JPS61100260A - 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] <Industrial Application Field> The present invention relates to an artificial dialysis device for a medium needle (single needle). Regarding.

<Prior Art> Artificial dialysis using a single needle is performed when a shunt connecting an artery and a vein has not been established in the human body undergoing artificial dialysis, or when the condition of the shunt is poor. FIG. 4 is a configuration diagram showing a conventional example of a single-needle artificial dialysis device.

In the figure, 1 is a dialyzer, 2 is a blood circuit, one end is connected to the blood vessels of the human body, the other end is divided into three sides, one is connected to the inlet side of dialyzer 1 via blood pump 3 and venous chamber 4, and the other is connected to the inlet side of dialyzer 1. is connected to the outlet side of dialyzer 1 via valve 5.

Reference numeral 6 denotes a dialysis circuit, in which dialysate is supplied to and discharged from the dialyzer 1 as shown by arrows. 7 is a pressure gauge for measuring blood pressure, and 8 is a control circuit for controlling the blood pump 3 and valve 5 based on the signal from the pressure gauge 7.

With this configuration, the valve 5 is initially in a closed state, and from this state the blood pump 3 is rotated to extract blood from the human body through the single needle. The extracted blood passes through the blood circuit 2, passes through the venous chamber 4, and enters the dialyzer 1.
supplied to

A dialysate is passed through the dialyzer 1, where blood dialysis and water removal (ultrafiltration) are performed.

When the blood pressure detected by the pressure gauge 7 reaches a set value, a signal is sent from the 1t1111!1 circuit 8 to stop the rotation of the blood pump 3 and open the valve 5.

L (7) ta'X! , Tsiawi V1. Hey, □
, □ is returned to the human body through the same route from which the blood was initially taken.

In this case, a straining pump is usually used as the blood pump 3, and when the pump stops, this part is closed, so that the blood that has been refluxed through the valve 5 does not flow back into the dialer 1 side.

When the pressure detected by the pressure gauge 7 reaches the lower limit,
The valve 5 is closed, the blood pump 3 is rotated, blood is taken out, and dialysis and water removal are performed again in the dial live 1. Such operations are repeated many times until the targeted dialysis and water removal are achieved.

By the way, in an artificial dialysis machine, in order to achieve the target water removal, the pressure applied to the dialysis membrane in the dialyzer 1, that is,
The difference between the pressure on the blood side and the pressure on the dialysate side (ultrafiltration pressure, hereinafter referred to as TMP) is controlled.

On the other hand, in the conventional device shown in Fig. 4, the upper and lower limit values are set in advance, and blood is taken out and recirculated based on these values, so that the blood pressure changes every moment! and
Using such a signal has the disadvantage that TMP cannot be controlled effectively.

<Problems to be Solved by the Invention> The technical problem to be solved by the present invention is to provide a single-needle artificial dialysis device that extracts and recirculates blood in response to changes in blood pressure. The goal is to ensure that the desired amount of water removal can be achieved.

[Means for Solving the Problems] The configuration of the present invention is such that a blood pump provided in a blood circuit to a dialyzer and a valve provided in a blood circuit from the dialyzer are connected to the pressure of blood flowing through the blood circuit. In the apparatus, the blood is controlled every time the upper and lower limit set values are reached, the blood is taken out through the single needle to the dialive, and after dialysis and ultrafiltration, the blood is returned to the human body through the single needle. means for dividing a constant flow of dialysate into a dialyzer, means for detecting the pressure of the dialysate, means for adjusting the pressure of the dialysate, and control given at a predetermined timing from an effusion calculation control unit. means for detecting the amount of ultrafiltration of the dialybe based on the signal; and means for determining the average pressure from the pressure of the blood, and the ultrafiltration pressure between this pressure and the pressure of the dialysate, as well as the ultrafiltration rate. Calculate the ultrafiltration capacity of the dialyzer based on the amount, set an ultrafiltration pressure to subtract 1q from the target water removal amount based on this calculation result, and adjust the dialysate pressure adjustment means to this set value. The reason is that an arithmetic and control circuit is provided.

Function> The above technical means works as follows. That is, in the single-needle artificial dialysis apparatus, the operation of filling the dialyzer with blood and the operation of circulating blood into the human body are repeatedly performed. During this time, the blood pressure is fluctuating between the upper and lower limit set values, so if this is used, TMP cannot be controlled effectively. Therefore, the arithmetic and control circuit calculates the average value of this pressure signal, and sets the difference between this and the pressure of the dialysate (ultrafiltration pressure) to a value that provides the target water removal amount in relation to the ultrafiltration capacity. Then, the pressure adjusting means provided on the dialysate side was controlled so as to have this set value. Even if the pressure on the blood side fluctuates, the target amount of water removal can be achieved reliably by 1r.

