CN115192805B - A pre-flushing method for a combined artificial kidney circuit - Google Patents
A pre-flushing method for a combined artificial kidney circuit Download PDFInfo
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- CN115192805B CN115192805B CN202210805248.XA CN202210805248A CN115192805B CN 115192805 B CN115192805 B CN 115192805B CN 202210805248 A CN202210805248 A CN 202210805248A CN 115192805 B CN115192805 B CN 115192805B
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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
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3621—Extra-corporeal blood circuits
- A61M1/3643—Priming, rinsing before or after use
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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
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Abstract
一种组合型人工肾管路的预冲洗方法，组合型人工肾管路包括血液灌流器、透析器、动脉管路和静脉管路，预冲洗方法步骤如下：从动脉管路的第一端接入预冲液，检测动脉管路内的液体流量；计算动脉管路内的液体流量和预设流量值间的差值，如果动脉管路内的液体流量和预设流量值的差值大于0且小于预设流量差值，采用单独预冲洗模式对组合型人工肾管路进行预冲洗，如果动脉管路内的液体流量和预设流量值的差值大于或等于预设流量差值，采用串联预冲洗模式对组合型人工肾管路进行预冲洗。本发明根据组合型人工肾管路内的液体流量来确定预冲洗模式，便于组合型人工肾管路在恰当的预冲洗模式下进行预冲洗，提高了预冲洗效率，简化了管路预冲洗的操作。
A pre-flushing method for a combined artificial kidney pipeline, the combined artificial kidney pipeline includes a hemoperfusion device, a dialyzer, an arterial pipeline and a venous pipeline, and the pre-flushing method steps are as follows: accessing a pre-flushing liquid from the first end of the arterial pipeline, detecting the liquid flow in the arterial pipeline; calculating the difference between the liquid flow in the arterial pipeline and a preset flow value, if the difference between the liquid flow in the arterial pipeline and the preset flow value is greater than 0 and less than the preset flow difference, using a separate pre-flushing mode to pre-flushing the combined artificial kidney pipeline, if the difference between the liquid flow in the arterial pipeline and the preset flow value is greater than or equal to the preset flow difference, using a series pre-flushing mode to pre-flushing the combined artificial kidney pipeline. The present invention determines the pre-flushing mode according to the liquid flow in the combined artificial kidney pipeline, facilitates the combined artificial kidney pipeline to be pre-flushed in an appropriate pre-flushing mode, improves the pre-flushing efficiency, and simplifies the operation of pipeline pre-flushing.
Description
Technical Field
The invention belongs to the technical field of blood purification, and particularly relates to a combined type pre-flushing method of an artificial kidney pipeline.
Background
The blood purification is to draw the blood of human body out of the body, and remove pathogen related molecules in the blood by using a blood purifier, so as to achieve the purposes of purifying the blood and treating diseases. According to the specific principle of blood purification, blood purification can be divided into treatment modes such as hemodialysis, hemofiltration, hemoperfusion, plasmapheresis and the like. Each blood purification treatment mode is applicable to different clinical symptoms. At present, the blood purification has been applied to a plurality of departments such as kidney disease, neurosurgery, hematopathy, respiratory disease, liver disease, ICU and the like, and good clinical treatment effect is obtained.
The combined artificial kidney has wide application in uremia treatment. The combined artificial kidney is mainly characterized in that a dialyzer and a hemoperfusion apparatus are connected in series, toxins in a patient and excessive water stored in the patient can be removed in the treatment process, substances required in the patient are supplemented, and the balance of electrolyte, acid and alkali in the patient is maintained. Before the blood purification treatment is carried out on the patient, the blood purification treatment pipeline, namely the combined artificial kidney pipeline, is required to be pre-washed so as to ensure the safety of the blood purification treatment. The pre-flushing of the combined artificial kidney pipeline is to convey pre-flushing liquid such as physiological saline into the combined artificial kidney pipeline, and clean impurities in the pipeline and remove air in the pipeline in the process that the pre-flushing liquid is filled in the pipeline and flows in the pipeline. Pre-flushing is an indispensable step in the blood purification treatment process, and if the pipeline is not fully pre-flushed, residual gas or impurities and the like in the pipeline can affect the safety of the blood purification treatment of a patient.
The combined artificial kidney comprises two blood purifiers, namely a dialyzer and a blood perfusion device, the two devices have different internal structures, the connecting pipeline between the devices is complex, and in order to ensure good cleaning effect, the combined artificial kidney pipeline is usually subjected to a single pre-flushing mode, namely a single flushing of the dialyzer and a single flushing of the blood perfusion device, but the pre-flushing mode has lower efficiency, is not flexible enough and is not beneficial to popularization and application of combined artificial kidney treatment.
Disclosure of Invention
The invention aims to provide a combined type pre-flushing method for an artificial kidney pipeline, which is simple and convenient to operate, good in pre-flushing effect and high in efficiency.
In order to achieve the above object, the present invention adopts the following technical solutions:
The combined artificial kidney pipeline comprises a blood perfusion device, a dialyzer, an arterial pipeline and a venous pipeline, wherein the second end of the arterial pipeline is connected with a first bypass branch and a second bypass branch through a first connector, the second bypass branch is sequentially connected with the blood perfusion device and a third bypass branch, the first bypass branch is sequentially connected with the third bypass branch and a fourth bypass branch through a second connector, the fourth bypass branch is sequentially connected with the dialyzer and the venous pipeline, and a fifth bypass branch is connected to the third bypass branch;
The pre-flushing method comprises the following steps:
S1, accessing pre-flushing liquid from a first end of the arterial pipeline, and detecting the liquid flow in the arterial pipeline;
S2, calculating a difference value between the liquid flow in the arterial line and a preset flow value, if the difference value between the liquid flow in the arterial line and the preset flow value is larger than 0 and smaller than the preset flow difference value, pre-flushing the combined artificial kidney line by adopting a single pre-flushing mode, and if the difference value between the liquid flow in the arterial line and the preset flow value is larger than or equal to the preset flow difference value, pre-flushing the combined artificial kidney line by adopting a series pre-flushing mode;
Under the independent pre-flushing mode, controlling the pre-flushing liquid to sequentially pass through the arterial pipeline, the second bypass branch, the blood perfusion device, the third bypass branch and the fifth bypass branch until a waste liquid bag is formed, and pre-flushing the blood perfusion device, or controlling the pre-flushing liquid to sequentially pass through the arterial pipeline, the first bypass branch, the fourth bypass branch, the dialyzer and the venous pipeline until a waste liquid bag is formed, and pre-flushing the dialyzer;
and under the serial pre-flushing mode, controlling the pre-flushing liquid to sequentially pass through the arterial pipeline, the second bypass branch, the blood perfusion device, the third bypass branch, the fourth bypass branch, the dialyzer and the venous pipeline until reaching a waste liquid bag, and carrying out combined pre-flushing on the blood perfusion device and the dialyzer.
