JPH11276578A - Measuring container and continuous blood purifying device using the same - Google Patents

Abstract

PROBLEM TO BE SOLVED: To make automatically and precisely measurable and controllable the waste liquor amount by forming a measuring container from a lower pipe, a container lower taper section, a cylinder, a container upper section, and an upper pipe, providing sensors at the lower taper section and the lower pipe, and forming the container lower taper section as a cone shape projecting in the direction to the inside of the container. SOLUTION: The measuring container 1 comprises a lower pipe 6, a container lower taper section 5, a cylinder 4, a container upper section 3, and an upper pipe 2, and tubes 9, 10 for connecting with the upper pipe 2 and the lower pipe 6 respectively have sensors 12, 11. When an inner diameter 7 of the lower pipe of the connecting section between the container lower taper section 5 and the lower pipe 4 is d (=2, 4 to 4 mm), the container lower taper section 5 is formed as a cone shape projecting to an interior direction of the container which is formed from a curved line having a radius of 5 to 40 times d to prevent bubbles and fluid from standing. The measuring container 1 is formed in such a size that a volume of flowing within a range less than 20 L per hour can be measured. Preferably, the measuring container is applied to a volume measuring means for the flow rate of dialysis fluid in a continuous blood purifying device, and/or the flow rate of a waste liquor.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a method of introducing blood removed from a vein or artery into a blood purifier such as a blood filter, filtering out water, metabolites, electrolytes, etc., and replenishing useful substances. Also, the present invention relates to a measuring container used for a continuous blood purification apparatus that assists or substitutes for organ functions of a living body by activating and holding a self-protection mechanism.

[0002]

2. Description of the Related Art Conventionally, as blood purification methods, whole blood exchange, plasma exchange, blood adsorption, hemodialysis, hemofiltration, hemodiafiltration, peritoneal dialysis and the like have been widely applied to clinical practice. Improve serious conditions, such as patients with renal insufficiency or other conditions that are severe enough to show signs of renal insufficiency or who have become hyperhydric due to postoperative infusions Performing hemofiltration in a clinical setting has been practically used for a long time.

[0003] In hemofiltration, a membrane has pores, and the solvent itself containing solute moves from the blood side to the other side through the pores of the membrane due to the pressure difference applied between the membranes. The solutes are regulated by the size of the solute and the pore size of the membrane, which, unlike dialysis, allows for selective removal by the principle of filtration. In this case, the body fluid component of the removed water is usually supplied as a replenisher (hereinafter referred to as a replenisher).

However, when this therapy is administered in a short time,
A sudden change in the patient's fluid balance causes a sudden change in the patient's condition, which adversely affects the patient, and thus a method of gradually returning the patient to a normal state over a long period of time, that is, continuous blood purification therapy is particularly useful for severely ill patients. It is rapidly spreading as an effective treatment method, and is mainly performed in intensive care units such as ICU and CCU while strictly controlling the body fluid balance.

For example, in Japanese Patent Application Laid-Open No. 9-10304, I
In a very narrow place such as CU, CCU, etc., it is provided with a small and light blood pump and a waste liquid pump which are excellent in operability and measurement accuracy, and which enable doctors and the like to perform effective treatment. Equipped with a volume measuring means having a measuring container for intermittently measuring the waste liquid flow rate, enabling the rotation speed of the waste liquid pump to be adjusted so that the measured value matches the set value, and the accumulated flow error of the waste liquid pump to be within ± 1%. Certain continuous blood purification devices have been disclosed.

[0006]

SUMMARY OF THE INVENTION A continuous blood purification apparatus for conducting blood purification by guiding blood drawn from a patient's vein or artery to a blood purifier and then returning the blood to the patient's vein. In a typical blood purification treatment, for example, it is necessary to gradually perform blood purification over a long period of time in a range of a filtrate flow rate of 3 L / hour or less.

[0007] In an emergency or lifesaving facility, strict control of the patient's body fluid can be performed in order to effectively treat fulminant hepatitis, acute pancreatitis, etc. There is a demand for an apparatus for removing insoluble substances in blood which is larger than the liquid flow rate and which can perform hemofiltration dialysis in a shorter time and more quickly.

[0008] In addition, patients with chronic renal failure cannot excrete urine. Therefore, at present, water and waste products in urine for two to three days are rapidly removed from blood using a dialysis device in a short time of about four hours. However, depending on the patient, this treatment can cause a loss of fluid balance and lower blood pressure,
It is desired to perform strict hemofiltration dialysis in which strict control of the patient's body fluid balance can be performed, the patient's body fluid balance does not fluctuate rapidly, and the filtrate flow rate is smaller than that of a conventional dialysis device.

[0009]

Means for Solving the Problems As described above, the present inventors can carry out strict patient body fluid balance management in continuous blood purification therapy, continuous hemofiltration therapy and continuous hemofiltration dialysis therapy, and To quickly remove insoluble substances in blood without a sudden change in body fluid balance
In view of the importance of maintaining a constant and accurate filtrate flow rate and waste liquid volume of 0 L / hour or less, we have intensively studied the means for automatically and accurately measuring and controlling the waste liquid amount, and can measure accurately. The inventors have found a measuring container having a small volume and a continuous blood purification apparatus using the measuring container, and have accomplished the present invention.

