JPH0928791A - Priming method for dialysis part, priming device used in the same and disposal connection tube used in the same - Google Patents

Abstract

PROBLEM TO BE SOLVED: To prime a large number of dialysis parts comprehensively simultaneously with dialysis liquid by sending the dialysis liquid to the large number of dialysis parts simultaneously as purifying from the artery circuit exits of the large number of dialysis parts and passing a prescribed quantity of purified dialysis liquid. SOLUTION: The dialysis liquid is sent in the dialysis liquid entry 14 of a dialyzer 1, and the dialysis liquid is purified. At this time, liquid pressure is confirmed by a pressure gage 31, and the pressure of the dialysis liquid is adjusted by a valve 32 so as not to be set higher. The dialysis liquid purified by the dialyzer 1 is induced to the dialysis liquid entries 14a, 15a of a second dialyzer 1a via a terminal fork shape dialysis liquid output tube 2a connected to blood circuit connection ports 12, 13. Also, in such a case, the dialysis liquid is purified and dialyzed while confirming the liquid pressure by a pressure gage 31a. The artery circuit connection port 12a and the artery circuit connection port 13a of the dialyzer 1a are connected to plural dialysis parts via a purifying dialysis liquid output tube 2, a disposal connection tube 5 and a valve 22.

Description

Detailed Description of the Invention

[0001]

An object of the present invention is to eliminate the mechanical instruments such as a blood pump, an anticoagulant continuous injector and a dialysis monitor in an artificial dialysis machine which is indispensable for the treatment of kidney disease.
Preliminary cleaning and air bleeding operations, so-called priming, which are mainly carried out before the start of dialysis treatment for a dialyzer (dialyzer, artificial kidney) and a blood circuit connected to it (hereinafter collectively referred to as a dialysis site). A physiological saline solution that has been used for priming, as well as enabling simultaneous priming of multiple dialysis sites, one for each patient to be treated and priming for each one at the same time. However, even though it is relatively inexpensive, the cumulative cost increases with the number of patients treated, and the cost burden is becoming non-negligible.Therefore, it is possible to use dialysis fluid instead of physiological saline for priming. A new priming method for a dialysis site, a priming device used for the priming method, and the priming device Is use is intended to provide an advantageous disposable tubes.

[0002]

2. Description of the Related Art Waste products, such as urea nitrogen, creatine and urinary toxins such as uric acid, or Na, K, Ca, etc.
If the kidney, which plays an important function of removing electrolytes such as P and maintaining an appropriate amount of water, falls into renal failure (uremic state) due to functional disorders such as chronic glomerulonephritis and diabetic nephropathy, Will no longer be able to lead a normal daily life. Although it is difficult to completely cure this kidney disease even with modern medicine, which has made remarkable progress and development, it is necessary to surely prevent only the progression (deterioration) of kidney disease because hemodialysis therapy has been established and spread. Became able to do, received certification from the national as a physically handicapped person,
By continuing this hemodialysis therapy on a regular basis under the guidance of a doctor, it is possible for a patient with kidney disease to lead an extremely ordinary daily life and to work even if he / she does not overdo it.

Although the fear of kidney disease has been overcome for some time by the power of such medical science, and the lives of many patients are guaranteed, it is unfortunate that patients with kidney disease are suffering. The number is increasing every year,
According to the data at the end of 1993, the number of affected people was 13
The number reached 4,293, and when compared with the previous year, it increased by 8.4% and 10,372. Needless to say, this tendency becomes a very serious concern for people who live a normal life, but for medical institutions and countries that support the national treasury that continue to support these kidney disease patients day and night, There is a new problem in maintaining the system for receiving hemodialysis therapy.

That is, about 40,000 yen is required for one dialysis cost of this hemodialysis therapy, and the patient undergoes dialysis about 13 times a month on average, so that a monthly treatment cost of about 500,000 yen or more. Since most of them are covered by public funds, the ratio of medical cost of renal failure to total medical cost is extremely high, and of course, the problem is that the cost increases year by year. Due to such medical circumstances, various policies have been put in place to curb medical expenses, and even for the implementation of hemodialysis therapy, sterilized physiological saline necessary for pre-operation, that is, priming, is excluded from medical assistance. It has been done.

