JP4232103B2 - Blood dewatering device and preparation method thereof - Google Patents

Description

The present invention relates to a blood dehydrating apparatus and a preparation method thereof, and more particularly to a blood dehydrating apparatus using a dialyzer and a preparation method thereof .

Conventionally, a dialysis apparatus for performing artificial dialysis is known, and a technique for performing “ECUM treatment” that only removes water from a patient's blood without flowing dialysate is also known (for example, using this dialysis apparatus) (for example, Patent Document 1 and Patent Document 2).
Japanese Patent Publication No. 64-9025 Japanese Utility Model Publication No. 62-38667

In general, “ECU treatment” is often performed during or after the end of artificial dialysis on a patient with a dialysis machine. Recently, ECUM treatment alone is used as an emergency treatment for congestive heart failure or the like. May be done in
By the way, when the dialyzer is first used, the inside of the tube through which the dialysate flows is filled with rinse water after washing. In this case, the rinsing water in the tube is replaced with the dialysis solution in the same manner as in the normal dialysis treatment, and then the treatment is performed.
However, if the hospital does not prepare dialysate on a holiday, etc., the water supply equipment and dialysate supply device are operated to replace the rinse water even though the dialysate is not used for the treatment itself. It was necessary to prepare dialysate.

In view of the circumstances described above, the first aspect of the present invention described in claim 1 includes a dialyzer that performs artificial dialysis, a blood supply pipe that supplies blood to the dialyzer, and a blood collection pipe that collects blood from the dialyzer. A blood circuit, a dialysate supply pipe for supplying dialysate to the dialyzer, and a dialysate circuit comprising a dialysate recovery pipe for recovering dialysate from the dialyzer, and a blood pump is connected to the blood supply pipe of the blood circuit And providing a water removal means in the dialysate recovery pipe of the dialysate circuit, operating the blood pump to circulate blood through the blood circuit and the dialyzer, and operating the water removal means to operate the dialyzer. A method for preparing a blood dehydrating device for removing water from blood without flowing dialysate into
Actuates the blood pump in a state above the blood feed tube upstream of the blood pump by connecting a vessel containing saline meets the blood circuit with saline, also of closing the blood collecting tube Then, physiological saline is supplied to the dialysate supply pipe connected to the dialyzer via the dialyzer, and the rinsing water contained in the dialyzer and the dialysate supply pipe is replaced with physiological saline. vessel and at least the tip portion of the dialysis liquid supply pipe in which a saline filled et permeability析液prevents the state of inflow of saline water from the supply pipe to the dialyzer.
A second aspect of the present invention according to claim 2 is a blood circuit comprising a dialyzer for performing artificial dialysis, a blood supply pipe for supplying blood to the dialyzer, and a blood recovery pipe for recovering blood from the dialyzer. A dialysate supply pipe for supplying dialysate to the dialyzer and a dialysate circuit comprising a dialysate recovery pipe for recovering dialysate from the dialyzer, a blood pump being provided in the blood supply pipe of the blood circuit, and dialysis A water removal means is provided in the dialysate recovery pipe of the liquid circuit, the blood pump is operated to circulate blood through the blood circuit and the dialyzer, and the water removal means is operated to operate the dialyzer and the dialysate recovery pipe. In the dewatering device for blood that is dewatered from the blood via
A physiological saline container is connected to the blood supply pipe upstream of the blood pump, a first opening / closing means for opening / closing the blood recovery pipe is provided, and a second opening / closing means for opening / closing the dialysate supply pipe is provided, Control means for controlling the operation of the blood pump, the water removal means, the first opening / closing means and the second opening / closing means, the control means closing the first opening / closing means and opening the second opening / closing means. The pump is operated to supply physiological saline to the dialysate supply pipe connected thereto via the dialyzer, and the control means includes at least tip portions of the dialyzer and the dialysate supply pipe. Is filled with physiological saline, the first opening / closing means is opened, the blood pump is operated to circulate blood through the blood circuit, and the water removal means is operated with the second opening / closing means closed, and dialysis is performed. Vessel It is obtained to perform the water removal from the blood through the fine dialysate recovery pipe.

  According to the above-described method and apparatus, when ECUM treatment is performed, the physiological saline is supplied to the dialysate supply pipe in the dialyzer and the dialysate circuit. Preparatory work for treatment is simplified and can be performed in a short time.

