JPS596664B2 - Dialysis “filtration” device - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION The present invention relates to a dialysis filtration device, and particularly to a device for dialysis and purification of body fluids such as blood, in which unnecessary components such as water are pushed out from the body fluid side to the dialysate side in a part of the device. In other parts, conversely, by drawing dialysate into the body fluid side at the same time, it is possible to perform dialysis with high efficiency and easy operation, which also has the effect of hemodiafiltration (HDF). The present invention relates to a dialysis filtration device that eliminates the need for a substituent fluid introduction mechanism, which is indispensable in conventional HDF devices.

In recent years, so-called artificial kidneys, which are devices that dialyze and purify body fluids such as blood or its components, have come into widespread use for the treatment and life support of patients with renal insufficiency.

Such a device uses a clarifier (dialyzer) containing a semipermeable membrane such as a film, tube, or hollow fiber cellulose membrane, such as a cupraammonium rayon membrane, in a box, which allows for example HDF operation. In some cases, dialysis is carried out in parallel with a partial replacement of body fluids, which can advantageously remove both low-molecular-weight substances and also larger substances, such as medium-molecular-weight substances, by the filtering action of the membrane;
This is used to dialyze and remove solutes such as urea and uric acid that have accumulated in the patient's body fluids, while replenishing the blood with a solution containing necessary substances and returning it to the body.

In carrying out such an HDF operation, it is necessary to have a substituting liquid introduction mechanism for returning the substituting liquid containing necessary substances into the body, the injection rate of the substituting liquid, or the reduction of the P overrate of the solution containing unnecessary substances from the blood side. Mechanisms are required to control both, and these must be controlled so that the amount and rate of fluid loss during HDF operation is pre-planned.

However, such a mechanism is extremely complex and highly precise.
This method has the drawback of requiring troublesome operations.

Further, problems such as the need for the replacement liquid itself, its transportation, and storage, together with the need for a special mechanism, made HDF an expensive and complicated method.

Therefore, there has been a need for an inexpensive dialysis furnace that enables highly efficient dialysis and p-filtration and is easy to operate.

The present invention has been made against this background, and its gist is that a semi-permeable membrane is housed in a box, and body fluids such as blood are passed through the semi-permeable membrane. A dialyzer that purifies the body fluid by contacting the dialysate through the dialyzer, a body fluid flow means that allows the body fluid to flow through the dialyzer, and a dialysis machine that allows a controlled amount of dialysate to flow through the dialyzer. A device having a fluid flow means, a differential pressure amplification mechanism for increasing the fluid pressure gradient on the body fluid flow path in the dialyzer, and one body fluid on the upstream side with respect to the differential pressure amplification mechanism. It is possible to amplify the pressure difference between the fluid pressure in the flow path section and the pressure in the other body fluid flow path section downstream of the differential pressure amplification mechanism.

In this way, in the high-pressure part that is upstream of the differential pressure amplification mechanism in the dialyzer, fluid from body fluids is transferred to the dialysate, and conversely, the dialysis fluid is transferred to the dialysate in the low-pressure part that is downstream of the differential pressure amplification mechanism. The dialysate is transferred from the fluid into the body fluid as a replacement fluid.

When the p-translucent fluid is pushed out from the body fluid, solutes (waste products) consisting of substances with a molecular weight of several thousand or less are also moved at the same time, so the more p-translucent fluid is pushed out, the more Waste products will be removed.

On the other hand, to compensate for the lack of water in body fluids, a dialysate containing necessary substances is automatically transferred into the body fluids as a replacement fluid through a semipermeable membrane.

When the difference between the outflow amount and the inflow amount is set to a constant amount in the dialysate fluid distribution means that allows the dialysate to flow through the dialyzer, the water equivalent to the difference between the outflow amount and the inflow amount is drawn out of the body from the body fluid. The same effects can be obtained.

Moreover, the operation of the dialysis device is extremely easy, and there is no need to separately provide a special sterile replacement fluid and replacement fluid introduction mechanism, so that troublesome operation can be completely omitted.
The device can be made smaller and simpler, and its cost can be significantly reduced.

EMBODIMENT OF THE INVENTION Hereinafter, the present invention will be described in more detail based on drawings showing embodiments thereof.