According to the present invention, the measuring container comprises a lower tube, a lower tapered portion of the container, a tube, an upper portion of the container, and an upper tube, and a tube connected to the lower tube or the lower tube and a tube connected to the upper tube or the upper tube. The present invention relates to a measuring container in which a sensor is provided on a tube and a tapered portion at a lower portion of the container has a conical shape protruding toward the inside of the container.

Still preferably, in the present invention, the convex conical shape has a radius in a range of 5 to 40 times the inner diameter (d) of the lower tube at the connection between the lower taper portion of the container and the lower tube. The present invention relates to a measuring container having a convex conical shape inside a measuring container made of

Still preferably, the present invention relates to a measuring container characterized in that the measuring container can measure a flow rate in a range of 20 L / hour or less.

Still preferably, in the present invention, the inner diameter (d) of the lower pipe at the connection between the lower tapered portion of the container and the lower pipe is as follows:
The present invention relates to a measuring container having an inner diameter in a range of 2.4 to 4 mm.

Further, the present invention provides that the above-mentioned measuring container is used as a volume measuring means for a dialysate flow rate, a replacement fluid flow rate and / or a waste liquid flow rate in a continuous blood purification apparatus of the following (a) and (b). The invention relates to a device for continuous blood purification. (A) A device for continuous blood purification in which blood derived from a patient's vein or artery is guided to a blood purifier to purify the blood, and then the blood is returned to the patient's vein. A blood pump is provided in the blood removal circuit that guides the blood to the purifier, and a waste liquid pump is provided in the waste liquid circuit that discharges the filtrate from the blood purifier. An apparatus for continuous blood purification, comprising: a volume measuring means having a measuring container for actual measurement, wherein the rotational speed of a waste liquid pump is adjusted so that the obtained measured value of the waste liquid matches a set value. (B) A device for continuous blood purification in which blood derived from a patient's vein or artery is guided to a blood purifier to purify the blood, and then the blood is returned to the patient's vein. A blood pump is provided in the blood removal circuit that guides the blood to the blood purifier, and a function is provided that can perform hemodialysis and hemofiltration simultaneously in parallel. A dialysis pump for transferring dialysate in the circuit, and a circuit for returning blood from the blood purifier to blood from the blood purifier from a replacement fluid tank for replenishing body fluid after blood filtration. A circuit for introducing a fluid into the section and a fluid replacement pump for transferring a fluid replacement in the circuit, a circuit for discharging waste fluid after blood purification (dialysis and filtration), and a waste fluid pump in the circuit.
An apparatus provided with a kind of pump, wherein each of the pumps functions independently and has a volume measuring means having a measuring container for individually and intermittently measuring a dialysate flow rate, a replacement fluid flow rate, and a waste fluid flow rate. An apparatus for continuous blood purification in which the rotation speeds of the corresponding pumps can be adjusted so that the obtained measured values match the set values.

[0015]

BEST MODE FOR CARRYING OUT THE INVENTION A measuring container according to the present invention comprises a lower tube, a lower tapered portion of a container, a tube, an upper portion of the container, and an upper tube, and a tube connected to the lower tube or the lower tube and a tube connected to the upper tube or the upper tube. The present invention relates to a measuring container, wherein a sensor is provided on a tube connected to the measuring container, and the tapered portion at the lower part of the container has a conical shape protruding toward the inside of the container.

The above-mentioned convex conical shape has a radius in the range of 5 to 40 times the inner diameter (d) of the lower tube at the connection between the lower tapered portion of the container and the lower tube, or 5 times, and more preferably 7 times, especially Preference is given to measuring vessels which are convex-conical inside the measuring vessel having a radius with a radius in the range from 10 to 40 times, more particularly 30 times, especially 20 times.

It is preferable that the above-mentioned measuring container can measure a flow rate of 20 L / hour or less, more preferably 18 L / hour or less, and particularly preferably 15 L / hour or less. Furthermore, the above-mentioned measuring container has a lower limit of 3.5 L / hr, preferably 4 L / hr, more preferably 4.5 L / hr, particularly preferably 5 L / hr, and preferably 20 L / hr, preferably 18 L / hr, More preferably 15 L / hour, particularly preferably 1 L / hour
It is preferable that the flow rate can be measured up to the upper limit of 2 L / hour.

By using the above-mentioned measuring container, bubbles and the like do not enter the liquid to be measured within the above-mentioned flow rate range.
The liquid to be measured does not blow out from the lower pipe in the form of a fountain, and can be accurately measured. When the liquid to be measured blows out from the lower pipe in a fountain shape, bubbles may enter the liquid, or a sensor attached to the upper pipe or its connection pipe may detect a protruding liquid droplet and may not be able to accurately measure the liquid. In particular, the above-mentioned flow rate range is preferable because the body fluid balance of the patient does not suddenly fluctuate and blood purification can be performed promptly.

