Haemodialysis control unit
This utility model relates to a kind of medical apparatus and instruments, a kind of in more detail sick haemodialysis control units such as the acute and chronic renal failure of treatment, uremia, multiple organ failure, MOF, severe poisonous substance and drug intoxication that are applicable to.
Haemodialysis control unit is the dialyser that blood is made by a kind of semipermeable membrane that can only allow small-molecule substance (as electrolyte, micromolecule kidney toxin) pass through, make the side of blood at film, dialysis solution is at the opposite side of film, the solution of both sides is by disperse, osmosis, be that solute is by the high low side flow of a side direction concentration of concentration, allow the micromolecule kidney toxin in the blood may penetrate in the dialysis solution, electrolyte also can reach balance by osmosis, thereby reaches the therapy equipment of blood purification purpose.
Haemodialysis control unit commonly used at present mainly is the import type, has following shortcoming: 1, cost an arm and a leg; 2, must use gravity and pressure transducer and electronic equilibrium to claim device to finish ultrafiltration; 3, machine construction complexity, operation are tired of lock, easy break-down, maintenance difficult, are difficult to ensure safety, the reliability and stability of machine performance.
China utility model patent 96233248.x discloses a kind of unidirectional circulating haemodialysis control unit, attempts to overcome above-mentioned some shortcoming.Fig. 1 is the structural representation of this haemodialysis control unit, and as shown in the figure, this haemodialysis control unit mainly is made of dialysis fluid circuit 1, dialyser 2, blood circuit 3; The dialyser upper end is dialysis solution inlet and blood outlet, and the lower end is dialysis solution outlet and blood inlet; Dialysis fluid circuit 1 is made of dialyser 2, high-order liquid bag 1 (1), flow plug 1 (2), blood leakage monitor 1 (3), low level liquid bag 1 (4), liquid pump 1 (5) and dialysis solution pipe 1 (6); Blood circuit 3 is made of dialyser 2, anticoagulant injection device 3 (1), blood pump 3 (2), venous pressure monitor 3 (3), bubble trap 3 (4), bubble monitor 3 (5), choked flow folder 3 (6), blood tube 3 (7).Gravity and pressure transducer 4 are installed in high and low position liquid bag 1 (1) and 1 (4) bottom, and the installation of liquid bag side is heated and temperature measuring set 5.The operation principle and the structure of this haemodialysis control unit are as follows:
Dialysis fluid circuit 1: the dialysis solution in the high-order liquid bag 1 (1) is because action of gravity enters dialyser 2 by flow plug 1 (2) control flow, dialysis solution displaces the toxin in the blood, and the dialysis solution that contains toxin passes through blood leakage monitor 1 (3) back from low level liquid bag 1 (4) top influent bag; Liquid pump 1 (5) is evacuated to high-order liquid bag 1 (1) with the dialysis solution of low level liquid bag 1 (4) bottom, so moves in circles and carries out blood dialysis.
Blood circuit 3: blood enters from the inlet in loop, after injecting anticoagulant, the anticoagulant injection device is evacuated to dialyser 2 by blood pump 3 (2), dialysis solution displaces blood behind the toxin in the blood from dialyser 2 outputs, behind venous pressure monitor 3 (3), bubble trap 3 (4), bubble monitor 3 (5), flow to the blood vessel outlet by choked flow folder 3 (6).
Gravity and pressure transducer 4 are measured important parameters such as dialysis flow, ultrafiltration volume by measuring the volume or weight variation of dialysis solution in the high and low liquid bag 1 (1), 1 (4) in the dialysis procedure, according to parameter dialysis procedure are adjusted.When dialysis solution consumption, ultrafiltration volume hit the target, can finish dialysis.
