JP4354625B2 - Peritoneal dialysis machine - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
  The present inventionThe bellyThe present invention relates to a membrane dialysis apparatus.
[0002]
[Prior art]
In recent years, dialysis methods using peritoneal dialysis have attracted attention for reasons such as lower treatment costs and prevention of peritoneal adhesion compared to dialysis methods using an artificial kidney.
[0003]
A peritoneal dialysis apparatus used for a dialysis method by peritoneal dialysis is generally an injection connected to a dialysate bag containing peritoneal dialysate (hereinafter referred to as dialysate) to be injected into a patient's peritoneum (intraperitoneal). A fluid bag and a reservoir bag connected to a drainage bag for collecting dialysate discharged from the patient are used as pumps. That is, a chamber for accommodating an infusion bag and a reservoir bag is formed in the dialyzer body of the peritoneal dialysis device, and the infusion bag or the reservoir bag is pumped by pressurizing and depressurizing the inside of the chamber. is there. The dialysis machine body is provided with a heater for heating the dialysis solution in the injection bag to a predetermined temperature range.
[0004]
However, in the conventional peritoneal dialysis device, the chamber and the heater need to be sized corresponding to the infusion bag and the reservoir bag, and the peritoneal dialysis device itself is increased in size and the peritoneal dialysis device is heavy. Become. Therefore, in the medical field, especially home medical care, a large installation space is required for the peritoneal dialysis device, and handling of the peritoneal dialysis device becomes troublesome and hinders smooth medical practice. There is a fear.
[0005]
[Problems to be solved by the invention]
  The object of the present invention is to reduce the size and weight.BellyThe object is to provide a membrane dialysis device.
[0006]
[Means for Solving the Problems]
  Such purposes are as follows (1) to (6This is achieved by the present invention.
[0007]
  (1) Dialysis machine body of peritoneal dialysis machine for peritoneal dialysisAnd the dialyzer bodyFor peritoneal dialysis machinePeritoneal dialysis deviceBecause
The cassette for the peritoneal dialysis machine is:The cassette body,
  A switching cassette circuit capable of switching between an injection circuit state for injecting dialysate to the patient and a drain circuit state for discharging dialysate from the patient;
  Connected to the switching cassette circuit;It has a plurality of divided heating cassette circuits arranged opposite to each other through a gapA heating cassette circuit;
A bypass circuit connecting the upstream side and the downstream side of the heating cassette circuit;
  A pump means connected to the switching cassette circuit for feeding the dialysate;,
A temperature sensor for detecting the temperature of the dialysate;With
The dialyzer body includes a heating means for heating the dialysate in the heating cassette circuit,
When injecting the dialysate, based on the temperature detected by the temperature sensor, driving the heating means so that the temperature of the dialysate is within a predetermined temperature range,
When the temperature detected by the temperature sensor is equal to or higher than a predetermined temperature, the heating means is stopped and the dialysate is cooled by circulating between the bypass circuit and the heating cassette circuit. Is configured toPeritoneal dialysis equipment characterized byPlace.
[0011]
  (2) The pump means was formed by blow moldingDescribed in (1) abovePeritoneal dialysis equipmentPlace.
[0012]
  (3) The switching cassette circuit is formed by blow moldingDescribed in (1) or (2) abovePeritoneal dialysis equipmentPlace.
[0013]
  (4) The heating cassette circuit was formed by sheet moldingAny one of (1) to (3) abovePeritoneal dialysis equipmentPlace.
[0025]
  (5)When the dialysate is drained, the dialysate is collected via the bypass circuit according to any one of (1) to (4) above.Peritoneal dialysis machine.
(6) The temperature sensor detects the temperature of the dialysate flowing downstream of the heating cassette circuit,
Furthermore, a temperature sensor for inlet liquid temperature for detecting the temperature of the dialysate flowing upstream of the heating cassette circuit is provided,
When injecting the dialysate, the temperature of the dialysate falls within a predetermined temperature range based on the temperature detected by the inlet liquid temperature sensor and the temperature detected by the temperature sensor. The peritoneal dialysis apparatus according to any one of (1) to (5), wherein the heating means is driven.
[0026]
DETAILED DESCRIPTION OF THE INVENTION
Hereinafter, the peritoneal dialysis device of the present invention will be described in detail based on preferred embodiments shown in the accompanying drawings.
[0027]
FIG. 1 is a diagram schematically showing an embodiment of the peritoneal dialysis device of the present invention, FIG. 2 is an exploded perspective view of a cassette for a peritoneal dialysis device, FIG. 3 is a perspective view of a cassette for a peritoneal dialysis device, and FIG. FIG. 5 is a schematic sectional view showing a pumping operation means, and FIG. 6 is a dialysis in a state where the lid member is closed and a state where the lid member is opened. FIG. 7 is a block diagram of the control system, and FIG. 8 is a flowchart of temperature control of the dialysate.
[0028]
As shown in FIGS. 6A and 6B, the peritoneal dialysis device 1 includes a dialysis device body 2 and a peritoneal dialysis device cassette 8 that is detachably attached to the dialysis device body 2. ing.
[0029]
The dialysis machine body 2 includes a cassette mounting part 21 to which the peritoneal dialysis machine cassette 8 is mounted, a lid member 22 for opening and closing the cassette mounting part 21, a display part 23, and an operation part 24 a for performing a treatment start operation. And an operation unit 24b for performing a treatment stop operation.