The present invention is characterized in that the measuring container is used as a volume measuring means for a dialysate flow rate, a replacement fluid flow rate and / or a waste liquid flow rate in the continuous blood purification apparatus of the following (a) and (b). Device for blood purification. (A) A device for continuous blood purification in which blood derived from a patient's vein or artery is guided to a blood purifier to purify the blood, and then the blood is returned to the patient's vein. A blood pump is provided in the blood removal circuit that guides the blood to the purifier, and a waste liquid pump is provided in the waste liquid circuit that discharges the filtrate from the blood purifier. An apparatus for continuous blood purification, comprising: a volume measuring means having a measuring container for actual measurement, wherein the rotational speed of a waste liquid pump is adjusted so that the obtained measured value of the waste liquid matches a set value. (B) A device for continuous blood purification in which blood derived from a patient's vein or artery is guided to a blood purifier to purify the blood, and then the blood is returned to the patient's vein. A blood pump is provided in the blood removal circuit that guides the blood to the blood purifier, and a function is provided that can perform hemodialysis and hemofiltration simultaneously in parallel. A dialysis pump for transferring dialysate in the circuit, and a circuit for returning blood from the blood purifier to blood from the blood purifier from a replacement fluid tank for replenishing body fluid after blood filtration. A circuit for introducing a fluid into the section and a fluid replacement pump for transferring a fluid replacement in the circuit, a circuit for discharging waste fluid after blood purification (dialysis and filtration), and a waste fluid pump in the circuit.
An apparatus provided with a kind of pump, wherein each of the pumps functions independently and has a volume measuring means having a measuring container for individually and intermittently measuring a dialysate flow rate, a replacement fluid flow rate, and a waste fluid flow rate. An apparatus for continuous blood purification in which the rotation speeds of the corresponding pumps can be adjusted so that the obtained measured values match the set values.

The above blood pump has a flow rate of 400 ml / min or less, more preferably 5 to 400 ml / min, especially 10 to 300 m / min.
1 / min pump, the dialysate pump described above has a flow rate of 20 L
/ Hour or less, 0.1 to 20 L / hour, especially 0.5 to 1
0L / hour pump, the above replacement fluid pump is 10L flow rate
/ Hr or less, further 0.05 to 10 L / hr, especially 0.25
５5 L / hour pump, and the above waste liquid pump has a flow rate of 20
L / hr or less, further 0.25-20 L / hr, especially 0.7
A pump of 5-15 L / hr can be used.

By using the above-mentioned measuring container, even when the pump flow rate is within the above range, the liquid to be measured can be accurately measured without bubbles or the like, and the liquid to be measured does not blow out from the lower pipe in a fountain shape. Becomes When the liquid to be measured blows out from the lower pipe in a fountain shape, bubbles may enter the liquid, or a sensor attached to the upper pipe or its connection pipe may detect a protruding liquid droplet and may not accurately measure the liquid.

The above measuring container has an inner volume of 20 to 200.
range cm ^3, it is possible to use further the range of 20 to 100 ^3, in particular in the range of 30~80cm ^3.

It is preferable to use a weighing container having the above-mentioned range of the internal volume, since measurement can be accurately performed within an appropriate weighing time range within the weighing range of the above-mentioned weighing container.

The lower pipe and the upper pipe have an inner diameter of 2 to 8 mm.
Tube having an inside diameter capable of connecting a tube in the range of 2.0 mm or more, further 2.4 mm or more, particularly 2.9 m
m or more and 12 mm or less, further 10 mm or less, especially 8
mm or less can be used. In addition, as the above-mentioned lower pipe and upper pipe, pipes having the same inner diameter at the end and pipes having different inner diameters at the end can be used.

The above-mentioned sensor comprises: a lower sensor provided on a lower tube or a tube connected near the lower tube;
There are two locations: an upper tube or an upper sensor provided on a tube connected near the upper tube. As the sensor, an optical sensor, an ultrasonic sensor, or the like can be used.

In the above-mentioned measuring container, the connecting portion between the tapered portion at the lower portion of the container and the tube or the connecting portion between the tube and the upper portion of the container has a curved shape projecting outside the measuring container, and the connecting portion between the upper portion of the container and the upper tube. Can use a measuring container having a convex curve inside the measuring container. This measuring container is preferable because there is no bubble pool and / or liquid pool at each connection portion, and the measuring accuracy is further improved.

As the above-mentioned tube, a tube having an inner diameter in the range of 20 to 50 mm can be used, and it is preferable to use a tube having an inner diameter larger than that of the above-mentioned lower tube and upper tube. Further, as the above-mentioned tube, a tube composed of a straight tube, a tube having a linear tapered portion, and / or a tube having a convex curve outside the container can be used.

The inner diameter (d) of the lower tube at the connection between the lower taper portion of the container and the lower tube is 2.0 mm or more, and further 2.4 mm.
Above, the lower limit of 2.9 mm or more, preferably 8 mm or less, more preferably 6 mm or less, particularly the upper limit of 4 mm or less, or the range of 2.4 to 4 mm is preferable.

In particular, when the inner diameter (d) of the lower tube at the connection between the lower tapered portion of the container and the lower tube is in the range of 2.4 to 4 mm, a general medical device used in a general blood purification apparatus is used. The tube is preferable because it is easy to obtain and easy to handle, so that operations such as replacement can be performed without any problem.

The upper part of the container is preferably a tube having a conical shape convex toward the inside of the measuring container, a straight conical shape, and / or a conical shape convex outside the measuring container. A tube having a taper can be used for the upper part of the container.

