JP2004313522A - Dialysis machine - Google Patents

Abstract

The present invention can be applied to a blood purifier having a blood purification membrane having a low UFR and a low membrane strength, and avoids reconnection of piping in a series of operations such as priming, dialysis treatment and blood return, thereby improving workability. Provided is a dialysis device that can prevent bacteria and the like from entering a blood circuit while improving the dialysis device.
The dialysis apparatus includes an arterial blood circuit (2) provided with a blood pump (8), a venous blood circuit (3), a dialysate introduction line (L1), a dialysate discharge line (L2), and a pump (5). A fluid feed line L3 that allows the dialysate flowing through the dialysate introduction line L1 to flow to the arterial blood circuit 2, and a clamp 7 that can block or open the flow of the dialysate through the fluid feed line L3. The direction and flow rate of the dialysate flowing from the liquid supply line L3 to the arterial blood circuit 2 or the venous blood circuit 3 can be adjusted by the blood pump 8.
[Selection diagram] Fig. 1

Description

[0001]
TECHNICAL FIELD OF THE INVENTION
TECHNICAL FIELD The present invention relates to a dialysis device for performing dialysis with a blood purifier connected to a blood circuit.
[0002]
[Prior art]
Generally, a dialysis device used for dialysis treatment supplies a dialysate to a dialyzer connected to a blood circuit, and a dialysate introduction line and a dialysate discharge line to discharge dialysate containing waste products from the dialyzer by dialysis. The line has been extended. The ends of the dialysate introduction line and the dialysate discharge line are connected to the dialysate inlet and the dialysate outlet of the dialyzer, respectively, to supply and discharge the dialysate.
[0003]
Since the blood purifier and the blood circuit before being used for hemodialysis as described above contain air or filled sterile water or the like, a blood circuit is used as a pretreatment to remove the air or sterile water. It was necessary to perform priming by flowing a saline solution into the inside. Further, after the dialysis treatment, in order to return the blood remaining in the blood circuit to the patient, physiological saline is flown into the blood circuit as post-processing, and blood is returned to replace the remaining blood with the physiological saline. Needed.
[0004]
By the way, recently, there has been proposed a technique for performing the priming and the blood return using a dialysate to be supplied to a dialyzer during dialysis treatment. For example, in Patent Document 1, after connecting the tip of the arterial blood circuit and the tip of the venous blood circuit, a dialysate is supplied to the dialyzer, and the dialysate obtained by back-filtering the dialysis membrane flows into the blood circuit. Priming is performed by discharging from an overflow tube connected to a drip chamber (this technique is referred to as a first conventional example).
[0005]
Further, in Patent Document 2, after connecting the tip of the arterial blood circuit to the venous blood circuit, a dialysate is supplied to the dialyzer, and the dialysate obtained by back-filtering the dialysis membrane and the blood remaining in the blood circuit are combined with the dialysate. And the remaining blood is returned to the patient's body from the tip of the venous blood circuit (this technique is referred to as a second conventional example).
[0006]
In the case where a blood purifier is applied to hemodiafiltration (HDF) and a dialysate is used as a replacement fluid (hereinafter referred to as online HDF), the dialysate is replaced with the blood of the patient only by removing water. There is a need to. Therefore, as shown in FIG. 8, a dialyzer 101, a blood circuit including an arterial blood circuit 102 and a venous blood circuit 103 provided with a blood pump 104, and a dialysate supplied from a pump 105 are introduced into the dialyzer 101. A dialysate introduction line L1 to be discharged, a dialysate discharge line L2 for discharging dialysate from the dialyzer 101, a bypass line L4 connecting the dialysate introduction line L1 and the dialysate discharge line L2 without passing through the dialyzer 101, and a replacement fluid. There is also a dialysis device having a replacement fluid line L3 to be used in such a case (this technique is referred to as a third conventional example).
[0007]
Such an online HDF dialysis apparatus removes a predetermined amount of water from blood when performing dialysis treatment (filtration), and supplies a dialysate from the replacement fluid line L3 to replace the water in the blood with the dialysate. It has a rehydration pump 106 for controlling the flow rate of the rehydration line L3 during rehydration. In the figure, reference numerals 109 and 110 indicate filtration filters for filtering and purifying the dialysate flowing through the dialysate introduction line L1, and reference numerals 104 and V indicate a blood pump and an electromagnetic valve, respectively. I have. Drip chambers D1 and D2 are connected to the arterial blood circuit 102 and the venous blood circuit 103, respectively.
