JPS60241449A - Artificial dialytic apparatus - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

DETAILED DESCRIPTION OF THE INVENTION (Technical Field) The present invention relates to an artificial dialysis device in which the ultrafiltration rate can be changed over time.

(Prior Art) A pressure-reducing type artificial dialysis apparatus (see FIG. 1) has been known, for example, as disclosed in Japanese Patent Application Laid-Open No. 5-6-84606. In FIG. 1, 1 is a dialyzer and 2 is a blood circuit. The blood circuit 2 includes a blood pump 3
．． It consists of an arterial line 6 leading to an arterial chamber 4 and a blood pressure sensor 5, and a venous line 8 leading to a venous chamber 7.

9 is a dialysate circuit, which includes a fluid supply valve 10 and a dialysate pressure sensor 11.
and a discharge line 15 having a pressure relief pump 13 such as a roller pump and a three-way valve 14. Further, 16 is a measuring circuit, and the measuring circuit 16 is connected to a point where the air chamber is opened to the outside air.
7, the δII pump 18 (roller pump), and the metering pump 1 mo 3 which sends a signal to keep the liquid level in the chamber 17 at a constant value.
It consists of a liquid level sensor (not shown) that outputs an output to The control system including this liquid level sensor is designed to operate only when the supply of dialysate is interrupted and when measuring pHj5 and ultrafiltration capacity (hereinafter referred to as UFRP).

19 is a circuit for measuring ultrafiltration pressure (hereinafter referred to as TMP), and 20 is a timing circuit.The measuring circuit 19 inputs signals from the blood pressure sensor 5 and the dialysate pressure sensor 11. The TMP obtained by performing the prescribed calculation is
The depressurizing pump 13 is controlled so that the difference between the set value and the set value becomes zero.

The timing circuit 20 also connects the liquid supply valve 3 and the three-way self-valve 14.
The UFRP measurement circuit is configured to control the operation timing of the UFRP measurement circuit and to periodically configure the UFRP measurement circuit.

In such an artificial dialysis @ system, dialysis and ultraviolet filtration are
The blood pump 3 is continuously driven to flow blood into the blood circuit 2, and at the same time, the liquid supply valve 10 is opened, and the three-way self-valve 14 is connected to the discharge line 1.
Connect 5 to the discharge destination.

At this time, due to the operation of the TMP calculation circuit 19, the TMP
Since MP is controlled according to the set value, the dialyzer 1 continues to perform ultrafiltration corresponding to the set MP.

On the other hand, the UFRP of dialyzer 1 not only differs for each individual dialyzer, but also gradually decreases over time as dialysis is continued.Furthermore, even if the same dialyzer + f is used, the tJFRP will differ depending on the patient. Show me the octopus.

For this reason, in an artificial dialysis apparatus that performs a predetermined ultra-hemorrhage using UFRP as a base, FF<P measurement is periodically performed at t7 (the timing is controlled by the timing circuit 20), as described below.

UFRF' measurement is performed by closing the liquid supply valve 10 and connecting the discharge line 15 to the metering circuit 16 through the -77J[] valve 14 (the inside of the chamber 17 is in communication with the outside air). At this time as well, due to the operation of the TMP 34 arithmetic circuit 19, the TM
Since P is controlled according to the set value,
In the step, ultrafiltration corresponding to the set TMP is continuously performed. Then, the liquid in the discharge line 15 is transferred to the metering circuit 1
6, flows into a buttonhole 17, and is discharged by a metering pump 18 operated by a control system including a liquid level sensor.

As a result, the liquid level in the -1 yamper 17 is maintained constant, and ultrafiltration (hereinafter referred to as UF) is applied from the discharge ff1 (tll hanging) of the metering pump 13, and from the operating time of the metering pump 18. The ultrafiltration rate (hereinafter referred to as tJFR) is calculated. Then, from T M )) at this time, (
) r RP (= U I-R/Ding M [)),
Based on this U-RP, the predetermined limit is exceeded.

By the way, when performing dialysis/ultrafiltration, it is necessary to set LJF:R depending on the patient's condition (the patient's condition changes during treatment) and the artificial dialysis machine.

However, in conventional artificial dialysis machines, it is troublesome to change U[1(1-) according to changes in the patient's condition during treatment, so UFR is set empirically and TMP is kept constant. Dialysis and ultrafiltration were performed while maintaining a constant UFR (UFR remained constant).As a result, patients whose condition changes significantly during treatment may experience physiological pain such as nausea and headaches. was there.

