. The operation of injecting the dialysate from the first dialysate container 1 into the abdominal cavity, the monitoring of the flow state in the flow passage during the injection, and the like are performed in the same manner as the first injection of the dialysate.

The first dialysate container 1 for the second dialysis
When the dialysate maintained at a predetermined temperature is injected into the abdominal cavity from, the second dialysis is performed for a predetermined time.

During the second dialysis, the dialysate contained in the second dialysate container 8b is transferred into the first dialysate container 1. This first dialysate container 1
The transfer of the dialysate into the inside is performed in the same manner as the transfer of the dialysate in the first dialysis.

When the transfer of the dialysate from the second dialysate container 8b to the first dialysate container 1 is completed and the dialysate in the first dialysate container 1 is heated and maintained at a predetermined temperature. , The third dialysis is performed.

Even in the case of performing the third dialysis operation, it is necessary to discharge the post-dialysis dialysate stored in the abdominal cavity into the drainage container 2 by the second dialysis operation. The discharge of the dialysate after this dialysis is the same as in the first dialysis operation.

When the dialysate after dialysis is completely discharged into the drainage container 2, the dialysate in the first dialysate container 1 maintained at a predetermined temperature is injected into the abdominal cavity. This first dialysate container 1
The injection of the dialysate into the abdominal cavity is also performed by the same operation as the first injection of the dialysate.

First dialysate container 1 for the third dialysis
When a dialysate at a predetermined temperature is injected into the abdominal cavity from, the third dialysis is performed for a predetermined time. Even during the third dialysis, the dialysate contained in the second dialysate container 8c is transferred into the first dialysate container 1. The transfer of the dialysate into the first dialysate container 1 in the third dialysis is performed similarly to the transfer of the dialysate in the first dialysis.

Even in the case of performing the fourth dialysis operation, it is necessary to discharge the dialyzed dialysate stored in the abdominal cavity into the drainage container 2 by the third dialysis operation. The discharge of the dialysate after this dialysis is the same as in the first dialysis operation.

When the dialysate after dialysis is completely discharged into the drainage container 2, the dialysate in the first dialysate container 1 is injected into the abdominal cavity. The injection of the dialysate into the abdominal cavity from the first dialysate container 1 is also performed by the same operation as the first injection of the dialysate.

For the fourth dialysis, the first dialysate container 1
Injection of the dialysate into the abdominal cavity from the first dialysate container 1 for the first to the fourth dialysis so that the time when the injection of the dialysate into the abdominal cavity is completed is the wake-up time of the patient. The time to complete is adjusted.

When the patient is almost awake, the injection of dialysate from the first dialysate container 1 into the abdominal cavity is completed for the fourth dialysis. The patient removes the catheter-side connector 35 from the second connector 36 and attaches the cap to the catheter-side connector 35. In this state, since the patient is free from the automatic peritoneal dialysis device, he / she can carry out his / her daily life with almost no hindrance. Then, while the patient is engaged in daily life, dialysis is performed with the dialysate stored in the abdominal cavity.

Even in the dialysis operation after the second time,
The first dialysate container 1 from the second dialysate containers 8b and 8c is controlled by the first weight measuring means 23a and the control calculator 15.
The disconnection state of the flow path during the transfer of the dialysate to is monitored, and when it is determined that the disconnection state has occurred, the alarm as described above is issued.

Even in the dialysis operation after the second time,
Drainage storage container 2 for dialyzed fluid stored in the abdominal cavity after dialysis
At the time of discharging, the second weight measuring means 23b and the control calculator 15 determine whether or not the total amount of dialyzed dialysate pooled in the abdominal cavity has been discharged in the same manner as described above, and the total amount is discharged. After it is confirmed that the dialysate has been injected, the dialysate in the first dialysate container 1 is injected into the abdominal cavity.

Even in the second and subsequent dialysis operations,
Drainage storage container 2 for dialyzed fluid stored in the abdominal cavity after dialysis
At the time of discharging the liquid into the container, the second weight measuring means 23b and the control calculator 15 monitor the flow state from the distal end of the catheter to the drainage container 2 in the same manner as described above.
When a distribution abnormality occurs, the alarm means 16 issues an alarm.

In the second and subsequent dialysis operations, while the dialysate is being transferred from the second dialysate container 8b, 8c to the first dialysate container 1, the first weight measuring means 23a is operated by the first dialysate container. 1 continues to be weighed, and in the same manner as described above, the flow state in the flow path from the second dialysate container 8b, 8c to the first dialysate container 1 is monitored, and the flow path is not connected. When it occurs, it is detected and an alarm is issued by the alarm means 16, and when it is confirmed that a predetermined amount of dialysate has been transferred to the first dialysate container 1, the transfer operation is stopped.

In this automatic peritoneal dialysis device, the amount of dialysate to be injected into the peritoneum is determined by the control calculation unit 15 for each dialysis.
The amount of post-dialysis fluid stored in the drainage storage container 2 is stored in the storage device in the control calculation unit 15. At the end of each dialysis, the control calculator 15 subtracts the amount of dialysate injected into the peritoneum from the amount of dialysate after dialysis to calculate the water removal amount. The calculated water removal amount for each time is stored in the storage device, while the control calculation unit 15 outputs the data indicating the water removal amount to the output display unit 18, so that the output display unit 18 displays the water removal amount for each dialysis. Let Furthermore, when dialysis four times a day is completed, 4
By adding the amount of water removed by dialysis once to calculate the amount of water removed per day and storing it in the storage device, while outputting the data indicating the amount of water removed per day to the output display means 18,
The output display means 18 displays the amount of water removed per day. If desired, the output display means 18 displays a list or a graphic display of the amount of water removed as a result of each dialysis, the amount of water removed daily, and the amount of water removed as a result of dialysis from a certain point in the past to the present. It can be printed out or displayed on the CRT screen.