Further, when the pre-flushing is performed in the serial pre-flushing mode, the method further comprises a pipeline blockage detection step:
s3, detecting the liquid flow of the second bypass flow branch to obtain a first detected flow;
S4, detecting the liquid flow of the venous pipeline to obtain a second detection flow;
s5, judging whether the combined artificial kidney pipeline is blocked or not according to the difference value between the first detection flow and the second detection flow.
Further, when the pre-flushing is performed in the serial pre-flushing mode, the method further comprises a step of detecting a leakage fault of the hemoperfusion apparatus and/or a step of detecting a leakage fault of the dialyser:
Detecting the liquid flow in the second bypass flow branch and the liquid flow in the third bypass flow branch, calculating the difference value of the liquid flow in the second bypass flow branch and the liquid flow in the third bypass flow branch, and considering that the liquid leakage fault occurs in the blood perfusion device when the difference value of the liquid flow in the second bypass flow branch and the liquid flow in the third bypass flow branch is larger than a first liquid leakage judgment threshold value;
the liquid leakage fault detection of the dialyzer comprises the steps of detecting the liquid flow in the fourth bypass branch and the liquid flow in the venous pipeline, calculating the difference value between the liquid flow in the fourth bypass branch and the liquid flow in the venous pipeline, and considering that the dialyzer has a liquid leakage fault when the difference value between the liquid flow in the fourth bypass branch and the liquid flow in the venous pipeline is larger than a second liquid leakage judgment threshold value.
Further, when the pre-flushing is performed in the tandem pre-flushing mode, the method further comprises the following steps:
s3', recording the continuous flowing time of the pre-flushing liquid in the arterial pipeline;
s4', if the continuous flowing time of the pre-flushing liquid in the arterial line is longer than the pre-flushing stop prompt time, sending out the pre-flushing stop prompt message;
the pre-flush stop prompting time is determined by the following method:
a. Calculating the total capacity of the combined artificial kidney pipeline according to the blood chamber capacity of the blood perfusion device and the blood chamber capacity of the dialyser, wherein the total capacity of the combined artificial kidney pipeline is equal to the blood chamber capacity of the blood perfusion device and the blood chamber capacity of the dialyser;
b. And determining the pre-flushing stop prompting time according to the total capacity of the combined artificial kidney pipeline and the liquid flow in the arterial pipeline.
Further, when the duration of the continuous flow of the pre-flushing liquid in the arterial line is longer than the pre-flushing stop prompt time, detecting the air bubble quantity in the venous line, and stopping the pre-flushing if no air bubble exists in the venous line.
Further, when the pre-flushing is performed in the serial pre-flushing mode or the pre-flushing is performed in the single pre-flushing mode, detecting the temperature of the liquid in the arterial line, and if the detected temperature of the liquid in the arterial line is smaller than a preset temperature, sending out a temperature alarm signal.
Further, when the pre-flushing is performed in the serial pre-flushing mode, detecting the liquid temperature in the arterial line and the liquid temperature in the venous line, comparing the difference value between the liquid temperature in the arterial line and the liquid temperature in the venous line with a preset temperature difference value, and if the difference value between the liquid temperature in the arterial line and the liquid temperature in the venous line is larger than the preset temperature difference value, adjusting the liquid flow in the arterial line.
Further, in the pre-flushing process, the method further comprises a mode switching step:
When the single pre-flushing mode is switched to the series pre-flushing mode, the liquid flow in the arterial line is regulated to ensure that the difference value between the liquid flow in the arterial line and the preset flow value reaches the preset flow difference value;
When the serial pre-flushing mode is switched to the independent pre-flushing mode, the liquid flow in the arterial line is regulated down so that the difference between the liquid flow in the arterial line and the preset flow value is smaller than the preset flow difference.
Further, when switching from the serial pre-flush mode to the single pre-flush mode, comparing the blood chamber volumes of the blood perfusion device and the dialyzer, if the blood chamber volume of the blood perfusion device is greater than the blood chamber volume of the dialyzer, controlling the pre-flush to sequentially pass through the arterial line, the second bypass branch, the blood perfusion device, the third bypass branch and the fifth bypass branch until a waste liquid bag is reached, and pre-flushing the blood perfusion device;
And if the blood chamber capacity of the blood perfusion device is smaller than or equal to the blood chamber capacity of the dialyzer, controlling the pre-flushing liquid to sequentially pass through the arterial pipeline, the first bypass branch, the fourth bypass branch, the dialyzer and the venous pipeline until reaching a waste liquid bag, and pre-flushing the dialyzer.
Further, the device also comprises a circulating pre-flushing mode, and in the circulating pre-flushing mode, the pre-flushing liquid is controlled to circularly flow in a loop formed by the first bypass branch, the second bypass branch, the blood perfusion device and the third bypass branch.
According to the technical scheme, the pre-flushing mode is determined according to the liquid flow in the arterial line of the combined artificial kidney line aiming at the structural characteristics of the combined artificial kidney line, and the independent pre-flushing mode or the series pre-flushing mode is correspondingly selected when the liquid flow in the arterial line meets different conditions, so that the combined artificial kidney line can be pre-flushed in a proper pre-flushing mode, the pre-flushing operation is simplified, the pre-flushing effect of the line can be ensured, the pre-flushing efficiency is improved, the pre-flushed combined artificial kidney line has higher safety, and the popularization and the application of the combined artificial kidney treatment mode in clinical treatment are facilitated.
Drawings
In order to more clearly illustrate the embodiments of the present invention, the following description will briefly explain the embodiments or the drawings required for the description of the prior art, it being obvious that the drawings in the following description are only some embodiments of the present invention and that other drawings may be obtained according to these drawings without inventive effort to a person skilled in the art.
