WO2014162489A1 - Machine de dialyse péritonéale automatique - Google Patents

Machine de dialyse péritonéale automatique Download PDF

Info

Publication number
WO2014162489A1
WO2014162489A1 PCT/JP2013/060000 JP2013060000W WO2014162489A1 WO 2014162489 A1 WO2014162489 A1 WO 2014162489A1 JP 2013060000 W JP2013060000 W JP 2013060000W WO 2014162489 A1 WO2014162489 A1 WO 2014162489A1
Authority
WO
WIPO (PCT)
Prior art keywords
peritoneal dialysis
cassette
patient
peritoneal
dialysate
Prior art date
Application number
PCT/JP2013/060000
Other languages
English (en)
Japanese (ja)
Inventor
友隆 國分
Original Assignee
テルモ株式会社
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by テルモ株式会社 filed Critical テルモ株式会社
Priority to PCT/JP2013/060000 priority Critical patent/WO2014162489A1/fr
Priority to JP2015509742A priority patent/JP6097822B2/ja
Publication of WO2014162489A1 publication Critical patent/WO2014162489A1/fr

Links

Images

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
    • A61M1/28—Peritoneal dialysis ; Other peritoneal treatment, e.g. oxygenation
    • A61M1/281—Instillation other than by gravity
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
    • A61M1/15—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with a cassette forming partially or totally the flow circuit for the treating fluid, e.g. the dialysate fluid circuit or the treating gas circuit
    • A61M1/153—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with a cassette forming partially or totally the flow circuit for the treating fluid, e.g. the dialysate fluid circuit or the treating gas circuit the cassette being adapted for heating or cooling the treating fluid, e.g. the dialysate or the treating gas
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
    • A61M1/15—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with a cassette forming partially or totally the flow circuit for the treating fluid, e.g. the dialysate fluid circuit or the treating gas circuit
    • A61M1/155—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with a cassette forming partially or totally the flow circuit for the treating fluid, e.g. the dialysate fluid circuit or the treating gas circuit with treatment-fluid pumping means or components thereof
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
    • A61M1/15—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with a cassette forming partially or totally the flow circuit for the treating fluid, e.g. the dialysate fluid circuit or the treating gas circuit
    • A61M1/156—Constructional details of the cassette, e.g. specific details on material or shape
    • A61M1/1565—Details of valves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
    • A61M1/15—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with a cassette forming partially or totally the flow circuit for the treating fluid, e.g. the dialysate fluid circuit or the treating gas circuit
    • A61M1/159—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with a cassette forming partially or totally the flow circuit for the treating fluid, e.g. the dialysate fluid circuit or the treating gas circuit specially adapted for peritoneal dialysis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
    • A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
    • A61M1/1654—Dialysates therefor
    • A61M1/1656—Apparatus for preparing dialysates
    • A61M1/166—Heating
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
    • A61M1/28—Peritoneal dialysis ; Other peritoneal treatment, e.g. oxygenation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
    • A61M1/15—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with a cassette forming partially or totally the flow circuit for the treating fluid, e.g. the dialysate fluid circuit or the treating gas circuit
    • A61M1/152—Details related to the interface between cassette and machine
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
    • A61M1/15—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with a cassette forming partially or totally the flow circuit for the treating fluid, e.g. the dialysate fluid circuit or the treating gas circuit
    • A61M1/156—Constructional details of the cassette, e.g. specific details on material or shape
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/12—General characteristics of the apparatus with interchangeable cassettes forming partially or totally the fluid circuit