[0008]
Then, the proximal end of the rehydration line L3 is connected to one T-shaped tube 107 of the bypass line L4, and the distal end of the rehydration line L3 is connected to the distal end of a tube C extending from the drip chamber D1 of the arterial blood circuit 102. Thus, the dialysis treatment was performed while the dialysate was replaced (pre-replacement) with the drip chamber D1 by an amount of water to be filtered. In some cases, a tube is extended from the drip chamber D2, and the distal end of the tube is connected to the distal end of the rehydration line L3 to perform rehydration (post-rehydration).
[0009]
In order to perform priming using such a dialysis device, as shown in FIG. 9, the distal end of the rehydration line L3 is connected to the distal end of the arterial blood circuit 102 (of course, the connector before the arterial puncture needle is attached), and the vein is connected. The tip of the side blood circuit 103 is connected to the other T-tube 108 provided on the bypass line L4. Note that the electromagnetic valve V is closed.
[0010]
Thereafter, when the dialysate is supplied to the dialysate introduction line L1 by driving the pump 105, a part of the dialysate reaches the arterial blood circuit 102 through the bypass line L4 and the replacement fluid line L3, and the inside of the hollow fiber membrane of the dialyzer 101 is removed. After passing through, it flows from the venous blood circuit 103 to the dialysate discharge line L2. In order to supply the dialysate to the replacement fluid line L3 and the blood circuit side, it is necessary to rotate the replacement fluid pump 106 and the blood pump 104 forward. The other dialysate supplied to the dialysate introduction line L1 passes through the same route as during the dialysis treatment, that is, from the dialysate introduction line L1 to the outside of the hollow fiber membrane of the dialyzer 101, and then to the dialysate discharge line L2. .
[0011]
On the other hand, to perform blood return after dialysis treatment, as shown in FIG. 10, the distal end of the rehydration line L3 is connected to the distal end of the arterial blood circuit 102 while the puncture needle at the distal end of the venous blood circuit 103 is punctured by the patient. As in the case of priming, the puncture needle is connected to the connector after removing the arterial puncture needle, and the dialysate is supplied from the pump 105. As a result, the blood remaining in the blood circuit is replaced with the dialysate, and the remaining blood can be returned to the patient from the venous puncture needle. It should be noted that the rehydration pump 106 and the blood pump 104 need to be normally rotated even at the time of blood return.
[0012]
[Patent Document 1]
JP 2001-245970 A
[Patent Document 2]
JP 2001-252352 A
[0013]
[Problems to be solved by the invention]
However, in the dialysis apparatus according to the first conventional example and the second conventional example, at the time of priming or blood return, the dialysate is supplied outside the hollow fiber membrane of the dialyzer and back-filtered to the blood circuit side. However, there is a problem that the hollow fiber membrane can be applied only to the one that can withstand the pressure feeding of the dialysate, and the applicable range is significantly limited. That is, a dialyzer provided with a hollow fiber membrane having a low UFR (ultrafiltration rate) and a low membrane elasticity cannot withstand the high pressure applied at the time of back-filtration of the dialysate, and collapses to block the flow path. Therefore, the above-mentioned conventional method cannot be applied.
[0014]
Further, the dialysis device according to the third conventional example has a wide application range since the dialyzer does not have a reverse filtration action on the hollow fiber membrane at the time of priming and blood return, but has the following problems. That is, in a series of operations such as priming, dialysis treatment, and blood return, it is necessary to change the connection of the pipe such as the replacement fluid line L3, and the work is complicated, and bacteria are mixed into the pipe when the connection is changed. As a result, there is a risk of reaching the blood circuit.
[0015]
The present invention has been made in view of such circumstances, and can be applied to a blood purifier having a blood purification membrane having a low UFR and a low membrane elasticity, and a series of priming, dialysis treatment, and blood return. It is an object of the present invention to provide a dialysis apparatus capable of avoiding connection of pipes in a work and improving workability while preventing bacteria and the like from entering a blood circuit.
[0016]
[Means for Solving the Problems]
According to the first aspect of the present invention, a blood purification membrane is provided, a blood inlet for introducing blood and a blood outlet for introducing the introduced blood are formed, and a dialysate inlet for introducing a dialysate and the dialysate are introduced. A dialysate outlet for discharging dialysate is formed, and a blood purifier that performs a dialysis purification action by contacting the dialysate with the blood via the blood purification membrane, and one end is provided at a blood inlet of the blood purifier. Connected to the arterial blood circuit in which a blood pump is disposed in the middle thereof, one end connected to the venous blood circuit connected to the blood outlet of the blood purifier, and connected to the dialysate inlet of the blood purifier. A dialysate introduction line for introducing a dialysate into the blood purifier, and a dialysate discharge line connected to a dialysate outlet of the blood purifier and discharging dialysate from the blood purifier. Introduce dialysate into the dialysate And a supply means for supplying the dialysate introduction line or the dialysate discharge line to the arterial blood circuit or the venous blood circuit, and connecting the dialysate introduction line or the venous blood circuit to the dialysate introduction line or the venous blood circuit. A blood supply line that allows the dialysate flowing through the line to flow into the arterial blood circuit or the venous blood circuit; and a flow regulating unit that can block or open the flow of the dialysate through the liquid supply line, and A pump is capable of adjusting the flow direction and flow rate of the dialysate flowing from the liquid feed line to the arterial blood circuit or the venous blood circuit.
