WO2021241647A1 - Dispositif de mesure de composant sanguin et dispositif de purification sanguine - Google Patents

Dispositif de mesure de composant sanguin et dispositif de purification sanguine Download PDF

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Publication number
WO2021241647A1
WO2021241647A1 PCT/JP2021/020046 JP2021020046W WO2021241647A1 WO 2021241647 A1 WO2021241647 A1 WO 2021241647A1 JP 2021020046 W JP2021020046 W JP 2021020046W WO 2021241647 A1 WO2021241647 A1 WO 2021241647A1
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Prior art keywords
blood
light
output voltage
unit
light receiving
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PCT/JP2021/020046
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English (en)
Japanese (ja)
Inventor
歩 星野
Original Assignee
株式会社ジェイ・エム・エス
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Priority to CN202180029367.4A priority Critical patent/CN115427090A/zh
Publication of WO2021241647A1 publication Critical patent/WO2021241647A1/fr

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    • 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
    • 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
    • A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N21/00—Investigating or analysing materials by the use of optical means, i.e. using sub-millimetre waves, infrared, visible or ultraviolet light
    • G01N21/17—Systems in which incident light is modified in accordance with the properties of the material investigated
    • G01N21/25—Colour; Spectral properties, i.e. comparison of effect of material on the light at two or more different wavelengths or wavelength bands
    • G01N21/27—Colour; Spectral properties, i.e. comparison of effect of material on the light at two or more different wavelengths or wavelength bands using photo-electric detection ; circuits for computing concentration

Definitions

  • the present invention relates to a blood component measuring device and a blood purifying device capable of continuously measuring changes in the concentration of blood components in blood circulating outside the body.
  • the concentration of blood components contained in the patient's blood is an important index for judging the effect and efficiency of the treatment. Since the concentration of blood components changes even during treatment, it is necessary to continuously measure changes in the concentration of blood components circulating outside the body.
  • a method for continuously measuring the concentration of blood components light of a predetermined wavelength is irradiated from a light emitting portion without contacting blood through a tube or the like, and the intensity of the transmitted light or reflected light is converted into a voltage by the light receiving portion. , A method of measuring the concentration based on the output voltage of the light receiving unit is known.
  • Patent Document 2 describes a blood purification device capable of measuring blood component concentrations such as hematocrit value and oxygen saturation in blood by using a plurality of light emitting units.
  • blood component concentrations such as hematocrit value and oxygen saturation in blood by using a plurality of light emitting units.
  • light in two wavelength bands of about 600 nm and about 800 nm is used for measuring oxygen saturation
  • light in a wavelength band of about 800 nm is used for measuring the hematocrit value.
  • light in two wavelength bands of about 1300 nm may be used in addition to about 800 nm.
  • each extinguishing time should be such that the afterglow disappears.
  • the output voltage of the external light may be measured by lengthening the length to.
  • the extinguishing time is lengthened, the lighting cycle of the light of each wavelength band becomes long. Therefore, the time required for measurement becomes long.
  • an object of the present invention is to provide a blood component measuring device capable of accurately measuring the concentration of blood components in a short time.
  • the present invention is a blood component measuring device that continuously measures changes in the concentration of blood components based on the intensity of transmitted light or reflected light of light emitted toward blood, and has a plurality of wavelengths including visible light.
  • a light emitting unit that emits light in a band, a light receiving unit that converts transmitted light or reflected light of light emitted from the light emitting unit into a voltage and outputs it, and a light emitting control unit that controls lighting and extinguishing of the light emitting unit.
  • the light emission control unit includes a concentration calculation unit that calculates the concentration of blood components based on the output voltage of the light receiving unit, and the light emission control unit emits light in a plurality of wavelength bands so that the lighting sections do not overlap in a predetermined cycle.
  • Each unit is blinked, and of the plurality of extinguishing sections, the length of one extinguishing section is longer than the fall time of the output voltage of the light receiving unit, and the length of the other extinguishing sections is the one extinguishing section.
  • the concentration calculation unit acquires the output voltage of the light receiving unit as the output voltage of the external light in the one extinguishing section, and the outside from the output voltage of the light receiving unit in the lighting section.