FIG. 1 is a schematic view of a combined artificial kidney line according to an embodiment of the present invention;
Fig. 2 is a flow chart of the method of the present invention.
The following describes the embodiments of the present invention in further detail with reference to the drawings.
Detailed Description
In describing embodiments of the present application in detail, the drawings showing the structure of the device are not to scale locally for ease of illustration, and the schematic illustrations are merely examples, which should not limit the scope of the application. It should be noted that the drawings are in simplified form and are not to scale precisely, but rather are merely intended to facilitate and clearly illustrate the embodiments of the present application. Meanwhile, in the description of the present application, the terms "first", "second", etc. are used for distinguishing the description only, and are not to be construed as indicating or implying relative importance or implying any particular amount of technical features, and the terms "forward", "reverse", "bottom", "upper", "lower", etc. are used for convenience in describing the present application and simplifying the description only with respect to the orientation or positional relationship shown in the drawings, but do not necessarily indicate or implicate that the apparatus or element being referred to must have a specific orientation, be constructed and operated in a specific orientation, and thus should not be construed as limiting the present application.
In the description of the present invention, unless explicitly specified and limited otherwise, the terms "connected," "connected," and "connected" are to be construed broadly, and may be, for example, fixedly connected, detachably connected, integrally connected, mechanically connected, electrically connected, directly connected, indirectly connected through an intermediate medium, and in communication with each other between two elements, and may be wireless or wired. The specific meaning of the above terms in the present invention will be understood in specific cases by those of ordinary skill in the art.
As shown in fig. 1, the combined artificial kidney line of the present embodiment includes a hemodiafiltration device 1, a dialyzer 2, an arterial line 3, a venous line 4, a first bypass line 5, a second bypass line 6, a third bypass line 7, a fourth bypass line 8, and a fifth bypass line 9. The second bypass branch 6, the first bypass branch 5 and the third bypass branch 7 are sequentially connected, and the second bypass branch 6 and the third bypass branch 7 are respectively connected with the input end and the output end of the blood perfusion device 1 to form a circulation loop of the blood perfusion device. The pre-flushing liquid is connected from the first end of the arterial line 3, the second end of the arterial line 3 is connected with the first bypass branch 5 and the second bypass branch 6 through the first connector 10, the other end of the first bypass branch 5 is connected with the fourth bypass branch 8 and the third bypass branch 7 through the second connector 11, the other end of the fourth bypass branch 8 is connected with the dialyzer 2, the other end of the dialyzer 2 is connected with the venous line 4, and the other end of the venous line 4 is connected with a waste liquid bag (not shown). One end of the fifth bypass flow branch 9 is connected to the third bypass flow branch 7 and is communicated with the third bypass flow branch 7, and the other end of the fifth bypass flow branch 9 is connected with a waste liquid bag 12. The fifth bypass flow branch 9 of the present embodiment is connected to the third bypass flow branch 7 by a third joint 13. In other embodiments, the fifth bypass branch 9 may be connected to the connection of the third bypass branch 7, the first bypass branch 5 and the fourth bypass branch 8 through a four-way joint or a four-way valve. The joint in the pipeline can be a valve joint with a pipeline on-off control function, such as a three-way valve, a four-way valve and the like, or can be a joint with a pipeline connecting function only, such as a three-way joint, a four-way joint and the like, when the joint with the pipeline connecting function is only used, a control valve for controlling the on-off of the pipeline, such as a water stop clamp Q and the like, can be independently arranged on each bypass branch, and the on-off of the pipeline can be controlled through the control valve so as to control the flowing state of liquid in the pipeline.
The blood perfusion device and the dialyzer in the combined artificial kidney pipeline are conventional blood perfusion and dialyzer, and the structure of the blood perfusion device and the dialyzer is not improved. The blood perfusion device is internally provided with a blood perfusion adsorbent, blood is introduced into the blood perfusion device, and endogenous or exogenous toxins or pathogenic substances in the blood of a patient are removed through the blood perfusion adsorbent. The dialyzer is internally provided with a hollow fiber membrane, blood is introduced into the dialyzer, and blood and dialysate are respectively arranged at two sides of the hollow fiber membrane, and various harmful and redundant metabolic wastes and excessive electrolytes in human blood are removed from the body by utilizing the semi-permeable membrane principle so as to correct water electrolyte and acid-base balance in the blood.
The combined artificial kidney pipeline comprises a blood purifier such as a blood perfusion device and a dialyzer, and also comprises various connecting pipelines including a bypass branch, an arterial pipeline, a venous pipeline and the like. In practical application, the volume of the blood purifier is generally far greater than that of the connecting pipeline, and the internal structure of the blood purifier is complex, so that the full flushing and the efficient flushing of the blood purifier are the difficulties of pre-flushing of the combined artificial kidney pipeline.
In order to improve the pre-flushing efficiency and ensure the pre-flushing effect, the main idea of the method is to determine the pre-flushing mode based on the liquid flow in the arterial line, and the pre-flushing mode comprises a single pre-flushing mode and a series pre-flushing mode. Wherein the single pre-flush mode is a pre-flush of the hemodiafunctional or a pre-flush of the dialyzer. The series pre-flushing mode is to connect the hemodiafiltration device and the dialyzer in series, so that the pre-flushing liquid flows through the hemodiafiltration device and the dialyzer in sequence, and the hemodiafiltration device and the dialyzer are subjected to combined pre-flushing.
The following describes a method for pre-flushing a combined artificial kidney according to the present invention, which includes the steps of:
S1, connecting pre-flushing liquid from a first end of an arterial pipeline, and detecting the liquid flow in the arterial pipeline;
S2, calculating a difference value between the liquid flow in the arterial line and a preset flow value, determining whether to use a single pre-flushing mode or a series pre-flushing mode according to the difference value, when the difference value between the liquid flow in the arterial line and the preset flow value is larger than 0 and smaller than the preset flow difference value, pre-flushing the combined artificial kidney line by using the single pre-flushing mode, and when the difference value between the liquid flow in the arterial line and the preset flow value is larger than or equal to the preset flow difference value, pre-flushing the combined artificial kidney line by using the series pre-flushing mode.
