JP5217355B2 - Blood purification control device - Google Patents

Description

  BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a blood purification control device having a blood purification circuit having a filter for purifying blood and controlling the flow of liquid in the attached blood purification circuit, and more particularly to a blood purification control device that controls priming of the blood purification circuit. .

  For patients whose kidney function is reduced due to illness or the like, blood purification such as hemodialysis is performed by medical personnel. The blood purification control apparatus controls the flow of the liquid flowing through the blood purification circuit so as to clean the patient's blood safely and efficiently. The blood purification circuit includes a blood circuit through which a patient's blood flows, a liquid supply circuit through which dialysate and replacement fluid flow, and a filtrate circuit through which filtrate flows, and is attached to the blood purification control device.

  Priming is performed as a preparation before the patient's blood is purified. Priming is to fill the circuit with a priming solution such as physiological saline for the purpose of cleaning the blood purification circuit and removing air.

  The circuit is a flow path through which blood, dialysate, replacement fluid, and the like flow, and is formed by a filter, a chamber, a needle, a tube, and the like. A filter is an instrument that purifies blood by material exchange between blood and dialysate according to principles such as diffusion and ultrafiltration. The chamber is an instrument that traps bubbles in the liquid passing through the line. A needle is an instrument that is attached to a circuit at the time of surgery, and is punctured at each of a removal location such as a patient shunt and a blood return location in order to take blood from the body and return the blood to the body. The tube is attached to a connection port provided in these instruments, and connects the instruments.

  The chamber has an original function of trapping bubbles in the blood when it flows in the direction in which blood should flow (hereinafter referred to as “forward direction”) during the treatment. Therefore, in order to fill the interior with the priming liquid, the priming liquid is allowed to flow in the forward direction with the top of the chamber reversed from that during blood purification, or the priming liquid is left in the state where the chamber top is in the state of blood purification. Must flow in the opposite direction.

  Moreover, it is difficult for the filter to flow the priming liquid in the forward direction and fill the inside with the priming liquid because of its structure. Therefore, in order to fill the inside of the filter with the priming liquid, like the chamber, the priming liquid is allowed to flow in the forward direction with the top of the filter reversed from the time of blood purification, or the top of the filter is It is necessary to flow the priming solution in the reverse direction while maintaining the blood purification state.

  Conventionally, at the time of priming, the pack containing the priming solution is connected to the blood return port, and the pump is operated so that a pressure difference is generated in the opposite direction to that during the operation. A blood purification control device that circulates in a direction and a priming method thereof have been proposed (see, for example, Patent Document 1).

In addition, since the priming operation is performed to remove bubbles and foreign substances from the circuit and the filter (blood purifier), it is necessary to wash with a sufficient amount of the priming liquid. In addition, it is also required to reduce the amount of the cleaning liquid within a possible range because the replacement operation of the storage container is excluded. Therefore, a so-called rinse-type cleaning operation is also widely performed in which the cleaning liquid that has passed through the circuit or the filter only once is not discarded as it is, but is drained after recirculation (see, for example, Patent Document 2). ).
JP 2006-175103 A No. 5-19076

  What is important in the conventional recirculation-type cleaning operation is the amount of fluid supplied by a replacement fluid pump for feeding into the blood circuit and the amount of blood pump sent by the blood pump. If the amount of blood pump that sends fluid (blood, priming fluid, etc.) in the blood circuit is greater than the amount of fluid supplied by the replacement pump that delivers priming fluid into the blood circuit, the An excessive negative pressure may be applied to the flowing priming liquid. Therefore, conventionally, there is a problem that air is taken into the filter from the outside and the air remains in the filter after priming.

  If air remains in the circuit after priming, there is a risk that the blood in the circuit will clot and the blood cannot be purified. In addition, if the remaining air enters the patient's body through the circuit, it will affect the patient's life.

  Conversely, if the flow rate of the replacement fluid pump is higher than the flow rate of the blood pump, excessive pressure is applied to the filter, which may damage the filter. As a result, the patient's blood cannot be purified safely and sufficiently.