In hemodialysis therapy (artificial dialysis therapy),
When performing artificial dialysis, first, as shown in the schematic configuration diagram of FIG. 4, a dialysis site, that is, an arterial circuit (AB) that guides blood from the patient's body to a dialyzer and dialysis. Blood circuit having a venous circuit (C to D) for returning the purified blood to the patient's body via the blood vessel P, and an arterial circuit (A
~ B) and the venous circuit (C ~ D) in the blood circuit between the fall vertically arranged, the upper end (because it is arranged fall,
The arterial circuit outlet P2 is connected to the lower part of the figure, and the venous circuit inlet P3 is connected to the lower end (the upper part in the figure because it is arranged to fall), and a semipermeable membrane-made ultrafine hollow fiber tube is connected between them. P1, P1, ... A structural part that is tightly connected with a bundle,
Semi-permeable membrane-made ultra-fine hollow fiber tubes P1, P1, ...
The structure is isolated from the blood circuit except for the action parts of 1, ..., The dialysate outlet O is on the upper side (lower side in the figure because it is arranged to fall) and the lower side (the upper side is arranged to fall, in the figure). The inside of the part constituted by the dialyzer P consisting of a structural part which is a part of the dialysate circuit having the same solution inlet I on the upper side) is flushed with commercially available sterilized physiological saline S. , While cleaning and filling the inside,
The dialyzer P is turned upside down and returned to the original state (that is, the arterial circuit connection port P2 is on the upper side and the venous circuit connection port P3 is on the lower side. In contrast, the dialysate inlet is on the bottom and the dialysate outlet is on the top, and the dialysate escapes from the bottom to the top opposite to the blood.) (Hereinafter, simply referred to as priming.) Before this artificial dialysis can be started.

The sterilized physiological saline required for this priming has so far been purchased and prepared by all medical institutions on the market. One artificial dialysis is prepared for each patient. The dialysis site of the device has been allocated one each, and priming has been performed by a separate operation for each device. The unit price of one sterilized physiological saline solution is about 260 yen at present, and it cannot be said that the unit price itself is so expensive, but as we have already seen, even one patient has a monthly average. Since I receive artificial dialysis about 13 times, it costs 3,400 yen per month per person, and at a very average medical institution capable of hemodialysis therapy, this sterilized physiological saline solution is used monthly. It is the actual situation that the cost required for this is as high as 400,000 to 500,000 yen.

According to the present invention, in view of the above situation,
As a measure to ensure that medical institutions that support the important treatment of artificial dialysis can continue to perform sound medical treatment without deteriorating the environment of medical care, In the priming method that is indispensable for hemodialysis therapy, a liquid that replaces this sterilized physiological saline solution is used as a focus. Whether or not the priming of dialysis is possible, we have earnestly continued research and development for many years, and finally, based on the following findings, an extremely innovative priming method for a dialysis site, a priming device used for it, and This is the successful realization of a disposable connection tube used together with the device.

The present invention is used as a liquid replacing sterilized physiological saline in order to permeate and diffuse through the semipermeable membrane a waste product (urea toxin) mixed in the blood in the priming method. An attempt is made to utilize the dialysate that has been used, and the dialysate is made individually in each medical institution before the start of dialysis, assuming that its composition is similar to blood in terms of its function. In the dialysate circuit of the dialyzer in the above, it is always flowing water, and since it does not come into direct contact with blood, it is not necessary to sterilize it unless it is used only as dialysate. In the present invention, the dialysate can be sterilized with an extremely simple structure as described in detail below,
Completed the priming method for the dialysis site used as a liquid that replaces sterilized saline solution, and also realized a new structure of priming device to realize it, and a disposable connection tube required for the priming It was done.

[0009]

According to the dialysis site priming method of the present invention, when dialysis site priming is performed, the dialysis solution is purified from the arterial circuit outlet side of each blood circuit of the dialysis site into the dialysis site. The basic priming method for the dialysis site is to wash and deaerate the large number of dialysis sites together with the purified dialysis solution by sending a predetermined amount of the purified dialysis solution at almost the same time. This is the gist of the configuration.

