JPH09313601A - Peritoneal dialyzer - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a peritoneal dialyzer which prevents the removal of excess moisture from the inside of the humor (blood) and is less degraded in the efficiency of removing wastes. SOLUTION: This peritoneal dialyzer is constituted by connecting a first vessel 10 contg. a dialyzate of a high osmotic pressure and a second vessel 10 contg. a dialyzate of a low osmotic pressure at the bottoms by a conduit 30 and providing the bottom of the first vessel 10 with a stirrer 11 and a dialyzate delivery port 12. The dialyzer is so constituted that the dialyzate provided with the osmotic pressure gradient from the high osmotic pressure to the low osmotic pressure is delivered continuously from the delivery port described above and is injected into the abdominal cavity while both dialyzates are continuously mixed by the static pressure of the dialyzates put into both vessels and the stirrer. More particularly, auxiliary vessels (10a, 20a, 10b, 20b) for contg. the respective dialyzates are preferably installed above the first vessel 10 and the second vessel 20.

Description

Detailed Description of the Invention

[0001]

TECHNICAL FIELD The present invention relates to a peritoneal dialysis device used for peritoneal dialysis.

[0002]

2. Description of the Related Art Peritoneal dialysis is a peritoneal dialysis membrane in which a dialysate is injected into the abdominal cavity to remove waste products (toxic metabolites) accumulated in the body due to renal failure and the like. This is a method of contacting blood with a dialysate across the peritoneum, and transferring waste products to the dialysate by the principle of membrane parallelism to remove the waste.

For this peritoneal dialysis, continuous peritoneal dialysis (CP
D) and intermittent peritoneal dialysis (IPD), which is performed after being left for a certain period of time, and then discharged, but intermittent peritoneal dialysis (IPD) is generally performed. In addition, continuous outpatient peritoneal dialysis (C), which is a further development of the above intermittent peritoneal dialysis (IPD).
APD) and continuous circulation peritoneal dialysis (CCPD) are also performed.

In this type of peritoneal dialysis, a dialysate containing 0.5 to 2 liters of dialysate adjusted to a constant osmotic pressure in a soft plastic bag is used. After setting on the perfusion device, an abdominal cavity catheter was inserted into the abdominal cavity, a dialysate with a constant osmotic pressure was injected into the abdominal cavity, and the dialysate was left in the abdominal cavity for about 30 to 60 minutes. Drain the liquid outside the body. This operation is repeated several times to several tens of times, whereby waste products in blood are removed across the peritoneum (for example, temporary dialysis 944-9.
51 (116-123) vol. 4 no. 7 198
(See 8)

[0005]

However, in the peritoneal dialysis using such a conventional peritoneal dialysis device, a dialysate having a constant osmotic pressure is left in the abdominal cavity to separate the peritoneum from the blood. In order to remove the waste products, the waste products accumulate in the dialysate at a high concentration in the latter half of the one dwell time, and the removal efficiency of the waste products decreases.

On the other hand, since the osmotic pressure is kept at a high hypertonic pressure, excessive water is removed from the body fluid (blood) together with waste products at the same time, which causes a considerable burden on the patient's body. There is.

The present invention is intended to solve the above problems, and an object thereof is to prevent excessive removal of water from body fluid (blood) and to reduce the efficiency of removing waste products. It is to provide a peritoneal dialysis device.

[0008]

In the peritoneal dialysis apparatus of the present invention, a first container for holding a dialysate having a high osmotic pressure and a second container for holding a dialysate having a low osmotic pressure are connected at the bottom by a conduit,
A stirrer and a dialysate outlet are provided at the bottom of the first container, and while both dialysates are continuously mixed by the static pressure of the dialysate contained in both containers and the stirrer,
A dialysate having an osmotic pressure gradient from a high osmotic pressure to a low osmotic pressure is continuously delivered from the delivery port and injected into the abdominal cavity (claim 1). invention).

Further, the peritoneal dialysis apparatus of the present invention is the above-mentioned peritoneal dialysis apparatus, wherein an auxiliary container is provided above each of the first container and the second container for containing a dialysate, and the first container and the second container are provided. The dialysate contained in each auxiliary container is configured to flow into the first container and the second container by static pressure when the respective dialysate contained in the respective containers is lowered to a certain level. (Invention of Claim 2)

Hereinafter, the configuration of the peritoneal dialysis apparatus of the present invention will be described in detail with reference to the drawings with reference to the drawings. FIG. 1 is a perspective view showing an example of the peritoneal dialysis device of the present invention. In FIG. 1, 10 is a first container for containing a dialysate having a high osmotic pressure, and 20 is a second container for containing a dialysate having a low osmotic pressure. It consists of a container.