There is following shortcoming in this haemodialysis control unit:
1, claiming device to measure in the liquid bag dialysis solution weight and volume by traditional gravity and pressure transducer and electronic equilibrium in the dialysis procedure changes to adjust ultrasiltrated rate and ultrafiltration volume and finishes ultrafiltration work, cause the hemo system complex structure, easy break-down;
2, contain the dialysis solution of toxin and clean dialysis solution mixes repeated use after the displacement, influence dialysis-effect; And the dialysis solution repetitive cycling must suspend dialysis when using certain number of times, changes clean liquid bag, restarts dialysis then, and operation inconvenience in addition, because blood in extracorporeal circulation, is shut down when changing the liquid bag, can cause patient's life danger;
3, before the dialysis liquid bag to place machine to need etc. to be heated, middle when changing the liquid bag, need the liquid bag is heated earlier machine outside, operate loaded down with trivial details;
4, must use blood leakage monitor monitoring dialyser to have or not leakage blood, cause the hemo system complex structure, easy break-down;
5, so big dialyzate bag is all having sizable difficulty aspect storage, packing, the transportation, causes this machine to be difficult to apply.
The purpose of this utility model is the defective at the prior art existence; a kind of haemodialysis control unit is provided; use ultrafiltrate pump to realize control to ultrafiltration volume etc.; in dialysis procedure, only use clean dialysis solution; the dialysis solution that contains toxin after need not replacing; avoid shutting down and change the liquid bag, the simplified apparatus structure improves the handling safety reliability greatly.
Haemodialysis control unit of the present utility model mainly is made of dialysis fluid circuit, dialyser, blood circuit; The dialyser upper end is dialysis solution inlet and blood outlet, and the lower end is dialysis solution outlet and blood inlet; Blood circuit is made of dialyser, anticoagulant injection device, blood pump, venous pressure monitor, bubble trap, bubble monitor, choked flow folder, blood tube; Characteristics are that dialysis fluid circuit is made of dialyser, dialysis fluid container, dialysis hydraulic pressure detector, air monitor, dialysis solution voltage regulator, dialysis liquid pump, ultrafiltrate pump, ultrafiltrate vessel, dialysis solution pipe; Ultrafiltrate pump is installed on the arm that dialysis fluid circuit tells, this arm can be arranged on any position of dialysis fluid circuit, for example be arranged on the dialysis solution pipe before dialysis solution enters dialyser, perhaps be arranged on the dialysis solution pipe before dialysis solution flows into dialysis fluid container, perhaps be arranged on the dialysis fluid container, wherein, it is best to be arranged on the dialysis solution pipe before dialysis solution flows into dialysis fluid container effect.
This utility model is told arm in dialysis fluid circuit, ultrafiltrate pump is installed, and purpose is to replace gravity, pressure transducer and electronic equilibrium to claim.
The ultrafiltrate pump that this utility model is installed, its structure is identical with conventional blood pump with operation principle, by roller squeezed fluid pipe, liquid is extracted out.The operation principle of ultrafiltrate pump is under the changeless condition of dialysis solution capacity, and the liquid of extracting out through ultrafiltrate pump is the amount of liquid deviate from the patient body.Therefore, need to use one to have the liquid that the ultrafiltration of graduated ultrafiltrate vessel dress goes out, how many amount of liquid that ultrafiltration goes out has, at any time as can be known, and accurately and reliably; For this reason, require to use the constant dialysis fluid container of capacity in dialysis procedure, promptly in dialysis procedure, the capacity of container or shape do not change because of dialysate pressure changes.
The inventor is through exploration discovery, but when ultrafiltrate pump Extract scale of construction adjustable extent is 0-2000ml/ hour, is convenient to clinical use.
The dialysis fluid container that this utility model uses can be made by transparent, hard medical material, as can be the medical plastic etc. of medical glass, medical quartz glass, hard.The capacity of dialysis fluid container is that 20-100 is suitable for clinical use when rising.
Used dialysis solution can avoid dialysis solution to reuse when the bottom of dialysis solution enters container.Because colourless clean dialysis solution is evacuated to dialyser by the upper end open of container, the used dialysis solution that contains various solutes enters container from the dialysis fluid container bottom, because action of gravity, below the used dialysis solution (being faint yellow) that contains various solutes sinks to, make to form a demarcation line between clean dialysis solution and the used dialysis solution, be in different aspects, clean dialysis solution is on the upper strata, used dialysis solution has been avoided the dialysis solution repeated use in lower floor.For this reason, can with the dialysis solution pipe that flows into dialysis fluid container from container end opening be inserted into container bottom, the opening of dialysis solution pipe bottom dialysis fluid container that perhaps will flow into dialysis fluid container is connected, and makes dialysis solution enter the bottom of container from outside of containers.