  • the present invention relates to a blood component measuring device that calculates the concentration of blood components based on a value obtained by subtracting the output voltage of light.
  • the light emission control unit is controlled so that the other extinguishing sections are shorter than the fall time of the output voltage of the light receiving unit.
  • the light receiving unit has a plurality of light receiving elements, the plurality of light receiving elements receive light in different wavelength bands, and the concentration calculation unit has the plurality of light receiving elements in the one extinguishing section.
  • Each output voltage of the light receiving element is acquired as the output voltage of each external light, and blood is obtained based on the value obtained by subtracting the output voltage of each external light from each output voltage of the plurality of light receiving elements in the lighting section of each wavelength band. It is preferable to calculate the concentration of the component.
  • the present invention relates to the blood component measuring device, a blood purifier, a blood circuit, a blood pump provided in the blood circuit for sending blood to the blood purifier, and blood flowing through the blood circuit.
  • a blood purification device including a measuring unit for measuring a component concentration and a control device, wherein the light emitting unit and the light receiving unit are provided in the measuring unit, and the light emitting control unit and the concentration calculating unit are provided.
  • the present invention relates to a blood purification device provided in the control device.
  • the blood component measuring device of the present invention it is possible to accurately acquire the output voltage of external light and accurately measure the concentration of blood components by lengthening one of the extinguished sections among a plurality of extinguished sections. By shortening the other extinguished sections, the concentration of blood components can be measured in a short time.
  • the blood component measuring device of the present invention continuously circulates a patient's blood extracorporeally using a blood purification device for performing dialysis therapy or the like, an artificial heart-lung machine, or the like, without contacting the blood. It makes it measurable.
  • a blood component measuring device capable of measuring oxygen saturation as a blood component will be described
  • a blood component measuring device capable of measuring oxygen saturation and hematocrit value will be provided as a blood component.
  • the blood purification device will be described.
  • FIG. 1 is a block diagram showing a blood component measuring device 1 according to the first embodiment of the present invention.
  • the blood component measuring device 1 includes a measuring unit 10, a control unit 20, and a display unit 30.
  • the measuring unit 10 has a light emitting unit 11 that emits light in two wavelength bands, and a light receiving unit 12 that receives the transmitted light or reflected light emitted from the light emitting unit 11 and converts it into a voltage and outputs the light. It is attached to a flow path such as a tube through which blood flows or a blood chamber.
  • the light emitting unit 11 includes two light emitting elements L1 and L2 and a light emitting circuit LC.
  • a light emitting diode that emits light in a wavelength band of about 600 nm, which is visible light is used as the light emitting element L1
  • the light emitting element L2 is about 800 nm.
  • a light emitting diode that emits light in the wavelength band of is used.
  • the light emitting circuit LC turns on or off the light emitting elements L1 and L2 based on the signal sent from the light emitting control circuit 21 described later.
  • Light in the wavelength band of about 600 nm is mainly absorbed by reduced hemoglobin
  • light in the wavelength band of about 800 nm is mainly absorbed by reduced hemoglobin and oxidized hemoglobin.
  • light in these two wavelength bands is applied to blood, part of it is absorbed, part of it is transmitted, and part of it is reflected.
  • the light receiving unit 12 includes one light receiving element F1 and a light receiving circuit RC. Since the two wavelength bands used in this embodiment are close to each other at about 600 nm and about 800 nm, the light receiving element F1 uses a photodiode capable of receiving light in both wavelength bands. Different photodiodes may be used for the two wavelength bands.
  • the light receiving circuit RC is a circuit that converts a weak current flowing according to the intensity of light incident on the light receiving element F1 into a voltage, amplifies it, and outputs it. In the present embodiment, as shown in FIG.
  • the light emitting unit 11 and the light receiving unit 12 are arranged in parallel, and light is emitted from the light emitting unit 11 toward the blood B flowing through the tube and reflected on the surface portion of the blood. The reflected light is incident on the light receiving unit 12 and converted into a voltage.
  • the control unit 20 includes a light emission control unit 21 and a concentration calculation unit 22.
  • the light emitting control unit 21 sends a signal for blinking the light emitting elements L1 and L2 in the light emitting unit 11 to the light emitting circuit LC at a predetermined cycle, and controls lighting and extinguishing of the light emitting unit 11.