The first container 10 and the second container 20
Are connected at their bottoms by a conduit (rubber tube) 30. Further, a stirrer (for example, a star rubber) 11 for uniformly mixing the dialysate and a dialysate outlet 12 are provided in a tubular shape at the bottom of the first container 10. The stirring tool 11 is operated by, for example, an electromagnetic force or a mainspring.

The simplest peritoneal dialysis apparatus of the present invention is, as described above, the first container 10 for containing the hyperosmotic dialysate.
A second container 20 for containing a dialysate having a low osmotic pressure, a dialysate stirring tool (star rubber) 11, a conduit 30, and a dialysate delivery port 12, and an auxiliary container 1 described later.
0a and 20a, separate auxiliary containers 10b and 20b, etc. are not required.

To carry out peritoneal dialysis using the above-mentioned peritoneal dialysis device, first, a peritoneal catheter (not shown) is connected to the dialysate delivery port 12, and the tip of this catheter is inserted into the abdominal cavity. The catheter of the delivery port 12 and the conduit 30 are closed by an appropriate means such as a pinch cock.

Next, a dialysate having a high osmotic pressure [eg, Perisolita G manufactured by Shimizu Pharmaceutical Co., Ltd .: osmotic pressure 678] is placed in the first container 10.
(MOsm / l)], and the second container 20 is filled with a low osmotic pressure dialysate [eg, Shimizu Pharmaceutical's Perisolita: osmotic pressure 361].
(MOsm / l)], and while rotating the stirring tool (star rubber) 11 at the bottom of the first container 10, remove the closure by a pinch cock or the like to open the dialysate delivery port 12.

Then, the dialysate in the first container 10 is naturally delivered by the static pressure from the dialysate at the bottom continuously from the dialysate outlet 12, and is continuously injected into the abdominal cavity through the abdominal cavity catheter. It In this case, the dialysate in the first container 10 is delivered from the delivery port 12, and the low osmotic dialysate in the second container 20 is naturally dialyzed in the first container 10 by its static pressure so as to supplement this. It is delivered to the bottom of the liquid, where both dialysates are continuously and uniformly mixed by means of the stirrer 11.

The uniformly mixed dialysate is the first mixture before mixing.
Exhibits an osmotic pressure smaller than that of the dialysate in the container 10,
This is continuously delivered from the dialysate delivery port 12. Thus, the dialysate having an osmotic pressure gradient from high osmotic pressure to low osmotic pressure is continuously injected into the abdominal cavity through the abdominal cavity catheter.

The dialysate continuously infused into the abdominal cavity as described above contacts the blood across the peritoneum while flowing through the abdominal cavity, and the waste products in the blood are transferred to the dialysate, after which the waste products are removed. The containing dialysate is continuously discharged to the outside of the body, or left in the abdominal cavity for a certain period of time and then discharged to the outside of the body.

Such a peritoneal dialysis operation is usually repeated a plurality of times, and when only the first container 10 and the second container 20 are used as described above, the first empty container is emptied each time.
Peritoneal dialysis must be performed by newly filling the container 10 and the second container 20 with a high osmotic pressure dialysate and a low osmotic pressure dialysate, respectively, which is a little cumbersome.

Therefore, an auxiliary container for containing the dialysate is provided above the first container 10 and the second container 20 so that the dialysate contained in the first container 10 and the second container 20 has a constant level. It is preferable that the dialysate contained in each auxiliary container is allowed to flow into each of the first container 10 and the second container 20 by static pressure when the temperature decreases.

A specific example of such a peritoneal dialysis device will be described below. In FIG. 1, an auxiliary container 10a for containing a similar dialysate is provided above a first container 10 for containing a dialysate having a high osmotic pressure, and an auxiliary container for containing a similar dialysate is provided above a second container 20. 20a is provided. Similar to the first container 10 and the second container 20, these auxiliary containers 10a and 20a are, for example, cylindrical containers made of transparent plastic having the same shape and the same capacity.