The dialysis site, as shown in FIG. 4 shown in the prior art, is an artificial dialysis device required when performing artificial dialysis with hemodialysis therapy on a patient suffering from kidney disease. In particular, a blood circuit having an arterial circuit (AB) for guiding blood from the patient's body to the dialyzer and a venous circuit (CD) for returning blood purified via the dialyzer to the patient's body, Further, it is arranged vertically in the blood circuit between the arterial circuit (A to B) and the venous circuit (C to D), and the artery is arranged at the upper end (downward in the figure because it is arranged to fall). A circuit outlet B and a venous circuit inlet C are connected to the lower end (upper side in the figure because it is arranged to fall), and a semipermeable membrane-made ultrafine hollow fiber tube P1, P1, ... Structured parts that are tightly connected to each other, and semi-permeable membrane made ultrafine hollow fiber tubes P1, P1, ...
It is an internal space that is in contact with the surroundings and has a structure that is isolated from the blood circuit except for the semipermeable membrane acting portion of the ultrafine hollow fiber tubes P1, P1 ,. A dialyzer P comprising a dialysate outlet O on the lower side in the figure and a structural portion that is part of the dialysate circuit with the lower side (the lower side in the figure on the lower side in the figure) being the inlet I of the same. The device part including the blood pump M, the anticoagulant continuous injector, and the dialysis monitor (bedside monitor) in the artificial dialysis device is excluded.

In the blood circuit, the members constituting the arterial circuit (A to B) are mainly made of a transparent silicon tube main of φ5 to 6 mm, and a puncture needle for connecting a puncture needle at one end side. The connecting joint is arranged in a state of being capped and protected by a protective sheath tube in advance, and an arterial coupler B for connecting to an arterial circuit connecting port P2 provided on the upper end side of the dialyzer is incorporated at the other end. In addition, a pressure pump hose (φ10 to 12 mm) H for mounting a blood pump, an air trap (chamber) N, etc. are arranged in series in the middle, and a three-pronged connection joint is arranged at a required location. One of them has a thin tube (φ2-3mm) for injecting anticoagulant, and the total length is about 4
m, and the venous circuit (C ~
The member D) is also mainly composed of a transparent silicon tube main pipe having a diameter of about 5 to 6 mm, and one end of which has a vein coupler C for connecting to a dialysate inlet provided on the upper end side of the dialyzer. , And a puncture needle connection joint for connecting a puncture needle is arranged at the other end in a state of being previously capped and protected by a protective sheath tube. An air trap (chamber) N with a built-in venous pressure gauge connection pipe is arranged in series, and is formed to a length of about 3 m. All are sterilized and rigorously packaged, and they are ready-made products. It is commercially available.

The dialyzer P itself is also provided as an independent ready-made product that has been sterilized, and blood circuit connection ports P2 and P are provided at the upper and lower ends of a cylindrical hollow housing.
3 is formed, and a semipermeable membrane made ultrafine hollow fiber tube P is formed between them.
1, P1, ... Bundles are arranged, and a pair of upper and lower dialysate circuit circuits connected to the inner space in contact with the surroundings are provided on the side surface of the housing. Ports I and O are formed, and each connection port is capped or plugged so that each connection port and the inside thereof are protected.

Before the start of artificial dialysis, the above-mentioned blood circuit and this dialyzer are kept in a strictly packaged state before starting the artificial dialysis, and the dialysis treatment for the patient is started. Only immediately before it is taken out from the packaging container, and as predetermined, that is, the arterial circuit outlet B in the arterial circuit (A to B) in the blood circuit is connected to the arterial circuit connection port P2 of the dialyzer and the venous circuit (C). To D) are connected to the venous circuit inlet C to the venous circuit connecting port P3 of the dialyzer (provided that both the arterial circuit and the venous circuit, the puncture needle connecting joint is either a protective sheath tube or a disposable tube). Thus, the dialysis site in the dialysis machine is formed, and the dialyzer in the dialysis site is attached to the already prepared stand with casters. As the arterial circuit connection port B side is positioned downward, the arrangement in the dialysis treatment course suspended as a fall vertically arranged to reverse, so that the wait for the priming.

One dialysis machine must be prepared for each patient, and usually, each medical institution will intensively treat a large number of patients in a dedicated room for treatment. Since each dialysis site is in a stand-by state for priming in a state where it is suspended on a stand with casters, combine them into one place and connect them to the puncture needle of the arterial circuit (AB) at each dialysis site. The protective sheath tube is removed from the joint, and appropriate means capable of supplying purified dialysate to the joints A, A, ... For connecting puncture needles of the plurality of arterial circuits (A to B) at approximately the same time, for example As in the priming device of the invention, a plurality of connectors are arranged in series on a single purified dialysate extraction tube, and the joint A for puncture needle connection at the tip of each dialysis site is connected to the connector. Then, supply a purified dialysate using one purified dialysate extraction tube, or prepare a plurality of nozzles in the supply tank that temporarily stores the purified dialysate while purifying each nozzle. A plurality of supply tubes are arranged in parallel with each other, the respective puncture needle connection joints A are connected to the supply tubes, and the purified dialysis fluid is forced to flow down to each dialysis site substantially simultaneously. The dialysis site is primed.