  • the concentration calculation unit 22 calculates the oxygen saturation as a blood component based on the voltage output from the light receiving circuit RC. The specific calculation method will be described in detail later.
  • the display unit 30 is composed of a liquid crystal panel or the like that displays the concentration of the blood component calculated by the concentration calculation unit 22 and the change over time of the blood component.
  • the light emitting control unit 21 controls the light emitting unit 11 so that the light emitting elements L1 and L2 each blink at a predetermined period T.
  • the output voltage of the light receiving unit 12 has a waveform as shown in FIG.
  • the section from the start of lighting of the light emitting element L1 to the start of extinguishing is referred to as the lighting section Ton1
  • the section from the start of lighting of the light emitting element L2 to the start of extinguishing is referred to as the lighting section Ton2.
  • the section from the start of turning off the light emitting element L2 to the start of turning on the light emitting element L1 is referred to as the turn-off section Toff1
  • the section from the start of turning off the light emitting element L1 to the start of turning on the light emitting element L2 is referred to as the turn-off section Toff2.
  • the light emission control unit 21 controls so that of the two extinguished sections Toff1 and Toff2, the extinguished section Toff2 is shorter than the extinguished section Toff1. Further, the length of the extinguished section Toff1 is set so as to continue even after the influence of the afterglow due to the lighting of the light emitting element L2 disappears.
  • the output voltage that has risen to a predetermined value falls in the extinguishing section Toff1 at a predetermined fall time and converges. That is, in the extinguished section Toff1, after the predetermined fall time has passed, the output voltage of the light receiving unit 12 can be regarded as the output voltage Vn due to the incident of external light.
  • the period T can be shortened. This makes it possible to measure the blood concentration in a short time.
  • the period T 28 ms, and the number of blinks of the light emitting element L1 that emits visible light per second is 35.7 times. Generally, blinking 35 times or more per second does not appear to flicker, so the above settings can also reduce flicker.
  • the concentration calculation unit 22 acquires the output voltage of the light receiving unit 12 as the output voltage Vn of the external light in the extinguished section Toff1. Next, in the lighting section Ton1 of the light emitting element L1, the value obtained by subtracting the output voltage Vn of the external light from the output voltage V1 is acquired as the correction voltage Vc1. Finally, in the lighting section Ton2 of the light emitting element L2, the value obtained by subtracting the output voltage Vn of the external light from the output voltage V2 is acquired as the correction voltage Vc2.
  • the concentration calculation unit 22 obtains the ratio of reduced hemoglobin and oxidized hemoglobin from the correction voltage Vc1 that depends on the concentration of reduced hemoglobin and the correction voltage Vc2 that depends on the concentration of reduced hemoglobin and the concentration of oxidized hemoglobin, and determines the oxygen saturation. calculate. Hereinafter, this is repeated to continuously calculate the concentration.
  • the blood component measuring device 1 causes the light emitting control unit 21 to blink the light emitting unit 11 in a plurality of wavelength bands so that the lighting sections do not overlap in a predetermined period T, and among the plurality of extinguishing sections Toff1 and Toff2. It is assumed that the length of one extinguished section Toff1 is longer than the fall time of the output voltage of the light receiving unit 12, and the length of the other extinguished section Toff2 is controlled to be shorter than the one extinguished section Toff1.
  • the density calculation unit 22 is made to acquire the output voltage Vn of the external light in one extinguishing section Toff1, and the value Vc1 obtained by subtracting the output voltage Vn of the external light from the output voltages V1 and V2 of the light receiving unit 12 in the lighting sections Ton1 and Ton2. ,
  • the concentration of blood components was calculated based on Vc2. As a result, it is not necessary to lengthen all the extinguished sections to the extent that the afterglow disappears, so that the blood concentration can be measured in a short time and accurately. Further, the period T can be shortened to reduce flicker.
  • the blood component measuring device 1A according to the second embodiment will be described with reference to FIGS. 4 to 7.
  • the configuration in which the extracorporeal circulation device includes the blood component measuring device 1A will be described.
  • a blood purification device 100A capable of performing dialysis therapy will be described.