Definitions

  • the present invention relates to an automatic peritoneal dialysis apparatus that automatically feeds peritoneal dialysis fluid and drains spent peritoneal dialysis fluid.
  • a patient who needs to undergo hemodialysis due to a decrease in kidney function visits the hospital three or four times a week and undergoes hemodialysis while being restrained by a hemodialysis apparatus for four to five hours.
  • an automatic peritoneal dialysis apparatus in which an automatic peritoneal dialysis apparatus is disposed at the patient's home and is operated by the patient himself is being used (see Patent Document 1). ).
  • a doctor In such an automatic peritoneal dialysis device, a doctor must examine the degree and progress of the patient's illness and make the dialysis content based on the prescription that is the result of the diagnosis.
  • a doctor gives a document describing the prescription contents to the patient, the patient returns home, and the peritoneal dialysis is performed by setting the contents as prescribed for the automatic peritoneal dialysis machine at home. I try to receive it.
  • the conventional automatic peritoneal dialysis device as its main operation part, a tube for feeding from the peritoneal dialysate bag, a switching part for feeding liquid such as a clamp, and a diaphragm pump for providing driving force for feeding, The heating part of the peritoneal dialysis solution is set together, and a cassette and a set of tubes attached to the set of tubes are used. This cassette was replaced every time it was used, and the used cassette body and tube set were discarded.
  • a predetermined amount of peritoneal dialysis solution is delivered into the abdominal cavity of the patient, stored in the abdominal cavity for a predetermined time, subjected to dialysis treatment through the peritoneum, and then peritoneal cavity.
  • the peritoneal dialysis treatment is performed by one cycle by feeding, storing, and draining the peritoneal dialysis fluid.
  • a predetermined amount of peritoneal dialysis fluid is repeatedly delivered into the abdominal cavity of the patient a plurality of times, so that a predetermined set value of peritoneal dialysis fluid is delivered into the peritoneal cavity. It is designed to store for a predetermined time. If the patient undergoing peritoneal dialysis is an adult patient with a large amount of abdominal cavity, the cumulative amount of peritoneal dialysis fluid delivered by repeatedly delivering a predetermined amount of peritoneal dialysis fluid into the abdominal cavity of the patient multiple times Can be adjusted to a predetermined set value as much as possible.
  • the patient undergoing peritoneal dialysis is a patient subject to small volume delivery, for example, a child with a small amount of abdominal cavity compared to an adult patient
  • the prescribed amount of peritoneal dialysis fluid is repeatedly delivered multiple times. Even if it is attempted to adjust the accumulated amount of peritoneal dialysis fluid so that it reaches the set value, the accumulated amount may greatly exceed the set value. It cannot be adjusted to the value.
  • the present invention provides a predetermined amount of peritoneal dialysis fluid when the peritoneal dialysis fluid is delivered to the abdominal cavity of a patient subject to a small amount of fluid delivery such as a child whose abdominal volume is smaller than that of an adult. It is an object of the present invention to provide an automatic peritoneal dialysis apparatus that can be accurately adjusted so that the set value becomes.
  • the automatic peritoneal dialysis device of the present invention has a dialysate circuit including at least one dialysate container filled with dialysate and at least one drainage recovery container for collecting dialysate, and the dialysate container as a starting point.
  • an automatic peritoneal dialysis apparatus having a liquid feeding means for feeding the dialysate with the drainage collection container as an end point, and a display means for displaying dialysis-related conditions, etc.
  • the normal peritoneal dialysis fluid is sent to the peritoneal dialysis fluid a plurality of times, and the peritoneal dialysis fluid is stored at a target set value to match the peritoneal dialysis fluid to the target set value.
  • the quantitative delivery is performed when the target set value is approached.
  • a small amount of liquid that is less than the amount of liquid A peritoneal dialysis solution from the cassette to the normal liquid supply target patient based on the normal liquid supply target patient table of the storage unit and a storage unit having a small volume liquid supply target patient table that is switched to match the target set value.
  • a control unit that performs any one of the small-volume liquid supply target patient modes to be supplied to the patient.
  • the peritoneal dialysis solution is quantitatively delivered multiple times to a small amount of liquid-feeding target patient with a smaller amount of peritoneal dialysate than the normal liquid-feeding target patient.
  • the dialysate feeding amount is adjusted to the target set value, when the dialysate approaches the target set value, the amount can be switched to a minute amount feeding smaller than the fixed amount feeding amount to match the target set value.
  • the cumulative amount of peritoneal dialysis fluid is set to a predetermined value. Can be fitted with high accuracy.
  • the apparatus has a display unit capable of selecting the normal liquid feeding target patient mode or the small volume liquid feeding target patient mode.
  • the mode suitable for the display unit can be easily set without mistake. Can be selected.
  • the cassette includes a pump for feeding the peritoneal dialysate and a heating unit for heating the peritoneal dialysate.
  • the temperature can be raised, and the pump can be fed into the abdominal cavity by a pump to a normal liquid feeding target patient or a small volume liquid feeding target patient.
  • thermosensitive member is provided in the cassette, and the state is changed by heating of the heating unit when the cassette is mounted and used in the cassette mounting portion, and a change in the state of the thermal member is detected.
  • a cassette used detection unit wherein the control unit determines that the cassette is used based on a signal from the cassette used detection unit. According to the said structure, it can prevent reliably that a normal liquid feeding subject patient or a small amount liquid feeding subject patient reuses a used cassette.
  • the present invention sets a predetermined amount of peritoneal dialysis fluid when the peritoneal dialysis fluid is delivered to the abdominal cavity of a patient to whom a small amount of fluid is delivered, such as a child whose abdominal volume is smaller than that of an adult. It is possible to provide an automatic peritoneal dialysis apparatus that can be accurately adjusted so as to have a value.
  • the perspective view which shows the state which closed the cover member of the cassette mounting part of preferable embodiment of the automatic peritoneal dialysis apparatus of this invention The perspective view which shows the state which opened the cover member of the cassette mounting part of preferable embodiment of the automatic peritoneal dialysis apparatus of this invention.
  • the perspective view which shows a mode that a cassette is mounted in a cassette mounting part.
  • the figure which shows the structural example of the heating part of a cassette, and a cassette used detection part.
  • the figure which shows the pneumatic circuit of an automatic peritoneal dialysis apparatus.
  • the figure which shows the liquid feeding example of the peritoneal dialysate in the automatic peritoneal dialysis apparatus mentioned above.
  • FIGS. 1 and 2 are perspective views showing a preferred embodiment of the automatic peritoneal dialysis apparatus of the present invention.
  • 1 shows a state in which the lid member of the cassette mounting portion 100 of the automatic peritoneal dialysis apparatus 1 is closed
  • FIG. 2 is a perspective view showing a state in which the lid member of the cassette mounting portion 100 of the automatic peritoneal dialysis apparatus 1 is opened. is there.
  • FIG. 3 is a perspective view showing a preferred example of the lower casing 3 and the cassette 100 of the automatic peritoneal dialysis device 1.
  • the automatic peritoneal dialysis apparatus 1 shown in FIG. 1 and FIG. 2 has an upper housing part 2 and a lower housing part 3, and when the cassette 100 is not mounted, the weight of the automatic peritoneal dialysis apparatus 1 is 9 kg. Yes, it is lightweight.
  • Each of the upper housing 2 and the lower housing 3 is a box-shaped member made of, for example, plastic.
  • the upper housing part 2 has a front surface part 4, an upper surface part 5, left and right side surface parts 6 and 7, and a back surface part 8 and covers the upper part of the lower housing part 3.
  • the shape of the front surface portion 4 of the upper housing portion 2 considers the use of a peritoneal dialysis patient who is a user.
  • the front unit 4 Is inclined obliquely at an angle ⁇ with respect to the vertical line.
  • a display unit 10 is disposed at the center of the front unit 4, and a start switch 11 and a stop switch 12 are disposed at the left and right positions of the display unit 10.
  • This display unit 10 is used for visually informing a user such as a peritoneal dialysis patient, inputting necessary peritoneal dialysis conditions, confirming peritoneal dialysis conditions, displaying operation procedures and the like together with a voice guide.
  • the display unit 10 also functions as a touch panel type setting input unit for notifying the operation state of the automatic peritoneal dialysis apparatus 1 and inputting various peritoneal dialysis conditions.
  • the operating state of the automatic peritoneal dialysis device 1 refers to, for example, injecting peritoneal dialysis fluid into the abdominal cavity based on various peritoneal dialysis modes set in accordance with a patient to which peritoneal dialysis fluid to be described later is sent.
  • a peritoneal dialysis patient who intends to deliver peritoneal dialysis fluid an adult patient or a child patient is a target.
  • the volume of peritoneal dialysis fluid that can be stored in the abdominal cavity of pediatric patients is small compared to the volume that can store peritoneal dialysis fluid in the abdominal cavity of adult patients due to the difference in physique between adults and children. is there.