[0169]

In the automatic peritoneal dialysis apparatus of the present invention, the dialysate is injected into the abdominal cavity by utilizing the natural head. Therefore, even if the tube is blocked by bending or crushing due to the patient turning over while sleeping, etc., the internal pressure of the tube rises sharply and the tube is damaged as in the forced injection by a roller pump. There is no danger of doing. On the other hand, the dialysate after dialysis is discharged from the abdominal cavity by utilizing the suction force by depressurizing the outside of the drainage container. Therefore, unlike the case where the dialysate is discharged from the abdominal cavity into the drainage storage container after dialysis using the natural drop, the drainage storage container does not need to be arranged at a position considerably lower than the position of the patient's body.

Therefore, according to the present invention, the entire apparatus can be made compact, and there is no need to lay the patient on the bed in order to place the bag lower than the patient's body. It is possible to provide an automatic peritoneal dialysis device that can perform CCPD therapy while a patient lies on a futon.

Further, in the automatic peritoneal dialysis device of the present invention, since the dialyzed solution after dialysis is discharged from the abdominal cavity by utilizing the suction force by depressurizing the outside of the storage container, a tube or the like is used. Even if the dialysate flow passage is blocked by bending or crushing due to the patient rolling over while sleeping, etc., there is no sudden decrease in internal pressure as in the case of forced discharge by a roller pump, etc. . Therefore, when the tube is blocked for a short time, as in the case of forced discharge by a roller pump,
It is possible to return to a normal discharge state without performing an operation such as reverse rotation of the pump. Therefore, according to the automatic peritoneal dialysis device of the present invention, it is possible to provide an automatic peritoneal dialysis device that has a simple device configuration and can be downsized.

According to the present invention, there is no need for frequent switching of valves as in the case of using a double pump,
It is possible to provide an automatic peritoneal dialysis device with extremely low operating noise.

In summary, according to the present invention, it is possible to provide an automatic peritoneal dialysis device suitable for home treatment.

[Brief description of the drawings]

FIG. 1 is an explanatory diagram showing an outline of a configuration of an embodiment of the present invention.

[Explanation of symbols]

1 ... 1st dialysate container 1, 2 ... drainage container, 3
... Container chamber, 4 ... Decompression means, 5 ... Dialysate flow pipe, 6 ... First branch pipe, 7 ... Second branch pipe, 7
a, 7b, 7c ... Branch pipe, 8a, 8b, 8c ... Second dialysate container, 9 ... First normally closed valve, 10 ... Second normally closed valve, 11 ... Third Normally closed valve, 12 ...
4th normally closed valve, 13 ... 5th normally closed valve, 14 ...
6th normally closed valve, 15 ... Control operation part, 16 ... Alarm means, 17 ... Input means, 18 ... Output display means, 19 ... First dialysate container 1 side connector, 20・ ・
Derivation pipe, 21 ... Panel heater, 22 ... Temperature measuring means, 23a ... First weight measuring means, 23b ...
2nd weight measurement means, 24 ... container side connector, 2
5 ... Introducing pipe, 26 ... Internal space, 27 ... Exhaust pipe, 28 ... Positive displacement pump, 29 ... Pressure measuring means, 30 ... Pressure releasing means, 31 ... Air Distribution pipe,
32 ... Valve, 33 ... First connector, 34 ...
・ Catheter, 35 ... Catheter side connector, 36
... Second connector, 37 ... Third connector, 38 ...
.... Fourth connector, 39a, 39b, 39c ... Outlet pipe, 40 ... Second dialysate container side connector.

 ─────────────────────────────────────────────────── ─── Continuation of the front page (72) Inventor Toshio Sawairi 498-1 Shizuya, Haibara-cho, Haibara-gun, Shizuoka Prefecture Nikkiso Shizuoka Factory

Claims (3)

[Claims] 1. A dialysate container containing a dialysate and a drainage container for storing drainage after dialysis are provided, and the drainage is stored by depressurizing the outside of the drainage container. A drainage suction means for forcibly storing in the container, a first circulation means for supplying the dialysate in the dialysate container into the abdominal cavity of the patient via the catheter by a drop, and the drainage container after dialysis An automatic peritoneal dialysis device comprising: a second circulation means to be supplied inside; and a control means for controlling the operations of the first circulation means and the second circulation means. 2. A main dialysate container containing a dialysate, and a drainage container containing the drained liquid after dialysis are provided, and the drainage is drained by reducing the pressure outside the drainage container. A drainage suction means for forcibly accommodating in the accommodating container, a preliminary dialysate container containing a dialysate, and a dialysate in the main dialysate container is supplied into the abdominal cavity of a patient via a catheter by a drop.
A flow means, a second flow means for supplying the effluent after dialysis into the waste liquid storage container, and a third flow means for supplying the dialysate in the preliminary dialysate container into the empty main dialysis container due to a drop. An automatic peritoneal dialysis device comprising: a first circulation means, a second circulation means, and a control means for controlling operations of the third circulation means. 3. The drainage suction means has a storage container for storing the drainage storage container, a decompression means for decompressing the inside of the storage container, and a decompression control means for controlling the decompression means. The automatic peritoneal dialysis device according to claim 1 or 2, wherein