[0030]
The shapes and colors of the operation unit 24a and the operation unit 24b are different from each other so that they can be easily distinguished from each other. In addition, braille indicating the meaning is formed in each of the operation units 24a and 24b.
[0031]
The display unit 23 can be configured by a touch panel including a liquid crystal (LCD) panel or the like, for example. In this case, the display of information and the operation of the apparatus can be respectively performed by the touch panel, and operability and convenience are good.
[0032]
Further, as shown in FIG. 1, the peritoneal dialysis apparatus 1 includes a dialysate circuit unit 3, and the dialysate circuit unit 3 is dialyzed (injected) into the peritoneum (intraperitoneal) of the patient K. Collect a plurality of dialysate bags (dialysate containers) 4 that contain (contain) fluid, an additional dialysate bag 5 that contains dialysate of different concentrations, and dialysate drained from within the peritoneum of patient K A drainage tank (drainage container) 6 is connected to a dialysis catheter (catheter tube) 7 placed in the peritoneum of patient K.
[0033]
Here, the dialysate circuit unit 3 includes a liquid injection tube circuit 31, an additional liquid injection tube circuit 32, a liquid injection / drainage tube circuit 33, and a liquid discharge tube circuit 34. Further, the dialysate circuit unit 3 includes a switching cassette circuit 82, a heating cassette circuit 83, and a bypass circuit (patient side tube circuit) 84 provided in a cassette body 81 of a cassette 8 for peritoneal dialyzer (details will be described later). The switching cassette circuit 82 includes a liquid injection circuit 821, an additional liquid injection circuit 822, a liquid injection / drainage circuit 823, and a liquid discharge circuit 824. Note that connection tubes 85a, 85b, 85c, and 85d are provided at one end of the liquid injection circuit 821, one end of the additional liquid injection circuit 822, the other end of the liquid injection / drainage circuit 823, and the other end of the liquid discharge circuit 824, respectively. Provided (connected).
[0034]
A plurality of branch tube circuits 35 are branched and connected to one end side of the injection tube circuit 31, and one end of each branch tube circuit 35 is connected to the dialysate bag 4. The other end is connected to one end of the liquid injection circuit 821 through the connection tube 85a. One end of the additional tube circuit 32 is connected to the additional dialysate bag 5, and the other end of the additional tube circuit 32 is connected to one end of the additional liquid injection circuit 822 via the connection tube 85b.
[0035]
One end of the liquid injection / drainage tube circuit 33 is connected to the other end of the liquid injection / drainage circuit 823 via the connection tube 85c, and the other end of the liquid injection / drainage tube circuit 33 is The dialysis catheter 7 is connected via a transfer tube set 36. One end of the drainage tube circuit 34 is connected to the other end of the drainage circuit 824 via the connection tube 85 d, and the other end of the drainage tube circuit 34 is connected to the drainage tank 6.
[0036]
The liquid injection tube circuit 31, the additional liquid injection tube circuit 32, the liquid injection / drainage tube circuit 33, and the liquid discharge tube circuit 34 connected to the switching cassette circuit 82 are connected to the peritoneal dialyzer cassette 8 in the dialyzer body 2. When it is mounted on the dialysis apparatus, it is located on the front surface or the front side surface of the dialyzer body 2.
[0037]
Each branch tube circuit 35, additional liquid injection tube circuit 32, liquid injection / drainage tube circuit 33, and liquid discharge tube circuit 34 are each provided with a clamp (channel opening / closing means) 37 that opens and closes the flow path. ing.
[0038]
As shown in FIGS. 1, 2, and 3, the peritoneal dialysis machine cassette 8 includes the cassette body 81 as described above, and this cassette body 81 is attached to the cassette mounting portion 21 of the dialysis machine body 2. On the other hand, it is detachable. The cassette body 81 includes a lower body frame 811, an upper body frame 812 that is detachably provided on the lower body frame 811, and a ceiling frame 813 that is detachably provided on the lower body frame 811.
[0039]
As described above, the cassette body 81 is provided with the switching cassette circuit 82. The switching cassette circuit 82 includes the liquid injection circuit 821, the additional liquid injection circuit 822, the liquid injection / drainage circuit 823, and the drainage circuit 823. It consists of a liquid circuit 824. The other end of the additional liquid injection circuit 822 communicates with the liquid injection circuit 821, and one end of the liquid discharge circuit 824 communicates with the vicinity of the other end of the liquid injection circuit 821.
[0040]
Furthermore, the switching cassette circuit 82 is configured to be able to switch between the liquid injection circuit state and the drainage circuit state when the cassette body 81 is mounted on the cassette mounting portion 21 of the dialyzer body 2. .
[0041]
Here, the liquid injection circuit state means that the liquid injection circuit 821 (or the additional liquid injection circuit 822) and the liquid injection / drainage circuit 823 communicate with each other so that the dialysate bag 4 (or the additional dialysate bag 5) is dialyzed. This refers to a state in which the catheter 7 is communicated, in other words, a state for injecting dialysate into the peritoneum of the patient K (a state in which injection is possible). Further, the drainage circuit state is a state in which the injection / drainage circuit 823 and the drainage circuit 824 communicate with each other so that the dialysis catheter 7 and the drainage tank 6 communicate with each other, in other words, dialysis from within the peritoneum of the patient K. This refers to a state for draining the liquid (a state where the liquid can be drained).