  • an adult patient is referred to as a normal liquid supply target patient
  • a pediatric patient is referred to as a small volume liquid supply patient with respect to a normal liquid supply target patient.
  • the display unit 10 may employ, for example, a color liquid crystal display device that allows a peritoneal dialysis patient to perform a touch operation with a finger and directly input various operations, an organic EL (electroluminescence) display device, or the like.
  • a plurality of touch-operated icons 10A to 10F that are relatively large and easy to operate are provided.
  • these icons for example, a “return” icon 10A for returning the operation to the previous state, a “confirmation” icon 10B, icons 10C to 10F for setting peritoneal dialysis conditions, and the like are provided.
  • the icon 10D is pressed when the normal liquid supply target patient is a peritoneal dialysis patient, so that the normal transfer for supplying the peritoneal dialysate to the normal liquid supply target patient MM-A is performed.
  • a liquid subject patient mode can be selected.
  • the icon 10E is pressed when the patient subject to small volume delivery such as a child is a peritoneal dialysis patient.
  • a mode can be selected. The size and number of these icons can be set arbitrarily.
  • liquid feeding is also called injection.
  • FIG. 1 and FIG. 2 has an inclined portion 4A to 4D, and the inclined portions 4A to 4D are formed around the display unit 10. Therefore, the display unit 10 is arranged at a position slightly depressed from the surface of the front surface part 4.
  • index protrusions 9D to 9F are formed on the upper inclined portion 4A at positions corresponding to the icons 10D to 10F.
  • index protrusions 9A to 9C are formed on the lower inclined portion 4C at positions corresponding to icons 10A to 10C having touch panel functions.
  • index protrusions 9A to 9F indicate the positions of the icons 10A to 10F on the screen of the display unit 10, respectively.
  • the peritoneal dialysis patient can touch the index protrusions 9A to 9F on the screen of the display unit 10 by touching the index protrusions 9A to 9F.
  • the positions of the icons 10A to 10F can be accurately confirmed. Therefore, the normal liquid delivery target patient MM-A presses the icon 10D to select the normal liquid delivery target patient mode, or the small liquid delivery target patient MM-B presses the icon 10E to send a small quantity.
  • the operation of selecting the liquid subject patient mode can be performed reliably and easily.
  • the index protrusions 9A to 9F shown in FIGS. 1 and 2 are, for example, rectangular parallelepiped protrusions, but are not limited to this, and other shapes may be adopted. Further, the index protrusions 9A to 9F may adopt “Braille” indicating the contents of the icons 10A to 10F instead of such simple shapes.
  • a start switch 11 is disposed on the right side of the display unit 10 and a stop switch 12 is disposed on the left side of the display unit 10 on the front unit 4. Since the start switch 11 and the stop switch 12 are particularly important switches, they are not provided on the screen of the display unit 10 and, as will be described later, the peritoneal dialysis patient directly operates mechanically and clicks. It is formed in a large size so that you can feel it.
  • the start switch 11 has a pilot lamp 11L
  • the stop switch 12 has a pilot lamp 12L.
  • a cassette mounting portion 20 is provided on the lower front side of the lower housing portion 3 shown in FIG.
  • the flat plate-shaped cassette 100 which comprises a dialysate circuit shown in FIG. 3 can be attached to this cassette mounting part 20 manually so that attachment or detachment is possible.
  • the lower housing part 3 includes a left side part 22, a right side part 23, a back part 24, and a bottom part 25.
  • the cassette mounting portion 20 has a substantially rectangular lid member 21 that can be opened and closed on the front side.
  • the lid member 21 can be exposed to the inside of the cassette mounting portion 20 by opening and closing in the R direction using the hinges 26, 26 on both sides.
  • the detailed structure of the cassette 100 shown in FIG. 3 will be described later.
  • the cassette mounting portion 20 includes a main body portion 30, a first latch 31, a second latch 32, and a shade 33.
  • the main body 30 and the shade 33 are, for example, metal members.
  • the first latch 31 and the second latch 32 guide the cassette 100 shown in FIG. 3 into the cassette mounting portion 20 or take it out from the cassette mounting portion 20.
  • the cassette 100 side is damaged. Made of plastic so that there is no.
  • FIG. 4 is a top view of the cassette 100
  • FIG. 5 is a rear view of the cassette 100
  • FIG. 6 is a perspective view showing the internal structure of the cassette 100.
  • the entire first casing unit 101 is illustrated, but the second casing unit 102 is illustrated only in the lower portion for the sake of space.
  • the cassette 100 includes a plastic first housing portion 101, a second housing portion 102, a pump portion 103, heating portions 104A and 104B, a tube flow path switching portion 105, and the like. have.
  • the first housing unit 101 has a panel unit 106, a frame unit 107, an opening 108, and an extension unit 109.
  • the second housing part 102 includes a panel part 110, a frame part 111, an opening part 112, and an extension part 113.
  • the panel part 106 and the panel part 110 are overlapping parts
  • the frame part 107 and the frame part 111 are overlapping parts
  • the extension part 109 and the extension part 113 are overlapping parts.
  • the first housing portion 101 and the second housing portion 102 can be detachably fixed to each other by four connecting portions 114 and three connecting portions 115.
  • the casing 101 and the second casing 102 can be reused repeatedly as necessary.
  • Four connecting portions 114 are provided on the frame portion 107 and the frame portion 111, and three connecting portions 115 are provided on the insertion rear end portion 100 ⁇ / b> N side of the cassette 100.
  • the three connecting portions 115 shown in FIGS. 5 and 6 have a fitting projection 115A and a fitting recess 115B as shown in FIG. 6, and the fitting projection 115A is formed on the second housing portion 102 side. ing.
  • a fitting recess 115B is formed on the first housing 101 side, and the fitting protrusion 115A is detachably fitted to the fitting recess 115B.
  • the four connecting portions 114 shown in FIG. 4 have a fitting projection 114A and a fitting recess 114B, and the fitting projection 114A is formed on the second housing portion 102 side.
  • a fitting recess 114B is formed in the first body portion 101, and the fitting protrusion 114A is detachably fitted to the fitting recess 114B.
  • the pump unit 103 which is a liquid feeding means, indicated by a two-dot chain line, is between the panel unit 106 of the first housing unit 101 and the panel unit 110 of the second housing unit 102. It is fixed so that it is pinched.
  • the pump unit 103 is a driving unit that exerts a driving force for feeding peritoneal dialysate, and a diaphragm pump, an intermittent pump, or the like is used as the pump unit 103 as described later.
  • the diaphragm pump refers to a structure that is housed in a sealed state by a flange member and is pressurized or depressurized by air pressure. Thereby, in order to send peritoneal dialysate, the diaphragm pump contracts when pressurized and expands when decompressed.
  • the tube flow path switching unit 105 is between the panel unit 106 of the first housing unit 101 and the panel unit 110 of the second housing unit 102, and next to the pump unit 103. It is fixed so as to be sandwiched between positions. 6 is a clamp disposed in the upper casing 2 of the automatic peritoneal dialysis apparatus 1 shown in FIG. 1 in the middle of the dialysate flow path disposed in the cassette 100. By switching, the flow path for peritoneal dialysis fluid is switched, and the flow path for liquid feeding processing or drainage processing is switched. The contents will be described in detail later.
  • soft resin for example, polyolefin such as polyethylene, polypropylene, ethylene-propylene copolymer, ethylene-vinyl acetate copolymer (EVA), polyvinyl chloride, polyvinylidene chloride, polystyrene, polyamide, Polyimide, poly- (4-methylpentene-1), ionomer, acrylic resin, polyester such as polyethylene terephthalate (PET), polybutylene terephthalate (PBT), styrene, polyolefin, polyvinyl chloride, polyurethane, polyester And various thermoplastic elastomers such as polyamides, silicone resins, polyurethanes, etc., or copolymers, blends, polymer alloys, etc. mainly composed of these, and combinations of one or more of these, and combinations of one or more of these
  • the tube flow path switching unit 105 shown in FIG. 6 is formed thin in a film shape and has flow paths 105A to 105G.
  • One and the other dialysate heating portions 104A and 104B are formed in a film shape and are detachably disposed in the openings 108 and 112, respectively.
  • a flow path 120 for passing the dialysate is formed substantially continuously in an S shape. As shown in FIGS.
  • one film-like warming portion 104 ⁇ / b> A is attached / detached corresponding to the opening portion 108 using a plurality of projections 107 ⁇ / b> N and 107 ⁇ / b> M of the frame portion 107 of the first housing portion 101. Held possible.
  • the other film-like heating unit 104 ⁇ / b> B corresponds to the opening 112 using the plurality of protrusions 111 ⁇ / b> N and 111 ⁇ / b> M of the frame unit 111 of the second housing unit 102. Removably held.
  • One and the other heating parts 104A and 104B are fixed in the openings 108 and 112 so as to overlap each other, and the peritoneal dialysate passing through the flow path 120 of the one and the other heating parts 104A and 104B is Heating can be performed using an electric heater and a heat transfer member (for example, an aluminum member) described later.
  • the heater includes the upper surface heater and the lower surface heater so as to sandwich the flow path 120 for liquid feeding treatment, so that the peritoneal dialysis solution can be efficiently heated so that the temperature of the abdominal cavity of the peritoneal dialysis patient is obtained.
  • the flow path 120 for injecting liquid processing in one heating section 104A has connection sections 120R and 120T, and the flow path 120 for drainage processing in the other heating section 104B is It has connection parts 120F and 120V.
  • the connecting part 120F and the connecting part 120T are connected by a pipe 120K.