  • the blood purification device 100A described in the present embodiment purifies the blood of a renal insufficiency patient or a drug addict patient, and has a priming step of cleaning the components of the device, a blood removal step of removing blood from the patient, and blood.
  • FIG. 4 is a diagram showing a schematic configuration of a blood purification device 100A including a blood component measuring device 1A according to a second embodiment of the present invention, showing a state in a dialysis step
  • FIG. 5 is a diagram showing a state in the blood purification device 100A. It is a block diagram of.
  • the blood purifying device 100A includes a blood circuit 110 for flowing blood, a blood purifying device 120, a measuring unit 10A, a dialysate circuit 130, and a control device 140.
  • the blood circuit 110 has an arterial side line 111, a venous side line 112, a drug line 113, a drainage line 114, and a blood chamber 115.
  • the arterial side line 111, the venous side line 112, the drug line 113, and the drainage line 114 are all mainly composed of a soft tube having flexibility through which a liquid can flow.
  • the arterial side line 111 is connected to the blood inlet 122a of the blood purifier 120 described later on one end side.
  • An arterial side connection portion 111a, an arterial side bubble detector 111b, a blood pump 111c, and an arterial side clamp 111d are arranged on the arterial side line 111.
  • the arterial side connection portion 111a is arranged on the other end side of the arterial side line 111.
  • a needle that is punctured into the patient's blood vessel is connected to the arterial side connection portion 111a.
  • the arterial bubble detector 111b detects the presence or absence of bubbles in the tube.
  • the blood pump 111c is arranged downstream of the arterial bubble detector 111b in the arterial line 111.
  • the blood pump 111c discharges a liquid such as blood or a priming solution inside the arterial line 111 by squeezing the tube constituting the arterial line 111 with a roller.
  • the arterial side clamp 111d is arranged on the upstream side of the arterial side bubble detector 111b. For example, when blood is returned via the arterial side line 111, the arterial side clamp 111d is controlled according to the detection result of the air bubble by the arterial side bubble detector 111b, and opens and closes the flow path of the arterial side line 111.
  • the venous side line 112 is connected to the blood outlet 122b of the blood purifier 120 described later on one end side.
  • the venous side connection portion 112a, the venous side bubble detector 112b, the drip chamber 112c, and the venous side clamp 112d are arranged on the venous side line 112.
  • the venous side connection portion 112a is arranged on the other end side of the venous side line.
  • a needle that is punctured into the patient's blood vessel is connected to the venous side connection portion 112a.
  • the vein side bubble detector 112b detects the presence or absence of bubbles in the tube.
  • the drip chamber 112c is arranged on the upstream side of the vein side bubble detector 112b.
  • the drip chamber 112c stores a certain amount of blood in order to remove air bubbles and coagulated blood mixed in the venous side line 112 and to measure venous pressure.
  • the venous side clamp 112d is arranged on the downstream side of the venous side bubble detector 112b. The venous side clamp 112d is controlled according to the result of detecting bubbles by the venous side bubble detector 112b, and opens and closes the flow path of the venous side line 112.
  • the drug line 113 supplies the drug required during hemodialysis to the arterial side line 111.
  • One end of the drug line 113 is connected to the drug solution pump 113a for delivering the drug, and the other end is connected to the arterial line 111.
  • the drug line 113 is provided with a clamping means (not shown), and the flow path is closed by the clamping means except when the drug is injected.
  • the other end side of the drug line 113 is connected to the downstream side of the blood pump 111c in the arterial side line 111.
  • the drainage line 114 is connected to the drip chamber 112c.
  • a drainage line clamp 114a is arranged on the drainage line 114.
  • the drainage line 114 is a line for draining the priming liquid in the priming step of cleaning and cleaning the blood circuit 110 and the blood purifier 120.
  • the blood chamber 115 is provided at a position in the blood circuit 110 where the measuring unit 10A is attached.
  • the blood chamber 115 is made of a transparent and hard resin such as polycarbonate, and is formed in a flat shape so that the irradiation area from the light emitting portion 11A is larger than that of the tube constituting the blood circuit 110.
  • the blood chamber 115 is provided on the arterial side line 111 in order to measure the state of blood taken out from the patient.