During the so-called artificial dialysis treatment, the dialysate is continuously supplied to the dialyzer during the dialysis, and waste products from the patient's blood, that is, uremic toxins such as urea nitrogen, creatine and uric acid, or It is a liquid that removes electrolytes such as Na, K, Ca, P and adjusts to an appropriate amount of water, so that electrolytes such as Na, K, Ca, P and others can be adjusted according to patient symptoms. , Has a property similar to physiological saline because it is produced in a large amount each time at each medical institution, and in particular, it is not sterilized like commercial saline provided for commercial priming. However, it is much cheaper than that. In addition, the purified dialysate is a dialysate that is purified from the dialysate used for artificial dialysis through a semipermeable membrane to eliminate the contamination of bacteria, and is a commercially available dialyzer as a part for artificial dialyzer. Or, dialyzing the dialysate with a dialyzer specially prepared as having a structural function equivalent to or more than that,
It is obtained by purifying.

[0016]

[Related invention 1] The present invention relates to a priming method of the present invention having the basic structure as described above as a gist, and in the present invention, a priming device having the following novel structure for carrying out the priming is provided. Is also included. That is, the arterial circuit connection port and the venous circuit connection port of a dialyzer (semipermeable membrane permeation diffusion type filter, or a dialyzer having a structural function equivalent to or higher than that) employed in an artificial dialyzer,
Alternatively, either one of the end-forked or single-ended single-tubular washing liquid removal silicon tubes formed with a large number of connectors for connecting the arterial circuit inlet side of the blood circuit at the dialysis site to be washed midway A silicon tube for sending dialysate, in which a pressure gauge is arranged in the middle, is connected to either one of the dialysate inlet or the outlet of the dialyzer while connecting the ends. The pressure-adjusted dialysate is fed into the internal space around the semipermeable membrane ultrafine hollow fiber tubing inside the dialyzer, and the purified dialysate that permeates into the semipermeable membrane ultrafine hollow fiber tubing inside the dialyzer and is purified , Arterial circuit connection and venous circuit connection of dialyzer,
Alternatively, the priming device is characterized in that either one of them is made to flow through and pass through the dialysis site connected to the same connector through the silicon tube for taking out the cleaning and washing liquid.

As a further improved structure, the arterial circuit connection port of a dialyzer (semipermeable membrane permeation diffusion type filter, or a dialyzer having a structural function equivalent to or higher than that) adopted in an artificial dialyzer. And a venous circuit connection port, or either one of them, which has a plurality of connectors for connecting the arterial circuit inlet side of the blood circuit in the dialysis site to be washed midway, formed at predetermined intervals with a bifurcated end or single end tubular washing liquid While connecting each end of the taking-out silicone tube, either one of the dialysate inlet or outlet of the dialyzer is connected to a dialysate feeding silicone tube in which a pressure gauge is arranged in the middle, and the dialyzing is performed. The dialysis solution whose pressure is adjusted from the liquid feeding silicone tube is sent into the internal space that is in contact with the periphery of the semipermeable membrane ultrafine hollow fiber tube inside the dialyzer, and is fed into the semipermeable membrane ultrafine fiber tube inside the dialyzer. Dialysis fluid that has been purified by passing through it is connected to the same connector through a disposable connection tube through a silicone tube for taking out the purified cleaning fluid from the arterial circuit connection port and the vein circuit connection port of the dialyzer, or one of them. The present invention also includes a priming device, which is characterized in that it is made to flow into and pass through the site.

The dialyzer used in this pumming device is
A commercially available dialyzer for a so-called artificial dialysis machine is adopted as it is, and a housing formed as a cylindrical hollow body (most commercially available has an outer diameter of about 5 cm and a length of about 20 cm) is at the upper end. An arterial circuit connecting port connecting the arterial circuit outlet, and a vein circuit connecting port connecting the vein circuit inlet is formed at the lower end, respectively, and in the housing in between,
Tightly connected with a semi-permeable membrane ultra-fine hollow fiber tube bundle that is made by bundling 20,000 or more semi-permeable membrane ultra-fine hollow fibers with an inner diameter of about 200 microns (total membrane area: 0.3 to 2.2 square meters). A structure that has a structural part that is formed and is an internal space of the housing that is in contact with the periphery of the semipermeable membrane ultrafine hollow fiber tube, and is isolated from the blood circuit except for the semipermeable membrane action part of the semipermeable membrane ultrafine hollow fiber tube. The dialysate outlet is provided on the upper side of the dialysate and the dialysate inlet is provided on the lower side of the dialysate.