  • the connecting portion 120R is connected to the flow paths 105F and 105G.
  • the connection part 120V is connected to the flow paths 105E and 105G.
  • the flow paths 105A to 105D are connected to the flow paths 105G and 105E.
  • the flow paths 105A to 105D are connected to tubes 131 to 134, respectively.
  • the flow path 105G is connected to the pump unit 103.
  • a plurality of openings 105 ⁇ / b> S and groove portions 120 ⁇ / b> C are formed in the panel portion 110 of the second housing portion 102, in the lower portion inside the upper housing portion 2 shown in FIG. 1.
  • a plurality of clamp members are provided. These clamp members can switch the flow path through which the peritoneal dialysate can pass by appropriately pressing the corresponding flow paths 105A to 105D through the opening 105S and the groove 120C.
  • the tube 131 is connected to the abdominal cavity MMR of the normal patient MM-A or the abdominal cavity MMR of the small patient MM-B, and the peritoneal dialysate is fed to the abdominal cavity MMR, Used to drain peritoneal dialysate from MMR.
  • the tube 132 is connected to a liquid supply bag 138 for additional peritoneal dialysate liquid supply, and the tube 133 is connected to a plurality of liquid supply bags 139 for peritoneal dialysate liquid supply.
  • the tube 134 is connected to the drainage tank 140.
  • an automatic peritoneal dialysis apparatus 1 includes a CPU (central processing unit) such as a microcomputer, a control program for the entire apparatus executed by the CPU, a ROM for storing various data, and measurement data as a work area. It has the control part 200 provided with RAM etc.
  • CPU central processing unit
  • the cassette 100 of FIG. 7 is detachably mounted in the cassette mounting portion 20 (see FIGS. 2 and 3) of the automatic peritoneal dialysis device 1, but the cassette 100 already has FIGS.
  • the tube flow path switching unit 105, the pump unit 103, and the liquid feeding heating units 104A and 104B are incorporated.
  • the clamp part 204 provided in the automatic peritoneal dialysis apparatus 1 shown in FIG. 7 is provided with the flow paths 105A to 105D of the tubes 131 to 134 arranged in the tube flow path switching part 105 on the cassette 100 side (see FIG. 6). ) Can be selectively switched to switch the flow path through which the peritoneal dialysate flows. For this reason, the switching unit 105 of the tube flow path supplies the peritoneal dialysate to the abdominal MMR of the normal patient MM-A or the abdominal MMR of the small patient MM-B, or once to the abdominal MMR. The stored dialysate is drained from the abdominal cavity MMR side.
  • the pump driving unit 201 controls the operation of the pump unit 103 according to a command from the control unit 200.
  • the clamp control unit 202 controls the operation of each clamp member of the clamp unit 204 according to a command from the control unit 200.
  • the warming control unit 203 controls the operation of the warming units 104 ⁇ / b> A and 104 ⁇ / b> B for feeding liquids according to instructions from the control unit 200.
  • the control unit 200 includes a display unit 10, a start switch 11, a stop switch 12, a pump drive unit 201, a clamp control unit 202, a heating control unit 203, and a recording unit.
  • 211, the cassette used detection unit 220, and the information storage unit 500 are electrically connected. Each of these elements receives power supply from the power supply circuit unit 213.
  • the display unit 10, the start switch 11, and the stop switch 12 shown in FIGS. 1 and 2 constitute the operation unit shown in FIG.
  • the recording unit 211 is a memory in which information contents and the like regarding a plurality of peritoneal dialysis patients who use the automatic peritoneal dialysis apparatus 1 are recorded.
  • the cassette used detection unit 220 detects whether the mounted cassette 100 has already been used or is new. , Notify the control unit 100.
  • the information storage unit 500 stores a normal liquid feeding target patient table 500T and a small volume liquid feeding target patient table 500R.
  • the normal liquid supply target patient table 500T notifies the control unit 200 of the operation content of the normal liquid supply target patient mode when the normal liquid supply target patient MM-A presses the icon 10D. ing.
  • the operation content of the small amount liquid supply target patient in the small amount liquid supply target patient mode is indicated to the control unit 200. It comes to notify.
  • FIG. 9 is a perspective view showing how the cassette 100 is mounted in the cassette insertion space SP of the cassette mounting unit 20.
  • the lid member 21 is opened, the cassette mounting portion 20 is opened, and the cassette 100 is inserted in the insertion direction SS by the finger F of the normal liquid feeding target patient or the finger F of the small volume feeding target patient.
  • the shutter 28 is not moved in the Y1 direction, and the opening 27 is closed.
  • FIG. 9B to FIG. 9C when the cassette 100 is further pushed in the insertion direction SS, the extension portions 109 and 113 of the cassette 100 push the abutting surface portion 28A of the shutter 28 in the Y1 direction.
  • the shutter 28 is pushed in the Y1 direction, and the opening 27 is opened.
  • the tubes 131 to 134 from the extended portions 109 and 113 of the cassette 100 can be led out from the opening 27 to the side of the automatic peritoneal dialysis apparatus 1.
  • a thermal printing paper 400 for identification is affixed on the other film-like heating unit 104B.
  • the thermal printing paper 400 is preferably printed with a bar code.
  • this bar code is the ID (identification code) of the normal liquid feeding target patient to be treated, the peritoneal dialysis prescription information content, or the small volume liquid feeding target patient. ID (identification code), peritoneal dialysis prescription information content, and the like.
  • the thermal printing paper 400 is affixed in the cassette 100, particularly in the vicinity of the liquid feeding and heating unit. Specifically, for example, the thermal printing paper 400 is pasted on one film-like heating unit 104A and the other film-like heating unit 104B of the cassette 100. In a state where the cassette 100 is mounted in the cassette mounting portion 20 as shown in FIG. 9, the thermal printing paper 400 is disposed on the upper casing portion 2 side of the automatic peritoneal dialysis apparatus 1 as shown in FIG. It faces the barcode reader 401.
  • a barcode reader 401 shown in FIG. 10 can read the barcode of the thermal printing paper 400 in a non-contact manner, and is electrically connected to the control unit 200.
  • the cassette 100 is mounted in the cassette mounting portion 20 as shown in FIG.
  • the barcode reader 401 shown in FIG. 10 reads the barcode information of the thermal printing paper 400, so that the control unit 200 obtains the peritoneal dialysis prescription information content of the peritoneal dialysis patient, and the control unit 200 displays the peritoneal prescription information. Based on the contents, it is determined whether the peritoneal dialysis patient to be treated is the normal liquid feeding target patient MM-A or the small volume liquid feeding target patient MM-B.
  • the peritoneal dialysis operation corresponding to the normal liquid feeding target patient MM-A or the small volume liquid feeding target patient MM-B can be started by the command of the control unit 200.
  • the control unit 200 can obtain the peritoneal dialysis prescription information contents of the normal liquid feeding target patient MM-A or the small volume liquid feeding target patient MM-B by using the thermal printing paper 400.
  • the information content in the display unit 10 shown in FIG. 1 and the prescription of the peritoneal dialysis patient using the operation unit such as the start switch 11 and the stop switch 12 that the patient MM-A or the patient MM-B subject to small volume delivery is usually required There is an advantage that the input work of information can be omitted.
  • the thermal printing paper 400 on the cassette 100 changes to black by heating from the heating units 104A and 104B for a certain time or longer. Due to the discoloration of the thermal printing paper 400, the barcode reader 401 cannot detect the barcode of the thermal printing paper 400. As described above, when the barcode reader 401 cannot detect the barcode of the thermal printing paper 400, the control unit 200 determines that the cassette 100 in use has already been used for peritoneal dialysis treatment (warmed). to decide. Further, the control unit 200 determines that the dialysate circuit 900 of the heated cassette 100 shown in FIG. 6 has been used once for dialysis treatment based on a signal from the barcode reader 401.
  • the dialysate circuit 900 is constituted by an assembly unit of one film-like heating unit 104A, the other film-like heating unit 104B, a tube flow path switching unit 105, and tubes 131 to 134.
  • the control unit 200 determines that the cassette 100 has been used (warmed), and determines that the dialysate circuit of the heated cassette 100 has been used at least once for dialysis treatment. As a result, the control unit 200 does not start the peritoneal dialysis control by the automatic peritoneal dialysis device 1, and notifies the peritoneal dialysis patient that the cassette 100 has been used (warmed). This is notified by the display at 10. In this way, it is possible to reliably limit the number of times the dialysate circuit of the cassette 100 is used to one time, and it is possible to reliably prevent the cassette 100 that has already been used from being reused by mistake.
  • the assembly unit of one used film-like heating unit 104A, the other film-like heating unit 104B, the tube flow path switching unit 105, and the tubes 131 to 134 is a dialysis unit.
  • a liquid circuit 900 is configured.
  • the dialysate circuit 900 the first housing portion 101 and the second housing portion 102 of the cassette 100 are separate. For this reason, the dialysate circuit 900 cannot be reused for hygiene management.
  • casing part 102 has the merit which can be used repeatedly as needed.
  • the barcode reader 401 may be an optical reading method or a magnetic reading method. Further, instead of using the thermal printing paper 400, other types of identification labels may be used, and the identification label reader in that case can adopt an optical reading method or a magnetic reading method.
  • one film-like heating unit 104A and the other film-like heating unit 104B shown in FIG. 10 are heated by a plurality of sheet heaters 300 in order to bring the peritoneal dialysis solution closer to the body temperature of the peritoneal dialysis patient. It can be done.