[0042]
As described above, the cassette body 81 is provided with the heating cassette circuit 83. The heating cassette circuit 83 includes two sheet-like divided heating cassette circuits 831 and 832 arranged to face each other.
[0043]
One end of the lower divided heating cassette circuit 831 communicates with the other end of the liquid injection circuit 821, and the other end of the lower divided heating cassette circuit 831 is connected to the upper divided heating cassette via the connection pipe 833. The circuit 832 communicates with one end. The other end of the upper divided heating cassette circuit 832 communicates with one end of the liquid injection / drainage circuit 823.
[0044]
Accordingly, the dialysate sequentially flows in the lower divided heating cassette circuit 831 and the upper divided heating cassette circuit 832 in this order.
[0045]
In the present invention, the dialysate may be divided and flow into the lower divided warming cassette circuit 831 and the upper divided warming cassette circuit 832 and then merged.
[0046]
Further, a gap 86 is formed between the two divided heating cassette circuits 831 and 832. When the cassette main body 81 is mounted on the cassette mounting portion 21 of the dialyzer main body 2, each will be described later. The heaters (heating units) of the heating means 9 are located on both sides (upper surface and lower surface) of the divided heating cassette circuits 831 and 832, and each divided heating cassette circuit 831 and 832 is sandwiched between the corresponding heaters. It is configured to be heated in a state. The positions of the divided heating cassette circuits 831 and 832 are maintained by the lower main body frame 811 and the upper main body frame 812 (supporting portion).
[0047]
Although the flow path of each division | segmentation heating cassette circuit 831 and 832 has comprised the meandering shape as shown in FIG. 4, in this invention, you may comprise the spiral shape, for example. Thus, by making it meander shape or spiral shape, the flow path of each division | segmentation cassette circuit 831 and 832 becomes long, and it can heat a dialysate reliably.
[0048]
As shown in FIG. 5, the cassette body 81 is provided with a diaphragm pump 87 as pump means for pumping operation by contraction and expansion to send dialysate, and the diaphragm pump 87 is provided in the middle of the liquid injection circuit 821. It is connected. Between the ceiling frame 813 and the lower main body frame 811, a chamber 814 for accommodating the diaphragm pump 87 in a sealed state is formed. Here, when the inside of the chamber 814 is pressurized, the diaphragm pump 87 contracts, and when the inside of the chamber 814 is decompressed, the diaphragm pump 87 expands.
[0049]
As shown in FIG. 1, the cassette body 81 is provided with the bypass circuit 84 as described above.
[0050]
One end of the bypass circuit 84 is connected to the upstream side of the heating cassette circuit 83, in the present embodiment, in the middle of the liquid injection circuit 821, and the other end of the bypass circuit 84 is connected to the downstream side of the heating cassette circuit 83, this embodiment. Then, it is connected in the middle of the liquid injection / drainage circuit 823. The bypass circuit 84 connects the upstream side and the downstream side of the heating cassette circuit 83 to form a circulation circuit for cooling the dialysate.
[0051]
Further, in order to forcibly cool the dialysate in the bypass circuit 84, forcible cooling means such as a Peltier element may be provided to cool quickly and reliably.
[0052]
The switching cassette circuit 82, the heating cassette circuit 83, the bypass circuit 84, and the diaphragm pump 87 are arranged substantially in a plane. Thereby, the thickness of the cassette 8 for peritoneal dialysis apparatus can be made thinner.
[0053]
When the cassette body 81 is mounted on the cassette mounting portion 21 of the dialyzer body 2, the outlet side (downstream side) of the heating cassette circuit 83 can be switched between the final injection circuit state and the return circuit state. It is configured. Here, the final liquid injection circuit state means a state in which the outlet side of the heating cassette circuit 83 communicates with the liquid injection / drainage circuit 823 and does not communicate with the bypass circuit 84. The return circuit state refers to a state in which the outlet side of the heating cassette circuit 83 communicates with the bypass circuit 84 and does not communicate with the liquid injection / drainage circuit 823.
[0054]
As shown in FIG. 2, first to eighth support protrusions 881 to 888 are formed on the lower main body frame 811 at positions corresponding to the switching cassette circuit 82. The first support protrusion 881 supports the vicinity of one end of the liquid injection circuit 821, the second support protrusion 882 supports the additional liquid injection circuit 822, and the third support protrusion 883 is an injection liquid. The fourth support protrusion 884 supports between the diaphragm pump 87 and one end of the bypass circuit 84 in the liquid circuit 821, and supports between the diaphragm pump 87 and one end of the heating cassette circuit 83 in the liquid injection circuit 821. To do. Similarly, the fifth support protrusion 885 supports the drain circuit 824, and the sixth support protrusion 886 is connected to the other end of the heating cassette circuit 83 and the bypass circuit 84 in the liquid injection / drain circuit 823. The seventh support protrusion 887 supports the vicinity of the other end of the liquid injection / drainage circuit 823, and the eighth support protrusion 888 supports the bypass circuit 84. To do.