  • the blood chamber 115 may be attached anywhere on the arterial side line 111, but it is attached to the connection portion of the blood purifier 120 on one end side of the arterial side line 111 with the blood inlet 122a.
  • the blood purifier 120 includes a container body 121 formed in a tubular shape and a dialysis membrane (not shown) housed inside the container body 121, and the inside of the container body 121 is made of blood by the dialysis membrane. It is divided into a side flow path and a dialysate side flow path (neither is shown).
  • the container body 121 is formed with a blood inlet 122a and a blood outlet 122b communicating with the blood circuit 110, and a dialysate inlet 123a and a dialysate outlet 123b communicating with the dialysate circuit 130.
  • the blood taken out from the artery of the subject flows through the arterial side line 111 by the blood pump 111c and flows through the blood side flow path of the blood purifier 120.
  • the blood introduced into the blood purifier 120 is purified by the dialysate circulating in the dialysate circuit 130 described later via the dialysate membrane.
  • the blood purified in the blood purifier 120 flows through the vein side line 112 and is returned to the subject's vein.
  • the measuring unit 10A includes a light emitting unit 11A that emits light in three wavelength bands, and a light receiving unit 12A that converts transmitted light or reflected light emitted from the light emitting unit 11A into a voltage and outputs the light. , And attached to the blood chamber 115.
  • the light emitting unit 11A includes three light emitting elements L1, L2, and L3, and a light emitting circuit LCA.
  • the oxygen saturation and the hematocrit value are measured as an example of blood components. Since the light emitting diodes L1 and L2 for measuring the oxygen saturation use the same light emitting diodes as those described in the first embodiment, the description thereof will be omitted.
  • the light emitting element L3 uses a light emitting diode that emits light in a wavelength band of about 1300 nm.
  • the light emitting circuit LCA turns on or off the light emitting elements L1, L2, and L3 based on the signal sent from the light emitting control circuit 21A described later.
  • Light in the wavelength band of about 1300 nm is mainly absorbed by water, and light in the wavelength band of about 800 nm is mainly absorbed by hemoglobin. The hematocrit value is measured using light in these two wavelength bands.
  • the light receiving unit 12A includes two light receiving elements F1 and F2 and a light receiving circuit RCA. Of the three wavelength bands used in this embodiment, about 600 nm and about 800 nm are close to each other. Therefore, as described in the first embodiment, the light receiving element F1 is a photodiode capable of receiving light in both wavelength bands. Use. The light receiving element F2 uses a photodiode capable of receiving light in a wavelength band of about 1300 nm.
  • the light receiving circuit RCA is a circuit that converts a weak current flowing according to the intensity of light incident on the light receiving elements F1 and F2 into a voltage, amplifies it, and outputs each voltage.
  • the light emitting unit 11A and the light receiving unit 12A are arranged so as to face each other with the blood chamber 115 interposed therebetween. Light is emitted from the light emitting unit 11 toward the blood B flowing through the blood chamber 115, and the light transmitted through the blood is incident on the light receiving unit 12A and converted into a voltage.
  • the dialysate circuit 130 is composed of a so-called closed capacity control type dialysate circuit 130.
  • the dialysate circuit 130 includes a dialysate supply line 131a, a dialysate drainage line 131b, a dialysate introduction line 132a, a dialysate lead-out line 132b, and a dialysate delivery unit 133.
  • the dialysate feed unit 133 includes a dialysate chamber 1331, a bypass line 1332, and a water removal / backfiltration pump 1333.
  • the dialysate chamber 1331 is composed of a hard container capable of accommodating a constant volume (for example, 300 mL to 500 mL) of dialysate, and the inside of the container is formed by a soft diaphragm (diaphragm) to provide a liquid feed accommodating portion 1331a and drainage. It is partitioned into the accommodating portion 1331b.
  • the bypass line 1332 connects the dialysate lead-out line 132b and the dialysate drainage line 131b.
  • the water removal / backfiltration pump 1333 is arranged at the bypass line 1332.
  • the water removal / back filtration pump 1333 has a direction in which the dialysate inside the bypass line 1332 is circulated to the dialysate drainage line 131b side (water removal direction) and a direction in which the dialysate is circulated to the dialysate discharge line 132b side (back filtration direction). It is composed of a pump that is driven so that the liquid can be sent to the dialysis machine.