[0017]
According to a second aspect of the present invention, in the dialysis apparatus according to the first aspect, the blood purifier is applied to hemodialysis, and the liquid sending line is a line for performing replacement fluid only during an emergency during dialysis treatment. It is characterized by being.
[0018]
According to a third aspect of the present invention, in the dialysis apparatus according to the second aspect, a filtration filter for filtering and purifying the dialysate flowing through the liquid sending line is connected in the middle of the liquid sending line. Features.
[0019]
According to a fourth aspect of the present invention, in the dialysis apparatus according to any one of the first to third aspects, the arterial blood circuit is connected to the fluid supply line from the dialysate introduction line or the dialysate discharge line. Alternatively, a check valve for permitting the flow of the dialysate to the venous blood circuit and restricting the flow of the dialysate on the opposite side is provided.
[0020]
According to a fifth aspect of the present invention, in the dialysis apparatus according to any one of the first to fourth aspects, a drip chamber is connected to the venous blood circuit, and the liquid is supplied at the time of blood return. The dialysate flowing from the line passes through the drip chamber together with the blood remaining in the arterial blood circuit or the venous blood circuit, and returns to the patient in a direction from the arterial blood circuit to the venous blood circuit. It is characterized by comprising a blood return regulation means for regulating the flow direction.
[0021]
BEST MODE FOR CARRYING OUT THE INVENTION
Hereinafter, embodiments of the present invention will be specifically described with reference to the drawings.
The dialysis apparatus according to the first embodiment is applied to hemodialysis (HD). As shown in FIG. 1, a dialyzer 1 as a blood purifier includes an arterial blood circuit 2 and a venous blood circuit 3. , A dialyser main body B having a dialysate inlet line L1 and a dialysate outlet line L2, and a liquid feed line L3.
[0022]
The dialyzer 1 includes a blood purification membrane (not shown, which is a hollow fiber membrane but includes a semipermeable membrane and a filtration membrane in the present embodiment), and derives the blood introduction port 1a for introducing blood and the introduced blood. A blood outlet 1b is formed, and a dialysate inlet 1c for introducing dialysate and a dialysate outlet 1d for discharging dialysate are formed, and the blood inlet 1a is formed through a hollow fiber membrane. The dialysis fluid is brought into contact with the blood introduced from the dialysis to perform the dialysis purification action.
[0023]
The arterial blood circuit 2 is mainly composed of a flexible tube, one end of which is connected to the blood inlet 1a of the dialyzer 1 and guides blood collected from a patient's artery into the hollow fiber membrane of the dialyzer 1. At the other end of the arterial blood circuit 2, a connector 6a to which an arterial puncture needle a can be attached is formed, and a drip chamber D1 (arterial drip chamber), a blood pump 8, and a connector 10 are connected in the middle. Have been. The blood pump 8 is an ironing type pump (having a configuration in which, when rotated forward, the blood flows in a predetermined direction from the outside of the flexible tube).
[0024]
The venous blood circuit 3 is mainly composed of a flexible tube similarly to the arterial blood circuit 2, and has one end connected to the blood outlet 1b of the dialyzer 1 to draw out the dialysate that has passed through the hollow fiber membrane. It is. At the other end of the venous blood circuit 3, a connector 6b to which the venous puncture needle b can be attached is formed, and a drip chamber D2 (venous drip chamber) is connected on the way.
[0025]
The dialysate inlet 1c and the dialysate outlet 1d of the dialyzer 1 are connected to a dialysate inlet line L1 and a dialysate outlet line L2, respectively, and introduced into the dialyzer 1 via the dialysate inlet line L1. The dialysate is configured to pass through the outside of the hollow fiber membrane and be discharged from the dialysate discharge line L2. A solenoid valve V1 and a solenoid valve V2 are connected in the middle of the dialysate introduction line L1 and the dialysate discharge line L2, respectively.
[0026]
Further, a pump 5 is connected to the dialysate introduction line L1 as a supply unit for supplying the prepared dialysate to the dialysate introduction line L1, and between the pump 5 and the solenoid valve V1 is provided. The primary filter 4a and the T-tube 9 are connected. The T-tube 9 can connect the base end of the liquid sending line L3, and the primary filtration filter 4a is a filtration filter for filtering and purifying the dialysate flowing through the dialysate introduction line L1. It has the same configuration as a secondary filtration filter 4b described later.