(Object of the invention) The present invention has been made in view of the above points, and
The purpose is to realize an artificial dialysis device that performs dialysis and ultrafiltration without causing physical pain to the patient.

(Structure of the Invention) The present invention achieves this object by controlling the ultrafiltration rate.
In 8 artificial dialysis machines equipped with a control unit, the time required for exiting the limit m is divided, and the time required for exiting the limit i [! The present invention is characterized in that it is provided with means for setting the pass rate, and is configured such that the set value is supplied from the means to the control section.

(Example) Hereinafter, an example of the present invention will be described in ST III with reference to the drawings.

FIG. 2 is a block diagram of an embodiment of the present invention.

In FIG. 2, the same parts as in FIG. 1 are designated by the same reference numerals, and their explanation will be omitted. 21 is a constant flow valve, 22 is a three-way self-valve having boats a, b, and c, and 23 is a bypass line. The dialysate, which has reached a constant flow with the constant flow valve 21, is caused to flow from the supply line 12 to the dialyzer 1 or from the bypass line 23 to a discharge destination by means of a three-way valve 22. 24 is a measuring line, 25 is a measuring container having two ultrasonic sensors 26, 27 is a magnetic valve, and 28 is an air suction line that communicates the outside air with the measuring container 25 via a throttle mechanism 29. Reference numeral 30 represents a control unit comprising a microprocessor, etc., and 31 represents a UFR setting device (means for setting the UFR). The control unit 30 controls dialysis/ultrafiltration,
ROM or RA that stores programs such as tJFRP measurement
M, blood pressure sensor 5.32<32 is set in the venous chamber i? ), dialysate Ff sensor 11,
The ultrasonic sensor 26 of the measuring container 25 (inputs signals from the lF'R setting device 31, etc., performs predetermined processing, and operates the depressurizing pump 13゜Ijll valve 22 and solenoid valve 27W) The UFRitQ regulator 31 is
To setting switch 31 1 hour setting switch 31 L”l
, a write command switch 3IC, and a display section 31D (the vertical axis of the display section 31D indicates UF' II, and the horizontal axis indicates time), and the time required for ultrafiltration (divided into time intervals). Since the time required for ultrafiltration is 5 to 7 hours, in this example (・ is divided into 30-minute intervals on time axes j and l), the UFR () for each divided time is set, and , fS settings can be written into the RAM of the control unit 30.

According to the above configuration, in the dialysis/ultrafiltration operation U [prior to the RP measurement operation], the U F RP setting device 31 performs 111"
Since the R setting operation 1 is performed, the above operations and operations will be sequentially explained below.

The UFR setting operation is performed by a doctor, a nurse, etc., who examines the patient's condition and recognizes an FR pattern suitable for the patient's dialysis/ultratherapy. When the LI FR setting device 31 is put into operation, the display unit 310 shows LJ FR (in %) on the vertical axis and 30 on the horizontal axis as shown in FIG.
of time divided into minute intervals? keyaki will be displayed (however,
At this time, only the orthogonal coordinate axes are displayed and the graph shown in FIG. 3 is not displayed (4T). In this state, when the time setting switch 31B is operated, time period T+ (time period corresponding to 30 minutes after the start of treatment) on the time axis is specified. Next, (operate the JFR setting switch 31A, set tJFR1, for example, UFR+, in the time period T+ (this setting 1fIUFR1 is displayed in a graph on the display section 31D), and write this value to the command switch 31.
The RAM of the control unit 30 is filled in by the operation of C. Similarly, each time period T2 (time period corresponding to 30 minutes to 11 hours after the start of treatment), T'3 (time period corresponding to 1 hour to 1 hour 30 minutes after the start of treatment)... ni, U[R,? ,
Set UFR3..., perform an operation to write it into the RAM of the control unit 30, and set the UFR for the entire treatment time (1.1 on the display unit 31D, as shown in Fig. 3). , LJ FR pattern is displayed).

U RP measurement operation starts when treatment starts (blood circuit 2
blood flows through the air), and is performed based on a program stored in the ROM of the control unit 30.