For the ease of the dialysis fluid container sterilization, can in container, insert an isolated tube, can insert the sterilization pipe in the isolated tube.Isolated tube can be by the material that can see through the sterilization ray, for example material such as quartz glass, fiberglass; The sterilization pipe can be ultraviolet tube, gamma-rays pipe etc.
This utility model can place the dialysis fluid container that is heated to predetermined temperature in the attemperator, perhaps directly makes dialysis fluid container with insulation material, makes the temperature constant of liquid in the dialysis fluid container, need heater be set in the dialysis fluid container side.Attemperator can use thermals source such as heater strip, infrared ray light pipe, electric filament lamp.
Because the coefficient of expansion of liquid is minimum, can ignore, the coefficient of expansion of air is big, so require no air in the whole dialysis fluid circuit, is a closed system, so this utility model is equipped with air monitor on dialysis fluid circuit.
For the simplified apparatus structure, increase security reliability, whole dialysis fluid circuit of the present utility model can adopt transparent material to make, and can not need to leak the blood monitoring system like this.
Work process of the present utility model is as follows:
Blood circuit: the patients'blood delivery outlet is connected in the tremulous pulse pipe end of blood tube, after the anticoagulant injection device injects anticoagulant, input to dialyser by blood pump, toxin in the blood is displaced in the dialysis solution, clean blood is exported from dialyser, through venous pressure monitor, bubble monitor, bubble trap, choked flow folder, flow to the vein pipe end of blood tube, fail back in the patient body again.
Dialysis fluid circuit: dialysis solution is from the upper end open output of dialysis fluid container, behind dialysis hydraulic pressure monitor, air monitor, dialysis solution voltage regulator, enter dialyser, toxin in the blood is displaced in the dialysis solution, the dialysis solution that the contains toxin liquid pump of being dialysed is extracted dialyser out, flow into the dialysis fluid container bottom, the ultrafiltrate pump on the arm of dialysis fluid circuit is extracted liquid out and is loaded in the ultrafiltrate vessel, the dehydrating amount that this liquid should be patient when carrying out dialysis treatment.
As required the dialysis treatment time, regulate dialysate flow by the dialysis liquid pump, the dialysate flow adjustable extent is more suitable when being 50ml-500ml/ minute.It is more suitable to make the dialysis solution negative pressure remain on the 0-450mmHg scope by the dialysis solution voltage regulator.Ultrafiltrate pump scalable ultrafiltration volume scope 0-2000ml/ hour is more suitable, and ultrasiltrated rate is adjustable at any time, and the liquid that ultrafiltration goes out is packed into and had in the graduated ultrafiltrate vessel, the amount of liquid that ultrafiltration goes out what, at any time as can be known, the liquid measure that ultrafiltration goes out should be patient's dehydrating amount.Here the scale of indication can be weight scale or volume markings.
When dialysis time, ultrafiltration volume, dialysis solution consumption hit the target, can finish dialysis treatment.
Dialysis solution or displacement liquid flow adjustable extent are defined as 50ml-500ml/ minute, mainly are the flows of selecting dialysis solution according to different dialysis process (hemodialysis, blood filter) and time (30 minutes to 7 hours), to reach the purpose that makes full use of dialysis solution.Therefore, this utility model also can be used for doing plasmapheresis and hemoperfusion.
This utility model compared with prior art has following advantage:
1, the use ultrafiltrate pump is realized the control to ultrasiltrated rate, ultrafiltration pressure, ultrafiltration volume etc., and the simplified apparatus structure increases security reliability greatly.
2, only use clean dialysis solution in dialysis procedure, contain the dialysis solution of toxin after need not replacing, avoid shutting down and change the liquid bag, handling safety is reliable.
3, its whole dialysis solution system adopts transparent material to make, and does not need to leak the blood monitoring system, and the simplified apparatus structure increases security reliability greatly.