In the following, the present invention will be described with reference to the illustrated embodiment. In FIG. 1, reference numeral 1 denotes a dialysis machine. The dialysis machine 1 supplies a dialysate to and from a conventionally known dialyzer 2 for performing artificial dialysis. And a dialysate supply / discharge device 3. The dialyzer 2 accommodates a large number of hollow fibers, and the inside of the hollow fibers is a blood flow path and the outside is a dialysate flow path.
One end of the blood supply tube 4 is connected to the blood supply port 2 a of the dialyzer 2, and one end of the blood recovery tube 5 is connected to the blood recovery port 2 b of the dialyzer 2. A pump 6 is provided. When performing artificial dialysis on a patient, the other ends of the blood supply tube 4 and the blood recovery tube 5 are connected to the patient. The blood supply tube 4 and the blood recovery tube 5 constitute a blood circuit 7.
The operation of the blood pump 6 is controlled by a control means (not shown). When performing artificial dialysis, the blood pump 6 is connected to the patient at the other end of the blood supply pipe 4 and the blood recovery pipe 5 and then the blood pump 6 is controlled by the control means. When 6 is driven to rotate, the blood of the patient is supplied to the dialyzer 2 via the blood supply pipe 4, while the blood in the dialyzer 2 is returned to the patient via the blood collection pipe 5. Yes. At that time, since the dialysate is supplied / discharged from the dialysate supply / discharge device 3 described later to the dialyzer 2, waste in the blood is transferred into the dialysate in the dialyzer 2 and artificial dialysis is performed. It is like that.

The dialysate supply / discharge device 3 includes two dialysate containers 8 and 8 ′, and from the dialysate supply pipe 11 and the dialyzer 2 that supply dialysate to the dialyzer 2 from the dialysate containers 8 and 8 ′. And a dialysate recovery pipe 12 for recovering dialysate after dialysis.
Each dialysate container 8, 8 'is partitioned into three chambers in order from the right side by two diaphragms: supply chambers 8a, 8a', variable volume chambers 8b, 8b ', and recovery chambers 8c, 8c'.
The supply chambers 8a and 8a ′ communicate with the dialysate supply port 2A of the dialyzer 2 via the three-way solenoid valves 13 and 13 ′ and the dialysate supply pipe 11.
The collection chambers 8c and 8c ′ communicate with the dialysate discharge port 2B of the dialyzer 2 via the three-way solenoid valves 15 and 15 ′ and the dialysate collection pipe 12. A pump 16 is provided in the dialysate recovery pipe 12 upstream of the dialysis containers 8 and 8 ', and the pump 16 is operated so that dialyzed dialysate is dialyzed from the dialyzer 2 to the recovery chambers 8c and 8c'. I'm trying to send liquid. Furthermore, a supply pipe 9 for supplying dialysate is connected to the supply chambers 8a and 8a ′ via three-way solenoid valves 13 and 13 ′, and dialyzed dialysate is discharged to the recovery chambers 8c and 8c ′. A drainage pipe 10 is connected via three-way solenoid valves 15 and 15 ′, and a pump 14 is provided in the liquid supply pipe 9. A dialysate circuit 17 is constituted by the supply pipe 9, the dialysate supply pipe 11, the dialysate recovery pipe 12, and the drain pipe 10.
Silicone oil is stored in the variable volume chambers 8b and 8b ′, and the amount of silicone oil stored in both the variable volume chambers 8b and 8b ′ is changed by suction or discharge by the supply / discharge pumps 18 and 18 ′. Be able to.
The operations of the pumps 14, 16 and the three-way solenoid valves 13, 13 ', 15, 15' and the supply / discharge pumps 18, 18 'are controlled by control means (not shown).