[0027]
The liquid feed line L3 has a proximal end connected to the T-tube 9 and a distal end connected to the connector 10 of the arterial blood circuit 2 as described above. 7, and a disposable secondary filtration filter 4b is connected. As a result, the dialysate supplied to the dialysate introduction line L1 flows through the liquid supply line L3 and reaches the arterial blood circuit 2. In addition, the clamp 7 can shut off or open the flow of the dialysate through the liquid sending line L3, and is set to shut off the liquid sending line L3 during the dialysis treatment.
[0028]
The secondary filtration filter 4b is a filtration filter for filtering and purifying the dialysate flowing through the liquid feeding line L3, and as shown in FIG. 2, a cylindrical filter having a plurality of hollow fibers 14 as a filtering material. , And lid members 12 and 13 fixed to both end surfaces of the housing 11 in a liquid-tight manner. In addition, an inlet 12a for introducing a dialysate is formed in the lid member 12, and a first outlet 11a and a second outlet 13a are formed in the side surface of the housing 11 and the lid member 13, respectively.
[0029]
The housing 11 and the lid members 12 and 13 are both formed of a transparent resin (or translucent resin) molded product. The lid members 12 and 13 are fixed to both ends of the housing 8 by ultrasonic welding or the like, respectively. Are integrally formed. Among them, the hollow fiber 14 in the housing 11 may be the same as the hollow fiber in which a general hollow fiber type dialyzer is present, but it is preferable that the filter has improved filtration performance as a filter. The hollow fiber 14 is a semipermeable membrane having extremely small holes in the thickness direction of the membrane.
[0030]
With this configuration, the dialysate introduced from the inlet 12a is transmitted through the hollow fiber membrane to the outside (inside the housing 11), whereby the dialysate can be filtered. The filtered and cleaned dialysate is drawn out of the housing 11 from the first outlet 11a and the second outlet 13a, and flows downstream of the liquid feed line L3. In the figure, reference numeral 15 denotes a sealant for fixing the plurality of hollow fibers 14 in a bundled state.
[0031]
To perform priming in the dialysis apparatus, the clamp 7 is opened while the solenoid valves V1 and V2 are closed, and the pump 5 is driven in this state to supply the dialysate to the dialysate introduction line L1. After the supplied dialysate passes through the primary filtration filter 4a, it reaches the liquid sending line L3 via the T-tube 9.
[0032]
The dialysate flowing through the liquid sending line L3 is purified by passing through the secondary filtration filter 4b, and then sent to the arterial blood circuit 2 via the connector 10. At this time, the blood pump 8 is driven to rotate in the normal direction, and the dialysate thus sent is upstream of the connector 10 in the arterial blood circuit 2 (ie, the arterial puncture needle a side) and downstream (ie, the dialyzer). 1).
[0033]
For example, the dialysate flows from the pump 5 to the dialysate introduction line L1 at a flow rate of 150 (ml / min), and the blood pump 8 is rotated forward to flow 100 (ml / min) to the downstream side. When set, the dialysate of 50 (ml / min) flows from the connector 10 to the arterial puncture needle a side and is discharged from there, and the dialysate of 100 (ml / min) flows to the dialyzer 1 side, After passing through the inside of the hollow fiber membrane of the dialyzer 1, it is discharged from the venous puncture needle b.
[0034]
As a result, the arterial blood circuit 2 and the venous blood circuit 3 and the drip chambers D1, D2 and dialyzer 1 connected thereto can be primed with the dialysate. However, in this case, the flow rate of the dialysate supplied from the pump 5 needs to be larger than the flow rate of the driving of the blood pump 8 in order to avoid sucking air from the arterial puncture needle a side. .
[0035]
Thereafter, in order to perform dialysis treatment, the flow of the dialysate through the liquid supply line L3 is blocked by the clamp 7 and the patient is punctured with the arterial puncture needle a and the venous puncture needle b. Thereafter, the solenoid valve V1 and the solenoid valve V2 are opened to supply the dialysate prepared from the pump 5 to the dialysate introduction line L1, and the blood pump 8 is driven to rotate in the normal direction, so that the venous blood is transmitted from the arterial blood circuit 2 to the venous blood. Blood is extracorporeally circulated to the circuit 3. In the process, dialysis by the dialyzer 1 is performed.
[0036]
During the dialysis treatment, if the blood pressure of the patient suddenly drops, emergency fluid replacement may be performed. At the time of such emergency fluid replacement, the solenoid valves V1 and V2 are closed, and the clamp 7 is opened to open the liquid feed line L3. For example, when the dialysate flows from the pump 5 to the dialysate introduction line L1 at a flow rate of 100 (ml / min) and the blood pump 8 is stopped, the dialysate does not flow downstream from the connector 10 and (Ml / min) of the dialysate is supplied from the arterial puncture needle a into the patient's body, and the fluid is urgently replaced. For example, the blood pump 8 may be rotated in the normal direction to perform rehydration to the connector 6b in addition to rehydration to the connector 6a.