  There is a certain error in the pressure applied by the pump. In the pump generally used for the blood purification control apparatus, it is actually difficult to control the positive pressure and the negative pressure applied to the filter so as to keep a constant balance due to this error. That is, the conventional technique has a problem that priming that can realize a safe treatment cannot be performed.

  In addition, the blood purification circuit has a complicated configuration because blood purification by various methods is realized by one blood purification circuit. Therefore, the priming procedure is complicated, and there is a problem that the burden on the operator is heavy in manual operation.

  Furthermore, the conventional blood purification control device and its control method at the time of priming have the problem that it is necessary to connect the pack storing the priming solution to the blood return port at the time of priming, and to remove it when priming is completed. .

  Conventionally, the priming liquid is poured from the blood return port of the blood circuit and discharged from the blood collection port. Therefore, at the time of priming, the operator connects the pack storing the priming solution to the blood return port. When the priming is completed, the operator removes the pack storing the priming solution in order to attach the blood return device to the blood return port. Thus, it is troublesome for the operator to connect the pack storing the priming solution and remove it later. In addition, it is desirable from the viewpoint of hygiene that the number of procedures for connecting and disconnecting circuits is as small as possible.

  Further, as described above, it is desirable that the amount of liquid for completing the priming operation is small in order to save the trouble of replacing the container (pack) and also from the viewpoint of cost reduction.

  The present invention has been made to solve the above problems, and safely and automatically executes a priming operation without removing or replacing a pack storing priming liquid during the operation or replacing it during the operation. It is an object of the present invention to provide a blood purification control device that can perform the above-described operation.

  “At the time of treatment” refers to the period from the start to the end of blood purification of a patient.

  A “filter” is an instrument that purifies blood. A typical filter passes a bunch of hollow fibers through a cylinder, allows blood to pass through the hollow fibers, and indirectly contacts the dialysate flowing in the cylinder via a hollow fiber membrane. By purifying the blood. Due to the principle of diffusion, ultrafiltration and osmotic pressure, wastes in the blood such as urea, uric acid, creatine, and excess water are discharged into the dialysate, and electrolytes in the dialysate are taken into the blood.

  The “chamber” is a gas-liquid separator that removes bubbles and foreign substances contained in the liquid flowing into the interior and discharges the liquid from which the bubbles and foreign substances have been removed. The chamber of the blood purification circuit generally traps air bubbles in the liquid flowing inside the chamber by collecting the air bubbles in the liquid on the inlet side of the chamber by utilizing the property that the air bubbles rise in the liquid. Some “chambers” have a function of separating foreign substances by incorporating a mesh.

  “Liquid supply” is a general term for “replacement fluid” and “dialysis fluid”. For the “liquid supply”, an isotonic solution adjusted so that the body fluid and the osmotic pressure and the electrolyte are generally equal is used.

  “Priming liquid” refers to a liquid used for priming of the blood purification control apparatus. “Replacement fluid” refers to a chemical solution that replenishes blood water and electrolytes lost by passing through a filter. “Dialyzed solution” refers to a chemical solution that exchanges substances with blood in a filter.

  The “filtrate” refers to waste products and excess water filtered from blood, or dialysate after purifying blood.

A “pump” is a device that applies pressure to cause the liquid in the circuit to flow.
The “valve” is a device that adjusts the flow rate of the liquid in the circuit and closes the flow path at the mounting position. “Close the valve” means to close the flow path of the liquid in the circuit at the mounting position, and “open the valve” means to flow the liquid in the circuit at the mounting position. For example, when the circuit is a tube having a certain elasticity, it is possible to close the flow path by attaching an instrument for pinching the tube from the outside, and pinching the normally opened tube from the outside.