[0055]
The switching cassette circuit 82, the bypass circuit 84, and the diaphragm pump 87 are integrally formed by blow molding. Thereby, joining by another part can be reduced, and while the quality of the cassette 8 for peritoneal dialysis apparatuses can improve, cost can be reduced.
[0056]
Further, each of the divided heating cassette circuits 831 and 832 of the heating cassette circuit 83 is formed by sheet molding. Thereby, manufacture of each division | segmentation heating cassette circuit 831 and 832 becomes easy, and cost can be reduced.
[0057]
The switching cassette circuit 82, the bypass circuit 84, and the diaphragm pump 87 are joined to the divided heating cassette circuits 831 and 832 by high frequency fusion (high frequency welding) and adhesion.
[0058]
Here, in order to form the division heating cassette circuits 831 and 832 by sheet molding, for example, two resin sheets are overlapped, and these are fused in a predetermined pattern. In addition, the part which was not melt | fused forms a flow path.
[0059]
The switching cassette circuit 82, the heating cassette circuit 83, the bypass circuit 84, and the diaphragm pump 87 are composed of soft resins such as polyethylene, polypropylene, ethylene-propylene copolymer, and ethylene-vinyl acetate copolymer, respectively. Polyolefin such as coalescence (EVA), polyvinyl chloride, polyvinylidene chloride, polystyrene, polyamide, polyimide, poly- (4-methylpentene-1), ionomer, acrylic resin, polyethylene terephthalate (PET), polybutylene terephthalate (PBT) ) And other polyester, styrene, polyolefin, polyvinyl chloride, polyurethane, polyester, polyamide and other thermoplastic elastomers, silicone resins, polyurethane, etc. Polymers, blends, polymer alloys and the like, can be used singly or in combination of two or more of these (e.g., a laminate of two or more layers).
[0060]
As shown in FIG. 4, a heating means 9 for heating the heating cassette circuit 83 of the peritoneal dialysis machine cassette 8 is provided in the dialysis machine main body 2. It has a layered lower surface heater 91, a plate-shaped (layered) upper surface heater 92, and a plate-shaped (layered) intermediate surface heater 93.
[0061]
Here, the lower surface heater 91 heats the lower surface of the lower divided heating cassette circuit 831 from below through an aluminum plate 94a as a heat transfer member, and the upper surface heater 92 The upper surface of the divided heating cassette circuit 832 is heated from above via an aluminum plate 94d as a heat transfer member. The intermediate surface heater 93 is located in the gap 86 and heats the upper surface of the lower divided heating cassette circuit 831 from above through an aluminum plate 94b as a heat transfer member, and also performs upper divided heating. The lower surface of the temperature cassette circuit 832 is heated from below through an aluminum plate 94c as a heat transfer member.
[0062]
As a result, as described above, the dialysate inside the lower divided heating cassette circuit 831 is heated while being sandwiched between the lower surface heater 91 and the intermediate surface heater 93, and the upper divided heating cassette circuit. The dialysate inside 832 is heated while being sandwiched between the upper surface heater 92 and the intermediate surface heater 93. Therefore, the heating efficiency of the dialysate inside the heating cassette circuit 83 by the heating means 9 is improved, which is advantageous in reducing the size and weight of the dialyzer body 2 and the peritoneal dialyzer cassette 8.
[0063]
As shown in FIG. 5, the dialyzer main body 2 is provided with a pumping operation means 10 for pumping the diaphragm pump 87.
[0064]
That is, an air circuit (air pressure increasing / decreasing circuit) 101 is provided in the dialyzer main body 2, and one end of the air circuit 101 communicates with the chamber 814 when the cassette main body 81 is mounted on the cassette mounting portion 22. It is configured as follows. One end of a pair of branch air circuits 102 and 103 is branched and connected to the other end of the air circuit 101, and an air pressure generator 104 is connected to the other end of the one branch air circuit 102. A vacuum pressure generator (decompressor) 105 such as an ejector is connected to the other end of the branched air circuit 103.
[0065]
A switching valve 106 is disposed in the middle of the pair of branch air circuits 102 and 103. The switching valve 106 can be switched between a pressurized state in which the air circuit 101 and one branch air circuit 102 communicate with each other and a reduced pressure state in which the air circuit 101 and the other branch air circuit 103 communicate with each other. .
[0066]
As shown in FIG. 1, a clamp means 11 is provided in the dialyzer body 2. For example, the clamp means 11 switches the switching cassette circuit 82 to one of a liquid injection circuit state and a liquid discharge circuit state, and the outlet side of the heating cassette circuit 83 is connected to a final liquid injection circuit state and a liquid discharge state. The circuit state is switched to one of the circuit states, and the pumping operation of the diaphragm pump 87 is assisted.
[0067]
That is, the first to eighth clamps 111 to 118 are provided in the dialyzer body 2. The first clamp 111 clamps the vicinity of one end of the liquid injection circuit 821 in cooperation with the first support protrusion 881 so that the flow path closes. The second clamp 112 is connected to the second support protrusion 882. In cooperation, the additional liquid injection circuit 822 is clamped so that the flow path is closed, and the third clamp 113 cooperates with the third support protrusion 883 to bypass the diaphragm pump 87 in the liquid injection circuit 821. Clamping is performed so that the flow path is closed between one end of the circuit 84, and the fourth clamp (clamp for pumping control) 114 cooperates with the fourth support protrusion 884 to operate the diaphragm pump in the liquid injection circuit 821. 87 and the heating cassette circuit 83 are clamped so that the flow path is closed.