  • the dialysate supply line 131a is connected to the dialysate supply device (not shown) at the proximal end side and to the dialysate chamber 1331 at the distal end side.
  • the dialysate supply line 131a supplies the dialysate to the liquid feed accommodating portion 1331a of the dialysate chamber 1331.
  • the dialysate introduction line 132a connects the dialysate chamber 1331 and the dialysate introduction port 123a of the blood purifier 120, and dialysates the dialysate stored in the liquid feed accommodating portion 1331a of the dialysate chamber 1331 to the blood purifier 120. Introduce into the liquid side flow path.
  • the dialysate lead-out line 132b connects the dialysate outlet 123b of the blood purifier 120 and the dialysate chamber 1331, and leads the dialysate discharged from the blood purifier 120 to the drainage accommodating portion 1331b of the dialysate chamber 1331. do.
  • the base end side of the dialysate drainage line 131b is connected to the dialysate chamber 1331, and the drainage of the dialysate stored in the drainage storage unit 1331b is discharged.
  • the inside of the hard container constituting the dialysate chamber 1331 is partitioned by a soft diaphragm (diaphragm), so that the amount of dialysate derived from the dialysate chamber 1331 (condensation of the dialysate).
  • the amount of dialysate supplied to section 1331a) and the amount of drainage collected in the dialysate chamber 1331 (drainage accommodating section 1331b) can be made the same amount.
  • the water removal / reverse filtration pump 1333 is stopped, the flow rate of the dialysate introduced into the blood purifier 120 and the amount of the dialysate (drainage) drawn out from the blood purifier 120 are the same. Can be done.
  • the blood purifier 120 removes a predetermined amount of water from the blood at a predetermined speed. Further, when the water removal / back filtration pump 1333 is driven so as to send the liquid in the back filtration direction, a predetermined amount of dialysate is injected (back filtration) into the blood circuit 110 in the blood purifier 120.
  • the control device 140 is composed of an information processing device (computer), and controls the operation of the blood purification device 100A by executing a control program. As shown in FIG. 5, specifically, the control device 140 controls the operations of various pumps, clamps, and the like arranged in the blood circuit 110 and the dialysate circuit 130, and is performed by the blood purification device 100. Steps such as priming step, blood removal step, dialysis step, fluid replacement step, blood return step and the like are executed.
  • control device 140 includes a control unit 20A constituting the blood component measuring device 1A.
  • the control unit 20A includes a light emission control unit 21A and a concentration calculation unit 22A.
  • the light emitting control unit 21A sends a signal for blinking the light emitting elements L1, L2, and L3 in the light emitting unit 11A to the light emitting circuit LCA at a predetermined cycle, and controls lighting and extinguishing of the light emitting unit 11A.
  • the concentration calculation unit 22A calculates the oxygen saturation and the hematocrit value as blood components based on the voltage output from the light receiving circuit RCA. The specific calculation method will be described in detail later.
  • the patient's excess water is removed and waste products are removed.
  • the patient's blood introduced from the arterial connection 111a is purified by the blood purifier 120 through the arterial line 111 and returned to the patient from the venous connection 112a through the venous line 112. ..
  • the arterial side connection portion 111a and the venous side connection portion 112a are in a state of being connected to a needle punctured by a patient's blood vessel, and the drainage line clamp 114a is in a closed state.
  • the venous side clamp 112d is in the open state.
  • the dialysate supply device (not shown) supplies and discharges dialysate to the dialysate chamber 1331 at an average flow rate of 500 mL / min, and uses the water removal / reverse filtration pump 1333 at 10 mL as an example in the water removal direction. It is operated to send a liquid, and 10 mL / min of water is removed in the blood purifier 120.
  • the blood pump 111c delivers blood from the arterial side connection portion 111a side to the blood purifier 120 side at a flow rate of, for example, 200 mL / min.
  • Light emission control unit 21A controls the light emitting section 11A so as to the light emitting element L1, L2, L3 respectively to blink with a predetermined period T A.