The upper part of the container has a conical shape protruding toward the inside of the container, a straight conical shape, and a conical shape protruding toward the outside of the container, and may be symmetrical or asymmetrical in the axial direction.

The above-mentioned tapered portion at the lower part of the container may be symmetrical or asymmetrical in the axial direction.

In the above-mentioned measuring container, the liquid to be measured flows in from the lower tube, and after the measurement, the liquid is discharged from the lower tube.

The measuring container is made of a plastic material such as polyacrylate resin such as polymethyl methacrylate (PMMA), polycarbonate resin, polyolefin resin such as polyethylene, polypropylene and poly (4-methylpentene-1). Can be used. The above-mentioned measuring container is a container made of the above plastic by a molding method such as injection molding, blow molding, or the like, or two, three, four, or five or more plastic parts, molded products, molded products. What connected these etc. can be used.

The material of the tube connected to the lower tube and / or the upper tube is a polyacrylate resin such as polymethyl methacrylate (PMMA), a polycarbonate resin, a polyvinyl halide resin such as polyvinyl chloride, Polyolefin resins such as polyamide resins, polyethylene, polypropylene, and poly (4-methylpentene-1) can be used.

The continuous blood purification apparatus using the measuring container according to the present invention uses the measuring container having the above-mentioned internal volume, and measures the volume of the solution at predetermined time intervals so that the target dialysate and replacement fluid can be accurately measured. , The range of the waste liquid flow rate is calculated. If this value is lower than the set pump flow value, the pump speed is increased, and if it is higher than the set value, the pump speed is decreased so that the true flow rate approaches the set value. Adjusted. By using the above measuring container and adjusting the flow rate, the flow rate error during 10 hours of operation is ±
It can be kept below 1%.

The apparatus for continuous blood purification using the measuring container of the present invention removes waste liquid slowly or promptly.
It must be used continuously for several hours, 10 hours or more, or intermittently until the organ function is restored. Therefore, the reason for keeping the flow rate error during the 10-hour operation at ± 1% or less is that when (dialysate flow rate + replacement fluid flow rate)> waste fluid flow rate, overflow (water swelling) occurs, and (dialysis fluid flow rate + replacement fluid flow rate). <In the case of waste liquid flow rate, it becomes dehydrated (dried),
If the balance between (dialysate flow rate + replacement fluid flow rate) and the waste fluid flow rate is out of balance, circulatory dynamics such as blood drop may deteriorate, which is not preferable. Further, since the flow rate error is ± 1% or less, it can be used under appropriate conditions such that (dialysate flow rate + replacement fluid flow rate) <waste fluid flow rate as a treatment for a patient who has already overflowed.

Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings and examples. The present invention is not limited only to these embodiments.

FIG. 1 is a longitudinal sectional view of an example of the measuring container 1 of the present invention. The measuring container 1 includes a lower tube 6, a lower container taper portion 5, a tube 4, an upper container 3, and an upper tube 2. A tube 10 connected to the lower tube has a lower sensor 11, and a tube 9 connected to the upper tube. Is provided with an upper sensor 12. Assuming that the lower tube inner diameter 7 at the connection between the lower container taper portion 5 and the lower tube 4 is d, the curve of the lower container taper portion 5 is d
It has a conical shape that is convex toward the inside of the container and has a curve with a radius of 8 that is 5 to 40 times the radius of the container.

FIG. 2 shows an example of a continuous blood purification apparatus using the measuring container of the present invention. The blood collection amount and the anticoagulant injection amount are set according to the patient's condition. The anticoagulant is injected by the syringe pump 30, and the blood is circulated in the blood circulation circuit 54 including the blood purifier 41 by the blood pump 31. The amount of dialysate and the amount of waste fluid filtered by the blood purifier 41 are determined according to the state of the patient, and the flow rate of the dialysate pump 34 and the waste fluid pump 32 are set. The waste liquid flow rate corresponds to the sum of the dialysate flow rate and the replacement fluid flow rate. Since the dialysate flow rate, waste fluid flow rate, and replacement fluid flow rate are precisely controlled as set values, each pump, each level, lower and upper sensors, and each clamp operate as follows.

Dialysate flow rate: The dialysate pump 34 is rotated, and the clamps 42 and 43 are opened. At the same time as the dialysate is sent from the dialysate supply unit 70 to the dialysate circuit 55, the dialysate is supplied to the measurement container (for dialysate) 35 due to the height drop between the dialysate supply unit liquid level and the liquid level in the measurement container. Inflow. When the liquid level reaches the upper sensor (for dialysate) 38c, the clamp 4
2 is opened and the clamp 43 is closed, and the liquid in the measuring container flows out of the container and is sent to the dialysate pump side. When the liquid level in the measuring container passes through the lower sensor (for dialysate) 38b, the clamp 43 is opened and the clamp 42 is closed, and the dialysate is continuously supplied. After a predetermined time, when the clamp 42 is opened, the dialysate flows into the container again, and when the liquid level passes through the upper sensor (for dialysate) 38c, the clamp 42 opens.
The clamp 43 is closed, and the liquid flows out of the measuring container (for dialysate). Such an operation is repeated every predetermined time. It is preferable that the dialysate circuit 55 be provided with a warmer 73 between the blood purifier 41 and the dialysate pump. The measuring container of the present invention is preferably used for a measuring container (for dialysate).