The liquid flow can reflect the capacity of the pre-flushing liquid connected into the pipeline, in the pre-flushing process, the liquid flow can reach a certain value to play a role in flushing the pipeline, and if the liquid flow is too low, the pre-flushing liquid cannot realize the pre-flushing function of the combined artificial kidney pipeline, so that the liquid flow in the arterial pipeline is larger than a preset flow value (the liquid flow in the arterial pipeline is larger than the preset flow value) to realize the normal pre-flushing function of the combined artificial kidney pipeline. The preset flow value is related to the volume of the blood purifier and the volume of each pipeline, and in specific application, the preset flow value can be set to any one value (including an endpoint value) from 5ml/min to 10 ml/min. When the difference between the liquid flow in the arterial line and the preset flow value is smaller than the preset flow difference, the pre-flushing liquid is insufficient to complete the pre-flushing of the blood perfusion device and the dialyser at the same time, a single pre-flushing mode is selected for pre-flushing, and when the difference between the liquid flow in the arterial line and the preset flow value reaches the preset flow difference (the liquid flow in the arterial line-the preset flow value is larger than or equal to the preset flow difference), the serial pre-flushing mode can be adopted for pre-flushing the blood perfusion device and the dialyser together. In a specific application, the preset flow difference value may be set to any one value (including an endpoint value) of 3ml/min to 5 ml/min.
When the pre-flushing mode is determined according to the difference between the liquid flow in the arterial line and the preset flow value, the pre-flushing operation of the combined artificial kidney line is started according to the pre-flushing execution instruction of the user. When the pre-flushing mode is the single pre-flushing mode, the user can select whether to perform single pre-flushing on the blood perfusion device or single pre-flushing on the dialyser, and corresponding pre-flushing operation is performed according to the pre-flushing execution instruction input by the user.
After the pre-flushing is started, under the single pre-flushing mode, the pre-flushing liquid has two circulation modes in the combined artificial kidney pipeline, wherein one circulation mode only flows through the blood perfusion device to perform single pre-flushing on the blood perfusion device, and the other circulation mode only flows through the dialyser to perform single pre-flushing on the dialyser. Taking the combined artificial kidney pipeline shown in fig. 1 as an example, in the single pre-flushing mode, the pre-flushing liquid is controlled to sequentially pass through the arterial pipeline 3, the second bypass branch 6, the hemoperfusion apparatus 1, the third bypass branch 7 and the fifth bypass branch 9 until reaching the waste liquid bag 12, so that the hemoperfusion apparatus 1 can be pre-flushed, or the pre-flushing liquid is controlled to sequentially pass through the arterial pipeline 3, the first bypass branch 5, the fourth bypass branch 8, the dialyzer 2 and the venous pipeline 4 until reaching the waste liquid bag (not shown), so that the dialyzer 2 can be pre-flushed. In the single pre-flush mode, only one of the hemodiafiltration device and the dialyzer can be pre-flushed.
After the pre-flushing is started, in the serial pre-flushing mode, the pre-flushing liquid is controlled to sequentially pass through the arterial pipeline 3, the second bypass branch 6, the blood perfusion device 1, the third bypass branch 7, the fourth bypass branch 8, the dialyzer 2 and the venous pipeline 4 until reaching a waste liquid bag. In the series pre-flush mode, the hemodiafiltration device and the dialyzer can be pre-flushed in combination by a pre-flush.
Under the independent pre-flushing mode, as only the blood perfusion device or the dialyser needs to be flushed, the liquid flow in the arterial pipeline is small relative to the serial pre-flushing mode, and for the pipeline with the same sectional area, the liquid flow is small, the liquid flow speed is correspondingly small, the time for the pre-flushing liquid to stay in the pipeline is relatively longer, the pipeline is favorably fully flushed, and the flushing effect of the blood perfusion device or the dialyser is ensured. In the series pre-flushing mode, more pre-flushing liquid is needed because the blood perfusion device and the dialyzer are required to be jointly flushed, so that the blood perfusion device and the dialyzer can be flushed simultaneously through one-time series pre-flushing, the pre-flushing efficiency is improved, and the pre-flushing time of the combined artificial kidney pipeline is saved. The liquid flow in the arterial line is used as a basis to determine a pre-flushing mode, when the liquid flow in the arterial line is greater than a preset flow value, the comparison and judgment are carried out according to the difference value between the two flow values and the preset flow difference value, when the difference value between the two flow values is smaller than the preset flow difference value, the single pre-flushing mode is selected, so that the situation that the cleaning effect cannot be ensured when the blood perfusion device and the dialyzer are subjected to combined pre-flushing is avoided, when the difference value between the two flow values reaches the preset flow value, the blood perfusion device and the dialyzer are subjected to combined pre-flushing, and therefore the pre-flushing operation of the combined artificial kidney line is simplified, and good pre-flushing effect and efficiency can be achieved.
The following is a description of one specific example of the application of the method of the invention. And determining whether to pre-flush the combined artificial kidney pipeline in an independent pre-flush mode or a series pre-flush mode according to the difference value between the liquid flow in the arterial pipeline and the preset flow value so as to conveniently take an optimal pre-flush mode for the combined artificial kidney pipeline. The preset flow value of the embodiment is 5ml/min, and the preset flow difference value is 5ml/min. When the measured liquid flow in the arterial line is 8ml/min, the liquid flow in the arterial line-preset flow value=8-5=3 ml/min, and 5ml/min >3ml/min >0, a single pre-flushing mode is adopted for the combined artificial kidney line, and the pre-flushing liquid is controlled to flow through the blood perfusion device or the dialyzer at 8ml/min, so that the pre-flushing of the combined artificial kidney line is completed.
If the measured liquid flow in the arterial line is 12ml/min, the liquid flow in the arterial line-preset flow value=12-5=7ml/min, and 7ml/min is more than 5ml/min, a serial pre-flushing mode is adopted for the combined artificial kidney line, and the pre-flushing liquid is controlled to sequentially flow through the blood perfusion device and the dialyzer at 12ml/min, so that the pre-flushing of the combined artificial kidney line is completed.