The control unit 30 connects the boats C and b of the valves 22,
The electromagnetic valve 27 is opened and the depressurizing pump 13 is driven to discharge the dialysate from the supply source via the bypass line 23. As a result, outside air is introduced into the measuring container 25 via the air suction line 28, and any liquid remaining in the 81 m container 25 (liquid may remain due to equipment cleaning, etc.) is discharged, and F! t m container 25 is completely emptied.

During this operation, an ultrafiltration operation is performed while operating the pressure relief pump 13 (details of the ultrafiltration operation will be given later). Next, the control unit 30 closes the electromagnetic valve 27 to form a flow path from the dagger array 1-4 suspended container 25 to the depressurization pump 13 to the discharge destination. Thereby, the ultrafiltered liquid is introduced into the metering container 25. and,
The control unit 30 uses the liquid level signals from the two ultrasonic hinges 1726 to send the ultrafiltered liquid to the measuring container 25.
Count the time T that satisfies the requirement, determine UFR (=V/1-1v, the volume of the measuring container 25), and from the current TMP (the origin of the king MP will be described later) () F RP o (
= U F - R / T M P ), and the value is RA
Store in M. Hereafter, ultrafiltration v3 operation based on this UFRPo is performed.

In the dialysis/ultrafiltration operation, the control unit 30 communicates ports C and a of the port valve 22, closes the solenoid valve 27, and controls the constant flow valve 21→
Boat C and a of the three-way valve 25 → Tie 7 Riser 1 → Another equal volume container 251 Negative pressure pump 13 - → Configure the flow path for the discharge destination,
This is performed while a constant flow of dialysate is flowing through the titerizer 1 (of course, blood is continuously flowing through the blood circuit 2). At this time, the control unit 30 controls the blood pressure sensors 5 and 32.
and each signal M1. of the dialysate pressure sensor 11. 'M3 and M2
(each signal is - and the respective hydraulic pressure Ml, M3 and M2
), (1) or (1') to determine the operating TMP II.

1MpHl -Ml -M2 +△ρ... (1)
Or, T M )) fi - (M l + M 3 )
/2-Mn)-ΔP(1') However, ΔP is an offset.

Then, the control unit 30 controls the control unit 30 in accordance with the treatment start time, that is, from 0 to 30 minutes after the start of the treatment (time period T+) 1, t, t.
Set JIR+ to the set value (actually, ()FRPo=UFR+
/1 - TMP determined by the relationship of MP is less than the set value)
, TMPI1+ are measured values and a control wave p is applied to operate the positive pressure bomb 713. Due to this.

A predetermined UFR+ is obtained in the h interval T1.

Next, for 30 minutes to 1 hour after the start of treatment (time period T?),
The control unit 30 sets UFR2 as a set value and generates a control wave i similar to that described above to obtain a predetermined LJFR2. Thereafter, in the same way, the l1il control unit 30 performs control every 30 minutes when the time exceeds 30 minutes. Continue the action to obtain R. Therefore, 1, J according to the patient's condition
This can be achieved by performing dialysis/ultrafiltration based on the FR pattern.

In addition, although the embodiment described in -1- was shown regarding a positive pressure type dialysis device for one person, the present invention is not limited to this, but
It may be a positive pressure type artificial dialysis machine, or it may be an artificial dialysis machine using a water removal pump. Since the system controls continuous water removal using the water removal pump, the speed of the water removal pump can be changed according to the required treatment time.

(Effects of the Invention) As explained above, according to the present invention, it is possible to proceed with treatment at an ultrafiltration rate that is tailored to the patient's condition. Dialysis and ultraviolet filtration can be performed.

[Brief explanation of the drawing]

Fig. 1 is a block diagram showing a conventional example, Fig. 2 is a block diagram showing an embodiment of the present invention, and Fig. 3 is a block diagram showing an embodiment of the present invention.
It is a figure which shows the example of a setting of JFR. 1...Dializer 2.Blood circuit 5.32...Blood juice sensor 11...Dialysis fluid pressure sensor 13...Positive pressure pump 25...Weighing container 26...Ultrasonic sensor 29... Aperture mechanism 30...control unit 3
1...tJ FR setting device Fig. 1 314 / / Fig. 3 UFR

Claims (1)

[Claims] In an artificial dialysis apparatus equipped with a control unit that controls the ultrafiltration rate, the ultrafiltration time is divided and the ultrafiltration rate is set for each divided time. An artificial dialysis device characterized by being configured to give a set value to a control section.