[0037]
Further, when blood is returned after the dialysis treatment is completed, the solenoid valves V1 and V2 are closed, the clamp 7 is opened to open the liquid sending line L3, and for example, the pump 5 is set to 150 (ml / min). The dialysate flows into the dialysate introduction line L1 at a flow rate. At the same time, the blood pump 8 is rotated forward to flow the dialysate at a flow rate of 100 (ml / min) downstream, and the dialysate at a flow rate of 50 (ml / min) flows upstream. The blood remaining in the venous blood circuit 3 is returned to the patient from both the arterial puncture needle a and the venous puncture needle b while being replaced with the dialysate.
[0038]
However, in this case, the flow rate of the dialysate supplied from the pump 5 needs to be larger than the flow rate by driving the blood pump 8 for the same reason as in priming. It should be noted that the residual blood volume (concentration of adhered blood) in the arterial blood circuit 2 and the venous blood circuit 3 is measured by an absorbance meter or the like, and the measured value is fed back, and dialysis supplied from the pump 5 based on the measured value If the ratio between the flow rate of the liquid and the flow rate of the dialysate flowing through the blood pump 8 is adjusted, more efficient blood return can be performed.
[0039]
After the dialysis treatment for a specific patient is completed, the liquid sending line L3 is removed from the T-tube 9 and the connecting device 10, and is discarded together with the secondary filtration filter 4b. Then, before the dialysis treatment of the next patient (that is, before priming), a new liquid sending line L3 is connected to the same position. Here, the dialysis apparatus according to the present embodiment is applied to hemodialysis (HD), and replacement fluid during dialysis treatment is not performed except in an emergency. Therefore, replacement fluid during dialysis treatment such as HDF cannot be performed. In addition, there is no need to provide a replacement fluid pump or the like for adjusting the flow rate of the dialysate in the middle of the fluid sending line (replacement fluid line). Therefore, the device configuration can be more simplified than that of the online HDF.
[0040]
Furthermore, since it is hemodialysis (HD), the flow rate of the dialysate flowing through the liquid sending line L3 is small, and a small-sized secondary filtration filter 4b disposed on the way can be used. Accordingly, a relatively inexpensive filtration filter can be used, and the filter can be made suitable for disposable use together with the liquid sending line L3.
[0041]
Thus, a series of operations such as priming, dialysis treatment, and blood return are completed. In such a series of operations, the connection of the liquid sending line L3 and other piping is not changed at all, and bacteria are not changed when the connection is changed. It is possible to avoid that such a substance adheres and enters a flow path such as a blood circuit, which is sanitary. Also, since no back-filtration action is imparted to the hollow fiber membrane of the dialyzer 1 during priming and blood return, it can be applied to a blood purifier having a blood purification membrane having a low UFR and a low membrane elasticity.
[0042]
In addition, it is preferable that the piping on the dialysis apparatus main body B side is configured as shown in FIG. That is, a bypass line L4 extending from a position between the primary filtration filter 4a and the T-tube 9 in the dialysate introduction line L1 to a portion downstream of the electromagnetic valve V2 of the dialysate discharge line L2 is provided, and the bypass line L4 is provided. Is connected to the solenoid valve V3. When priming or blood return is performed in such a configuration, the electromagnetic valve V3 is kept open.
[0043]
Next, a second embodiment according to the present invention will be described.
As shown in FIG. 4, the dialysis device according to the present embodiment includes an artery-side clamp 16 as a blood return regulation means between the connector 10 and the connector 6a. The other components are the same as those in the first embodiment provided with the bypass line L4 and the solenoid valve V3 shown in FIG. 3, and the respective components are denoted by the same reference numerals as those in the first embodiment. The detailed description is omitted.
[0044]
In order to perform priming, dialysis treatment and emergency fluid replacement by the dialysis device, the arterial clamp 16 is opened to allow blood and dialysate to flow. Alternatively, the arterial clamp 16 may be closed to replace only the connector 6b. Then, at the time of blood return, the arterial clamp 16 is closed with the venous puncture needle b punctured into the patient, and the flow direction of the dialysate from the liquid feed line L3 to the connector 10 is regulated. Here, the blood pump 8 is driven to rotate forward.
[0045]
Specifically, the dialysate supplied from the pump 5 at the time of blood return reaches the connecting device 10 through the liquid sending line L3, and then downstream of the arterial blood circuit 2 (the side to which the dialyzer 1 is connected). Will only flow to As a result, the dialysate flowing from the liquid supply line L3 flows together with the blood remaining in the arterial blood circuit 2 and the venous blood circuit 3 in the direction from the arterial blood circuit 2 to the venous blood circuit 3, and the process In this case, it passes through the drip chambers D1 and D2.