  • the sheet heater 300 is heated and controlled by the heating control unit 203.
  • thermal printing is performed.
  • the paper 400 is also heated, the color is positively changed to black, and the barcode reader 401 cannot read the information on the thermal printing paper 400.
  • the control unit 200 can recognize from the signal from the barcode reader 401 that the barcode reader 401 cannot read the information on the thermal printing paper 400. As a result, as shown in FIG. 6, the cassette 100 integrates one film-like warming portion 104A and the other film-like warming portion 104B that have been once heated and used. The control unit 200 can reliably recognize that the path switching unit 105 and the tubes 131 to 134 have been used. Therefore, the peritoneal dialysis patient mistakenly reassembles the assembly unit of one used film-like heating unit 104A, the other film-like heating unit 104B, the tube flow path switching unit 105, and the tubes 131 to 134. It will not be reused. It is particularly effective to perform such a reuse prohibition treatment on the cassette 100 when the peritoneal dialysis patient is a child.
  • 11 includes a pump driving unit 201, a first filter 451, a valve 452, a positive pressure tank 453, a valve 454, a negative pressure tank 455, a valve 456, a second filter 457, a valve 458, and a pressure sensor 459. 462 and a pump chamber 463.
  • Each valve 453, 456, 458 has an air release portion 464.
  • the pressure sensors 459 and 461 are sensors for protecting the pressure increasing / decreasing circuit 450
  • the pressure sensors 460 and 462 are sensors for controlling the pressure increasing / decreasing circuit 450.
  • a filter 451 is connected to the outlet of the pump drive unit 201 shown in FIG. 11, and the filter 451 is connected to a positive pressure tank 453 via a valve 452.
  • the positive pressure tank 453 is connected to the negative pressure tank 455 via a valve 454, and the negative pressure tank 455 is connected to the inlet side of the pump drive unit 201 via a valve 456.
  • Another filter 457 is connected to the valve 454, and the valve 454 is connected to the pump chamber portion 463 through this filter 457.
  • the pump chamber portion 463 includes a fixed portion 470, a movable portion 471, and a spring 472.
  • the spring 472 is disposed between the fixed portion 470 and the movable portion 471.
  • the movable part 471 can move relative to the fixed part 470 against the force of the spring 472.
  • the movable part 471 is in close contact with the diaphragm 103D of the pump part 103 on the cassette 100 side.
  • a valve 454 shown in FIG. 11 is a switching valve for alternately switching the pump chamber 463 between the positive pressure tank 453 and the negative pressure tank 455.
  • the clamp section 204 controls the flow paths 105A to 105D (see FIG. 6) of the tubes 131 to 134 disposed in the tube flow path switching section 105 on the cassette 100 side.
  • the flow path through which the peritoneal dialysate flows can be switched.
  • the peritoneal dialysate can be sent to the peritoneal MMR side of the peritoneal dialysis patient, or the dialysate once stored in the peritoneal MMR can be drained from the peritoneal MMR side.
  • the filter 451 and the filter 457 are arranged in two places in the air circuit 450, and the air is passed through the filter material 634 using the pipe 631H and the pipe 632H, so that the filter material 634 of the filter 451 is obtained.
  • the filter material 634 of the filter 457 is, for example, a bronze sintered filter material, and can remove dust of 5 ⁇ m or more in the air, so that a clogging phenomenon due to dust can be prevented in the pressure-reducing circuit 450.
  • the filter 451 is connected to the outlet side of the pump drive unit 201, and dust generated in the pump drive unit 201 can be removed before entering the valve 452 and the valve 454, thus preventing the clogging phenomenon of the valve 452 and the valve 454. be able to.
  • another filter 457 is disposed between the valve 454 and the pump chamber portion 463, dust generated on the pump chamber portion 463 side can be removed before entering the valve 454. Can be prevented.
  • FIG. 12 shows an example of feeding the peritoneal dialysis solution in the automatic peritoneal dialysis apparatus 1 described above.
  • FIG. 13 shows a numerical example of the amount of peritoneal dialysis fluid delivered when the peritoneal dialysis fluid is actually delivered to the patient.
  • the target set value SM of the peritoneal dialysis fluid delivery set in advance is set to, for example, the same value of 200 ml.
  • the quantitative liquid delivery quantity RM is, for example, 18 ml.
  • the quantitative liquid feeding amount RM which is a unit of the quantitative liquid feeding amount, can be set in a range of, for example, 10 ml to 20 ml.
  • the operation procedure of the cumulative liquid supply amount from the start of liquid supply for the normal liquid supply target patient MM-A shown in FIG. 12 is stored in the normal liquid supply target patient table 500T of the information storage unit 500 shown in FIG. .
  • the cumulative liquid supply amount from the start of liquid supply stored in the table 500T of the normal liquid supply target patient is a predetermined number of times, for example, 12 times the number of fixed liquid supply, when the 18 ml fixed liquid supply amount RM is in the fixed liquid supply state. Repeat once.
  • the cumulative amount of peritoneal dialysis fluid delivered to the normal fluid delivery target patient MM-A is adjusted to the target set value SM of 200 ml.
  • the operation procedure of the cumulative liquid supply from the start of liquid supply for the small volume liquid supply target patient MM-B shown in FIG. 12 is stored in the small volume liquid supply target patient table 500R of the information storage unit 500 shown in FIG. It is remembered.
  • the cumulative liquid supply amount from the start of liquid supply stored in the table 500R of the patient for small amount liquid supply is the predetermined number of times, for example, the number of times of constant liquid supply is repeated 11 times when the 18 ml fixed liquid supply amount RM is in the fixed liquid supply state. .
  • the fixed liquid supply state (mode) is changed to the micro liquid supply state (mode), and the peritoneal dialysis fluid with the micro liquid supply amount GP is changed.
  • a small amount of liquid is fed several times.
  • the accumulated amount of peritoneal dialysis fluid is adjusted so that the target set value SM is 200 ml.
  • the minute liquid feeding amount GP is set to 1 ml which is about 1/20 (about 5%) of 18 mL which is a unit of the quantitative liquid feeding amount in this case. If this minute liquid feeding amount GP is less than, for example, about 1/20 (about 5%) of 18 mL which is a unit of the fixed liquid feeding amount, liquid feeding control with high accuracy becomes difficult.
  • FIG. 13 shows an example of the amount of peritoneal dialysis fluid sent.
  • the items regarding the amount of peritoneal dialysis fluid to be sent shown in FIG. 13 are displayed on the display unit 10 in correspondence with the target set value SM (ml) of the peritoneal dialysis fluid delivered to the doctor in advance and the target set value SM.
  • the peritoneal dialysis fluid delivery target set value SM is displayed on the setting screen 600 of the display unit 10.
  • the actual liquid supply amount WM is the amount of peritoneal dialysis fluid actually supplied to the normal liquid supply target patient MM-A or the small amount liquid supply target patient MM-B.
  • a setting screen 600 shown in FIG. 13 is used to change a liquid supply amount display area 601 for displaying the liquid supply amount of the target set value SM of the peritoneal dialysate and the numerical value of the liquid supply amount set value 200.
  • the display value DM for the set value SM is displayed on the treatment screen 700 of the display unit 10.
  • the treatment screen 700 has a display area 701 for displaying the display value DM, a display area 702 for displaying the current time and the scheduled end time, a “setting confirmation” key 703, a “turn off” key 704, and the like. .
  • the peritoneal dialysis patient opens the lid member 21 of the automatic peritoneal dialysis apparatus 1 to open the cassette mounting unit 20, and the cassette 100 is inserted into the cassette mounting unit 20 along the insertion direction SS (Y1 direction). Attach to. Then, the peritoneal dialysis patient closes the lid member 21 shown in FIG. 3 to the state shown in FIG. Note that the tubes 131 to 134 of the cassette 100 shown in FIG. 10 are previously connected to the peritoneal dialysis patient's abdominal cavity MMB, bags 138 and 139, and drainage bag 140, respectively.
  • the barcode reader 401 shown in FIG. 10 reads the barcode of the thermal printing paper 400 of the cassette 100, so that the control unit 200 obtains the peritoneal prescription information content for the peritoneal dialysis patient. Then, from the peritoneal prescription information content, the control unit 200 determines whether the peritoneal dialysis patient using the automatic peritoneal dialysis device 1 of FIG. 1 is the normal liquid delivery target patient MM-A that is an adult or a small amount that is a child. It is determined whether or not the patient is a liquid feeding target patient MM-B.
  • the control unit 200 can start the peritoneal dialysis operation according to the normal liquid feeding target patient MM-A or the peritoneal dialysis operation according to the small volume liquid feeding target patient MM-B.
  • the control unit 200 automatically stores the peritoneal prescription information contents of the normal liquid feeding target patient MM-A or the small volume liquid feeding target patient MM-B. 200. Therefore, the screen information on the display unit 10 shown in FIG. 1, which is normally required by the peritoneal dialysis patient, and the prescription information of the peritoneal dialysis patient using the operation unit such as the start switch 11 and the stop switch 12 are input. Can be omitted.
  • the peritoneal prescription information content of a peritoneal dialysis patient is a prescription for dialysis treatment by a doctor.