  “Circuit” refers to the entire flow path through which a specific type of liquid flows. Specifically, the circuit is a flow path through which blood, priming solution, replacement fluid, and dialysate flow, and is realized by a combination of a filter, a chamber, a branch pipe, a tube, and the like. The circuit is divided into a “blood circuit” and a “fluid supply circuit” depending on the liquid flowing inside during the treatment, and blood flows through the blood circuit, and replacement fluid and dialysate flow through the liquid supply circuit. “Line” indicates a part of a circuit or a branch portion.

  “Forward direction” refers to the direction in which liquid flows in the circuit during treatment. The “reverse direction” refers to the direction opposite to the forward direction. The “forward direction” of circuits that are not attached at the time of treatment and lines where liquid does not flow are defined individually.

  In order to achieve the above object, a blood purification control apparatus for controlling a flow of liquid in a blood purification circuit having a filter for purifying blood and a blood return line connected to a blood outlet of the filter. A return valve for opening and closing the return line, a first pump for sending a priming liquid between the filter and the return valve of the return line, and closing the return valve, First control means for operating the first pump.

  In this way, the first pump is operated in a state where the flow of the blood return line is stopped by the blood return valve. Thereby, the priming liquid sent from between the filter of the blood return line and the blood return valve is sent from the blood outlet of the filter into the filter. In other words, the priming liquid can be flowed through the filter in the direction opposite to the blood flow during the treatment without attaching or removing the pack storing the priming liquid. Therefore, it is possible to automatically execute priming without attaching / detaching the pack storing the priming liquid.

  Preferably, the blood purification circuit further includes a blood removal line connected to a blood inlet of the filter, and the blood purification control device further filters the liquid through the blood removal line. A second pump capable of being sent to the filter and allowed to flow out of the filter, wherein the first control means causes the second pump to flow out the priming liquid from the filter. Operate with pump.

  Thus, the flow rate sucked out by the first pump and the second pump is smaller than the flow rate at which the priming liquid is fed into the filter. Thus, it becomes possible to make the flow of the priming liquid in a filter smooth by generating a surplus flow rate in a filter with two pumps, and applying pressure.

  More preferably, the first control means controls the first pump and the second pump so that a flow rate or pressure sent out by the first pump is larger than a flow rate or pressure discharged from the second pump. To do.

  When a negative pressure is applied to the inside of the filter hollow fiber, air is blown out when air bubbles are blown from the outside to the inside of the hollow fiber, so that the air in the blood circuit, which is the purpose of priming, cannot be removed. By controlling the pressure at which the priming liquid is fed to be greater than the pressure to be sucked out, it is possible to prevent negative pressure from being applied to the inside of the hollow fiber, and it is possible to reliably remove bubbles by priming Become.

  More preferably, the blood purification control device further includes second control means for opening the blood return valve and operating the first pump at the time of priming, and the second control means includes the blood return line. After the priming is completed, control is performed so that the above operation is executed.

  In this way, the priming of the return line is performed before the filter. Thus, when the blood return valve is opened, it is possible to prevent the priming liquid filled in the filter or the like from coming out through the blood return line. Therefore, it is possible to prime the blood return line and the filter with simple control without complicating the blood purification control device and the control by the blood purification control device such as newly providing a valve.

  More preferably, the blood purification circuit further includes an auxiliary circuit that connects ends of the blood return line and the blood removal line that are not connected to the filter, and has a chamber in the middle, and the blood purification control The apparatus further opens the blood return valve and completes operation of the second pump after the priming of the blood purification circuit is completed, thereby allowing the filter, the blood removal line, the auxiliary circuit, and the return circuit to operate. Recirculation control means for circulating the priming solution in the blood line is provided.

  Thus, after the priming of the blood purification circuit having the auxiliary circuit having the chamber is completed, the recirculation is performed. Thereby, the priming operation can be completed with a small amount of the priming liquid, and the air in the blood purification circuit that could not be removed by the conventional operation can be trapped in the chamber of the auxiliary circuit. Since the auxiliary circuit is unnecessary for the treatment, it is removed and discarded during the blood purification treatment. Therefore, the air remaining after priming can be removed with a simple operation.