The time T1 required for the outflow of the liquid from the measuring container (for the dialysate) 35 is determined by the upper surface of the sensor (for the dialysate) 38
It is measured as the time from passing through c to passing through the lower sensor (for dialysate) 38b. Measuring container (for dialysate) 3
5 is manufactured by plastic injection molding and has been confirmed in advance that there is almost no error. Therefore, the volume of the dialysate L1 flowing through the dialysate pump 34 is L1.
= V1 / T1. When the dialysate flow rate L1 is lower than the set value, the rotational speed of the pump 34 is increased, and when the dialysate flow rate L1 is higher, the rotational speed of the pump 34 is decreased to control the flow rate closer to the set value. When the measurement is performed again immediately after the predetermined time is short and the liquid outflow is completed, the measurement can be repeated without closing the clamp 42.

When the waste liquid pump 32 is rotated, the clamp 46 is opened, and the clamp 47 is closed, the waste liquid flows into the measuring container (for waste liquid) 37. The liquid level passes through the lower sensor (for waste liquid) 40a and the upper sensor (for waste liquid) 4a.
When the pressure reaches 0b, the clamp 46 is opened and the clamp 47 is opened, and the waste liquid in the measuring container (for waste liquid) 37 flows out to the waste liquid discharge section 72 outside the container due to a height drop. After a predetermined time, when the clamp 47 is closed, the waste liquid flows into the measuring container (for waste liquid) 37 again, and the liquid level becomes lower sensor (for waste liquid).
When passing through 40a and reaching the upper sensor (for waste liquid) 40b, the clamp 47 is opened, and the measuring container (for waste liquid) 37 is opened.
The waste liquid flows out of the container. Such an operation is repeated every predetermined time. The measuring container of the present invention is preferably used as a measuring container (for waste liquid).

The time T2 required to flow into the measuring container is measured as the time required for the liquid surface to pass through the lower sensor (for waste liquid) 40a and reach the upper sensor (for waste liquid) 40b. Since the measuring container (for waste liquid) 37 is manufactured by plastic injection molding and it is confirmed in advance that there is almost no error, it has a constant capacity V2, and the waste liquid flow rate L2 flowing through the waste liquid pump 32 is L2 = V2 / T2. . This flow rate L2
Is lower than the set value, the rotational speed of the waste liquid pump 32 is increased, and if it is higher, the rotational speed of the waste liquid pump 32 is decreased to control the flow rate closer to the set value. The lower sensor (waste liquid) and the upper sensor (waste liquid)
It is preferable that the ultrasonic sensor is not affected by liquid coloring.

Replacement fluid flow: The replacement fluid pump 33 is rotated, and the clamps 44 and 45 are opened. The replacement fluid is supplied from the replacement fluid supply unit 71 to the replacement fluid circuit 57 by the pump, and at the same time, the replacement fluid is supplied to the measurement container (for replacement fluid) 36 due to the height difference between the liquid surface of the replacement fluid supply unit and the liquid level in the measurement container (for replacement fluid) 36. Flows in.
When the liquid level reaches the upper sensor (for replacement fluid) 39c, the clamp 44 opens and the clamp 45 closes, and the liquid in the measuring container (for replacement fluid) flows out of the container and is sent to the replacement fluid pump 33. When the liquid level in the measuring container (for replacement fluid) passes through the lower sensor (for replacement fluid) 39b, the clamp 45 is opened and the clamp 44 is closed, and the supply of replacement fluid is continued. After a predetermined time, the clamps 44 and 45 are opened, the replacement fluid flows into the measuring container (for replacement fluid) 36 again, and when the liquid level passes through the upper sensor (for replacement fluid) 39c, the clamp 44 is opened and the clamp 4 is closed.
5 is closed, and the liquid flows out of the measuring container (for replacement fluid). Such an operation is repeated every predetermined time. The measuring container of the present invention is preferably used as a measuring container (for replacement fluid).

The time T3 required for the replacement fluid to flow out of the measuring container (for replacement fluid) 36 is determined by the upper surface sensor (for replacement fluid) 39c.
Is measured as the time from passing through to the lower sensor (for replacement fluid) 39b. Since the measuring container (for replacement fluid) 36 is manufactured by plastic injection molding and it is confirmed in advance that there is almost no error, it has a constant volume V3, and the replacement fluid flow rate L3 flowing through the replacement fluid pump 33 is L3 = V3 / T3
It is. When the flow rate L3 is lower than the set value, the rotation speed of the rehydration pump 33 is increased, and when the flow rate L3 is higher, the rotation speed of the pump 33 is reduced to control the flow rate closer to the set value. In the case where the measurement is performed again immediately after the liquid has flowed out after the predetermined time is short, the measurement can be repeated without closing the clamp 44.

The predetermined time depends on the flow rate of the liquid, but is preferably set every 1 to 20 minutes so that the accuracy is sufficiently improved, and is preferably set to be longer when the flow rate is small and shorter when the flow rate is large.