When performing artificial dialysis, the control means switches the flow paths of the three-way solenoid valves 13 and 13 ′ in a state where both pumps 14 and 16 are operated, and the three-way solenoid valves 15 and 15. Switching operation of 'is performed. As a result, fresh dialysate is introduced into one of the supply chambers 8a and 8a ′ from a dialysate supply device (not shown) through the supply pipe 9 and the other supply chamber 8a in which the dialysate has already been stored. , 8 a ′, the dialysate 2 is supplied to the dialyzer 2 through the dialysate supply pipe 11. At the same time, the dialysate after dialysis in the dialyzer 2 is collected into the recovery chambers 8c and 8c ′ of the same dialysis vessel 8 and 8 ′ as the other supply chambers 8a and 8a ′ that have supplied the dialysate to the dialyzer 2. The dialysate is recovered through the pipe 12 and discharged from the recovery chambers 8c and 8c ', which are different from this, through the drain pipe 10 to the outside of the apparatus.
In this way, the variable volume of the dialysis vessel 8 is the same as the collection chambers 8c and 8c ′ collecting the dialysate from the dialyzer 2 while the dialysate is supplied to and discharged from the dialysate supply / discharge device 3 to the dialyzer 2. The volume of the variable volume chambers 8b and 8b ′ is decreased by operating the supply and discharge pumps 18 and 18 ′ of the chambers 8b and 8b ′ to suck the silicone oil in the variable volume chambers 8b and 8b ′ by a predetermined amount, Water can be removed from the patient's blood according to the volume reduction. In the present embodiment, the dialysate containers 8 and 8, the supply / discharge pumps 18 and 18 ′, and the pump 16 constitute water removal means.
The configuration and operation of the dialysis apparatus 1 described above are conventionally known, for example, from Japanese Examined Patent Publication No. 3-54590.

In addition, in the dialysis device 1 of the present invention, a container 21 containing physiological saline is connected via a conduit 19 to a position upstream of the blood pump 6 in the blood supply pipe 4.
A clamp 22 (first opening / closing means) is provided in the middle of the blood collection tube 5, and the opening / closing operation of the clamp 22 is controlled by the control means.
Further, the dialysate supply pipe 11 and the dialysate recovery pipe 12 are communicated by a bypass passage 23 at a position near the dialyzer 2 upstream of the pump 16, and an electromagnetic opening / closing valve 24 is provided in the bypass passage 23. Yes.
The dialysate supply pipe 11 is provided with an electromagnetic opening / closing valve 25 (second opening / closing means) between the branch position to the bypass passage 23 and the connecting end 11A of the dialysate supply port 2A. The dialysate recovery pipe 12 is provided with an electromagnetic opening / closing valve 26 between the joining position with the bypass passage 23 and the connection end 12A with the dialysate discharge port 2B. The operation of the electromagnetic open / close valves 24 to 26 is controlled by control means.
Further, a deaeration tank 27 is provided downstream of the pump 16 in the dialysate recovery pipe 12 so that air contained in the liquid flowing through the dialysate recovery pipe 12 can be discharged to the outside of the dialysate recovery pipe 12. It has become.

A case where “ECUM treatment” is performed by the dialysis apparatus 1 having the above configuration will be described.
First, before connecting the dialysate supply pipe 11 and the dialysate recovery pipe 12 to the dialyzer 2, the blood circuit 7 is filled with physiological saline in the container 21 as follows.
That is, the blood pump 6 is operated with the clamp 22 opened, and the physiological saline in the container 21 is circulated to the blood supply pipe 4 on the downstream side of the blood pump 6 to fill the blood circulation side of the dialyzer 2. Further, after the blood collection tube 5 is circulated and allowed to flow out from the end portion, the end portion is closed with forceps or the like. Next, by stopping the operation of the blood pump 6, the physiological saline in the container 21 flows down in the blood supply pipe 4 upstream of the blood pump 6, and then the end is closed with forceps or the like. As a result, the blood circuit 7 and the dialyzer 2 are filled with physiological saline.

Next, the dialysate supply pipe 11 and the dialysate recovery pipe 12 are respectively connected to the dialyzer 2 with the electromagnetic open / close valves 24, 25 and 26 closed.
When the connection is completed, in a state where the clamp 22 is closed and the electromagnetic on-off valves 24 and 25 are opened, the feeding of the blood pump 6 and the suction operation of the supply / discharge pumps 18 and 18 ′ and the feeding of the pump 16 are started simultaneously. . At this time, both of the three-way solenoid valves 15 and 15 ′ are in a switching state in which the dialysate recovery pipe 12 communicates with both of the recovery chambers 8c and 8c ′, and the withdrawal flow rates of the supply / discharge pumps 18 and 18 ′ are both variable. The volume increase amount of the recovery chambers 8c and 8c ′ corresponding to the volume decrease of the volume chambers 8b and 8b ′ is set to match the liquid feeding flow rate of the blood pump 6. In this case, there is no fluctuation in volume because no liquid flows in and out of the supply chambers 8a and 8a ′.
Thereby, since the blood collection tube 5 is closed by the clamp 22, the physiological saline is pushed out from the inside to the outside through the hollow fiber of the dialyzer 2 by the liquid feeding operation of the blood pump 6. The extruded physiological saline fills the dialysate side in the dialyzer 2 and flows into the dialysate supply pipe 11 in which the electromagnetic on-off valve 25 is opened. The dialysate circuit 17 is washed after the previous dialysis treatment and contains rinse water, and the physiological saline flows into the dialysate supply pipe 11 so that the electromagnetic on-off valve 24 is opened in the rinse water. The dialysate recovery pipe 12 passes through the bypass passage 23 and is accommodated in both recovery chambers 8c and 8c ′.
In this way, both the blood side and the dialysate side of the blood circuit 7 and the dialyzer 2 and the inside of the dialysate supply pipe 11 are filled with physiological saline. The replacement with the physiological saline in the dialysate circuit 17 is to prevent the rinse water from flowing into the dialyzer 2, and at least the distal end portion of the dialysate supply pipe 11 having a risk of inflow, that is, What is necessary is just to replace between the electromagnetic opening-and-closing valve 25 and the connection end part 11A, and it is made to replace with the physiological saline to the branch position with the bypass channel 23 in general.