A discharge tube with a valve is connected to both the dialysate outlet and the dialysate inlet of the dialyzer, or to either one (however, in the case of only one of them, the other not selected). It will be plugged.)
A dialyzer delivery silicone tube with a pressure gauge is connected in the middle, and the dialysate is supplied at a predetermined pressure to the inner space of the housing in contact with the periphery of the semipermeable membrane ultrafine hollow fiber tube of the dialyzer. Along with the realization, both the arterial circuit connection port and the venous circuit connection port at the upper and lower ends of the dialyzer, or either one selected (However, in the case of only one, the other not selected is plugged. There must be.)
In, the ends of the forked silicone tube for removing the single tubular washing liquid is connected to each end, and the purified dialysate that has penetrated from the outside to the inside of the ultrafine hollow fiber tube made of a semipermeable membrane is purified,
The structure is designed to flow out from the arterial circuit connection port and / or the venous circuit connection port toward the outside of the dialyzer.

At a position separated by a predetermined distance from the side of the silicon tube for taking out the cleaning liquid, which is formed into a bifurcated end or a single tube at the end, a predetermined interval is set (for example, a separation distance of about 10 to 20 cm. Is not limited at all.)
A plurality of connectors are arranged in series, and each connector has a joint for connecting an arterial circuit puncture needle in a plurality of dialysis sites in a plurality of artificial dialysis machines that are already on standby for priming (arterial circuit entrance side). Each will be connected.

The cleaning liquid take-out silicone tube has a structure in which it branches into two or more parts from a position separated by a predetermined distance from the side formed into a bifurcated end part or a single tube part at the end part, and a connector is provided in each of them. Of course, it is also possible to arrange a large number of connectors within a limited range (effective for making the device advantageous for operability and averaging of the purified dialysate pressure). Further, the dialyzer is not limited to one, but may have a structure in which a plurality of dialysers are arranged in series. In the case of this structure,
Both the arterial circuit connection port and the venous circuit connection port of the dialyzer placed at the last position, or either one selected (however, in the case of only one, the other not selected is plugged). The silicon tube for taking out the cleaning liquid is connected to the end in a bifurcated shape or a single tube at the end.

On the other hand, if the connection of the arterial circuit puncture needle connection (arterial circuit entrance side) to the connector is also made through a disposable connection tube, the arterial circuit puncture needle connection performed by the priming method according to the present invention It is possible to prevent contamination that may occur due to the connection of the joint to the connector. Therefore, the present invention also relates to the above-described priming device and also includes a disposable connection tube having the following configuration.

[0023]

[Related invention 2] A relatively short silicone tube,
A coupler that fits into the puncture needle connection joint of the blood circuit at the dialysis site is installed at one end, and a connector connection joint with a protective sheath tube is installed at the other end, and the coupler is connected to the blood circuit at the dialysis site. 4. The silicone for removing cleaning liquid in the priming device according to claim 3, which is fitted in a joint for connecting a puncture needle on the side of an arterial circuit in the above, and removes the protective sheath tube from the joint for connecting the connector in which the protective sheath tube is capped. The present invention is characterized in that it is inserted into a connector of a tube and remains fitted in a joint for connecting a puncture needle of a blood circuit at a dialysis site for preventing contamination after priming and immediately before artificial dialysis treatment. It is a disposable connection tube used together with a priming device. Hereinafter, each embodiment shown in the drawings will be described in detail so that the above-described configurations included in the present invention can be more specifically and clearly understood.

[0024]

EXAMPLE 1 A priming device having the basic structure of the present invention, which is shown as a simplified block diagram of FIG. 1, is one of the cases in which two commercially available dialysis machines are adopted. First, the dialysate inlet 14 of the first dialyzer 1 (the same as the dialyzer P in FIG. 3 shown as a conventional example) 14
(A dialysate inlet I or a dialysate outlet O of the dialyzer P when used for artificial dialysis treatment) may be connected to a dialysate supply tube 3 having a pressure gauge 31 attached thereto, Dialysate in the housing of the dialyzer 1,
A semi-permeable ultrafine hollow fiber tube is fed into the inner space in contact with the periphery by using a blood pump to allow the dialysate to permeate into the interior of the semi-permeable ultrafine hollow fiber tube from at least the outside of the dialysate. Bacteria and impurities that interfere with priming are removed and purified, and the purified dialysate is plugged with the arterial circuit connecting port 12 and the venous circuit connecting port 13 (however, omitting either one). It is also possible.) From dialyzer 1
So that it flows toward the outside of.