[0068]
Similarly, the fifth clamp 115 cooperates with the fifth support protrusion 885 to clamp the drain circuit 824 so that the flow path is closed, and the sixth clamp 116 is connected to the sixth support protrusion 886. The seventh clamp 117 is configured to clamp the flow path between the other end of the heating cassette circuit 83 and the other end of the bypass circuit 84 in the liquid injection / drainage circuit 823 in cooperation with each other. The eighth clamp 118 cooperates with the eighth support protrusion 888 in cooperation with the seventh support protrusion 887 so that the flow path closes the other end of the liquid injection / drainage circuit 823. Thus, the bypass circuit 84 is clamped so that the flow path is closed.
[0069]
Therefore, when the switching cassette circuit 82 is switched to the liquid injection circuit state, the first clamp 111 (or the second clamp 112), the fourth clamp (pumping control clamp) 114, the sixth clamp 116, and the seventh clamp 117 are respectively In addition to switching to the unclamped state, the second clamp 112 (or the first clamp 111), the fifth clamp 115, and the eighth clamp 118 are each switched to the clamped state. When the inside of the chamber 814 is pressurized by the pumping operation means 10, the fourth clamp 114 is switched to the unclamped state and the third clamp 113 is switched to the clamped state. Further, when the pressure in the chamber 814 is reduced by the pumping operation means 10, the fourth clamp 114 is switched to the clamped state and the third clamp 113 is switched to the unclamped state. Thereby, the dialysate can be sent from the dialysate bag 4 (or the additional dialysate bag 5) toward the dialysis catheter 7, that is, injected.
[0070]
Further, when the switching cassette circuit 82 is switched to the drain circuit state, the seventh clamp 117 and the eighth clamp 118 are switched to the unclamp state, and the first clamp 111, the second clamp 112, the fourth clamp 114, Each of the sixth clamps 116 is switched to a clamped state. When the pressure in the chamber 814 is reduced by the pumping operation means 10, the third clamp 113 is switched to the unclamped state and the fifth clamp 115 is switched to the clamped state. Further, when the inside of the chamber 814 is pressurized by the pumping operation means 10, the third clamp 113 is switched to the clamped state and the fifth clamp 115 is switched to the unclamped state. Thereby, the dialysate can be sent from the dialysis catheter 7 toward the drainage tank 6, that is, drained.
[0071]
The diaphragm pump 87, the third clamp 113, the fourth clamp 114, the fifth clamp 115, and the pumping operation means 10 constitute a liquid feeding means for feeding dialysate.
[0072]
Further, when the switching cassette circuit 82 is in the liquid injection circuit state and the outlet side of the heating cassette circuit 83 is in the final liquid injection circuit state, the seventh clamp 117 is in the unclamped state and the eighth clamp 118 is in the clamped state. is there.
[0073]
When the outlet side of the heating cassette circuit 83 is switched to the return circuit state, the first clamp 111, the second clamp 112, and the seventh clamp 117 are switched to the clamped state, and the eighth clamp 118 is switched to the unclamped state. As a result, the dialysate does not flow from the outlet side of the heating cassette circuit 83 toward the dialysis catheter 7 but flows through the bypass circuit 84 toward the diaphragm pump 87. That is, the dialysate circulates between the bypass circuit 87 and the heating cassette circuit 83.
[0074]
The seventh clamp 117 and the eighth clamp 118 constitute liquid injection return circuit switching means for switching the outlet side of the heating cassette circuit 83 between the final liquid injection circuit state and the return circuit state.
[0075]
Here, when the dialysate is drained, the drainage is collected in the drainage tank 6 via the bypass circuit 84. Thereby, the structure of a flow path can be simplified.
[0076]
As described above, by providing the cassette body 2 with the switching cassette circuit 82, the heating cassette circuit 83, the bypass circuit 84, and the diaphragm pump 87, the peritoneal dialysis device 1 can be reduced in size and weight. The peritoneal dialysis device 1 can be installed in a small space, and the peritoneal dialysis device 1 can be easily handled and transported smoothly.
[0077]
In particular, since the dialysate flowing through each of the divided heating cassette circuits 831 and 832 is heated while being sandwiched between the corresponding heaters, the heating efficiency of the dialysate is improved. 1 can be further reduced in size and weight.
[0078]
As shown in FIGS. 1 and 4, the peritoneal dialysis device 1 includes various sensors for temperature control of the dialysate.
[0079]
That is, on the downstream side of the heating cassette circuit 83 of the dialyzer main body 2, an outlet for measuring (detecting) the temperature (outlet liquid temperature) of the dialysate flowing on the outlet side (downstream side) of the heating cassette circuit 83. A temperature sensor 12A for liquid temperature is installed, and the temperature (inlet liquid temperature) of the dialysate flowing on the inlet side (upstream side) of the heating cassette circuit 83 is measured (detected) on the upstream side of the heating cassette circuit 83. An inlet liquid temperature sensor 12B is installed.