FIG. 3 shows an example of a continuous blood purification apparatus using the measuring container of the present invention. In FIG. 3, the blood collection amount and the anticoagulant injection amount are set in accordance with the condition of the patient, the anticoagulant is injected by the syringe pump 101, and the blood pump 10
Blood circulation circuit 105a including blood purifier 104 in 2
Blood is circulated in 05b. Further, the amount of waste liquid filtered by the blood purifier 104 is determined according to the condition of the patient, and the flow rate of the filtrate pump 103 is set. The blood removed from the patient by the blood pump 102 is led to a blood purifier 104 through a blood removal circuit 105a, and the blood whose waste has been filtered and purified by the blood purifier 104 passes through a blood return circuit 105b. Blood is returned to the patient. In the blood purifier 104, by the rotation of the filtrate pump 103, the solute containing wastes is purified by ultrafiltration together with the solvent by ultrafiltration due to the pressure difference generated between the membranes. The waste liquid filtered by the blood purifier 104 is discharged to a waste liquid container 120 through a waste liquid circuit 106 by a filtrate pump 103.

In FIG. 3, reference numeral 111 denotes a pillow for detecting a defective blood removal, and 112, 113 and 114 denote pressure chambers for measuring the pressure in the circuit. 115 is a bubble clamp, 116 is a bubble sensor, 117, 118, 11
9 indicates a pressure sensor, and 121 indicates a replenisher supply unit. In addition, as the blood purifier 104 used in the present invention, a hollow fiber membrane module using a hollow fiber ultrafiltration membrane as a filter material is optimal.

Next, the operation of measuring the volume of the waste liquid flow will be described. When the filtrate pump 103 is rotating, the on-off valve 109 is opened and the waste liquid clamp 108 is closed, and the filtrate flows into the measuring container 107. Liquid level is lower sensor (filtrate)
After passing through 110a and reaching the upper sensor (filtrate) 110b, the on-off valve 109 remains open and the waste liquid clamp 108
Is opened, and the waste liquid in the measuring container 107 flows out of the container due to a height drop. After a predetermined time, the waste clamp 108
Is closed, the filtrate flows into the measuring container 107 again, and when the liquid level passes through the lower sensor (filtrate) 110a and reaches the upper sensor (filtrate) 110b, the waste liquid clamp 108 is opened, and the waste liquid in the measuring container 107 is opened. Flows out of the container. Such an operation is repeated every predetermined time.

The time T required to flow into the measuring container is measured as the time required for the liquid surface to pass through the lower sensor (filtrate) 110a and reach the upper sensor (filtrate) 110b. Since the measuring container (for filtrate) 107 is manufactured by plastic injection molding and it is confirmed in advance that there is almost no error, it has a constant volume V, and the waste liquid flow rate L flowing through the filtrate pump 103 is L = V / T It is. When the flow rate L is lower than the set value, the rotation speed of the filtrate pump 103 is increased, and when the flow rate L is higher, the rotation rate of the filtrate pump 103 is decreased so that the flow rate is closer to the set value.

The predetermined time depends on the flow rate of the liquid, but is set every 1 to 20 minutes so that the accuracy is sufficiently improved, and is preferably set longer when the flow rate is low and shorter when the flow rate is high. .

The tube 122 on the upper side of the measuring container (for filtrate) 107 is connected to the on-off valve 109. After the waste liquid is discharged, the on-off valve 109 is opened immediately after the liquid level passes through the lower sensor (filtrate) 110a. The container is closed to stop the air from flowing into the container, thereby preventing the liquid level in the drainage tube 123 from excessively lowering. If the tube 122 on the upper side of the measuring container 107 is in an open state after the liquid is discharged from the measuring container 107, air is sucked from the measuring container 107 side into the drain tube 123 by the negative pressure drop, and bubbles are generated. I do. After the start of the measurement, the air bubbles pass through the lower sensor (filtrate) 110a, and erroneously detect the correct liquid level, which causes a measurement error.

Further, if air bubbles are mixed, a drainage failure may occur. That is, when the waste liquid tube discharge end 125 is deeply immersed below the liquid level in the waste liquid container 120, the head and the rising force of the bubbles are balanced, so that the bubbles are not extruded and the bubbles are closed, and the waste liquid level is reduced. It can rise to the weighing container 107, which can result in virtually impossible weighing (for weighing, the liquid level must be located below the lower sensor (filtrate) 110a at the start).

In this embodiment, after the measurement is completed, the liquid is discharged from the measuring container 107, and when the liquid surface passes through the lower sensor (filtrate) 110a, a slight time lag is provided and the on-off valve 1 is provided.
By closing 09, the occurrence of a bubble entrained state is prevented. The upper tube 122 of the measuring container 107
The on-off valve 109 provided in the above is preferably an electromagnetic valve from the viewpoints of convenience of operation and no omission in management. Since the waste liquid is waste of body fluids and is colored, the lower sensor (filtrate) and the upper sensor (filtrate) are preferably ultrasonic sensors that are not affected by liquid coloring.

It should be noted that the blood purifier is used as the treatment progresses.
As described above, although the thrombus and proteins in body fluids gradually adhere and the filtration resistance gradually increases, as described above, the filtrate flow rate decreases when the filtrate pump has a constant rotation speed. Since the increase in filtration resistance is gradual, it is not usually a significant error to increase the time interval of metering, even if the flow rate during non-metering is unchanged. But,
The next measurement should be started immediately after the drainage after the measurement is completed without setting the measurement time interval to a fixed predetermined time, except for the short time required for draining the filtrate from the measurement container. Since the measurement is performed, even if there is an unexpected flow rate change, it is more preferable to realize high flow rate accuracy. The measurement time interval can be easily set by using a known means such as a timer. By setting the measurement time interval extremely short, almost continuous measurement can be performed, and higher flow rate accuracy can be realized.