[0046]
Therefore, the thrombus and the like contained in the residual blood replaced with the dialysate are captured by the drip chambers D1 and D2, and it is possible to prevent the thrombus and the like from returning to the patient when returning blood. However, in this embodiment, the flow rate of the dialysate supplied from the pump 5 and the flow rate of the blood pump 8 need to be equal, and if it is difficult to obtain the same flow rate, the solenoid valve V3 is opened. In advance, it is necessary to balance the flow rate of the dialysate in the bypass line L4. (This operation is the same as that shown in FIGS. 5 to 7).
[0047]
In addition, as described above, in the case where the flow of the dialysate is regulated by the arterial side clamp 16, the present invention can be applied not only at the time of blood return but also at the time of emergency fluid replacement. In this case, at the time of emergency fluid replacement, the dialysate supplied from the fluid feed line L3 does not flow to the connector 6a side, but flows downstream from the connector 10, and is refilled into the patient from the venous puncture needle b. Become. Thereby, even at the time of fluid replacement, the thrombus attached to the blood circuit can be captured by the drip chambers D1 and D2, and the thrombus can be prevented from entering the patient's body. Here, it is preferable to provide the arterial clamp 16 and the connector 10 as close to the connector 6a as possible, regardless of whether blood is returned or emergency fluid replacement is performed.
[0048]
Next, a third embodiment according to the present invention will be described.
As shown in FIG. 5, the dialysis device according to the present embodiment includes the artery-side clamp 16 between the connector 10 and the connector 6a, and extends the overflow line L5 from the drip chamber D2 on the venous side. Things. An overflow line clamp 17 is provided in the overflow line L5. The other components are the same as those of the second embodiment, and the same components as those of the second embodiment are denoted by the same reference numerals, and detailed description is omitted.
[0049]
To perform priming in the dialysis device, first, the connectors 6a and 6b are connected, the blood circuit A is closed, and then the clamp 7 and the overflow clamp 17 are opened while closing the solenoid valves V1 and V2. At this time, the arterial side clamp 16 is kept closed. When the pump 5 is driven to flow the dialysate into the liquid sending line L3, the dialysate that has reached the connector 10 passes through the inside of the hollow fiber membrane of the dialyzer 1 and the venous blood circuit 3, and flows into the overflow line L5. Overflows from At this time, the blood pump 8 is driven to rotate forward.
[0050]
Thereafter, if the blood pump 8 is stopped while the vein side clamp 16 is opened, the dialysate that has reached the connector 10 flows to the side where the connectors 6a and 6b are connected, and overflows from the overflow line L5. During the subsequent dialysis treatment, fluid replacement and blood return, the connectors 6a and 6b are separated from each other, the arterial puncture needle a and the venous puncture needle b are attached, and the overflow clamp 17 is closed. Work such as the embodiment or the second embodiment is performed.
[0051]
Next, a fourth embodiment according to the present invention will be described.
As shown in FIG. 6, the dialysis device according to the present embodiment includes a check valve 18 on the distal end side (the side connected to the connector 10) of the liquid sending line L3. The other components are the same as those in the first embodiment, and the same components as those in the first embodiment are denoted by the same reference numerals, and detailed description is omitted. In addition, the actions at the time of priming, dialysis treatment, fluid replacement and blood return are the same as those of the first embodiment.
[0052]
The check valve 18 connected to the liquid sending line L3 allows the flow of the dialysate from the base end (the end connected to the T-tube 9) of the liquid sending line L3 to the tip, and the base valve from the tip. It regulates the flow of dialysate to the end. Thus, the backflow of the dialysate flowing through the liquid feeding line L3 is prevented, so that priming and blood return can be performed more surely in the case of emergency fluid replacement.
[0053]
As described above, the dialysis apparatus according to the first to fourth embodiments has been described, but the present invention is not limited to this, and the ironing type blood pump 8 connects the liquid supply line L3 to the arterial blood circuit. Other configurations may be used as long as the direction and flow rate of the dialysate that has flowed can be adjusted. Of course, the present invention is not limited to the one applied to hemodialysis (HD) as in the above-described embodiment, and can be applied to an online HDF.
[0054]
Further, for example, in the dialysis device shown in FIG. 5, by driving only the blood pump 8 without driving the pump 5, the dialysate in the dialysate introduction line L1 is supplied to the liquid sending line L3 by the suction operation of the blood pump 8. May be introduced. In this case, the driving cost of the pump 5 is not required, so that the running cost can be reduced.