[0080]
Here, as the outlet liquid temperature sensor 12A and the inlet liquid temperature sensor 12B, it is preferable to use a thermopile type infrared sensor (non-contact type temperature sensor) having a very fast response speed. Thereby, the temperature of each surface heater 91,92,93 can be controlled with high precision.
[0081]
Each surface heater 91, 92, 93 is provided with a heater temperature sensor 13 such as a thermistor for measuring (detecting) the temperature. Further, the dialyzer main body 2 is provided with bubble sensors 14 for detecting bubbles on the inlet side and the outlet side of the switching cassette circuit 82, respectively. The peritoneal dialysis device 1 includes an occlusion sensor that detects occlusion of the circuit and other various sensors (various sensors 16).
[0082]
As shown in the block diagram of FIG. 7, the peritoneal dialysis apparatus 1 includes a control system (control means) 15 that controls each of injection and drainage of dialysate.
[0083]
That is, the control system 15 includes a CPU 151 and a storage unit 152. The CPU 151 controls the temperature of the clamp control unit 153 that controls the plurality of clamps 111 to 118 and the plurality of surface heaters 91, 92, and 93. A heater control unit 154 for controlling the pumping operation means 10 and a pumping operation control unit 155 for controlling the pumping operation means 10 are electrically connected to each other. The CPU 151 includes an outlet liquid temperature sensor 12A, an inlet liquid temperature sensor 12B, each heater temperature sensor 13, each bubble sensor 14, a display unit 23, and operation units 24a and 24b, respectively. Connected. A power supply circuit 156 and a battery circuit 157 are electrically connected to the CPU 151, respectively.
[0084]
When the temperature measured by the outlet liquid temperature sensor 12A is equal to or higher than a predetermined temperature (39 ° C. in the present embodiment), the control system 15 causes the clamp controller 153 to set the seventh clamp 117. Control to switch to the clamped state, control the eighth clamp 118 to switch to the unclamped state, and stop the driving of the plurality of surface heaters 91, 92, 93 by the heater control unit 154 (switch to OFF).
[0085]
The outputs (output values) of the surface heaters 91, 92, and 93 are selected from the following output values based on the dialysate temperature control flow and the dialysate temperature, as will be described later. That is, the control system 15 determines the temperature of the dialysate to be injected based on the temperature measured by the outlet liquid temperature sensor 12A and the temperature measured by the inlet liquid temperature sensor 12B. The outputs (drives) of the plurality of surface heaters 91, 92, 93 are controlled so as to be within the temperature range of
[0086]
(1) Heater output value by feedforward control (FF control)
[Heater output value] = (α × [inlet fluid temperature] + β) × [dialysis fluid speed]
[0087]
(2) Heater output value by P control of feedback control
[Heater output value] = Kp × dt
Here, Kp = γ × exp (δ × [dialysis fluid speed])
dt = [target temperature] − [outlet liquid temperature]
[0088]
(3) Heater output value by PI control in feedback control
[Heater output value] = Kp × (dt + ∫dt / Ti)
Where Kp = ε × exp (δ × [dialysis fluid speed])
Ti = − [speed of dialysate] / ζ + η
dt = [target temperature] − [outlet liquid temperature]
(Where α to η are constants introduced from experiments)
[0089]
Next, the operation of the peritoneal dialysis device 1 will be described with reference to the flowchart of FIG.
[1] The clamp control unit 153 controls the first clamp 111 (or the second clamp 112), the fourth clamp 114, the sixth clamp 116, and the seventh clamp 117 to switch to the unclamped state. (Or the first clamp 111), the fifth clamp 115, and the eighth clamp 118 are controlled to switch to the clamped state. Thereby, the switching cassette circuit 82 can be switched to the liquid injection circuit state.
[0090]
[2] After or before the operation of [1], the heater control unit 154 controls the power (output) to be supplied to the plurality of surface heaters 91, 92, and 93. Thereby, the heating process which heats the dialysate which flows through the heating cassette circuit 83, in other words, the temperature control flow of the dialysate enters the preheating process (step 1).
[0091]
[3] When the time T1 has elapsed since the start of power supply to the plurality of surface heaters 91, 92, 93, the preheating process ends (step 2). Here, T1 is the time until the temperatures of the plurality of surface heaters 91, 92, 93 become close to the body temperature, and is a constant obtained by experiments.
[0092]
[4] When the preheating step is finished, the pumping operation control unit 155 controls the pumping operation means 10 to alternately pressurize and depressurize the chamber 814. In addition, the clamp control unit 153 controls the fourth clamp 114 to switch between the clamped state and the unclamped state alternately according to the pressurization and decompression in the chamber 814, and also controls the third clamp 113 to perform the clamp. Switching between the state and the unclamped state is repeated alternately according to the pressurization and decompression in the chamber 814. Thereby, the diaphragm pump 87 can be pumped (contracted and expanded), so that the dialysate can be fed from the dialysate bag 4 toward the dialysis catheter 7 and injected.
[0093]
[5] When the preheating step is completed, the temperature control flow of the dialysate enters the initial heating step (steps 3 and 4). In the initial heating step, output control of the plurality of surface heaters 91, 92, 93 is performed as follows.
[0094]
When the temperature measured by the outlet liquid temperature sensor 12A is less than 33 ° C., the larger output value of the heater output value by the FF control and the heater output value by the P control is displayed on a plurality of surfaces. It outputs to the heaters 91, 92, 93 (step 5).