At this time, in order to prevent the pressure of the dialysate to be forcibly fed from rising, the fluid pressure is confirmed by a pressure gauge 31 arranged in the middle of the dialysate supply tube 3, and a proper fluid pressure is adjusted by a valve 32. (If the fluid pressure increases, the structure of the semipermeable membrane extra-fine hollow fiber tube may become abnormal, which may hinder the dialysis and purification of the dialysate.) At the same time, the dialysate supply tube 3 was not connected. Connected to the dialysate outlet 15 (which may be either the dialysate inlet I or the dialysate outlet O of the dialyzer P when used for artificial dialysis treatment, and is not the dialysate inlet 14 previously). A part of the dialysate supplied to the dialyzer 1 is made to flow out from the discharge tube 4 with the valve 41, which is adjusted to adjust the fluid pressure, and is dialyzed and separated by a semipermeable membrane ultrafine hollow fiber tube. Accumulated bacteria and impurities It has a structure that, as in no.

The dialysate purified by the first dialyzer 1 is secondly dialyzed by the purified dialysate take-out tube 2a having a forked end connected to the upper and lower blood circuit connection ports 12 and 13 of the dialyzer 1. It is guided to the dialysate inlets 14a and 15a (corresponding to the dialysate outlet 15 to which the discharge tube 4 was connected in the first dialyzer 1) of the device 1a, and here again, the liquid pressure is adjusted by the pressure gauge 31a just in case. While confirming, the dialysate purified by the first dialyzer 1 is dialyzed by the semipermeable membrane ultrafine hollow fiber tube of the dialyzer 1a so that the dialysate purified by the first dialyzer 1 can be surely treated as a surely purified dialysate.
As a purified dialysate that has been purified and re-purified, the dialyzer 1a
The arterial circuit connection port 12 and the venous circuit connection port 13 (however, either one can be omitted and plugged) to flow out toward the outside of the dialyzer 1a.

As shown in the figure, the arterial circuit connection port 12 and the venous circuit connection port 13 of the dialyzer 1a are provided with a number of connectors 21, 21, .. Since the extraction tube 2 is connected and the purified dialysis fluid that has been re-purified is passed through, the connectors 21, 21, ... Circuit puncture needle connection joint (venous circuit entrance side) A, A,
...... Or by connecting the disposable connection tubes 5, 5, ... separately connected thereto and closing the valve 22, the purified dialysate is supplied to the plurality of connected dialysis sites substantially at the same time. The priming device of the present invention is completed, which makes it possible to perform a priming treatment on a plurality of dialysis sites collectively with a purified dialysate instead of the conventional physiological saline S.

[0028]

EXAMPLE 2 FIG. 2 shows a concrete example of the disposable connecting tube 5 connected to the connectors 21, 21, ... It is shown as an enlarged cross-sectional view of a state in which it is connected to the circuit entrance side) A. That is, the disposable connection tube 5 is a silicon tube formed in a relatively short length of about 5 to 6 mm, for example, about 10 cm, which is substantially the same as the main silicon tube that constitutes the blood circuit of the dialysis site, and is formed at one end. Is a coupler 51 that fits into the puncture needle connection joint A of the blood circuit in the dialysis site, and a connector connection joint 52 with the protective sheath tube 6 capped at the other end. Of the connector sheath joint 6 for fitting the puncture needle connection joint A on the arterial circuit side in the blood circuit in FIG.
Is removed and inserted into the connector 21 of the silicon tube 2 for taking out the cleaning / cleaning liquid in the priming device of the first embodiment. In the figure, reference numeral 61 denotes an inscribed sheath tube which is arranged inside the protective sheath tube 6 and double protects the puncture needle connecting joint A, and 62 denotes intrusion of dust into the protective sheath tube 61. Shows a filter that blocks.