The method utilizes the pipeline structure layout characteristics of the combined artificial kidney pipeline, and flexibly sets an independent pre-flushing mode or a serial pre-flushing mode based on the liquid flow in the arterial pipeline, so that the combined artificial kidney pipeline can realize different pre-flushing functions under proper liquid flow, the operation is simple and convenient, the pre-flushing efficiency of the combined artificial kidney pipeline is improved, the safety of blood flow can be ensured by the combined artificial kidney pipeline after pre-flushing, and the treatment safety of a patient for the combined artificial kidney is improved.
As an optional implementation manner, in the tandem pre-flushing mode, the pre-flushing method further includes a pipeline blockage detection step, for judging whether the combined artificial kidney pipeline is blocked in the pre-flushing process, and the pipeline blockage detection step is as follows:
s3, detecting the liquid flow of the second bypass flow branch 6 to obtain a first detected flow;
S4, detecting the liquid flow of the venous line 4 to obtain a second detected flow;
s5, judging whether the combined artificial kidney pipeline is blocked or not according to the difference value between the first detection flow and the second detection flow.
The flow of liquid through the second bypass and venous lines may be measured using the flow sensor 14. The first detection flow represents the capacity of the pre-flushing liquid connected to the combined artificial kidney pipeline, and the second detection flow represents the capacity of the waste liquid output by the combined artificial kidney pipeline. After the pre-flushing liquid flows through each branch, the blood perfusion device and the dialyser, whether the combined artificial kidney pipeline is blocked or not can be judged according to the difference value between the first detection flow and the second detection flow. The blockage of the combined artificial kidney pipeline can be the blockage of the blood perfusion device or the dialyser, such as the blockage of the internal materials, which leads to the incapability of smooth flow of the pre-flushing liquid, or the blockage of the third bypass branch, the fourth bypass branch and other branches, such as the blockage of the branches, which leads to the incapability of smooth flow of the pre-flushing liquid, and when the blockage is judged, a fault alarm signal can be sent out to prompt related personnel to check the pipeline in time, so that the blockage reason is eliminated, and the treatment safety is ensured.
For example, if under normal conditions (i.e., when the combined artificial kidney line is not clogged), the pre-flush flow rate of the second bypass flow path 6 and the pre-flush flow rate of the venous line 4 are equal or approximately equal, for example, a difference between the liquid flow rate of the second bypass flow path 6 and the liquid flow rate of the venous line 4 is generally less than 3ml/min (a clogging judgment threshold value), and when the difference between the first detection flow rate and the second detection flow rate is greater than or equal to 3ml/min (a clogging judgment threshold value), which indicates that the liquid flow rate of the venous line 4 is significantly too small, it is judged that the combined artificial kidney line is clogged. Further, when the combined artificial kidney pipeline is judged to be blocked, a fault alarm signal is sent out to prompt a user to timely process the blocking fault of the combined artificial kidney pipeline.
As another alternative embodiment, in the tandem pre-flush mode, the pre-flush method further comprises a leakage failure detection step of the hemodiayer, and/or a leakage failure detection step of the dialyzer.
The leakage fault detection of the blood perfusion device comprises the steps of detecting the liquid flow in the second bypass flow branch 6 and the liquid flow in the third bypass flow branch 7, calculating the difference value between the two liquid flows, and considering that the blood perfusion device 1 has leakage fault when the difference value between the liquid flow in the second bypass flow branch 6 and the liquid flow in the third bypass flow branch 7 is larger than a first leakage judgment threshold value, such as 1 ml/min. When the pre-flushing liquid sequentially passes through the blood perfusion device 1 and the dialyzer 2, the liquid flow in the second bypass branch 6 represents the flow of the pre-flushing liquid which is accessed by the blood perfusion device 1, the liquid flow in the third bypass branch 7 represents the flow of the pre-flushing liquid which is output by the blood perfusion device 1, and when the liquid flow in the second bypass branch 6 is obviously larger than the liquid flow in the third bypass branch 7, the leakage fault of the blood perfusion device 1 is indicated, and whether the leakage fault of the blood perfusion device occurs due to the fact that a shell of the blood perfusion device is cracked or the pipeline connection is unstable can be checked.
The step of detecting the leakage fault of the dialyzer is to detect a difference between the fluid flow in the fourth bypass flow path 8 and the fluid flow in the venous line 4, and to consider that the dialyzer 2 has a leakage fault when the difference between the fluid flow in the fourth bypass flow path 8 and the fluid flow in the venous line 4 is larger than a second leakage judgment threshold, such as1 ml/min. The flow rate of the liquid in the fourth bypass flow branch 8 represents the flow rate of the pre-flushing liquid connected to the dialyzer 2, the flow rate of the liquid in the venous line 4 represents the flow rate of the pre-flushing liquid output by the dialyzer 2, and when the flow rate of the liquid in the fourth bypass flow branch 8 is obviously larger than the flow rate of the liquid in the venous line 4, the liquid leakage fault of the dialyzer 2 is indicated.
As yet another alternative embodiment, in the tandem pre-flush mode, the pre-flush method further comprises the steps of:
s3', recording the continuous flowing time of the pre-flushing liquid in the arterial pipeline 3;
s4', if the continuous flowing time of the pre-flushing liquid is longer than the pre-flushing stop prompt time, sending out the pre-flushing stop prompt message. The effect of the pre-flush stop message in this step is to indicate that the pre-flush process has not actually stopped.
In the tandem pre-flushing mode, the flow rate of the pre-flushing liquid in the combined artificial kidney pipeline is relatively high, the duration of liquid in the arterial pipeline 3 represents the duration of combined pre-flushing of the combined artificial kidney pipeline, and when the pre-flushing time is too long, the long-time flow of the pre-flushing liquid in the combined artificial kidney pipeline does not improve the flushing effect, only the waste of the pre-flushing liquid is caused, and the cost is increased. Therefore, the duration of the series pre-flushing mode is controlled by setting the pre-flushing stop prompt time, and the waste of pre-flushing liquid is avoided and the cost is reduced on the premise of ensuring the pre-flushing effect.