Example 1 Using the filtrate circuit section of FIG. 3, the filtrate pump flow rate and the measuring time were set, and the error between the filtrate pump flow rate set value after 2 hours and the amount of waste liquid in the waste liquid container was measured. Was measured. The measuring device used for the measurement is the one in which the end of the filtrate tube of the filtrate circuit 106 in the filtrate circuit of FIG. 3 is connected to a 20 L air-exchanged water tank instead of the blood purifier 104. used. The measuring container used had the shape shown in FIG. An ultrasonic sensor was used for the lower sensor and the upper sensor. The measuring container used was a combination of an injection-molded plastic part consisting of a lower tube, a container lower taper tube and a part of a tube, and an injection-molded plastic part consisting of an upper tube, a container upper part and a part of a tube. The measuring container has an inner volume from the lower sensor to the upper sensor of 50 cm ³ , and the inner diameter d of the lower tube at the connecting portion between the lower tube and the lower taper portion of the container is 3.3 m.
m, inner diameter of upper pipe 3.3 m at connection between upper pipe and upper part of container
m, inner diameter 3.3 mm at the other end of the lower and upper tubes
A plastic tube having a tapered lower part of the container, a convex curved surface inside the measuring container having a radius of 40 mm, a tube having an inner diameter of 26 mm and a length of 85 mm, and a taper angle of about 60 ° at the upper part of the container was used. The connecting portion between the tapered portion of the container and the tube and the connecting portion between the tapered portion and the tube at the upper portion of the container are convex outside the container, and the connecting portion between the tapered portion of the upper container and the upper tube is convex inside the container. Was used to eliminate bubble accumulation and liquid accumulation. The lower sensor was attached to the tube connected to the lower tube, and the upper sensor was attached to the tube connected to the upper tube.

The flow rate of the filtrate pump was set to 3.5 L / hour, the measuring time interval was set every three minutes, the solution was sucked and discharged from the ion-exchanged water tank by the filtrate pump, and the amount was measured using a measuring container.
The filtrate pump flow rate was controlled based on the measurement results. The filtrate pump was operated for 2 hours, and the amount of waste liquid in the waste liquid container was measured with an electronic balance. The amount of waste liquid was 7.50056 L (average of 3.502 L / hour). The specific gravity of ion-exchanged water was treated as 1. The error between the set value of the filtrate pump flow rate and the waste liquid amount was 0.08%. At the time of measurement, the ion-exchanged water flowing into the measuring container did not enter a fountain state, and was able to be measured without any intrusion of bubbles.

Example 2 The same operation as in Example 1 was performed except that the flow rate of the filtrate pump was set to 6 L / hour, and the amount of waste liquid was measured by an electronic balance. The waste liquid amount was 11.9931 L (average 5.9966 L / hour). The error between the set value of the filtrate pump flow rate and the waste liquid amount was -0.06%. At the time of measurement, the ion-exchanged water flowing into the measuring container did not enter a fountain state, and was able to be measured without any intrusion of bubbles.

Example 3 The same operation as in Example 1 was performed except that the flow rate of the filtrate pump was set to 12 L / hour, and the amount of waste liquid was measured by an electronic balance. The waste liquid amount was 24.0056 L (average 12.0028 L / hour). The error between the set value of the filtrate pump flow rate and the waste liquid amount was 0.02%. At the time of measurement, the ion-exchanged water flowing into the measuring container did not enter a fountain state, and was able to be measured without any intrusion of bubbles.

Comparative Example 1 The procedure of Example 2 was repeated, except that a tube having a taper angle of about 60 ° was used as the measuring vessel at the lower part of the vessel. At the time of measurement, the ion-exchanged water that had flowed into the measuring container was in a fountain state, bubbles were occasionally generated on the liquid surface in the measuring container and did not disappear.

Comparative Example 2 The procedure of Example 3 was repeated, except that a tube having a taper angle of about 60 ° was used as the measuring container at the lower part of the container. During the measurement, the ion-exchanged water flowing into the measuring container was in a fountain state, and the ion-exchanged water and bubbles were mixed in the measuring container, so that correct measurement could not be performed.

[0063]

According to the present invention, in the continuous blood purification therapy, the continuous hemofiltration therapy, and the continuous hemofiltration dialysis therapy, strict control of the patient's body fluid balance can be performed, and the blood fluid balance of the patient can be quickly changed without a sudden change. In order to remove insoluble substances in the filtrate, keep the filtrate flow rate and waste liquid volume below 20 L / hour constant.
In view of the importance of maintaining accuracy, a measuring vessel with a small internal volume that can accurately measure and control the amount of waste liquid automatically and accurately, and a continuous blood purification device that uses this measuring vessel is proposed. Can be provided.

Further, when the inner diameter (d) of the lower tube at the connection between the lower tapered portion of the container and the lower tube is in the range of 2.4 to 4 mm, a general medical tube used for a general blood purification apparatus is used. The present invention can provide a measuring container which can be easily obtained, easily handled, and can be replaced without any problem, and a continuous blood purification apparatus using the measuring container.