4, avoid using dialyzate bag that big liquid bag caused heat, store, pack, difficulty aspect the transportation and the existing type that caused be in the difficulty aspect applying.
5, dialysis hydraulic pressure monitor, dialysis solution voltage regulator and ultrafiltrate pump three combined effect make dialysate pressure and flow velocity all can be adjusted to appropriate state when doing hemodialysis the required concrete time, make hemodialysis reach optimum efficiency.
Fig. 2 is the structural representation of this utility model haemodialysis control unit.
Below by embodiment and accompanying drawing this utility model is described further.
Embodiment
As shown in Figure 2, haemodialysis control unit of the present utility model is made of dialysis fluid circuit 1, dialyser 2, blood circuit 3; Dialyser 2 upper ends are dialysis solution inlet and blood outlet, and the lower end is the inlet of dialysis solution outlet and blood; Blood circuit 3 is made of dialyser 2, anticoagulant injection device 3 (1), blood pump 3 (2), venous pressure monitor 3 (3), bubble trap 3 (4), bubble monitor 3 (5), choked flow folder 3 (6), blood tube 3 (7); Its characteristics are that dialysis fluid circuit 1 is made of dialyser 2, dialysis fluid container 1 (7), dialysis hydraulic pressure detector 1 (8), air monitor 1 (9), dialysis solution voltage regulator 1 (10), liquid pump 1 (5), ultrafiltrate pump 1 (11), ultrafiltrate vessel 1 (12), dialysis solution pipe 1 (6); Ultrafiltrate pump 1 (11) is installed in dialysis solution and flows on the arm 1 (13) that dialysis fluid container 1 (7) preceding dialysis solution pipe tells.
Among Fig. 2, the dialysis solution pipe 1 (6) of inflow dialysis fluid container 1 (7) end entrance from container is inserted into the dialysis fluid container bottom.In dialysis fluid container, insert quartz glass isolated tube 6, insert ultraviolet tube 7 in the isolated tube.It is in the attemperator 8 of thermal source that dialysis fluid container 1 (7) places with the infrared light,
Haemodialysis control unit work process of the present utility model is as follows:
Blood circuit: the patients'blood delivery outlet is connected in the tremulous pulse pipe end of blood tube 3 (7), after anticoagulant injection device 3 (1) injects anticoagulant, input to dialyser 2 by blood pump 3 (2), toxin in the blood is displaced in the dialysis solution, clean blood is from dialyser 2 outputs, process venous pressure monitor 3 (3), bubble trap 3 (4), bubble monitor 3 (5), choked flow are pressed from both sides 3 (6), are flow to the vein pipe end of blood tube 3 (7), fail back in the patient body again.
Dialysis fluid circuit: dialysis solution is from the upper end open output of dialysis fluid container 1 (7), behind dialysis hydraulic pressure monitor 1 (8), air monitor 1 (9), dialysis solution voltage regulator 1 (10), enter dialyser 2, toxin in the blood is displaced in the dialysis solution, the dialysis solution that the contains toxin liquid pump 1 (5) of being dialysed is extracted dialyser 2 out, flow into dialysis fluid container 1 (7) bottom, ultrafiltrate pump 1 (11) is extracted liquid out and is loaded in the ultrafiltrate vessel 1 (12) dehydrating amount when this liquid carries out dialysis treatment for patient.
As required the dialysis treatment time, regulate dialysate flow by the dialysis liquid pump, the dialysate flow adjustable extent is 50ml-500ml/ minute.Make the dialysis solution negative pressure remain on normal range by dialysis solution voltage regulator and dialysis hydraulic controller.Ultrafiltrate pump scalable ultrafiltration volume scope 0-2000ml/ hour, ultrasiltrated rate is adjustable at any time, and the liquid that ultrafiltration goes out is loaded on and has in the graduated ultrafiltrate vessel, and the amount of liquid that ultrafiltration goes out is how much, and at any time as can be known, this liquid measure that exceeds is patient's dehydrating amount.When dialysis time, ultrafiltration volume, dialysis solution consumption hit the target, can finish dialysis treatment.