The pre-flush stop cue time may be determined by the following method:
a. Obtaining the total capacity of the combined artificial kidney pipeline according to the blood chamber capacity of the blood perfusion device and the blood chamber capacity of the dialyzer, wherein the total capacity of the combined artificial kidney pipeline is equal to the blood chamber capacity of the blood perfusion device and the blood chamber capacity of the dialyzer; the blood chamber volume of the hemodiafiltration device refers to the maximum volume of the hemodiafiltration device that can hold liquid, and the blood chamber volume of the dialyzer refers to the maximum volume of the dialyzer that can hold liquid; the blood chamber capacity of the blood perfusion device is not equal to the volume of the blood perfusion device but smaller than the volume of the blood perfusion device because the resin material (blood perfusion adsorbent) is arranged in the blood perfusion device;
b. And determining the pre-flushing stop prompting time according to the total capacity of the combined artificial kidney pipeline and the liquid flow in the arterial pipeline. The pre-flushing stop prompt time is proportional to the total capacity of the combined artificial kidney pipeline and inversely proportional to the liquid flow in the arterial pipeline, for example, when the total capacity of the combined artificial kidney pipeline is larger and the liquid flow in the arterial pipeline is smaller, the combined pre-flushing time of the blood perfusion device and the dialyzer is longer, so that the full flushing of the blood perfusion device and the dialyzer can be realized, and at the moment, the pre-flushing stop prompt time is set longer, otherwise, when the total capacity of the combined artificial kidney pipeline is smaller and the liquid flow in the arterial pipeline is larger, the combined pre-flushing time of the blood perfusion device and the dialyzer is shorter, so that the waste of pre-flushing liquid is avoided. The pre-flushing stop prompt time can be set correspondingly according to experience based on the total capacity of the combined artificial kidney pipeline and the liquid flow in the arterial pipeline, so that the pre-flushing liquid is fully utilized and the waste is reduced on the basis of ensuring the flushing effect of the blood purifier. The pre-flushing stop prompting time can be accurately and reasonably determined according to the total capacity of the combined artificial kidney pipeline and the liquid flow in the arterial pipeline.
Further, when the continuous flowing time of the pre-flushing liquid is longer than the pre-flushing stop prompting time in the series pre-flushing mode, detecting the air bubble quantity in the venous pipeline, judging whether the pre-flushing is finished or not according to the air bubble quantity in the venous pipeline, and if the pre-flushing is finished, controlling the liquid flow in the arterial pipeline to be 0, stopping the pre-flushing, so that the purpose of automatically stopping and avoiding the waste of the pre-flushing liquid under the condition that the combined artificial kidney pipeline is fully pre-flushed is achieved.
When the amount of air bubbles in the venous line is close to 0 or is 0, the line flushing is indicated to be sufficient, the flushing can be stopped, and when the amount of air bubbles is greater than 0, the line flushing is indicated to be insufficient. In a specific application, a bubble sensor 15 may be provided on the venous line. The bubble sensor converts the detected bubble quantity into voltage quantity, the voltage quantity is used for representing the bubble quantity in the venous line, if the voltage quantity output by the bubble sensor is smaller than 1V, no bubble exists in the venous line or the bubble is approximate to 0 (negligible), the combined artificial kidney line is finished in the pre-flushing process, the liquid flow in the arterial line is controlled to be 0, the pre-flushing process is stopped, and when the voltage quantity output by the bubble sensor is larger than or equal to 1V, the bubble still exists in the venous line, the pre-flushing liquid is insufficient for flushing the combined artificial kidney line, and at the moment, a user can decide whether to stop flushing or continue flushing.
Optionally, the method further comprises the step of detecting the temperature of the liquid in the arterial line during the pre-flush in the single pre-flush mode or in the serial pre-flush mode, and issuing a temperature alarm signal if the detected temperature of the liquid is less than a preset temperature.
When the combined artificial kidney pipeline is pre-flushed, the pre-flushing effect of the combined artificial kidney pipeline can be influenced by the temperature of the pre-flushing liquid in the arterial pipeline. For example, when the temperature of the pre-flush in the arterial line is too low (the temperature of the liquid is less than the preset temperature), the too low temperature liquid may not only damage the chemical properties of the resin material in the hemodiayer, but also fail to flush out the micro impurities in the hemodiayer and the micro impurities in the dialyzer. Only when the temperature of the pre-flushing liquid in the arterial line is maintained at the normal temperature (the liquid temperature is greater than or equal to the preset temperature), the liquid maintained at the normal temperature does not damage the chemical properties of the material, and the blood perfusion device and the dialyser can be fully flushed through the pre-flushing liquid. The preset temperature is an empirical value, and can be generally set to any one of 30-33 ℃ (including an endpoint value). The temperature alarm signal prompts the user to timely remove the fault with too low treatment temperature, so that insufficient pipeline pre-flushing caused by too low pre-flushing temperature can be prevented, and better pre-flushing effect and pre-flushing safety are achieved.
Optionally, in the serial pre-flushing mode, the method further comprises the steps of detecting the liquid temperature in the arterial line and detecting the liquid temperature in the venous line, comparing the difference between the liquid temperature in the arterial line and the liquid temperature in the venous line with a temperature preset difference, and adjusting the liquid flow in the arterial line according to the comparison result.
Generally, compared with the single pre-flushing mode, the flow path of the pre-flushing liquid in the combined artificial kidney pipeline in the serial pre-flushing mode is longer, the flow time is longer, and whether the liquid flow in the arterial pipeline is to be regulated or not is judged through the difference value of the liquid temperatures in the arterial pipeline and the venous pipeline. When the difference between the liquid temperature in the arterial line and the liquid temperature in the venous line is larger than the preset temperature difference, the fact that the pre-flushing liquid flows in the combined artificial kidney line for too long is indicated, the flow rate of the pre-flushing liquid in the combined artificial kidney line is too low, the phenomenon that the temperature of the pre-flushing liquid is obviously reduced in the process of flowing in the line is caused, and the liquid flow rate in the arterial line needs to be regulated. Under the condition, the flow time of the pre-flushing liquid in the combined artificial kidney pipeline is shortened by adjusting the flow rate of the liquid in the arterial pipeline, so that the temperature drop amplitude of the pre-flushing liquid in the combined artificial kidney pipeline is reduced, and the problem of low combined pre-flushing efficiency caused by too small flow rate of the liquid in the arterial pipeline is avoided. And regulating the liquid flow in the arterial pipeline so that the difference value between the liquid temperature in the arterial pipeline and the liquid temperature in the venous pipeline does not exceed the preset temperature difference value. The temperature preset difference value is an empirical value and can be summarized according to clinical application conditions.