After the priming and immediately before the artificial dialysis treatment, the dialysis site is kept fitted in the puncture needle connection joint A of the blood circuit for contamination prevention, and the artificial dialysis treatment is started. At the stage of connecting the puncture needle, the entire disposable connection tube (however, the protective sheath tube 6 is discarded before the priming process) is first removed from the puncture needle connection joint A and discarded. It is something that you do. In the cross-sectional view of FIG. 3, this disposable connection tube 5 is removed so that its outer shape is indicated by a chain double-dashed line, and for connection of a puncture needle in an arterial circuit in a bare state in which a puncture needle can be connected. The end of the arterial circuit including joint A is shown.

[0030]

[Effects] The present invention having the above-described structure has the following advantages.
Unlike conventional priming methods, no commercial physiological saline solution is required, and each medical institution uses a dialysate prepared in advance for artificial dialysis treatment, which is safe and reliable without any change from the conventional case. Moreover, it was possible to realize an extremely innovative priming method for dialysis sites that allows priming treatment of multiple dialysis sites at once, and fulfills the important task of continuing to support kidney disease patients day and night. It is expected that existing medical institutions will be greatly helped in preventing the maintenance of the hemodialysis therapy system from being affected by the restraint of medical expenses.

Moreover, although the priming device for safely and reliably realizing the priming method is similar to physiological saline which is commercially available as a component for priming, it has hitherto come into direct contact with blood in artificial dialysis treatment. For that reason, we focused on the dialysis fluid that was easily produced by ourselves, without any purification treatment against various bacteria, and used it with a device with an extremely simple and economical structure, which was previously sterilized. A dialysis site that requires multiple dialysis sites to be primed together at the same time while continuously preparing a priming solution that replaces the saline solution. The priming of 1 is the same as before
It is possible to achieve the excellent feature that it is possible to significantly reduce the labor cost required for dialysis treatment by eliminating the need to carry out one by one, and the sterilized physiological saline solution mentioned above is unnecessary. In combination with this feature, it contributes to the reduction of the cost required for the treatment of kidney disease, and makes it possible to reliably prevent the deterioration of the treatment environment of medical institutions involved in the treatment of kidney disease.

In particular, in the priming device shown in the embodiment, a plurality of commercially available dialyzer P used in an artificial dialyzer for hemodialysis treatment is incorporated as the dialyzer 1 and 1a for the priming device. From
In addition to having the advantage that a commercially available product can be used as it is without customizing a dedicated dialysis dial, it can be used as a priming device for the sterilization treatment of dialysate, and is disposable as shown in Example 2. Contamination of the puncture needle connection joint A of the arterial circuit due to the connection with the connector 21 that may remain dirty during the repeated priming process by the same priming device by using the connection tube 5 for priming together. Can be reliably blocked, and after priming, the disposable connection tube 5 can be simply removed to immediately start the hemodialysis treatment with the puncture needle connected, which is also useful for speeding up the treatment, and the priming method Along with simplification, it can greatly contribute to the efficiency of hemodialysis treatment.

As described above, the present invention is an excellent method for priming a dialysis site, which is indispensable for the stable maintenance of the medical field related to the treatment of kidney disease which is gradually compressed, though the necessity of the treatment increases more and more. , And a priming device used therefor, and a disposable connection tube used in combination with the device, which has an immeasurable effect on the treatment and salvage of renal disease patients, which is statistically expected to increase further in the future. Therefore, it is expected that medical institutions involved in hemodialysis treatment will be highly evaluated, and above all, highly evaluated by patients with kidney disease.

[Brief description of drawings]

The drawings schematically show one of typical configurations of the priming device of the present invention and the disposable connecting tube used together with the priming device.

FIG. 1 is a schematic diagram showing a priming device of the present invention.

FIG. 2 is an enlarged cross-sectional view of a disposable connection tube used together with the priming device of the present invention, in which a part of a state in which it is combined with a joint for connecting an arterial circuit puncture needle is omitted.

FIG. 3 is an enlarged cross-sectional view of an end portion of an arterial circuit including a puncture needle connection joint, with a disposable connection tube removed.

FIG. 4 is a schematic configuration diagram for explaining conventional priming.