  • the peritoneal dialysis patient uses the automatic peritoneal dialysis apparatus 1 as follows, for example. That is, when the peritoneal dialysis patient is a normal liquid delivery target patient MM-A such as an adult peritoneal dialysis patient, the peritoneal dialysis person presses the icon 10D shown in FIGS. As a result, the control unit 200 in FIG. 8 reads the normal liquid feeding target patient table 500T in the information storage unit 500 and starts the peritoneal dialysis operation according to the contents of the normal liquid feeding target patient table 500T. . This operation mode is referred to as a normal liquid supply target patient liquid supply mode in the automatic peritoneal dialysis device 1.
  • the control unit 200 in FIG. 8 reads the normal liquid feeding target patient table 500T in the information storage unit 500 and starts the peritoneal dialysis operation according to the contents of the normal liquid feeding target patient table 500T. .
  • This operation mode is referred to as a small-volume liquid supply target patient liquid supply mode in the automatic peritoneal dialysis apparatus 1.
  • the normal liquid feeding target patient liquid feeding mode in the automatic peritoneal dialysis apparatus 1 and the small volume liquid feeding target patient liquid feeding mode in the automatic peritoneal dialysis apparatus 1 will be described.
  • the peritoneal dialysis patient is a normal liquid supply target patient MM-A such as an adult peritoneal dialysis patient, and the normal liquid supply target patient MM-A presses the start switch 11 in FIG.
  • the control unit 200 of FIG. 8 starts the peritoneal dialysis operation according to the contents of the table 500T of the normal liquid feeding target patient.
  • the peritoneal dialysate is heated while facing the heating unit 300 shown in FIG. Warm up.
  • the control unit 200 shown in FIG. 7 performs clamp control, heating control, and pump drive unit 201 control by peritoneal dialysis control.
  • the 18 ml fixed liquid feeding amount RM of the peritoneal dialysate is repeatedly executed a predetermined number of times.
  • the display value DM is 200 to 217 ml, but the display value DM is 200 to 217 ml.
  • the actual liquid supply amount WM actually supplied to the normal liquid supply target patient MM-A is 215 to 232 ml, and the error of the actual liquid supply amount WM with respect to the display value DM is 7 to 16%.
  • the peritoneal dialysate is supplied to the normal liquid supply target patient MM-A because the amount of the abdominal cavity of the normal liquid supply target person MM-A that is an adult is large. So there is no problem.
  • the peritoneal dialysis fluid is delivered to the small-volume patient MM-B in the normal liquid-feed target patient mode for the small-volume patient MM-B, such as a child, This is not preferable because it is smaller than the amount of abdominal cavity. Therefore, peritoneal dialysis fluid is delivered to the small-volume delivery target patient MM-B in the small-volume delivery target patient mode described below for a small-volume delivery target patient MM-B such as a child.
  • the 18 ml quantitative liquid feeding amount RM of the peritoneal dialysis liquid is a predetermined number of times. Repeatedly, it is sent into the abdominal cavity of the patient MM-B to which a small amount of liquid is to be delivered.
  • the cumulative liquid supply amount from the start of liquid supply stored in the table 500R of the patient to be supplied with a small amount of liquid is the predetermined number of times, for example, the number of times of constant liquid supply is repeated 11 times when the 18 ml fixed liquid supply amount RM is in the fixed liquid supply state.
  • the quantitative liquid supply state (mode) CC1 moves to the minute liquid supply state (mode) CC2, and the peritoneal dialysis of the minute liquid supply amount GP is performed.
  • the accumulated amount of peritoneal dialysate is accurately adjusted so that the target set value SM is 200 ml. For this reason, the accumulated liquid feeding amount can be accurately adjusted to the target set value SM of 200 ml.
  • the cumulative liquid feeding amount is the liquid feeding amount.
  • the displayed value DM is 200 to 205 ml, but the displayed value DM is a small amount with respect to 200 to 205 ml.
  • the actual liquid supply amount WM actually supplied to the liquid supply target patient MM-B is 215 to 220 ml, and the error of the actual liquid supply amount WM with respect to the display value DM is 7 to 10%.
  • the controller 200 switches from the constant volume delivery state CC1 to the minute quantity delivery state CC2 when the target set value SM is approached. Therefore, the liquid feeding accuracy can be improved.
  • the minute liquid feeding control function is added to the quantitative liquid feeding control function, so
  • the accuracy can be improved by about 5 to 10%, for example.
  • the peritoneal dialysis control is automatically terminated in the automatic peritoneal dialysis apparatus 1.
  • This is considered a single peritoneal dialysis treatment.
  • the cassette 100 is discarded only by one dialysis treatment from the viewpoint of hygiene.
  • only the first casing 101 and the second casing 102 of the cassette 100 shown in FIG. 6 can be reused as necessary from the consideration of the environment after removing the dialysis circuit section. The dialysis circuit is completely discarded and not reused.
  • a glucose solution containing an electrolytic solution as a main component is usually used as the peritoneal dialysis solution in the injection bags 138 and 139 shown in FIG.
  • the peritoneal dialysis solution heated to a predetermined temperature is sent to the peritoneal cavity of a peritoneal dialysis patient.
  • the peritoneal dialysis fluid stored in the abdominal cavity takes in the peritoneal fluid into the peritoneal fluid using the osmotic pressure of the peritoneum, and is discarded in the drainage tank 140 together with water.
  • peritoneal dialysis treatment a predetermined amount of peritoneal dialysis solution is fed into the abdominal cavity, stored for a predetermined time, and then drained, and this feeding, storing, and draining constitute one cycle.
  • a type a type in which each retention time in one cycle of peritoneal dialysis fluid in the abdominal cavity is set as a fixed time and is adjusted by the dialysis time
  • B type the entire dialysis time (for example, 4 cycles) is set as a fixed time, and the storage period in each cycle is adjusted so as to match
  • NPD Prescription with continuous dialyzate exchange at night and emptying the abdominal cavity during the day.
  • CCPD Prescription with continuous nighttime dialysate exchange and final fluid delivery, with no dialysate exchange in the daytime and remaining in the abdominal cavity or daytime dialysate exchange if necessary.
  • Tidal A prescription in which about half of the initial liquid delivery volume is changed frequently. Conditioning Only A type technique is possible. A prescription in which only peritoneal dialysis fluid is sent and drained for conditioning in the early stages of introduction.
  • the automatic peritoneal dialysis apparatus 1 of the present invention can be used for any type of peritoneal dialysis treatment prescription.
  • the automatic peritoneal dialysis device is a normal liquid supply target in which the peritoneal dialysate is metered into a normal liquid supply target patient MM-A several times and the amount of peritoneal dialysate is adjusted to the target set value.
  • Peritoneal dialysis fluid is delivered multiple times to patient table 500T and a small amount of peritoneal dialysis fluid reservoir MM-B, which has a smaller amount of peritoneal dialysis fluid than MM-A.
  • the memory having a small volume liquid supply target patient table 500R that switches to a small amount of liquid that is smaller than the amount of quantitative liquid supply and matches the target set value.
  • a control unit 200 that performs either a small amount liquid feeding subject patient mode for feeding a peritoneal dialysis solution to a target set value in a small amount liquid feed subject patient MM-B from the cassette 100 based on the user table.
  • the peritoneal dialysis solution is quantitatively delivered multiple times to a small volume target patient with a smaller amount of peritoneal dialysate than the normal target patient.
  • the liquid supply amount to the target set value when the target set value is approached, it is possible to switch to a minute amount of liquid that is smaller than the fixed amount of liquid supply and accurately match the target set value. For this reason, when delivering peritoneal dialysis fluid to the abdominal cavity of a patient subject to small volume delivery, such as a child whose abdominal volume is smaller than that of an adult, the cumulative amount of peritoneal dialysis fluid is set to a predetermined value. Can be fitted with high accuracy.
  • the peritoneal dialyzer is a normal liquid delivery target patient such as an adult or a small volume liquid delivery target patient such as a child, a mode suitable for the display unit can be easily selected without making a mistake. be able to.
  • the cassette 100 has a pump 103 for feeding peritoneal dialysate and heating units 104A and 104B for heating the peritoneal dialysate.
  • the temperature of the cassette can be increased when the liquid is sent to the peritoneal dialyzer, and the liquid can be fed into the abdominal cavity by a pump for a normal liquid feeding target patient or a small volume liquid feeding target patient.
  • the automatic peritoneal dialysis device of the present invention is not limited to the illustrated example, and any shape can be adopted.
  • the extension portions 109 and 113 are formed to protrude to the right side in the insertion direction SS of the cassette 100, but conversely, may be formed to protrude to the left side.
  • the arrangement shape of the peritoneal dialysis fluid flow path is not limited to the example shown in FIG.
  • the automatic peritoneal dialysis apparatus of the present invention operates by setting a treatment pattern, a single liquid supply amount, a single drainage amount, a time for performing dialysis, and a total dialysis amount for ending dialysis as a prescription.
  • the dialysis prescription can be displayed on the display unit 10.
  • the setting of the dialysis prescription can be set and changed by an operator such as a peritoneal dialysis patient using the display unit 10.
  • the prescription information is set to the barcode 400, and the cassette 100 with the barcode 400 attached is inserted into the automatic peritoneal dialysis apparatus 100, the barcode reader 401 displays the information content of the dialysis prescription of the patient in the barcode 400 Can be set as dialysis prescription information.