The top of the first container 10 and the auxiliary container 1
The bottom of 0a is connected by a conduit (rubber tube) 31a. The top of the first container 10 and the bottom of the auxiliary container 10a are separately connected by another conduit (rubber tube) 32a. Further, the first container 10 and the auxiliary container 10a are provided with a float 13 and a float 13a, respectively.

Above the float 13, the first container 1 is provided.
When the liquid level of 0 rises to the full and the float 13 is positioned above, the closing piece 14 and the outlet of the conduit 32a (first container 10a) (the hole on the first container 10 side) are closed. Closure piece 1 designed to close the hole on the 10 side)
5 is attached.

Further, the closing piece 15 is the first container 10
When the dialysate of the above is emptied and the float 13 of the first container 10 reaches the bottom of the first container 10, the outlet of the conduit 32a (the hole on the side of the first container 10) closed by the closing piece 15 is opened. The dialysate in the auxiliary container 10a flows into the first container 10 by static pressure.

Below the float 13a, the liquid level in the auxiliary container 10a is fully raised, and the float 13a
Is located above, the inlet of the conduit 31a (auxiliary container 1
0a side hole), the liquid level of the auxiliary container 10a lowers, and the float 13a moves downward, the above-mentioned conduit 31a.
Of the auxiliary container 1 (hole on the side of the auxiliary container 10a) opens
The dialysate in 0a flows into the first container 10 by static pressure.

The second container 20 and the auxiliary container 20a are also
The first container 10 and the auxiliary container 10a have exactly the same structure. Therefore, the second container 20 and the auxiliary container 20
The description of specific configurations of a, other floats, and conduits will be omitted here.

In order to carry out peritoneal dialysis using the peritoneal dialysis device configured as described above, first, as described above, the dialysate in the first container 10 is delivered from the delivery port 12, and the first
When the container 10 becomes empty and the float 13 of the first container 10 reaches the bottom of the first container 10, the outlet of the conduit 32a (the hole on the first container 10 side) that has been closed by the closing piece 15 opens, The dialysate in the auxiliary container 10a flows into the first container 10.

When the liquid level of the first container 10 gradually rises, the outlet of the conduit 32a (hole on the side of the first container 10) is closed again by the closing piece 15. At this time, the auxiliary container 10 is closed.
The liquid level of a is lowered by the amount of outflow, and the closing piece 16a attached to the float 13a provided in the auxiliary container 10a comes out of the inlet of the conduit 31a (hole on the auxiliary container 10a side). All the dialysate in the container 10a flows into the first container 10 through the conduit 31a.

In this way, when the liquid level in the first container 10 reaches the full level again, the float 13 in the first container 10
The outlet (the hole on the side of the first container 10) of the conduit 31a is closed by the closing piece 14 attached to. With this, the first container 10 is refilled with the high osmotic pressure dialysate again.

The second container 20 and the auxiliary container 20a are also
Since the first container 10 and the auxiliary container 10a are configured in exactly the same manner, the dialysate in the auxiliary container 10a is stored in the second container 20.
And the second container 20 is completely refilled with the low osmotic pressure dialysate.

When this peritoneal dialysis operation is repeated, for example, three times, as shown in FIG.
0a is provided with another auxiliary container for containing the respective dialysate, and when the dialysate contained in the auxiliary containers 10a and 20a is reduced to a certain level, the auxiliary containers are placed in the respective auxiliary containers 10a and 20a. It is preferable that the dialysate thus obtained is caused to flow into separate auxiliary containers by its static pressure.

A specific example of such a peritoneal dialysis device will be further described below. In FIG. 1, another auxiliary container 10b for containing the same dialysate is provided above the auxiliary container 10a for containing the dialysate with high osmotic pressure, and further above the auxiliary container 20a for containing the dialysate with low osmotic pressure. Another auxiliary container 20b for containing a similar dialysate is provided. These other auxiliary containers 10b and 20b are also connected to the first container 10
Similarly to the second container 20, the second container 20 is, for example, a transparent plastic cylindrical container having the same shape and volume.

The top of the auxiliary container 10a and the bottom of another auxiliary container 10b are connected by a conduit (rubber tube) 31b. Further, the top of the auxiliary container 10a and the bottom of the other auxiliary container 10b are separately connected by another conduit (rubber tube) 32b. Furthermore, the float 13b is provided in another auxiliary container 10b.