<Example> The present invention will be described in detail below with reference to the drawings. FIG. 1 is a block diagram of an apparatus according to an embodiment of the present invention, and FIG. 2 is an explanatory diagram of the operation of the apparatus according to an embodiment of the present invention shown in FIG. In FIG. 1, the same elements as those in FIG. 4 are given the same reference numerals, and explanations thereof will be omitted.

Reference numeral 9 denotes a dialysis circuit, which is comprised of a circuit section 9a for supplying dialysate to the dialyzer 1, a circuit section 9b for discharging the dialysate from the dialyzer 1, and a bypass circuit section 9C for measuring the water removal capacity of the dialyzer 1. There is. The circuit portion 9a is provided with a constant flow leg 10, a valve 11, and a pressure gauge 12 for detecting the pressure of dialysate, and the circuit portion 9b is provided with a valve 13.
and a negative pressure pump 14 are provided, and a bypass circuit portion 9C
is provided with a measuring device 15 consisting of a container 15a and ultrasonic sensors 15b and 15C provided at the top and bottom of this container. The meter 15 also has a structure in which it communicates with the outside air via a valve 1G and a throttle 17.

18 is an arithmetic control unit which receives, as input signals, a blood pressure signal from the pressure gauge 7, a dialysate pressure signal from the pressure gauge 12,
Signals etc. from the ultrasonic sensors 15b and 15G are given,
as an output signal a control signal to the blood pump 3 and the valve 5;
A control signal to the negative pressure pump 14 when performing TMP control, and a control signal to the valve 13 when measuring the water removal ability of the dialyzer 1.
16, and generates control signals and the like.

Next, the operation of the apparatus according to the embodiment of the present invention will be explained according to the waveform diagram shown in FIG. FIG. 2(a) shows the changing state of blood pressure, and FIG. 2(b) and FIG. 2(C) show the operating states of the blood pump 3 and valve 5, respectively. When the blood pump 3 is rotated from the state where the valve 5 is in the lever position, the blood pressure increases as shown in Figure (a).

The upper limit value Mu and lower limit 16MI2 of pressure are stored in the storage unit of the arithmetic control unit 18, and when the blood pressure rises to 1ylu, a control signal to stop the rotation of the blood pump 3 and a control signal to open the valve 5 are sent. Generates a control signal to This causes blood to circulate and blood pressure to drop by 1. When the blood pressure drops to MQ, the blood pump 3 is rotated and the valve 5 is opened! Generates an Il signal. Such operations are repeated until the targeted dialysis and water removal are achieved.

Next, a control method for obtaining the target water removal amount will be explained. The amount of water removed is determined according to the ultrafiltration capacity (hereinafter referred to as UFRP) representing the water removal ability of the dialyzer 1, and this UFRP is determined according to the ultrafiltration pressure TMP and the ultrafiltration rate (hereinafter referred to as UFR). .

Since UFRP differs for each individual dialybe and also changes over time as dialysis continues, it is necessary to measure UFRP periodically.

The bypass circuit portion 9C is a portion for measuring UrR.

While dialysis/ultrafiltration is being performed, valve 11 is open and valve 13 is open.
．． 16 is in a closed state, and the dialysate is flowing through the circuit section 9a, the dialyzer 11 circuit section 9b, and the meter 15. It flows through bypass circuit section 9c. Valve 1 is controlled by control number 1g given at a predetermined timing from calculation control section 18.
1 is opened, valves 13' and 16 are closed, and the inside of the measuring instrument 15 is emptied by air 13 supplied from the outside.

Next, the valve 1 is activated by a control signal from the calculation control section 18.
1 and valves 13 and 16 to the locks to allow the dialysate to flow. Thereby, the dialysate after ultrafiltration is introduced into the it ffi device 15. Ultrasonic sensor 15c.

15b, count the time it takes for the dialysate to reach the highest level from the lowest level in the meter 15, and calculate the amount of ultrafiltration (amount of water removed) by comparing it with the dialysate supplied to the dialyzer 1 at the same time. The UFR, which represents the performance of the permeable membrane, is determined from the above-mentioned time.