In Fig. 1, 1 is a dialysis machine (1) as a blood purification device.
A blood supply channel 2 for guiding blood from the patient's body is connected to the dialyzer 1, and a blood supply pump 3 is disposed on the blood supply channel 2,
Blood can be supplied into the dialyzer 1 at a predetermined rate.

Further, a blood delivery channel 4 is connected to the dialyzer 1 for returning blood purified within the dialyzer 1 into the patient's body.

Inside the dialyzer 1, a semipermeable membrane 6 in the form of a film, tube, or hollow fiber similar to conventional ones is housed, and the semipermeable membrane 6 connects the inside of the dialyzer 1 with the blood flow paths 8, 11 and the dialysate. The blood flow path is further divided into a first blood flow path portion 8 including a blood inflow port γ and a second blood flow path portion 11 including a blood outflow port 9. I'm forced to.

The first blood flow path section 8 and the second blood flow path section 11 are connected by a bypass 14, and a flow rate regulator 16 as a flow rate adjustment means is disposed on the bypass 14. , whereby a pressure difference is created between the first blood flow path section 8, i.e. upstream of the flow regulator 16, and the second blood flow path section 11, i.e. the downstream side of the flow regulator, or It is designed to be amplified.

Therefore, here, the bypass 14 and the flow regulator 16 are
This constitutes the differential pressure amplification mechanism in the present invention.

Further, a dialysate supply flow path 11 and a dialysate outflow flow path 18 are connected to the dialysate flow path 12 in the dialyzer 1, respectively, and the dialysate is introduced into the dialyzer 1, and the dialysate is The dialysate is allowed to flow out from the inside of the device 1 to the outside of the system.

On these flow paths 17 and 18, there is a dialysate supply pump 19 having a predetermined discharge volume, and a dialysate supply pump 19 whose discharge volume is larger than that of the dialysate supply pump 19 by the amount of scheduled removal of water from the body. A dialysate outflow pump 21, which can be configured as shown in FIG.

When performing a body fluid purification operation using a device with such a configuration, first, the dialysate delivery pump 21 and the dialysate supply pump 19 are operated so that the difference in their discharge amounts is the scheduled amount of water removed from the body. Then, the blood delivery pump 3 is operated to supply blood into the dialyzer 1 at a predetermined flow rate.

Then, the flow rate regulator 16 is adjusted so that the first blood flow path portion 8
By creating a constant fluid pressure difference between the first blood flow path portion 8 and the second blood flow path portion 11, the fluid pressure in the first blood flow path portion 8 in the dialyzer 1 can be made to flow through the dialysate flow path 12. The pressure of the dialysate is increased higher than that of the dialysate, while the fluid pressure in the second blood flow path 11 is lowered than the pressure of the dialysate in the dialysate flow path 12.

As a result, a solution containing waste products from the blood flowing through the first blood flow path 8 is moved into the dialysate flow path 12 by the P permeability of the semipermeable membrane.

Further, since the second blood flow path portion 11 has a lower fluid pressure than the dialysate flow path 12, the dialysate is transferred from the dialysate side to the blood flow path portion 11 here.

As a result, the water moves from the first blood flow path portion 8 to the dialysate side, thereby replenishing the insufficient amount of water in the blood.

Next, in order to further clarify the above-mentioned fluid inflow and outflow relationship, the dialysate supply pump 19,
The discharge volume of each dialysate outflow pump 21 is set to 150 l/
5H (5 (10rrLl/min), 152l/
5 H (5 0 6.7 rrLl,/min), the discharge rate of the blood delivery pump 3 was set to 200 ml/min, and the pressure in the first blood flow path section 8 was set to 400 mmHg and the second The pressure in the blood flow path section 11 is set to 10 mmHg (venous pressure).

Then, in the first blood flow path portion 8, the amount of water in the blood pushed out into the dialysate is 20 l/5H.

On the other hand, in the second blood flow path section 11, the amount of dialysate transferred into the blood is 11'/5H.

Here, 201 is the water withdrawal amount for waste removal,
Also, 18 liters is the amount of water that is replenished into the blood due to water withdrawal, and the difference, 2 liters, is the amount of water that is removed from the body.