In this way, when the preparatory work is completed, the ECUM treatment is performed in which only water is removed from the blood. That is, the end of the blood collection tube 5 and the end of the blood supply tube 4 are connected to the patient after the conduit 19 adjacent to the container 21 is closed with forceps or the like.
When the blood circuit 7 is connected to the patient, ECUM treatment is started under the control of the control means.
That is, on the blood circuit 7 side, the clamp 22 is opened and then the blood pump 6 is operated to continuously draw out blood and return it to the body via the dialyzer 2. On the dialysate circuit 17 side, the electromagnetic on-off valve 25 is closed and the electromagnetic on-off valve 26 is opened with the electrical foundation on-off valve 24 open, and the dialyzer 2 and the collection chambers 8c and 8c ′ are connected to the dialysate collection pipe. 12, the pump 16 is operated to draw physiological saline from the dialyzer 2, and the three-way solenoid valves 15, 15 ′ are switched to operate the recovery chambers 8 c, 8 c ′ alternately. Either one communicates with the dialysate recovery pipe 12 and the other communicates with the drainage pipe 10. At this time, the supply / discharge pumps 18 and 18 ′ draw silicone oil from the variable volume chambers 8 b and 8 b ′ of the dialysate containers 8 and 8 ′ communicated with the dialysis contact and recovery pipe 12, and the volume of the recovery chambers 8 c and 8 c ′. In addition, the silicone oil is pushed into the variable volume chambers 8b and 8b 'of the dialysate containers 8 and 8' communicated with the drainage pipe 10 to reduce the volumes of the collection chambers 8c and 8c '. Drain the tube 10. In the supply chambers 8a and 8a ′, when the liquid flows into the recovery chambers 8c and 8c ′ for the first time, the rinse water stored therein is emptied by being pushed out to the dialysate supply pipe 11.
When a predetermined amount of water removal is achieved by such an operation, the control means ends the operation of the ECUM treatment.

As described above, in this embodiment, the dialysate is not circulated in the dialysate circuit 17 in the preparation work for ECUM treatment.
On the other hand, conventionally, even when only the ECUM treatment is performed by the dialyzer 1, a dialysate originally unnecessary for the ECUM treatment is circulated through the dialysate circuit as a preparatory work before the ECUM treatment. . In such a conventional method, it is necessary to prepare an unnecessary dialysate for ECUM treatment, and the preparation work is complicated and time-consuming.
On the other hand, in the present embodiment, in the preparatory work before ECUM treatment, the dialysate is not circulated through the dialysate circuit 17, so that the preparatory work can be simplified by omitting the trouble of preparing the dialysate. it can. Moreover, the dialysate circuit 17 side only needs to fill at least the distal end portion of the dialysate supply pipe 11 adjacent to the dialyzer 2 with physiological saline. The time required for the work can be greatly shortened, and the work burden on the workers in the medical field can be reduced.

Next, FIG. 2 shows a second embodiment of the present invention, in which the configuration on the dialysate circuit 17 side is different from that of the first embodiment.
In the first embodiment described above, the dialysate containers 8 and 8 ′ are divided into three chambers, and water is removed using the variable volume chambers 8b and 8b ′ and the supply / discharge pumps 18 and 18 ′. The second embodiment is composed of an equal volume supply / discharge means 30 for supplying and recovering dialysate in equal amounts and a dewatering pump 31 connected to the dialysate recovery pipe 12 to draw out the liquid.