[Explanation of symbols]

1 Fluorizer 12 Same arterial circuit connection port 13 Same vein circuit connection port 14 Same dialysate inlet 15 Same dialysate outlet 2 Purified dialysate take-out tube 21 Same connector 22 Same valve 3 Dialysate supply tube 31 Same pressure gauge 32 Same Valve 4 Discharge tube 41 Same valve 5 Disposable connecting tube 51 Same coupler 52 Same connector connecting joint 6 Protective sheath tube 61 Same inscribed sheath tube 62 Same filter A Joint for connecting puncture needle at end of arterial circuit at dialysis site P Dialysis machine in artificial dialysis machine P1 Same semipermeable membrane extra-fine hollow fiber tube

Claims (4)

[Claims] 1. A blood circuit having an arterial circuit for guiding blood from the patient's body to a dialyzer and a venous circuit for returning blood purified through the dialyzer to the patient's body, and an arterial circuit and a venous circuit. A structure that is vertically arranged in the blood circuit between them, and the arterial circuit outlet is connected to the upper end and the venous circuit inlet is connected to the lower end, and the space between them is tightly connected by a bundle of semi-permeable ultrafine hollow fiber tubes. And a structure which is an internal space in contact with the periphery of the semipermeable membrane-made ultrafine hollow fiber tube and is isolated from the blood circuit except for the semipermeable membrane action part of the semipermeable membrane made ultrafine hollow fiber tube,
During priming of a dialysis site composed of a dialyzer consisting of a dialysate outlet on its upper side and a dialysate circuit on the lower side, the blood of each of the multiple dialysis sites From the arterial circuit entrance side of the circuit,
While purifying the dialysate, it is sent into these many dialysis sites at approximately the same time, and a certain amount of the purified dialysate is passed, so that the multiple dialysates can be collectively washed and bleeded with the purified dialysate. A method for priming a dialysis site. 2. An arterial circuit connecting port and a venous circuit connecting port of a dialyzer (semipermeable membrane permeation diffusion type filter, or a dialyzer having a structural function equivalent to or higher than that) used in an artificial dialyzer. On the other hand, each end of the silicone tube for removing the bifurcated end or the single-ended single tubular washing solution formed with a large number of connectors for connecting the arterial circuit entrance side of the blood circuit at the dialysis site to be washed midway Along with the connection, a dialysate delivery silicone tube with a pressure gauge is connected to either the dialysate inlet or outlet of the dialyzer, and the pressure is adjusted from the dialysate delivery silicone tube. The purified dialysate is sent to the internal space in contact with the semi-permeable membrane ultra-fine hollow fiber tube inside the dialyzer and permeates into the semi-permeable membrane ultra-fine hollow fiber tube in the dialyzer to purify the purified dialysate. of 2. The inflow or passage of a dialysis site connected to the connector through a purification / washing liquid removal silicone tube from one of the arterial circuit connection port and the venous circuit connection port. A priming device for use in the dialysis site priming method described. 3. An arterial circuit connecting port and / or a venous circuit connecting port of a dialyzer (semipermeable membrane permeation diffusion type filter, or a dialyzer having a structural function equivalent to or higher than that) employed in an artificial dialyzer. On the other hand, each end of the silicone tube for removing the bifurcated end or the single-ended single tubular washing solution formed with a large number of connectors for connecting the arterial circuit entrance side of the blood circuit at the dialysis site to be washed midway Along with the connection, a dialysate delivery silicone tube with a pressure gauge is connected to either the dialysate inlet or outlet of the dialyzer, and the pressure is adjusted from the dialysate delivery silicone tube. The dialyzed solution is fed into the inner space in contact with the periphery of the semipermeable membrane-made ultra-fine hollow fiber tube in the dialyzer, and the dialysate purified by permeating into the semipermeable membrane-made ultrafine hollow fiber tube in the dialyzer is artery Circuit connection port and vein circuit connection port,
The dialysis site according to claim 1, characterized in that the purified cleaning liquid is taken out from either one of them to flow into and pass through a dialysis site connected to the connector via a disposable connection tube. Priming device used in the priming method of. 4. A connector connection in which a relatively short silicone tube has a coupler fitted to a joint for connecting a puncture needle of a blood circuit at a dialysis site at one end and a protective sheath tube is capped at the other end. A joint for fitting, the coupler is fitted to the puncture needle connection joint on the arterial circuit side in the blood circuit at the dialysis site, and the protective sheath tube is removed from the connector connection joint to which the protective sheath tube is capped, The priming device according to claim 3, which is inserted into a connector of a silicone tube for taking out a cleaning and washing solution, and is fitted to a joint for connecting a puncture needle of a blood circuit at a dialysis site for prevention of contamination between after priming and immediately before artificial dialysis treatment. Disposable connection cord for use with the priming device according to claim 3, characterized in that it is retained. Tube.