In this way, the insufficient amount of water in the blood that occurs due to the P filtrate being pushed out from the blood side to the dialysate side is replenished by the transfer of dialysate to the blood side at the same time, so a special replacement fluid is used. Also, a replacement liquid introduction mechanism is completely unnecessary.

Therefore, the present apparatus not only simplifies, downsizes, and lowers the cost of the apparatus as a whole, but also makes the hemodiafiltration (HDF) method itself safe and low-cost.

Next, another embodiment of the present invention will be described based on FIG.

In this embodiment as well, the dialyzer 1 is divided into a first blood flow path section 8, a second blood flow path section 11, and a dialysate flow path 22 by a semipermeable membrane 6. part 8
and the second blood flow path section 11 are connected by a bypass 14, and the bypass 14 is provided with a flow regulator 16.

The dialysate flow path 22 is provided with a partition wall 23, so that the dialysate flow path 22 is connected to the first dialysate flow path portion that contacts the second blood flow path portion 11 via the semipermeable membrane 6. 26 and
It is divided into a second dialysate flow path portion 28 which is in contact with the first blood flow path portion 8 via the semipermeable membrane 6 .

Further, a through hole 29 is formed in the partition wall 28 so that the dialysate can flow from the first flow path section 26 to the second flow path section 28 through the through hole 29.

Note that the same reference numerals as in FIG. 1 represent the same or similar parts.

In a purification operation using such a device, the first dialysate flow path section 26 and the second dialysate flow path section 28 are connected to the partition wall 23.
Since the flow rate of the dialysate is increased in the through hole 29, the dialysate containing unnecessary substances and harmful substances that have been diffused or filtered from the blood in the first blood flow path section 8 is The fluid is prevented from migrating into the first dialysate flow path section 26 and mixing with the dialysate of said flow path, so that such unwanted and harmful components are returned to the second blood flow path section 11. This means that the risk of this transition has been completely eliminated.

It should be noted that in this device, there is no need to have a plurality of through holes 29, and it is possible to provide one through hole with a large diameter, or without providing such a through hole, the second dialysate flow path portion 2
6 and the second dialysate flow path section 28 by a bypass.

Furthermore, in the devices shown in the two embodiments described above, if a blood outflow pump is disposed on the blood outflow channel 4, the following advantages will occur.

That is, in the above embodiment device, the pressure in the second blood flow path portion 11 is transmitted directly into the patient's body through the blood outflow flow path 4, and therefore cannot be lowered below a certain limit (approximately 12 mmHg). However, if the blood outflow pump is installed, the pressure in the second blood flow path section 11 and the pressure in the living body are cut off, and the blood in the outflow path 4 is actively pumped out. Since the pressure in the second blood flow path portion 11 is further reduced, a more effective body fluid replacement effect can be obtained.

Although the present invention has been described above with reference to a few embodiments, the present invention is in no way limited to the description of these embodiments, and various modifications can be made based on the knowledge of those skilled in the art.

What is shown in FIG. 3 is one example.

In the system shown in FIG. 3, two dialyzers 36 and 37 are connected in series, and a flow rate regulator 42 is provided on a blood connection flow path 41 that connects the blood flow paths 38 and 39 to perform the purification operation. It is designed to do the following.

Further, as the flow rate regulator 16.42 in the above specific example, various known fixed or variable flow rate regulators may be used.
For example, a valve member capable of adjusting the flow rate may be suitably used.

Of course, instead of using a flow rate regulator as such a flow rate regulating means, by reducing the cross-sectional area of the body fluid flow path of the bypass 14 or the blood connection channel 41 to control the body fluid flow rate, the differential pressure can be reduced. configuring an amplification mechanism to increase body fluid pressure in the first blood flow path portions 8, 38 on the upstream side;
It is also possible to lower the body fluid pressure in the second blood flow path portion IL39 on the downstream side.

Furthermore, as a dialysing fluid, in addition to the normal dialysing fluid that has traditionally been used in artificial kidneys for dialysis operations, those modified by adding necessary components and substances as a replacement fluid are used. It is possible.