[Brief description of the drawings]

FIG. 1 is a longitudinal sectional view of an example of a measuring container of the present invention.

FIG. 2 is an example of a continuous blood purification apparatus using the measuring container of the present invention.

FIG. 3 is another example of a continuous blood purification apparatus using the measuring container of the present invention.

[Explanation of symbols]

1: Measuring container, 2: Upper tube, 3: Upper container, 4: Tube, 5: Tapered lower container, 6: Lower tube, 7: Inner diameter of lower tube at connection between tapered lower container and lower tube (d ), 8: radius (5 of d) forming the curved surface of the tapered portion at the bottom of the container
9, 10: tube, 11: lower sensor, 12: upper sensor, 30: syringe pump, 31: blood pump, 32: waste liquid pump, 33: replacement fluid pump, 34: dialysate pump, 35: weighing Vessel (for dialysate), 36: Measuring container (for replacement fluid), 37: Measuring container (for waste fluid), 38a: Level sensor (for dialysate), 38b: Lower sensor (for dialysate), 38c: Upper sensor ( 39a: Level sensor (for replacement fluid), 39b: Lower sensor (for replacement fluid), 39c: Upper sensor (for replacement fluid), 40a: Lower sensor (for waste fluid), 40b: Upper sensor (for waste fluid), 41: blood purifier, 42 to 48: clamp, 49 to 51: pressure sensor, 52: bubble sensor, 53: pillow for pressure detection, 54: blood circulation circuit, 55 Dialysate circuit, 56: waste liquid circuit, 57: replacement fluid circuit, 70: dialysate supply part, 71: replacement liquid supply part, 72: waste liquid container, 73: warmer, 101: syringe pump, 102: blood pump, 103: filtrate Pump, 104: blood purifier, 105a: blood removal circuit, 105b: blood return circuit, 106: filtrate circuit, 107: measuring container (for filtrate), 108: filtrate clamp, 109: open / close valve, 110a: lower part Sensor (for filtrate), 110b: Upper sensor (for filtrate), 111: Pillow, 112, 113, 114: Pressure chamber, 115: Bubble clamp, 116: Bubble sensor, 117, 118, 119: Pressure sensor, 120 : Waste liquid container 121: replenisher supply unit 122: upper tube 123: drain tube 124: branch unit 125: filtrate tube drain End

Claims (5)

[Claims] A weighing container comprises a lower tube, a lower taper portion of a container, a tube, an upper portion of a container, and an upper tube, and a tube connected to the lower tube or the lower tube, and a tube connected to the upper tube or the upper tube. Wherein the container is provided with a sensor, and the lower tapered portion of the container has a conical shape protruding toward the inside of the container. 2. The convex cone inside the measuring container, wherein the convex cone has a curve having a radius in the range of 5 to 40 times the inner diameter (d) of the lower tube at the connection between the lower taper portion of the container and the lower tube. The measuring container according to claim 1, wherein the container is in a shape. 3. The measuring container according to claim 1, wherein the measuring container can measure a flow rate in a range of 20 L / hour or less. 4. The measuring container according to claim 1, wherein an inner diameter (d) of the lower tube at a connection portion between the lower tapered portion of the container and the lower tube is in a range of 2.4 to 4 mm in inner diameter. 5. Use of the measuring container according to claim 1 as a volume measuring means for a dialysate flow rate, a replacement fluid flow rate and / or a waste liquid flow rate in a continuous blood purification apparatus of the following (a) and (b). An apparatus for continuous blood purification characterized by the following. (A) A device for continuous blood purification in which blood derived from a patient's vein or artery is guided to a blood purifier to purify the blood, and then the blood is returned to the patient's vein. A blood pump is provided in the blood removal circuit that guides the blood to the purifier, and a waste liquid pump is provided in the waste liquid circuit that discharges the filtrate from the blood purifier. An apparatus for continuous blood purification, comprising: a volume measuring means having a measuring container for actual measurement, wherein the rotational speed of a waste liquid pump is adjusted so that the obtained measured value of the waste liquid matches a set value. (B) A device for continuous blood purification in which blood derived from a patient's vein or artery is guided to a blood purifier to purify the blood, and then the blood is returned to the patient's vein. A blood pump is provided in the blood removal circuit that guides the blood to the blood purifier, and a function is provided that can perform hemodialysis and hemofiltration simultaneously in parallel. A dialysis pump for transferring dialysate in the circuit, and a circuit for returning blood from the blood purifier to blood from the blood purifier from a replacement fluid tank for replenishing body fluid after blood filtration. A circuit for introducing a fluid into the section and a fluid replacement pump for transferring a fluid replacement in the circuit, a circuit for discharging waste fluid after blood purification (dialysis and filtration), and a waste fluid pump in the circuit.
An apparatus provided with a kind of pump, wherein each of the pumps functions independently and has a volume measuring means having a measuring container for individually and intermittently measuring a dialysate flow rate, a replacement fluid flow rate, and a waste fluid flow rate. An apparatus for continuous blood purification in which the rotation speeds of the corresponding pumps can be adjusted so that the obtained measured values match the set values.