  • T A a predetermined period of the light emitting portion 11A
  • the output voltage 1 from the light receiving element F1 the output voltage 2 from the light receiving element F2 is obtained .
  • Each of the output voltage 1 and the output voltage 2 has a waveform as shown in FIG. 7.
  • a section up off starting from the start of lighting the light emitting element L1 is lit section T A on1
  • a section up off starting from the start of lighting the light-emitting element L2 is turned interval T A on2
  • start of lighting the light-emitting element L3 an interval of up to off start from the lighting section T a on3.
  • the section from off the start of the light-emitting element L3 until the start of lighting the light emitting element L1 is off interval T A off1
  • the section from off the start of the light emitting element L1 to the start of lighting the light-emitting element L2 is turned off interval T A off2
  • T A T A off1 + T A on1 + T A off2 + T A on2 + T A off3 + T A on3 is established.
  • Light emission control unit 21A has three off interval T A off1, T A off2 and, among the T A off3, than one off interval T A off3, other off interval T A off1, T A off2 is shortened To control.
  • the output voltages of the light receiving elements F1, F2 of the light receiving portion 12A is the respective output voltages due to the incident external light V A n1, V A n2 Can be regarded as.
  • the off period T A off1, T A off2 respectively afterglow afterglow and the light emitting element L1 of the light-emitting element L3 is still not converge, the lighting of the next light emitting element L1 and the light-emitting element L2 is started. That is, by turning on the light emitting element emits light immediately before, so as to be shorter than the fall time of the elevated output voltage to a predetermined value, it sets the off interval T A off1, T A off2.
  • the off interval T A off1, T A off2 other than off interval T A off3 for acquiring the output voltage V A n of the external light afterglow set to short time so as not to converge the period T A can be further shortened. This makes it possible to measure the blood concentration in a shorter time.
  • Concentration calculation unit 22A in the off interval T A off3, acquires the output voltages from the respective light receiving elements F1, F2 in the photodetecting section 12A output voltage V A n1 of ambient light, V A n2, as. Then, in the lighting section T A on3 of the light-emitting element L3, a value obtained by subtracting the output voltage V A n2 of the external light from the output voltage V A 3, acquires a correction voltage V A c3. Then, in the lighting section T A on1 of the light emitting element L1, a value obtained by subtracting the output voltage V A n1 of ambient light from the output voltage V A 1, is obtained as the correction voltage V A c1.
  • the concentration calculation unit 22A obtains the ratio of reduced hemoglobin and oxidized hemoglobin from the corrected voltage VA c1 depending on the concentration of reduced hemoglobin and the corrected voltage VA c2 depending on the concentration of reduced hemoglobin and the concentration of oxidized hemoglobin. Calculate oxygen saturation. Further, the concentration calculation unit 22A calculates the hematocrit value from the correction voltage VA c2 depending on the concentration of hemoglobin and the correction voltage VA c3 depending on the ratio of water. Hereinafter, this is repeated, and the oxygen saturation and the hematocrit value are continuously calculated.
  • the light emission control unit 21A of the blood component measuring apparatus 1A controls to turn off interval T A off1, T A off2 is shorter than the fall time of the output voltage from the light receiving element F3, F1 of the light receiving portion 12A I made it.
  • the cycle can be further shortened, so that the measurement of blood concentration can be shortened.
  • flicker can be further reduced.
  • the light receiving unit 12A of the blood component measuring device 1A has a plurality of light receiving elements F1 and F2, and the plurality of light receiving elements F1 and F2 receive light in different wavelength bands, respectively, and the concentration calculation unit 22A.
  • T a off3 acquires the output voltages from the plurality of light receiving elements F1, F2 as the output voltage V a n1, V a n2 of each external light, the lighting period T a of the respective wavelength bands on1, T a on2, T a the output voltage V a 1 of the plurality of light receiving elements F1, F2 in on3, V a 2, V a 3 from the value obtained by subtracting the output voltage V a n1, V a n2 of each external light
  • the concentration of blood components was calculated based on VA c1, VA c2, and VA c3. As a result, even if the number of light receiving elements included in the light receiving unit increases, only one light-off section is required to lengthen the light-receiving element, so that the cycle
  • the present invention is not limited to the above-described embodiments and can be appropriately modified.