As described in detail above, the present invention divides the blood flow path formed within the dialyzer, and provides a differential pressure amplification mechanism between them, so that the upstream and downstream sides of the differential pressure amplification mechanism are divided. This is to create a difference in pressure.

This has made it possible to accurately, safely, and easily control body fluid replacement and dialysis, and it has also become possible to control the replacement of body fluids and dialysis accurately, safely, and without the need for complicated auxiliary devices such as conventional replacement fluid introduction mechanisms and special replacement fluids for intravenous drips. The blood purification operation was made possible by an extremely simple mechanism without the need for a blood purification system, and the device became smaller, more compact, and lower in cost.

[Brief explanation of the drawing]

FIG. 1 is a system diagram showing one embodiment of the present invention.
The figure is a system diagram showing another embodiment of the invention, and FIG. 3 is a system diagram showing still another embodiment of the invention. L36, 37: dialyzer, 6: semipermeable membrane, 7: blood inlet,
8: first blood flow path portion, 9: blood outflow port, 11: second blood flow path portion, 14: bypass, 16, 42: flow rate regulator, 17: dialysate supply flow path, 18: dialysate outflow channel,
23: partition wall, 24: dialysate inlet, 27: dialysate outlet, 29: through hole, 41: blood connection channel.

Claims (1)

[Scope of Claims] 1. A dialyzer that contains a semipermeable membrane in a case and purifies body fluids such as blood by bringing the body fluids, such as blood, into contact with the dialysate through the semipermeable membrane. , a body fluid distribution means for causing body fluid to flow through the dialyzer, and a dialysate flow means for causing a controlled amount of dialysate to flow through the dialyzer, wherein body fluid pressure is applied to the body fluid flow path in the dialyzer. By providing a differential pressure amplification mechanism for amplifying the pressure difference, the difference between the body fluid pressure in the body fluid flow path section on the upstream side of the differential pressure amplification mechanism and the body fluid pressure in the body fluid flow path section on the downstream side is amplified, This makes the body fluid pressure in the body fluid flow path on the upstream side of the differential pressure amplification mechanism higher than the fluid pressure in the dialysate flow path in the dialyzer, and at the same time increases the body fluid pressure in the body fluid flow path on the downstream side of the differential pressure amplification mechanism. The filtrate is drawn out from the body fluid side into the dialysate in the body fluid flow path section upstream of the differential pressure amplification mechanism by lowering the body fluid pressure in the dialyzer section lower than the fluid pressure in the dialysate flow path in the dialyzer. , and a dialysis filtration device characterized in that the dialysate is transferred from the dialysate side into the body fluid in a body fluid flow path portion downstream of the differential pressure amplification mechanism in the dialyzer. 2 The differential pressure amplification mechanism controls the body fluid flow path within the dialyzer,
A first body fluid flow path section including a body fluid inlet and a second body fluid flow path section including a body fluid outflow port are partitioned, and the first and second body fluid flow path sections are connected to form a first body fluid flow path section. By providing a bypass that allows body fluid to flow from the flow path section to the second body fluid flow path section, and controlling the amount of body fluid that is allowed to flow through the bypass, the flow between the second body fluid flow path section and the second body fluid is controlled. The diafiltration device according to claim 1, which is formed by creating a fluid pressure difference between the flow path portion and the flow path portion. 3. The differential pressure amplification mechanism includes a flow rate adjustment means provided on the bypass, and the flow rate adjustment means controls the flow rate from the first body fluid flow path portion to the second body fluid flow path portion through the bypass. By controlling the flow rate of body fluid to be made to flow, the fluid pressure difference between the first body fluid flow path portion on the upstream side of the bypass and the second body fluid flow path portion on the downstream side is amplified. A diafiltration device according to claim 2, wherein the diafiltration device is configured to obtain a diafiltration device according to claim 2. 4 The dialysate flow path in the box formed by the semipermeable membrane is divided into a first dialysate flow path portion where the second body fluid flow path portion is located and a dialysate flow path portion where the first body fluid flow path portion is located. The diafiltration system according to claim 2 or 3, wherein a partition wall is provided to separate the dialysate flow path portion from the second dialysate flow path portion, and a through hole is formed in the partition wall to communicate the two dialysate flow path portions. Device.