According to the determined values of tJFR and TMP, a TMP at which the target amount of water removal can be obtained is set, and the negative pressure pump 14 is operated 11 times based on this set value.

By the way, TMP is generally calculated by the following formula.

TMP=M1-M2-△p...(1) However, M
l: blood pressure, M2: dialysate pressure, Δp: constant.

However, in single-needle dialysis machines,
As shown in FIG. 2(a), the blood pressure M1 fluctuates between upper and lower limit settings of 16MLJ and MQ. For this reason, υjiff cannot be performed successfully if this is used. In the present invention, the average value Mm of the pressure M1 is determined in the arithmetic control unit 18, and using this, TMP=Mm-M2-Δp-
= (2) is performed to obtain the setting TMP, and the dialysate pressure M2 is controlled based on this, so even if the pressure on the blood side fluctuates, the target water removal amount is reliably achieved by 1H.

Single-needle dialysis is performed in special cases, such as when the human body undergoing dialysis does not have a shunt, or when the shunt is in poor condition.
It is uneconomical to have a dedicated single-needle dialysis machine. FIG. 3 is a block diagram showing a specific example of the arithmetic and control unit 18 that can be used for both single needle and normal applications. In the figure, 18a is a blood pressure signal M
Addition point 18b by switching between the 1 side and the ground side
18c is an analog calculation circuit that performs control calculations such as proportionality, differentiation, and integration on the signal from the addition point 18b; 18d is a center circuit to which blood pressure signal M1 and dialysate pressure signal M2 are applied to inputs; The processing device (CPU) outputs the set TMP to the acceleration point 18b.

Note that this CPU is given signals from the ultrasonic sensors 5b, 15c, etc., calculates the ultrafiltration capacity, and operates the valves 11, 1.
3.Gives control signals to 16 etc.

When using a single needle, the switch 18a is switched to the ground side, and the pump 14 is controlled based on the setting TMP given from the CPU 18d based on equation (2). In the case of normal use, switch 18a is switched to the signal M1 side, and pump 1 is set by setting TMP based on equation (1).
4.

According to such a configuration, the simple configuration of adding the switch 18b can be used both for single needle use and for normal use.

<Effects of the Invention> According to the present invention, the average value of the blood pressure signal is determined, and the ultrafiltration pressure between this value and the dialysate pressure is determined as the target water removal ω in relation to the ultrafiltration capacity. Since the pressure adjustment means provided on the dialysate side was controlled to this set value, the target amount of water removed was reliably 1q even if the pressure on the blood side fluctuated. .

[Brief explanation of the drawing]

FIG. 1 is a configuration diagram of the apparatus according to the embodiment of the present invention, FIG. 2 is an explanatory diagram of the operation of the apparatus according to the embodiment of the present invention shown in FIG. 1, and FIG. A configuration diagram shown,
FIG. 4 is a configuration diagram, not showing a conventional example of a single needle artificial dialysis device. DESCRIPTION OF SYMBOLS 1... dialyzer, 2... blood circuit, 3... blood pump, 5... valve, 7... pressure gauge, 9... dialysis circuit, 10... constant flow valve, 11... ...Valve, 12...
Pressure gauge, 13... Valve, 14... Negative pressure pump, 15.
...Measuring instrument, 18... Arithmetic control unit Fig. 1 Fig. 2 Fig. 3 Fig. 4

Claims (1)

[Claims] A blood pump provided in the blood circuit to the dialyzer and a valve provided in the blood circuit from the dialyzer are controlled each time the pressure of blood flowing through the blood circuit reaches an upper or lower limit set value, and a blood pump provided in the blood circuit from the dialyzer is controlled to In the apparatus, blood is taken out into the dialyzer, and after dialysis and ultrafiltration, the blood is returned to the human body through the single needle, comprising means for flowing a constant flow of dialysate to the dialyzer, and a pressure of the dialysate. means for detecting the amount of ultrafiltration of the dialyzer, means for adjusting the pressure of the dialysate, means for detecting the amount of ultrafiltration of the dialyzer based on a control signal given at a predetermined timing from an arithmetic control section to be described later; The average pressure is calculated from the pressure of the dialysate, the ultrafiltration capacity of the dialyzer is calculated based on the ultrafiltration pressure between this pressure and the pressure of the dialysate, and the ultrafiltration amount, and the target is calculated based on the calculation result. An artificial dialysis apparatus comprising: an arithmetic control circuit that sets an ultrafiltration pressure for obtaining the amount of water removed, and controls the dialysate pressure adjustment means to reach this set value.