  More preferably, the blood purification control apparatus further includes a third pump that feeds a priming solution from a dialysate inlet of the filter, and a third control unit that operates the third pump during priming.

  The blood purification control device further includes a fourth pump that sucks out the priming solution from the dialysate discharge port of the filter, and the third control means uses the third pump to provide a dialysis circuit portion of the filter. After the priming liquid is filled, the fourth pump is further operated.

  In this way, the third pump that sends the priming solution from the dialysate inlet to the filter and the fourth pump that sucks out the priming solution from the dialysate outlet of the filter are sequentially operated. Thereby, the liquid supply circuit part of a filter can be primed.

  In addition, when the third pump feeds the priming solution from the dialysate inlet to the filter through the dialysate line, which is a line for feeding the dialysate to the filter during treatment, the dialysate line is primed. .

  Furthermore, when the fourth pump causes the priming solution to flow out from the dialysate discharge port via the filtrate line, which is a line through which the filtrate after filtering blood flows out from the filter, priming of the filtrate line is performed. Is made.

  As described above, when the priming liquid is flowed through the dialysate line through the third pump and the filtrate line through the fourth pump, the third pump and the fourth pump are sequentially operated to perform a series of procedures. Priming of the liquid supply circuit becomes possible.

  More preferably, the blood purification circuit further includes a container for storing the priming liquid discharged from the dialysate discharge port, a dialysate discharge line connecting the dialysate discharge port of the filter and the container, A waste line for discarding the priming liquid stored in the container, the fourth pump sucks out the priming liquid through the dialysate discharge line, and the blood purification control device further opens and closes the waste line. A waste valve (filtrate metering clamp) and the waste valve are closed, and the third pump and the fourth pump are operated to store the priming liquid in the container, and then the third pump and While stopping the fourth pump and opening the disposal valve, a part of the priming liquid stored in the container is removed. And a fourth control means for disposal.

  In this way, by controlling the discard valve (filtrate measuring clamp), the priming liquid is accumulated in the container for storing the priming liquid discharged from the dialysate discharge port, and a part of the accumulated priming liquid is discarded. . Thereby, when the progress of dialysis is monitored and controlled by the amount of dialyzed liquid (filtrate) after filtration stored in the container at the time of treatment, the amount of priming liquid stored in the container can be adjusted in advance. it can. Therefore, a certain amount of the priming liquid is accumulated in advance, and the progress of the treatment can be detected more accurately than in the case where the treatment is started from a state in which there is no priming liquid in the container.

  According to the blood purification control apparatus of the present invention, it is possible to automatically perform priming that ensures cleaning of the circuit and removal of air. In addition, it is possible to simplify the operation required of the operator for priming. Therefore, reliable priming can be performed by a simple priming operation.

(Embodiment 1)
A blood purification circuit is attached to the blood purification control apparatus according to the present invention. The blood purification control device controls a pump and a valve according to a predetermined rule based on information obtained from a sensor or the like. The patient's blood and fluid flow through the blood purification circuit according to the control of the blood purification control device. Thereby, the blood is purified.

First, the configuration of the blood purification control apparatus will be described with reference to the drawings.
FIG. 1 is a block diagram showing a configuration of a blood purification control apparatus according to an embodiment of the present invention.

  The blood purification control apparatus 10 according to the present embodiment is an apparatus that performs control for automatically executing priming. The blood purification control device 10 is also a device that controls blood purification of a patient by a plurality of operation methods (operation modes). In the present embodiment, as an operation mode, an automatic priming mode, a CHD (Continuous Hemodialysis) mode, a CHDF (Continuous Hemodiafiltration) mode, a CHF (Continuous Hemofiltration) mode, and an ECUM (ExtraCorporation Modulation mode) are provided. To do.

  The blood purification control apparatus 10 includes an input unit 12, a display unit 14, a mode receiving unit 16, a blood pump 20, a dialysis pump 22, a filtrate pump 24, a replacement fluid pump 26, a fluid supply valve 30, Filtrate valve 32, blood return valve 34, priming fluid discharge valve 36, filtrate pressure sensor 40, blood pressure drop sensor 42, inflow pressure sensor 44, discharge pressure sensor 46, and control method storage unit 48 The control part 49 is provided.