During the pre-flushing of the combined artificial kidney line, a mode switching step may be provided, such as switching from a separate pre-flushing mode to a serial pre-flushing mode, or switching from a serial pre-flushing mode to a separate pre-flushing mode. When the single pre-flushing mode is switched to the series pre-flushing mode, the liquid flow in the arterial line is regulated to be higher than the preset flow difference value, so that the difference value between the liquid flow in the arterial line and the preset flow value reaches the preset flow difference value (the liquid flow in the arterial line-the preset flow value is larger than or equal to the preset flow difference value), the combined artificial kidney line is convenient to continue to perform pre-flushing in the series pre-flushing mode, and when the single pre-flushing mode is switched to the series pre-flushing mode, the liquid flow in the arterial line is regulated to be lower than the preset flow difference value, so that the difference value between the liquid flow in the arterial line and the preset flow value is smaller than the preset flow difference value, and the combined artificial kidney line is convenient to continue to perform pre-flushing in the single pre-flushing mode. The mode is switched, so that the requirements of practical application are met.
Further, when the combined artificial kidney pipeline is switched from the serial pre-flushing mode to the single pre-flushing mode, the method further comprises the steps of comparing the blood chamber capacity of the blood perfusion device with the blood chamber capacity of the dialyzer, controlling the pre-flushing liquid to sequentially pass through the arterial pipeline, the second bypass branch, the blood perfusion device, the third bypass branch and the fifth bypass branch until the waste liquid bag is formed, and performing single pre-flushing on the blood perfusion device, and controlling the pre-flushing liquid to sequentially pass through the arterial pipeline, the first bypass branch, the fourth bypass branch, the dialyzer and the venous pipeline until the waste liquid bag is formed, if the blood chamber capacity of the blood perfusion device is smaller than or equal to the blood chamber capacity of the dialyzer, and performing single pre-flushing on the dialyzer.
Under the serial pre-flushing mode, the pre-flushing liquid is flushed through the blood perfusion device and the dialyzer in sequence, and the pre-flushing effect is slightly poorer than that of the blood perfusion device and the dialyzer with larger blood chamber capacity, so that the pre-flushing effect of the blood perfusion device and the dialyzer is judged according to the blood chamber capacity of the blood perfusion device and the dialyzer, and the blood perfusion device and the dialyzer are pre-flushed after being switched to the independent pre-flushing mode, so that the blood purifier can obtain a good flushing effect. For example, when the blood chamber volume of the hemodiafiltration device is greater than the blood chamber volume of the dialyzer, it is stated that the hemodiafiltration device requires more pre-flush (greater pre-flush volume) than the dialyzer, and therefore, only the hemodiafiltration device is flushed separately after switching to the single pre-flush mode, and similarly, when the blood chamber volume of the hemodiafiltration device is less than or equal to the blood chamber volume of the dialyzer, it is stated that the dialyzer requires more pre-flush than the hemodiafiltration device, and therefore, only the dialyzer is flushed separately after switching to the single pre-flush mode. By comparing the volume of the blood chamber of the hemodiafiltration device with the volume of the blood chamber of the dialyzer, the hemodiafiltration device and the dialyzer can be fully pre-flushed, and waste of pre-flushing liquid can be avoided.
In some embodiments, the pre-flush method of the present invention further comprises a cyclic pre-flush mode for performing a separate cyclic pre-flush of the hemodiayer. In the clinical application process of the combined artificial kidney pipeline, the blood perfusion device may need to be replaced, when the blood perfusion device needs to be pre-washed after being replaced, the blood perfusion device can be pre-washed through a circulating pre-washing mode, the pre-washing liquid is controlled to circularly flow in a loop formed by the first bypass branch, the second bypass branch, the blood perfusion device and the third bypass branch under the circulating pre-washing mode, so that the blood perfusion device is fully washed, and the circulating pre-washing mode can also avoid waste of the pre-washing liquid, thereby being beneficial to improving the efficiency of independently pre-washing the blood perfusion device.
The previous description of the disclosed embodiments is provided to enable any person skilled in the art to make or use the present invention. Various modifications to these embodiments will be readily apparent to those skilled in the art, and the generic principles defined herein may be applied to other embodiments without departing from the spirit or scope of the invention. Thus, the present invention is not intended to be limited to the embodiments shown herein but is to be accorded the widest scope consistent with the principles and novel features disclosed herein.
Claims (10)
1. The combined artificial kidney pipeline is characterized by comprising a blood perfusion device, a dialyzer, an arterial pipeline and a venous pipeline, wherein the second end of the arterial pipeline is connected with a first bypass branch and a second bypass branch through a first connector, the second bypass branch is sequentially connected with the blood perfusion device and a third bypass branch, the first bypass branch is sequentially connected with the third bypass branch and a fourth bypass branch through a second connector, the fourth bypass branch is sequentially connected with the dialyzer and the venous pipeline, and a fifth bypass branch is connected to the third bypass branch;
The pre-flushing method comprises the following steps:
S1, accessing pre-flushing liquid from a first end of the arterial pipeline, and detecting the liquid flow in the arterial pipeline;
S2, calculating a difference value between the liquid flow in the arterial line and a preset flow value, if the difference value between the liquid flow in the arterial line and the preset flow value is larger than 0 and smaller than the preset flow difference value, pre-flushing the combined artificial kidney line by adopting a single pre-flushing mode, and if the difference value between the liquid flow in the arterial line and the preset flow value is larger than or equal to the preset flow difference value, pre-flushing the combined artificial kidney line by adopting a series pre-flushing mode;
Under the independent pre-flushing mode, controlling the pre-flushing liquid to sequentially pass through the arterial pipeline, the second bypass branch, the blood perfusion device, the third bypass branch and the fifth bypass branch until a waste liquid bag is formed, and pre-flushing the blood perfusion device, or controlling the pre-flushing liquid to sequentially pass through the arterial pipeline, the first bypass branch, the fourth bypass branch, the dialyzer and the venous pipeline until a waste liquid bag is formed, and pre-flushing the dialyzer;
and under the serial pre-flushing mode, controlling the pre-flushing liquid to sequentially pass through the arterial pipeline, the second bypass branch, the blood perfusion device, the third bypass branch, the fourth bypass branch, the dialyzer and the venous pipeline until reaching a waste liquid bag, and carrying out combined pre-flushing on the blood perfusion device and the dialyzer.