[0095]
On the other hand, when the temperature measured by the outlet liquid temperature sensor 12A is 33 ° C. or higher and lower than 39 ° C., the larger one of the heater output value by the FF control and the heater output value by the PI control is output. The value is output to the plurality of surface heaters 91, 92, 93 (step 6).
[0096]
[6] When the time T2 has elapsed since the start of power supply to the plurality of surface heaters 91, 92, 93, the initial heating process ends (step 7). Here, T2 is the time until the dialysate accumulated in the heating cassette circuit 83 flows out of the heating cassette circuit 83 during the preheating step, and is a constant obtained by experiments.
[0097]
[7] When the initial heating step is completed, the temperature control flow of the dialysate enters the normal heating step (steps 8 and 9). In the normal heating process, output control of the plurality of surface heaters 91, 92, 93 is performed as follows.
[0098]
When the temperature measured by the outlet liquid temperature sensor 12A is less than 33 ° C., the output value of the heater by P control is output to the plurality of surface heaters 91, 92, 93 (step 10).
[0099]
On the other hand, when the temperature measured by the outlet liquid temperature sensor 12A is 33 ° C. or higher and lower than 39 ° C., the output value of the heater by PI control is output to the plurality of surface heaters 91, 92, 93 (step 11). ).
[0100]
Thereby, output control of the several surface heaters 91, 92, and 93 can be performed with high precision.
[0101]
[8] In the initial heating process or the normal heating process, when the temperature measured by the outlet liquid temperature sensor 12A is 39 ° C. or higher, the clamp controller 153 controls the seventh clamp 117. Switch to the clamped state and control the eighth clamp 118 to switch to the unclamped state. Further, the heater controller 154 stops the supply of power to the plurality of surface heaters 91, 92, 93, in other words, the plurality of surface heaters 91, 92, 93 are switched to OFF. Thereby, the outlet side of the heating cassette circuit 83 can be switched to the return circuit state, and the dialysate flows from the heating cassette circuit 83 toward the bypass circuit 84 without flowing toward the dialysis catheter 7. It returns to the upstream side of the heating cassette circuit 83 through the bypass circuit 84, circulates between the bypass circuit 84 and the heating cassette circuit 83, and the temperature decreases (cools) during that time. That is, the dialysate heating control flow shifts to the cooling step (step 12). Therefore, a dialysis solution having a temperature considerably higher than the body temperature of the patient K (a temperature of 39 ° C. or higher) is not injected into the patient K, and a safe dialysis treatment can be performed.
[0102]
When the temperature measured by the outlet liquid temperature sensor 12A is less than 39 ° C., the clamp controller 153 controls the seventh clamp 117 to switch to the unclamped state, and controls the eighth clamp 118. Switch to the clamped state. Further, the plurality of surface heaters 91, 92, 93 are switched on. Thereby, the exit side of the heating cassette circuit 83 can be returned to the final liquid injection circuit state, and the process proceeds to the initial heating process or the normal heating process again.
[0103]
[9] When a predetermined amount of dialysate is injected (injected) into the peritoneum of patient K, the injection of dialysate is terminated.
[0104]
[10] After the injection of dialysate is completed, the clamp controller 154 controls the seventh clamp 117 and the eighth clamp 118 to switch to the unclamped state, and controls the fourth clamp 114 and the sixth clamp 116. Switch to the clamped state. Thereby, the switching cassette circuit 82 can be switched to the drain circuit state.
[0105]
[11] Then, the pumping operation control unit 155 controls the pumping operation means 10 to alternately repeat the depressurization and pressurization of the chamber 814. In addition, the clamp control unit controls the third clamp 113 to alternately switch between the unclamped state and the clamped state according to the decompression and pressurization of the chamber 814, and also controls the fifth clamp 115 to perform the clamping. Switching between the state and the unclamped state is repeated alternately according to the pressure reduction and pressurization in the chamber 814. Thereby, the diaphragm pump 87 is pumped, and the dialysate in the peritoneum can be sent from the dialysis catheter 7 toward the drainage tank 6 to be drained.
[0106]
As mentioned above, although the peritoneal dialysis apparatus of this invention was demonstrated based on embodiment of illustration, this invention is not limited to this, The structure of each part is a thing of arbitrary structures which can exhibit the same function Can be substituted.
For example, the number of divided cassette circuits 831 and 832 may be increased.
[0107]
In the above embodiment, the dialysate flows in the order of the lower divided heating cassette circuit 831 and the upper divided heating cassette circuit 832, but the upper divided heating cassette circuit 832 and the lower divided heating cassette circuit 832. The cassette circuit 831 may flow in the order.
[0108]
【The invention's effect】
As described above, according to the present invention, it is possible to reduce the size and weight of the peritoneal dialysis device, and the installation space of the peritoneal dialysis device is sufficient, and handling such as transport of the peritoneal dialysis device is easy. Therefore, smooth medical practice can be performed.
[0109]
Further, when the heating cassette circuit has a plurality of divided heating cassette circuits arranged to face each other through a gap, the heating efficiency of the dialysate is improved, which is advantageous for miniaturization and weight reduction.