When ECUM treatment is performed in the second embodiment having such a configuration, in the first embodiment, the blood pump 6 is operated to supply physiological saline to the dialysate circuit 17 during the preparatory work. At the same time, the volumes of the recovery chambers 8c and 8c ′ are increased by operating the supply and discharge pumps 18 and 18 ′, but in this second embodiment, the water removal pump 31 is commensurate with the flow rate of the blood pump 6. The liquid is fed at a flow rate so that the rinse water is discharged directly out of the circuit. Further, in the treatment operation, in the first embodiment, the supply / drain pumps 18 and 18 'are operated and the liquid is discharged through the collection chambers 8c and 8c'. However, in the second embodiment, water removal is performed. The pump 31 is operated so that the liquid is directly discharged out of the circuit. Accordingly, ECUM treatment can be prepared and treated as in the first embodiment.
Also according to the second embodiment, in the preparatory work before the ECUM treatment, the inside of the dialyzer 2 and the dialysate supply pipe 11 is filled with physiological saline, so that the first embodiment described above is used. The same effect can be obtained.

1 is a schematic configuration diagram showing a first embodiment of the present invention. The schematic block diagram which shows 2nd Example of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Dialyzer 2 ... Dialyzer 4 ... Blood supply pipe 5 ... Blood collection pipe 6 ... Blood pump 7 ... Blood circuit 11 ... Dialysate supply pipe 12 ... Dialysate collection pipe 17 ... Dialysate circuit 18, 18 '... Supply / discharge Pump 21 ... Container 22 ... Clamp 25 ... Electromagnetic on-off valve 31 ... Dewatering pump

Claims (2)

A blood circuit comprising a dialyzer for performing artificial dialysis, a blood supply pipe for supplying blood to the dialyzer, and a blood collection pipe for collecting blood from the dialyzer;
A dialysate supply pipe for supplying dialysate to the dialyzer and a dialysate circuit comprising a dialysate recovery pipe for recovering dialysate from the dialyzer,
A blood pump is provided in the blood supply pipe of the blood circuit and a water removal means is provided in the dialysate recovery pipe of the dialysate circuit,
The blood pump is operated to circulate blood through the blood circuit and the dialyzer, and the water removal means is operated to remove water from the blood without flowing dialysate through the dialyzer. A method for preparing a water device,
Actuates the blood pump in a state above the blood feed tube upstream of the blood pump by connecting a vessel containing saline meets the blood circuit with saline, also of closing the blood collecting tube Then, physiological saline is supplied to the dialysate supply pipe connected to the dialyzer via the dialyzer, and the rinsing water contained in the dialyzer and the dialysate supply pipe is replaced with physiological saline. vessel and at least the tip portion of the dialysis fluid supply tube is filled with saline, et al., blood, characterized in that a condition like that prevented the flow of saline to the dialyzer from permeable析液supply pipe removal Preparation method of water equipment. A blood circuit comprising a dialyzer for performing artificial dialysis, a blood supply pipe for supplying blood to the dialyzer, and a blood recovery pipe for collecting blood from the dialyzer;
A dialysate supply pipe for supplying dialysate to the dialyzer and a dialysate circuit comprising a dialysate recovery pipe for collecting dialysate from the dialyzer,
A blood pump is provided in the blood supply pipe of the blood circuit, and a water removal means is provided in the dialysate recovery pipe of the dialysate circuit.
The blood pump is operated to circulate blood through the blood circuit and the dialyzer, and the water removal means is operated to remove water from the blood via the dialyzer and the dialysate recovery tube. In the water device,
A physiological saline container connected to the blood supply pipe upstream of the blood pump, and a first opening / closing means for opening and closing the blood collection pipe;
And a second opening / closing means for opening / closing the dialysate supply pipe, and a control means for controlling the operation of the blood pump, the water removal means, the first opening / closing means and the second opening / closing means,
The control means operates the blood pump with the first opening / closing means closed and the second opening / closing means open to supply physiological saline to the dialysate supply pipe connected thereto via the dialyzer. And
Further, the control means, after at least the tip portion of the dialyzer and the dialysate supply pipe is filled with physiological saline, opens the first opening and closing means and operates the blood pump to circulate blood to the blood circuit, A blood dehydrating apparatus, wherein the water removing means is operated with the second opening / closing means closed to remove water from the blood via a dialyzer and a dialysate recovery tube.

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