[0055]
Further, in the liquid sending line L3, the base end side is connected to any part of the dialysate introduction line L1 or the dialysate discharge line L2 (including the bypass line L4 when there is a bypass line L4 as shown in the figure). Alternatively, the distal end may be connected to any of the arterial blood circuit 2 and the venous blood circuit 3.
[0056]
For example, as shown in FIG. 7, when the connector 10 is disposed downstream of the blood pump 8 and the tip of the liquid sending line L3 is connected to the location, priming, emergency fluid replacement, and Blood can be returned. First, at the time of priming (also at the time of blood return), the solenoid valves V1 and V2 are closed, the clamp 7 is opened, and the liquid sending line L3 is opened.
[0057]
For example, the dialysate flows from the pump 5 to the dialysate introduction line L1 at a flow rate of 150 (ml / min), and the blood pump 8 is reversed to move the dialysate upstream (the arterial puncture needle a side) to 50 (ml / min). When the dialysate is set to flow, 100 (ml / min) of the dialysate flows to the downstream side (dialyzer 1 side), and the arterial puncture needle a and the venous puncture needle b are punctured by the patient. If not, the dialysate is discharged therefrom to perform priming. If the patient is punctured, the residual blood replaced with the dialysate is returned to the patient's body.
[0058]
Furthermore, at the time of priming, the blood pump 2 is stopped while closing the clamp 19 (that is, the outflow of dialysate to the connector 6a side is regulated), and the dialysate is supplied from the liquid feed line L3. Since the introduced dialysate passes through the pores of the blood purification membrane (specifically, the hollow fiber membrane) and is discharged from the dialysate discharge port 1d, the dialyzer 1 can be washed. At this time, it is necessary to keep the solenoid valve V1 of the dialysate introduction line L1 closed and open the solenoid valve V2 of the dialysate discharge line L2.
[0059]
At the time of emergency fluid replacement, the solenoid valves V1 and V2 are closed, the clamp 7 is opened, and the liquid feed line L3 is opened. For example, the dialysate is supplied from the pump 5 to the dialysate introduction line L1 at a flow rate of 100 (ml / min). Flow. At that time, if the blood pump 8 is stopped, the flow of the dialysate to the upstream side is cut off, and the dialysate is replaced by the venous needle b.
[0060]
According to the above-described embodiment, since there is no back-filtration effect in the dialyzer 1 as in the related art, it is possible to prevent the adherence (protein and the like) in the dialysis membrane on the blood side at the time of blood return and return to the patient's body. . In addition, when using the reverse filtration action, there is a restriction that the flow rate of the reverse filtration cannot be increased due to problems of membrane elastic modulus and UFR, it takes time to return blood, and the amount of dialysate returned to the patient also increases. However, according to the present embodiment, such a problem can be solved.
[0061]
Instead of the pump 5, another supply means such as a double pump provided over the dialysate introduction line L1 and the dialysate discharge line L2, or a pressure feeding means combining a pressure pump and a chamber may be used. Further, in the present embodiment, a dialyzer having a hollow fiber membrane is used. It may be.
[0062]
Further, instead of the T-tube 9 for connecting the base end of the liquid sending line L3, another connecting means for connecting the dialysate introducing line L1 and the liquid sending line L3 may be used. Further, the secondary filtration filter 4b (same for the primary filtration filter 4a) connected to the liquid sending line L3 may be of another form as long as it has a filter function for filtering and purifying the dialysate. It may be used, and may be omitted to provide a liquid sending line L3 without a filtration filter.
[0063]
【The invention's effect】
According to the first aspect of the present invention, since there is no back-filtration effect on the blood purification membrane, it can be applied to a blood purification device having a blood purification membrane having a low UFR and a low membrane elasticity, and can be used for priming, dialysis treatment and return. In a series of operations such as blood, reconnection of pipes can be avoided, and bacteria can be prevented from entering the blood circuit while improving workability.
[0064]
According to the second aspect of the present invention, the blood purifier is applied to hemodialysis (HD), and the liquid supply line is a line for performing replacement fluid only during an emergency during dialysis treatment. In addition, there is no need to dispose a replacement fluid pump or the like for adjusting the flow rate of the dialysate in the middle of the solution sending line, and the device configuration can be simplified.
[0065]
According to the third aspect of the present invention, in the case of hemodialysis (HD), the fluid is not replaced during the dialysis treatment and the flow rate of the replacement fluid is extremely small. A small filter is also sufficient. Therefore, a relatively inexpensive filtration filter can be used and can be disposable together with the liquid sending line.
[0066]
According to the fourth aspect of the present invention, the liquid sending line allows the flow of the dialysate from the base end to the distal end of the liquid sending line and controls the flow of the dialysate from the distal end to the base end. Since the valve is connected, backflow of the dialysate flowing through the liquid feed line is prevented, and priming and blood return can be performed more reliably.