  In the input unit 12, an operator of the blood purification control apparatus 10 inputs an operation mode of the blood purification control apparatus.

The display unit 14 is a part that presents information to the operator, and is, for example, a monitor screen.
The mode receiving unit 16 receives information indicating the operation mode input to the input unit 12.

  The blood pump 20 is a pump that applies pressure to extract blood from a patient. The blood pump 20 not only has a direction in which the liquid in the circuit flows during the operation (hereinafter, the pressure direction of such a pump is referred to as “forward direction”), but also in the opposite direction (hereinafter, such a pump). The pressure direction can be referred to as “reverse direction”). This corresponds to the “second pump” recited in the claims.

  The dialysis pump 22 is a pump that applies pressure to flow the dialysate. This corresponds to the “third pump” recited in the claims.

  The filtrate pump 24 is a pump that applies pressure to flow the filtrate. This corresponds to the “fourth pump” recited in the claims.

  The replacement fluid pump 26 is a pump that applies pressure to flow the replacement fluid. This corresponds to the “first pump” recited in the claims.

The liquid supply valve 30 is a valve for adjusting the supply amount of the liquid supply and stopping the supply.
The filtrate valve 32 is a valve for adjusting the discharge amount of the filtrate and stopping the discharge. This corresponds to the “disposal valve” recited in the claims.

  The blood return valve 34 is a valve that adjusts the amount of blood returned from the filter to the patient and stops the blood return. This corresponds to the “blood return valve” recited in the claims.

  The priming liquid discharge valve 36 is a valve for the priming liquid discharge path, but is also used as a valve for adjusting the flow rate of the rapid replacement fluid used when it is necessary to rapidly supplement the replacement fluid and stopping the rapid replacement fluid. Can do.

The filtrate pressure sensor 40 is a sensor that measures the pressure of the line through which the filtrate flows.
The blood pressure removal sensor 42 and the inflow pressure sensor 44 are sensors that measure the pressure at which the blood before purification, taken out from the patient by the action of the blood pump 20, flows. The blood pressure removal sensor 42 measures the pressure of blood flowing through the line on the patient side from the blood pump 20, and the inflow pressure sensor 44 measures the pressure of blood flowing through the line on the filter side from the blood pump 20.

The discharge pressure sensor 46 is a sensor that measures the pressure of blood discharged from the filter 56.
The control method storage unit 48 stores information related to the operation mode control method provided by the blood purification control device 10. The control method storage unit 48 of the present embodiment is a storage medium that stores automatic priming mode information 48a, CHD mode information 48b, CHDF mode information 48c, CHF mode information 48d, and ECUM mode information 48e. is there.

  The automatic priming mode information 48a is information including a method for controlling a pump and a valve when the blood purification control apparatus 10 automatically performs priming.

  The CHD mode information 48b, the CHDF mode 48c information, and the CHF mode information 48d are information including a method for controlling a pump and a valve in order to purify blood by each blood purification method. The ECUM mode information 48e is information including a method for controlling a pump and a valve in order to remove water from the blood through a filter without flowing dialysate. The CHD mode information 48b is information including a control method for performing continuous dialysis hemodialysis (CHD), and the CHDF mode 48c information includes a control method for performing continuous dialysis filtration (CHDF). The CHF mode information 48d is information including a control method in the case of performing continuous loose blood filtration (CHF). The ECUM mode information 48e is information including a control method when performing ultrafiltration (ECUM).

  The control unit 49 reads information corresponding to the operation mode received by the mode receiving unit 16 from the control method storage unit 48, and refers to information acquired from the pressure sensor and each sensor (not shown) based on the read information, Control the pump and each valve.