The float 1 of the auxiliary container 10a described above is also used.
When the liquid level of the auxiliary container 10a rises above 3a and the float 13a is located above it, the conduit 31
b (hole on the side of the auxiliary container 10a) and the outlet of the closing piece 14a and the conduit 32b (auxiliary container 10a).
The closing piece 15a is attached so as to close the side hole).

Further, the closing piece 15a is the auxiliary container 1
0a dialysate is emptied and float 1 in auxiliary container 10a
When 3a is attached to the bottom of the auxiliary container 10a, the closing piece 15a
The outlet of the conduit 32b that was closed by the
The hole on the a side) is opened so that the dialysate in another auxiliary container 10b flows into the auxiliary container 10a by static pressure.

In addition, the liquid level of the other auxiliary container 10b is fully filled in the other auxiliary container 10b, and the float 1
When 3b is located above, the inlet of the conduit 31b (a hole on the side of the other auxiliary container 10b) is closed, and when the liquid level of the other auxiliary container 10b is lowered and the float 13b moves downward, the inlet of the above-mentioned conduit 31b ( A hole on the side of the other auxiliary container 10b) is opened so that the dialysate in the other auxiliary container 10b flows into the auxiliary container 10a by static pressure.

The auxiliary container 20a and another auxiliary container 20a
b is also constructed in exactly the same manner as the auxiliary container 10a and another auxiliary container 10b. Therefore, the description of the specific configuration of the auxiliary container 20a, another auxiliary container 20b, each float, and each conduit is omitted here.

In order to carry out peritoneal dialysis using the peritoneal dialysis device constructed as described above, first, as described above, the dialysate in the auxiliary container 10a flows into the first container 10 and the auxiliary container 10a is opened. Empty and float 13a of auxiliary container 10a
When the liquid comes to the bottom of the auxiliary container 10a, the outlet (hole on the auxiliary container 10a side) of the conduit 32b closed by the closing piece 15a is opened, and the dialysate in another auxiliary container 20b flows into the auxiliary container 10a. .

When the liquid level of the auxiliary container 10a gradually rises, the outlet of the conduit 32b (hole on the auxiliary container 10a side) is closed again by the closing piece 15a. At this time, the liquid level of another auxiliary container 20b is increased. Is lowered by the amount of outflow, and the closing piece 16b attached to the float 13b provided in the other auxiliary container 20b comes out of the inlet of the conduit 31b (the hole of the other auxiliary container 20b). The dialysate in the auxiliary container 20b flows into the auxiliary container 10a from the conduit 31b.

Thus, when the liquid level in the auxiliary container 10a reaches the maximum level again, the closing piece 16a attached to the float 13a of the auxiliary container 10a causes the inlet of the conduit 31a (the hole on the auxiliary container 10a side) to move. Closed.
With this, the auxiliary container 10a is refilled with the high osmotic pressure dialysate, and the dialysate flows into the first container 10 as described above.

Further, an auxiliary container 20 different from the auxiliary container 20a
Since b is also constructed in exactly the same manner as the auxiliary container 10a and the other auxiliary container 10b, the dialysate in the other auxiliary container 20b flows into the auxiliary container 20a, and the dialysate having a low osmotic pressure enters the auxiliary container 20a. Will be replenished again and this dialysate will flow into the second container 20 as described above.

When the above-mentioned peritoneal dialysis operation is repeated four times or more, the above-mentioned auxiliary containers 10a and 2
It is preferable to use a peritoneal dialysis device in which the required number of similar auxiliary containers are further provided on the 0b.

[0042]

Embodiments of the present invention will be described below. Example 1 A peritoneal dialysis device shown in FIG. 1 was produced. Each of the first container 10, the second container 20, the auxiliary container 10a, the auxiliary container 20a, the other auxiliary container 10b, and the other auxiliary container 20b is a cylindrical transparent polyester (PE with an inner diameter of 5 cm and a height of 20 cm).
Each of the conduits for connecting the containers is a soft vinyl chloride pipe having an inner diameter of 3 mm.

Using the peritoneal dialysis device, first, a catheter (not shown) is connected to the dialysate delivery port 12, and the catheter of the delivery port 12 and the conduit 30 are closed with a pinch cock, and then the first container 10 is closed. 1 liter of a high osmotic pressure dialysate [Perisholita G from Shimizu Pharmaceutical: Osmotic pressure 678 (mOsm / l)] was placed in each of the auxiliary container 10a and another auxiliary container 10b. In addition, 1 liter of low osmotic pressure dialysate is added to each of the second container 20, the auxiliary container 20a and another auxiliary container 20b [Perisholita of Shimizu Pharmaceutical: Osmotic pressure 361 (mOsm / l)].
I put it in.