[0067]
According to the fifth aspect of the present invention, the blood remaining in the blood circuit by the blood return regulating means is returned to the patient's body in a direction from the arterial blood circuit to the venous blood circuit, and passes through the drip chamber on the way. As a result, the thrombus and the like contained in the remaining blood can be captured in the drip chamber, and the thrombus and the like can be reliably prevented from returning to the patient's body.
[Brief description of the drawings]
FIG. 1 is a piping diagram showing a dialysis device according to a first embodiment of the present invention.
FIG. 2 is a schematic diagram showing a filtration filter in the dialysis device according to the first embodiment of the present invention, wherein an upper half is a longitudinal sectional view and a lower half is a front view.
FIG. 3 is a piping diagram of a dialysis device main body which is preferable in the dialysis device according to the first embodiment of the present invention.
FIG. 4 is a piping diagram showing a dialysis device according to a second embodiment of the present invention.
FIG. 5 is a piping diagram showing a dialysis device according to a third embodiment of the present invention.
FIG. 6 is a piping diagram showing a dialysis device according to a fourth embodiment of the present invention.
FIG. 7 is a piping diagram showing a dialysis device according to another embodiment of the present invention.
FIG. 8 is a piping diagram showing a state during dialysis treatment in a dialysis device according to Conventional Example 3.
FIG. 9 is a piping diagram showing a state at the time of priming in the dialysis device according to Conventional Example 3.
FIG. 10 is a piping diagram showing a state when blood is returned in a dialysis device according to Conventional Example 3.
[Explanation of symbols]
1. Dialyzer (blood purifier)
2. Arterial blood circuit
3: venous blood circuit
4a: Primary filtration filter
4b: Secondary filtration filter
5 Pump (supply means)
6a, 6b ... connector
7. Clamp (flow control means)
8. Blood pump
9 ... T-tube
10 ... Connector
11 ... Housing
12, 13 ... lid member
14. Hollow fiber
15 ... Sealant
16. Arterial clamp (means for regulating blood return)
17… Overflow clamp
18. Check valve
L1 ... dialysate introduction line
L2: dialysate discharge line
L3: Liquid sending line
L4: Bypass line
L5: overflow line
V1 ... Solenoid valve
V2: Solenoid valve

Claims (5)

A blood inlet for introducing blood and a blood outlet for introducing the introduced blood are formed therein, and a dialysate inlet for introducing the dialysate and a dialysate drain for discharging the introduced dialysate are formed therein. An outlet is formed, and a blood purifier that performs a dialysis purification action by bringing a dialysate into contact with the blood through the blood purification membrane,
One end is connected to the blood inlet of the blood purifier, an arterial blood circuit in which a blood pump is provided in the middle,
A venous blood circuit having one end connected to the blood outlet of the blood purifier,
A dialysate introduction line connected to the dialysate inlet of the blood purifier and introducing a dialysate into the blood purifier;
A dialysate discharge line connected to the dialysate outlet of the blood purifier and discharging dialysate from the blood purifier;
Supply means for supplying the prepared dialysate to the dialysate introduction line,
A dialysis device comprising:
The dialysate introduction line or the dialysate discharge line is connected to the arterial blood circuit or the venous blood circuit, and the dialysate flowing through the dialysate introduction line or the dialysate discharge line is passed through the arterial blood circuit or the venous blood circuit. A liquid sending line capable of flowing to the
Flow regulating means capable of blocking or opening the flow of the dialysate by the liquid sending line,
And a flow direction and a flow rate of the dialysate flowing from the liquid feed line to the arterial blood circuit or the venous blood circuit can be adjusted by the blood pump. 2. The dialysis apparatus according to claim 1, wherein the blood purifier is applied to hemodialysis, and the liquid supply line is a line for performing replacement fluid only during an emergency during dialysis treatment. The dialysis apparatus according to claim 2, wherein a filtration filter for filtering and purifying the dialysate flowing through the liquid supply line is connected in the middle of the liquid supply line. The liquid supply line allows the flow of dialysate from the dialysate introduction line or dialysate discharge line to the arterial blood circuit or venous blood circuit, and restricts the reverse flow of dialysate. The dialysis device according to any one of claims 1 to 3, wherein a stop valve is provided. A drip chamber is connected to the venous blood circuit, and at the time of blood return, the dialysate flowing from the liquid supply line passes through the drip chamber together with blood remaining in the arterial blood circuit or the venous blood circuit. 5. A blood return regulating means for regulating a flowing direction of the blood flow so as to return to the patient's body in a direction from the arterial blood circuit to the venous blood circuit. A dialysis device according to any one of the preceding claims.

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