2. The method for pre-flushing a combined artificial kidney according to claim 1, further comprising a line blockage detecting step of, when the pre-flushing is performed in the tandem pre-flushing mode:
s3, detecting the liquid flow of the second bypass flow branch to obtain a first detected flow;
S4, detecting the liquid flow of the venous pipeline to obtain a second detection flow;
s5, judging whether the combined artificial kidney pipeline is blocked or not according to the difference value between the first detection flow and the second detection flow.
3. The method for pre-flushing a combined artificial kidney according to claim 1, further comprising a leakage failure detection step of the hemodynamic tank and/or a leakage failure detection step of the dialyzer when the pre-flushing is performed in the serial pre-flushing mode.
Detecting the liquid flow in the second bypass flow branch and the liquid flow in the third bypass flow branch, calculating the difference value of the liquid flow in the second bypass flow branch and the liquid flow in the third bypass flow branch, and considering that the liquid leakage fault occurs in the blood perfusion device when the difference value of the liquid flow in the second bypass flow branch and the liquid flow in the third bypass flow branch is larger than a first liquid leakage judgment threshold value;
the liquid leakage fault detection of the dialyzer comprises the steps of detecting the liquid flow in the fourth bypass branch and the liquid flow in the venous pipeline, calculating the difference value between the liquid flow in the fourth bypass branch and the liquid flow in the venous pipeline, and considering that the dialyzer has a liquid leakage fault when the difference value between the liquid flow in the fourth bypass branch and the liquid flow in the venous pipeline is larger than a second liquid leakage judgment threshold value.
4. The method for pre-flushing a combined artificial kidney according to claim 1, wherein the pre-flushing is performed in the serial pre-flushing mode, further comprising the steps of:
s3', recording the continuous flowing time of the pre-flushing liquid in the arterial pipeline;
s4', if the continuous flowing time of the pre-flushing liquid in the arterial line is longer than the pre-flushing stop prompt time, sending out the pre-flushing stop prompt message;
the pre-flush stop prompting time is determined by the following method:
a. Calculating the total capacity of the combined artificial kidney pipeline according to the blood chamber capacity of the blood perfusion device and the blood chamber capacity of the dialyser, wherein the total capacity of the combined artificial kidney pipeline is equal to the blood chamber capacity of the blood perfusion device and the blood chamber capacity of the dialyser;
b. And determining the pre-flushing stop prompting time according to the total capacity of the combined artificial kidney pipeline and the liquid flow in the arterial pipeline.
5. The method for pre-flushing a combined artificial kidney according to claim 4, wherein when the duration of the continuous flow of the pre-flushing liquid in the arterial line is longer than the pre-flushing stop prompting time, the amount of air bubbles in the venous line is detected, and if no air bubbles are present in the venous line, the pre-flushing is stopped.
6. A combined artificial kidney line pre-flushing method according to claim 1, wherein the temperature of the fluid in the arterial line is detected when the pre-flushing is performed in the serial pre-flushing mode or the pre-flushing is performed in the separate pre-flushing mode, and a temperature alarm signal is issued if the detected temperature of the fluid in the arterial line is less than a preset temperature.
7. The method for pre-flushing a combined artificial kidney according to claim 1, wherein when the pre-flushing is performed in the serial pre-flushing mode, the liquid temperature in the arterial line and the liquid temperature in the venous line are detected, a difference between the liquid temperature in the arterial line and the liquid temperature in the venous line is compared with a temperature preset difference, and if the difference between the liquid temperature in the arterial line and the liquid temperature in the venous line is greater than the temperature preset difference, the liquid flow rate in the arterial line is increased.
8. The method for pre-flushing a combined artificial kidney according to claim 1, further comprising a mode switching step of:
When the single pre-flushing mode is switched to the series pre-flushing mode, the liquid flow in the arterial line is regulated to ensure that the difference value between the liquid flow in the arterial line and the preset flow value reaches the preset flow difference value;
When the serial pre-flushing mode is switched to the independent pre-flushing mode, the liquid flow in the arterial line is regulated down so that the difference between the liquid flow in the arterial line and the preset flow value is smaller than the preset flow difference.
9. The method for pre-flushing a combined artificial kidney according to claim 8, wherein when the serial pre-flushing mode is switched to the single pre-flushing mode, comparing the blood chamber capacities of the blood perfusion unit and the dialyzer, and if the blood chamber capacity of the blood perfusion unit is greater than the blood chamber capacity of the dialyzer, controlling the pre-flushing liquid to sequentially pass through the arterial line, the second bypass branch, the blood perfusion unit, the third bypass branch and the fifth bypass branch until reaching a waste liquid bag, and pre-flushing the blood perfusion unit;
And if the blood chamber capacity of the blood perfusion device is smaller than or equal to the blood chamber capacity of the dialyzer, controlling the pre-flushing liquid to sequentially pass through the arterial pipeline, the first bypass branch, the fourth bypass branch, the dialyzer and the venous pipeline until reaching a waste liquid bag, and pre-flushing the dialyzer.
10. The method for pre-flushing a combined artificial kidney according to claim 1, further comprising a circulating pre-flushing mode in which the pre-flushing fluid is controlled to circulate in a circuit formed by the first bypass line, the second bypass line, the blood perfusion device and the third bypass line.
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| CN114404703A (en) * | 2021-12-21 | 2022-04-29 | 健帆生物科技集团股份有限公司 | Combined artificial kidney and its precharging method and working method |
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| JP5125013B2 (en) * | 2006-07-25 | 2013-01-23 | ニプロ株式会社 | Method for detecting occurrence of trouble causing poor blood removal and hemodialysis apparatus |
| CN205215829U (en) * | 2015-10-30 | 2016-05-11 | 珠海健帆生物科技股份有限公司 | Combined artificial kidney pipeline of annular closed type |
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| CN114191633A (en) * | 2021-12-22 | 2022-03-18 | 健帆生物科技集团股份有限公司 | Control method, system and storage medium for dual plasma molecular adsorption system |
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