Next, while rotating the stirring tool (star rubber) 11 at the bottom of the first container 10, the closure with a pinch cock or the like was removed and the dialysate delivery port 12 was opened. Then
Due to the static pressure, the dialysate in the first container 10 naturally flows out continuously from the dialysate at the bottom through the catheter at the dialysate delivery port 12, and to compensate for this, the dialysate of the second container 20 has a low osmotic pressure. Due to the static pressure of the dialysate, the first container 1
0 delivered to the bottom of the dialysate.

In this case, the level of the dialysate in the first container 10 and the second container 20 is lowered at the same level, and when it becomes empty, the dialysate from the auxiliary containers 10a and 20a is kept at the same level. When the first container 10 and the second container 20 are replenished and the dialysate in the auxiliary containers 10a and 20a becomes empty,
From the other auxiliary vessels 10b and 20b, the dialysate is replenished to the auxiliary vessels 10a and 20a, respectively, at the same level, and these dialysates are finally supplied to the first vessel 10 and the second vessel 20.
Was continuously replenished and continuously discharged from the catheter of the outlet 12.

When the osmotic pressure of the dialysate continuously flowing out from the catheter of the delivery port 12 was measured, the osmotic pressure of this dialysate consisted of 3 cycles, and the osmotic pressure of the dialysate in each cycle began to flow out. The osmotic pressure of the dialysate is 678 (mO
sm / l), the osmotic pressure of the dialysate at the end of the outflow is 361 (mOsm /
l) with a linearly decreasing osmotic pressure gradient

[0047]

As described above, in the peritoneal dialysis device of the present invention, the first container for storing the dialysate having a high osmotic pressure and the second container for storing the dialysate having a low osmotic pressure are connected by the conduit at the bottom,
A stirrer and a dialysate outlet are provided at the bottom of the first container, and both dialysates are continuously mixed by the static pressure of the permeated dialysate contained in both containers and the stirrer. In addition, a complicated control system is not required, the apparatus is extremely simple, and it can be manufactured at low cost, and its operation is also extremely simple.

Furthermore, since a dialysate having an osmotic pressure gradient from a high osmotic pressure to a low osmotic pressure is continuously obtained, and such a dialysate is injected into the abdominal cavity, Compared with a peritoneal dialysis machine configured to inject a hypertonic dialysate adjusted to a constant osmotic pressure into the abdominal cavity of the body, the osmotic pressure gradient creates an excessive amount of waste along with waste products in the body fluid (blood). Water is not removed at the same time, so the efficiency of removing waste products is hardly reduced,
There is an advantage that the burden on the patient's body due to lack of water is reduced.

[Brief description of drawings]

FIG. 1 is a perspective view showing an example of a peritoneal dialysis device of the present invention.

[Explanation of symbols]

 10 First container for holding dialysate with high osmotic pressure 10a Auxiliary container for holding dialysate with high osmotic pressure 10b Another auxiliary container for holding dialysate with high osmotic pressure 11 Agitating tool for dialysate 12 Dialysate outlet 20 Low Second container 20a containing osmotic dialysate 20a Auxiliary container containing low osmotic dialysate 20b Another auxiliary container containing low osmotic dialysate 30 Conduit

Claims (2)

[Claims] 1. A first container for holding a dialysate having a high osmotic pressure and a second container for holding a dialysate having a low osmotic pressure are connected at the bottom by a conduit, and a stirrer and a dialysate are placed at the bottom of the first container. An osmotic pressure gradient is applied from a high osmotic pressure to a low osmotic pressure while an outlet is provided and the static pressure of the dialysate contained in both containers and both dialysates are continuously mixed by the stirrer. The peritoneal dialysis device is characterized in that the dialysate is continuously delivered from the delivery port and injected into the abdominal cavity. 2. An auxiliary container is provided above the first container and the second container to store the respective dialysate, and when the dialysate contained in the first container and the second container respectively drops to a certain level. 2. The peritoneal dialysis device according to claim 1, wherein the dialysate contained in each auxiliary container is configured to flow into the first container and the second container by static pressure.