  • the light emitting unit shows a configuration using a plurality of light emitting elements that emit light in different wavelength bands, but by filtering one light emitting element, light in a plurality of wavelength bands is emitted. It may be configured to allow it.
  • the measuring unit is attached to the tube of the blood circuit or the blood chamber.
  • the measuring unit is provided in the housing of the main body of the extracorporeal circulation device to form the blood circuit.
  • the tube may be configured to be attached to the measuring section.
  • Dialysis device 1, 1A Blood component measurement device 10, 10A Measurement unit 11, 11A Light emitting unit 12, 12A Light receiving unit 20, 20A Control unit 21, 21A Light emission control unit 22, 22A Concentration calculation unit 30
  • Display unit 100A Dialysis device 110 Blood circuit 111 Arteries Side line 111c Blood pump 112 Venous side line 120 Blood purifier 130 Dialysate circuit 133 Dialysate delivery unit 140 Control unit

Abstract

Un dispositif de mesure de composant sanguin apte à mesurer avec précision la concentration d'un composant sanguin en une courte période de temps est divulgué. Un dispositif de mesure de composant sanguin (1) commande une unité de commande d'émission de lumière (21) pour faire clignoter chacune des unités d'émission de lumière (11) avec une pluralité de bandes de longueur d'onde de telle sorte que des sections d'éclairage ne se chevauchent pas les unes avec les autres dans un cycle prédéterminé T, et commande l'unité de commande d'émission de lumière (21) de telle sorte que la longueur d'une période d'arrêt Toff1 d'une pluralité de périodes d'arrêt Toff1 et Toff2 est plus longue qu'un temps de chute d'une tension de sortie d'une unité de réception de lumière (12) et que la longueur de l'autre période d'arrêt Toff2 est plus courte qu'une période d'arrêt Toff1, et amène une unité de calcul de concentration (22) à acquérir une tension de sortie Vn de lumière externe dans une période de mise hors tension Toff1 et calculer la concentration d'un composant sanguin sur la base de valeurs Vc1 et Vc2 obtenues par soustraction de la tension de sortie Vn de la lumière externe à partir des tensions de sortie V1 et V2 de l'unité de réception de lumière (12) dans les sections d'éclairage Ton1 et Ton2.
PCT/JP2021/020046 2020-05-28 2021-05-26 Dispositif de mesure de composant sanguin et dispositif de purification sanguine WO2021241647A1 (fr)

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JP2009136326A (ja) * 2007-12-03 2009-06-25 Nippon Telegr & Teleph Corp <Ntt> 成分濃度測定装置及び成分濃度測定装置制御方法
WO2012049753A1 (fr) * 2010-10-14 2012-04-19 株式会社日立製作所 Équipement pour l'acquisition et l'analyse de données in vivo
JP2012523254A (ja) * 2009-04-11 2012-10-04 フレセニウス・メディカル・ケア・ドイチュラント・ゲーエムベーハー 体外血液処理装置用の血液中の血液成分を測定するための装置及び方法
JP2012237758A (ja) * 2012-07-23 2012-12-06 Jms Co Ltd 成分測定用器具及び成分測定用器具を備えた血液透析装置
JP2018021940A (ja) * 2014-08-29 2018-02-08 国立大学法人東北大学 濃度測定方法

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2009136326A (ja) * 2007-12-03 2009-06-25 Nippon Telegr & Teleph Corp <Ntt> 成分濃度測定装置及び成分濃度測定装置制御方法
JP2012523254A (ja) * 2009-04-11 2012-10-04 フレセニウス・メディカル・ケア・ドイチュラント・ゲーエムベーハー 体外血液処理装置用の血液中の血液成分を測定するための装置及び方法
WO2012049753A1 (fr) * 2010-10-14 2012-04-19 株式会社日立製作所 Équipement pour l'acquisition et l'analyse de données in vivo
JP2012237758A (ja) * 2012-07-23 2012-12-06 Jms Co Ltd 成分測定用器具及び成分測定用器具を備えた血液透析装置
JP2018021940A (ja) * 2014-08-29 2018-02-08 国立大学法人東北大学 濃度測定方法

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