[0110]
Further, when the switching cassette circuit and the pump means are formed by blow molding, the switching cassette circuit and the pump means can be manufactured by integral molding, improving the quality of the cassette for the peritoneal dialysis device and reducing the cost. Can be reduced.
[0111]
Further, when the heating cassette circuit is molded by sheet molding, the manufacturing is simplified and the molding cost is reduced.
[Brief description of the drawings]
FIG. 1 is a diagram schematically showing an embodiment of a peritoneal dialysis device of the present invention.
FIG. 2 is an exploded perspective view of a cassette for a peritoneal dialysis device.
FIG. 3 is a perspective view of a cassette for a peritoneal dialysis device.
FIG. 4 is a diagram illustrating a relationship between a heating cassette circuit and heating means.
FIG. 5 is a schematic cross-sectional view showing a pumping operation means.
FIG. 6 is a perspective view of the dialysis apparatus main body with the lid member closed and the lid member opened.
FIG. 7 is a block diagram of a control system.
FIG. 8 is a flowchart of temperature control of dialysate.
[Explanation of symbols]
1 Peritoneal dialysis machine
2 Dialysis machine body
21 Cassette mounting part
22 Lid member
23 Display
24a, 24b operation unit
3 Dialysate unit
31 Injection tube circuit
32 Additional injection tube circuit
33 Injection / drainage tube circuit
34 Drainage tube circuit
35 Branch tube circuit
36 Transfer tube set
37 Clemme
4 Dialysate bag
5 Additional dialysate bag
6 Drainage tank
7 Dialysis catheter
8 Cassette for peritoneal dialysis machine
81 Cassette body
811 Lower body frame
812 Upper body frame
813 Ceiling frame
814 Chamber
82 switching cassette circuit
821 Injection circuit
822 Additional injection circuit
823 Injection / drainage circuit
824 drainage circuit
83 Heating cassette circuit
831 Divided heating cassette circuit
832 Divided heating cassette circuit
833 Connection pipe
84 Bypass circuit
85a-85d Connection tube
86 gap
87 Diaphragm pump
881 First support protrusion
882 Second support protrusion
883 Third support protrusion
884 Fourth support protrusion
885 Fifth support protrusion
886 6th support protrusion
887 7th support protrusion
888 8th support protrusion
9 Heating means
91 Lower surface heater
92 Upper surface heater
93 Intermediate heater
94a-94d aluminum plate
10 Pumping operation means
101 Air circuit
102 Branch air circuit
103 Branch air circuit
104 Air pressure generator
105 Vacuum pressure generator
106 Switching valve
11 Clamping means
111 1st clamp
112 Second clamp
113 3rd clamp
114 4th clamp
115 5th clamp
116 6th clamp
117 7th clamp
118 8th clamp
12A Temperature sensor for outlet liquid temperature
12B Temperature sensor for inlet liquid temperature
13 Heater temperature sensor
14 Bubble sensor
15 Control system
151 CPU
152 storage unit
153 Clamp control unit
154 Heater control unit
155 Pumping operation controller
156 Power circuit
157 Battery circuit
16 Various sensors
Steps S1-S12

Claims (6)

A peritoneal dialysis apparatus comprising a dialysis device for peritoneal dialysis apparatus, and a cassette for peritoneal dialysis apparatus that is detachably attached to the dialysis device for performing peritoneal dialysis,
The peritoneal dialysis machine cassette includes a cassette body,
A switching cassette circuit capable of switching between an injection circuit state for injecting dialysate to the patient and a drain circuit state for discharging dialysate from the patient;
A heating cassette circuit having a plurality of divided heating cassette circuits connected to the switching cassette circuit and arranged to face each other through a gap ;
A bypass circuit connecting the upstream side and the downstream side of the heating cassette circuit;
A pump means connected to the switching cassette circuit for feeding the dialysate ;
A temperature sensor for detecting the temperature of the dialysate ,
The dialyzer body includes a heating means for heating the dialysate in the heating cassette circuit,
When injecting the dialysate, based on the temperature detected by the temperature sensor, driving the heating means so that the temperature of the dialysate is within a predetermined temperature range,
When the temperature detected by the temperature sensor is equal to or higher than a predetermined temperature, the heating means is stopped and the dialysate is cooled by circulating between the bypass circuit and the heating cassette circuit. peritoneal dialysis equipment, characterized in that it is configured to. It said pump means, peritoneal dialysis equipment according to claim 1 and is formed by blow molding. The switching cassette circuit, peritoneal dialysis equipment according to claim 1 or 2, which has been formed by blow molding. The heating cassette circuit, peritoneal dialysis equipment according to any one of claims 1 to 3 and is formed by sheet molding. The peritoneal dialysis apparatus according to any one of claims 1 to 4, wherein when the dialysate is drained, the dialysate is collected via the bypass circuit . The temperature sensor detects the temperature of the dialysate flowing downstream of the heating cassette circuit,
  Furthermore, a temperature sensor for inlet liquid temperature for detecting the temperature of the dialysate flowing upstream of the heating cassette circuit is provided,
  When injecting the dialysate, the temperature of the dialysate falls within a predetermined temperature range based on the temperature detected by the inlet liquid temperature sensor and the temperature detected by the temperature sensor. The peritoneal dialysis apparatus according to any one of claims 1 to 5, wherein the heating means is driven.

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