  The “first control means”, “second control means”, “third control means”, “fourth control means”, and “recirculation control means” described in the claims include the automatic priming mode information 48a. This is realized by the control unit 49 that controls each pump and each valve based on the read and read automatic priming mode information 48a.

  Next, the configuration of a circuit attached to the blood purification control apparatus 10 capable of executing such a plurality of blood purification methods will be described with reference to the drawings.

  FIG. 2 is a diagram showing a configuration of a blood purification circuit during priming according to an embodiment of the present invention and a positional relationship among a pump, a valve, and a pressure sensor of the blood purification control device.

  The blood purification circuit during priming includes a first liquid supply pack 50, a second liquid supply pack 52, a filtrate pack 54, a filter 56, a blood return chamber 58, a recirculation chamber 60, The liquid branch pipe 62, the rapid replacement liquid branch pipe 64, the anticoagulation branch pipe 66, the blood removal side joint 68a, the blood removal side joint 68b, the blood return side joint 70a, the blood return side joint 70b, and the first Supply line 72, second supply line 74, dialysate line 76, filtrate line 78, waste liquid line 80, replacement liquid line 82, first blood removal line 84, and priming liquid discharge (rapid replacement liquid) ) Line 86, second blood removal line 88, third blood removal line 89, anticoagulant (bypass) line 90, first blood return line 92, second blood return line 94, and first circulation. Line 96 and second circulation line 98 are provided. That.

  In this figure, in order to explain the positional relationship of each pump, each valve, and each sensor included in blood purification control device 10 in the blood purification circuit, blood pump 20, dialysis pump 22, filtrate pump 24, and replacement fluid Pump 26, liquid supply valve 30, filtrate valve 32, blood return valve 34, priming liquid discharge valve 36, filtrate pressure sensor 40, blood pressure sensor 42, inflow pressure sensor 44, and discharge pressure A sensor 46 is also shown. Since each part with which these blood purification control apparatuses 10 are provided was demonstrated with reference to FIG. 1, description is abbreviate | omitted here.

The first liquid supply pack 50 is a container in which liquid supply is first stored.
The second liquid supply pack 52 is a container in which the liquid supply supplied from the first liquid supply pack 50 is stored.

  The filtrate pack 54 is a container in which a filtrate that is a dialysate after blood purification is stored. The filtrate pack 54 corresponds to a “container” described in the claims.

  In the present embodiment, it is assumed that the priming solution, the replacement fluid, and the dialysis solution are the same liquid. The liquid supply supplied from the first liquid supply pack 50 is temporarily stored in the second liquid supply pack 52 and then supplied to another blood purification circuit. During blood purification, the liquid supply stored in the second liquid supply pack 52 is used as a replacement fluid and dialysate, and the filtrate after blood purification is stored in the filtrate pack 54.

  Thereby, the exact weight of the 2nd liquid supply pack 52 and the filtrate pack 54 during treatment can be measured, for example. When the control unit 49 acquires these measurement results, it is possible to realize automatic control based on the progress of blood purification and the amount taken into the patient's body as a replacement fluid.

  The filter 56 is an instrument that purifies blood. In the filter 56 shown in this figure, blood flows in from the blood inlet provided in the upper part of the cylinder, and the blood is returned from the blood return port provided in the lower part of the cylinder. In addition, the dialysate flows from the dialysate inlet provided at the lower side of the cylinder and the dialysate after purifying the blood from the dialysate outlet provided at the upper side of the cylinder, that is, the filtrate Discharged.

  In this figure, the inside of the dotted line in the filter 56 schematically shows the inside of the hollow fiber which is a blood flow path, and the outside of the dotted line schematically shows the outside of the hollow fiber which is a dialysate flow path. The inside of the dotted line of the filter 56 is a part of the blood circuit, and the direction from the blood inlet to the blood outlet is the forward direction. Further, the outside of the dotted line of the filter 56 is a part of the liquid supply circuit, and the direction from the dialysate inlet to the dialysate outlet is the forward direction.

  The blood return chamber 58 is a part that traps air bubbles in the blood discharged from the filter 56 side and in which a replacement fluid is mixed into the blood return.