Abstract

L'objet de la présente invention est de fournir une machine de dialyse péritonéale automatique avec laquelle le volume de remplissage cumulatif de fluide de dialyse péritonéal peut être étalonné de manière bien précise à une valeur de consigne prédéterminée lorsqu'un fluide de dialyse péritonéal est rempli dans la cavité péritonéale d'un patient dont le volume de remplissage est faible tel qu'un enfant ayant un volume de séjour de cavité péritonéal plus petit que celui d'un adulte. La solution selon l'invention concerne les éléments suivants : une unité de stockage (500) qui a un tableau de patient ayant un remplissage normal (500T) qui permet d'étalonner le volume de remplissage de fluide de dialyse péritonéal selon une valeur de réglage cible lorsque le remplissage de fluide péritonéal à un volume constant est effectué de multiples fois pour un patient ayant un volume de remplissage normal (MM-A) et un tableau de patient ayant un volume de remplissage faible (500R) qui permet d'étalonner le volume de remplissage de fluide de dialyse péritonéal selon une valeur de consigne cible lorsque le remplissage de fluide péritonéal à un volume constant est effectué de multiples fois pour un patient ayant un volume de remplissage faible (MM-B), et lorsque le volume de remplissage avoisine la valeur de consigne cible, la machine passe à un micro-remplissage à un volume inférieur à celui d'un remplissage de volume constant ; et une unité de commande (200) destinée à mettre en œuvre soit un mode de patient ayant un remplissage normal en fonction du tableau de patient ayant un remplissage normal (500T) soit un mode de patient ayant un volume de remplissage faible en fonction du tableau de patient ayant un remplissage faible.
PCT/JP2013/060000 2013-04-01 2013-04-01 Machine de dialyse péritonéale automatique WO2014162489A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
PCT/JP2013/060000 WO2014162489A1 (fr) 2013-04-01 2013-04-01 Machine de dialyse péritonéale automatique
JP2015509742A JP6097822B2 (ja) 2013-04-01 2013-04-01 自動腹膜透析装置