  The recirculation chamber 60 is a chamber that traps bubbles remaining in the blood circuit and the filter after priming during recirculation. Here, “recirculation” means that the priming fluid is circulated in the blood circuit after the filling of the priming fluid into the blood purification circuit is completed and before the patient is treated.

  These chambers structurally trap bubbles in the liquid flowing in the forward direction but cannot trap in the reverse direction. Thus, the chamber can be primed by flowing fluid in the opposite direction.

The supply liquid branch pipe 62 is a branch pipe that separates the supply liquid into dialysate and replacement fluid.
The rapid replacement fluid branch pipe 64 is a branch pipe that rapidly mixes a replacement fluid or the like into blood taken from a patient.

The anticoagulant branch tube 66 is a branch tube that mixes an anticoagulant into blood taken from a patient.
The blood removal side joint 68a and the blood removal side joint 68b are detachable joint members. At the time of priming, as shown in this figure, the blood removal side joint 68a and the blood removal side joint 68b are connected.

  During the treatment, the blood removal side joint 68a and the blood removal side joint 68b are removed. In addition, a device for taking out blood from the patient is attached to the blood removal side joint 68a at the time of treatment instead of the blood removal side joint 68b. An example of an instrument attached to the blood removal side joint 68a is a needle that is punctured by a patient. The patient's blood is taken into the blood purification circuit through an instrument such as a needle.

  The blood return side joint 70a and the blood return side joint 70b are detachable joint members. At the time of priming, as shown in the figure, the blood return side joint 70a and the blood return side joint 70b are connected.

  During the treatment, the blood return side joint 70a and the blood return side joint 70b are removed. In addition, a device for returning blood to the patient's body is attached to the blood return side joint 70a at the time of treatment instead of the blood return side joint 70b. An example of an instrument attached to the blood return side joint 70a is a needle that is punctured by a patient. The purified blood is returned to the patient through the needle.

  As described above, the blood-removing side joint 68a and the blood-returning side joint 70a are different from each other in the instruments to be attached during the treatment and the priming. Therefore, the blood removal side joint 68a has a shape in which both the blood removal side joint 68b and a device for taking out blood from the patient can be attached and detached. The blood return side joint 70b has a shape in which both the blood return side joint 70a and an instrument for returning blood to the patient's body can be attached and detached.

  By providing the blood removal side joint 68a and the blood return side joint 70a having such a shape, the operator of the blood purification control device and the blood purification circuit can easily go from recirculation after priming to treatment. It becomes possible to migrate.

  The first liquid supply line 72 is a line through which the liquid supply flows in the direction from the first liquid supply pack 50 to the second liquid supply pack 52 during the treatment. Further, as shown in the figure, the first liquid supply line 72 is provided with the liquid supply valve 30 in the middle thereof.

  The second liquid supply line 74 is a line through which the liquid supply flows from the second liquid supply pack 52 toward the liquid supply branch pipe 62 during the treatment.

  The dialysate line 76 is a line through which the dialysate flows from the supply liquid branch pipe 62 to the dialysate inlet of the filter 56 during the treatment. In addition, the dialysate line 76 has a dialysis pump attachment part, which is a part to which the dialysis pump 22 is attached, in the middle. As shown in the figure, a dialysis pump 22 is attached to the dialysis pump attachment portion.

  The filtrate line 78 is a line through which the filtrate flows from the dialysate outlet of the filter 56 toward the filtrate pack 54. Moreover, the filtrate line 78 has a filtrate pump attachment part which is a site | part to which the filtrate pump 24 is attached in the middle. As shown in the figure, a filtrate pump 24 is attached to the filtrate pump mounting portion.

  The waste liquid line 80 is a line for discarding the filtrate stored in the filtrate pack 54 by the treatment. In addition, the waste liquid line 80 has a filtrate valve attachment portion that is a part to which the filtrate valve 32 is attached in the middle. As shown in the figure, a filtrate valve 32 is attached to the filtrate valve attachment portion.