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/JP2013/060000 WO2014162489A1 (fr) 2013-04-01 2013-04-01 Machine de dialyse péritonéale automatique

Publications (1)

Publication Number Publication Date
WO2014162489A1 true WO2014162489A1 (fr) 2014-10-09

Family

ID=51657822

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/JP2013/060000 WO2014162489A1 (fr) 2013-04-01 2013-04-01 Machine de dialyse péritonéale automatique

Country Status (2)

Country Link
JP (1) JP6097822B2 (fr)
WO (1) WO2014162489A1 (fr)

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2016182254A (ja) * 2015-03-26 2016-10-20 テルモ株式会社 腹膜透析装置およびその制御方法
US9861733B2 (en) 2012-03-23 2018-01-09 Nxstage Medical Inc. Peritoneal dialysis systems, devices, and methods
US9907897B2 (en) 2011-03-23 2018-03-06 Nxstage Medical, Inc. Peritoneal dialysis systems, devices, and methods
US11207454B2 (en) 2018-02-28 2021-12-28 Nxstage Medical, Inc. Fluid preparation and treatment devices methods and systems

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
KR102497829B1 (ko) * 2017-07-25 2023-02-07 에이치엘만도 주식회사 모터의 온도 측정 장치

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH10234849A (ja) * 1997-02-28 1998-09-08 Terumo Corp 腹膜透析装置
JP2003000704A (ja) * 2001-06-19 2003-01-07 Terumo Corp 腹膜透析装置
US20030220627A1 (en) * 2002-04-11 2003-11-27 Distler Carl Ray System and method for delivering a target volume of fluid

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH10234849A (ja) * 1997-02-28 1998-09-08 Terumo Corp 腹膜透析装置
JP2003000704A (ja) * 2001-06-19 2003-01-07 Terumo Corp 腹膜透析装置
US20030220627A1 (en) * 2002-04-11 2003-11-27 Distler Carl Ray System and method for delivering a target volume of fluid

Cited By (18)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10898630B2 (en) 2011-03-23 2021-01-26 Nxstage Medical, Inc. Peritoneal dialysis systems, devices, and methods
US9907897B2 (en) 2011-03-23 2018-03-06 Nxstage Medical, Inc. Peritoneal dialysis systems, devices, and methods
US11135348B2 (en) 2011-03-23 2021-10-05 Nxstage Medical, Inc. Peritoneal dialysis systems, devices, and methods
US11717601B2 (en) 2011-03-23 2023-08-08 Nxstage Medical, Inc. Dialysis systems, devices, and methods
US10603424B2 (en) 2011-03-23 2020-03-31 Nxstage Medical, Inc. Peritoneal dialysis systems, devices, and methods
US10610630B2 (en) 2011-03-23 2020-04-07 Nxstage Medical, Inc. Peritoneal dialysis systems, devices, and methods
US10688235B2 (en) 2011-03-23 2020-06-23 Nxstage Medical, Inc. Peritoneal dialysis systems, devices, and methods
US10688234B2 (en) 2011-03-23 2020-06-23 Nxstage Medical, Inc. Peritoneal dialysis systems, devices, and methods
US11690941B2 (en) 2011-03-23 2023-07-04 Nxstage Medical, Inc. Peritoneal dialysis systems, devices, and methods
US11433170B2 (en) 2011-03-23 2022-09-06 Nxstage Medical, Inc. Dialysis systems, devices, and methods
US10046100B2 (en) 2011-03-23 2018-08-14 Nxstage Medical, Inc. Peritoneal dialysis systems, devices, and methods
US11224684B2 (en) 2011-03-23 2022-01-18 Nxstage Medical, Inc. Peritoneal dialysis systems, devices, and methods
US11433169B2 (en) 2011-03-23 2022-09-06 Nxstage Medical, Inc. Dialysis systems, devices, and methods
US9861733B2 (en) 2012-03-23 2018-01-09 Nxstage Medical Inc. Peritoneal dialysis systems, devices, and methods
JP2016182254A (ja) * 2015-03-26 2016-10-20 テルモ株式会社 腹膜透析装置およびその制御方法
US11364328B2 (en) 2018-02-28 2022-06-21 Nxstage Medical, Inc. Fluid preparation and treatment devices methods and systems
US11872337B2 (en) 2018-02-28 2024-01-16 Nxstage Medical, Inc. Fluid preparation and treatment devices methods and systems
US11207454B2 (en) 2018-02-28 2021-12-28 Nxstage Medical, Inc. Fluid preparation and treatment devices methods and systems

Also Published As

Publication number Publication date
JPWO2014162489A1 (ja) 2017-02-16
JP6097822B2 (ja) 2017-03-15

Similar Documents

Publication Publication Date Title
JP6097822B2 (ja) 自動腹膜透析装置
EP1195171B1 (fr) Appareil de dialyse péritonéale
CN103491996B (zh) 输液泵
EP1382359B1 (fr) Appareil de dialyse péritonéale et support de stockage stockant un programme de son procédé de gestion
JP5714029B2 (ja) 透析装置
JP5740412B2 (ja) 透析装置、特に腹膜透析装置
US20090012454A1 (en) Dialysis system having non-invasive temperature sensing
JP5985224B2 (ja) 腹膜透析装置
JP2008104737A (ja) 腹膜透析装置
CN101977642A (zh) 泵盒和在使用多个流体管线的医用治疗系统中的使用方法
JP5539834B2 (ja) 自動腹膜透析装置
JP4066242B2 (ja) 腹膜透析装置及びその制御方法
JP2012075574A (ja) 自動腹膜透析装置
JP5632247B2 (ja) 自動腹膜透析装置
JP5688943B2 (ja) 自動腹膜透析装置
JP4231666B2 (ja) 腹膜透析装置及びその制御方法
JP4101577B2 (ja) 腹膜透析装置及び制御方法
JP2008000552A (ja) 腹膜透析装置、腹膜透析セットおよび腹膜透析装置の制御方法
CN103357079B (zh) 自动腹膜透析装置
JP5221693B2 (ja) 腹膜透析装置
CN111629767A (zh) 具有热致变色指示器的一次性流体回路
JP2012040445A (ja) 腹膜透析装置
JP2006218131A (ja) 腹膜透析装置、透析液セットおよび腹膜透析装置の制御方法
JP6133099B2 (ja) 自動腹膜透析装置
JP2004057433A (ja) 腹膜透析装置

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 13881080

Country of ref document: EP

Kind code of ref document: A1

ENP Entry into the national phase

Ref document number: 2015509742

Country of ref document: JP

Kind code of ref document: A

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 13881080

Country of ref document: EP

Kind code of ref document: A1