  The filtrate valve 32 is closed at the time of treatment, and the filtrate does not flow into the waste liquid line 80. After the treatment, the filtrate valve 32 is opened, and the filtrate flows from the filtrate pack 54 toward the open end. The direction in which this filtrate flows is defined as the “forward direction” of the waste liquid line 80.

  The replacement fluid line 82 is a line through which the replacement fluid flows from the supply fluid branch pipe 62 toward the blood return chamber 58 during the treatment. In addition, the replacement fluid line 82 has a replacement fluid pump mounting portion that is a portion to which the replacement fluid pump 26 is mounted. As shown in the figure, a replacement fluid valve 26 is attached to the replacement fluid pump mounting portion.

  The first blood removal line 84 is a line through which blood before purification flows from the blood removal side joint 68a in the direction of the anticoagulant branch tube 66 during the treatment.

  The priming fluid discharge (rapid replacement fluid) line 86 has an open discharge port at one end, and discharges air and priming solution in the circuit from the discharge port during priming. The priming fluid discharge (rapid replacement fluid) line 86 is also a line through which the replacement fluid flows when it is necessary to rapidly supplement the blood being purified during the treatment. That is, it is a line that connects a quick replacement fluid pack (not shown) and the quick replacement fluid branch pipe 64 at the time of treatment. The replacement fluid flows from a replacement fluid pack (not shown) in the direction of the rapid replacement fluid branch pipe 64. At the time of priming, it becomes a priming solution disposal line, one end is connected to the rapid replacement fluid branch pipe 64 and the other end is opened.

  Further, the priming liquid discharge (rapid replacement liquid) line 86 has a priming liquid discharge valve mounting portion that is a part to which the priming liquid discharge valve 36 is mounted in the middle. As shown in the figure, a priming liquid discharge valve 36 is attached to the priming liquid discharge valve mounting portion.

  The second blood removal line 88 is a line that allows blood before purification to flow from the rapid replacement fluid branch pipe 64 to the anticoagulation branch pipe 66 during the treatment. In addition, the second blood removal line 88 has a blood pump attachment part that is a part to which the blood pump 20 is attached on the way. As shown in the figure, the blood pump 20 is attached to the blood pump attachment portion.

  The third blood removal line 89 is a line for flowing blood before purification from the anticoagulant branch tube 66 toward the blood inlet of the filter 56 during the treatment.

  The anticoagulant (bypass) line 90 includes a line connected to the blood inlet side of the filter 56 and a blood return port of the filter 56 so as to prevent excessive pressure on the filter 56 during priming. It is a line which short-circuits the line connected to the side.

  The flow rate of the priming liquid flowing through the filter 56 is controlled by operating the pump.

  In the present embodiment, the replacement fluid pump 26 sends the priming solution to the filter 56, and the blood pump 20 sucks the priming solution from the filter 56. There are errors and irregularities in the operation of the pump. Therefore, the flow rate or pressure at which the replacement fluid pump 26 feeds the priming fluid is set larger than the flow rate or pressure at which the blood pump 20 draws out the priming fluid. By controlling the pump in this way, the priming liquid can be allowed to flow through the filter 56 without stagnation, and the priming of the filter 56 becomes possible.

  In addition, excessive pressure may be applied to the filter 56 due to pump operation errors and unevenness. Excessive pressure may damage the hollow fiber of the filter 56 and cause leakage or the like. Inhibits priming. Therefore, by bypassing the blood circuit with a line having a large flow path resistance at the time of priming, it is possible to prevent excessive pressure from being applied to the filter 56, thereby enabling more reliable priming.

  A line having a large flow resistance can be realized by a pipe having a smaller diameter than a pipe forming another line. In addition, the anticoagulant line at the time of treatment is generally narrower than the tubes forming the other lines. Therefore, at the time of priming, by attaching a syringe pump to one end of an anticoagulant (bypass) line 90 attached to the outflow side of the recirculation chamber 60, a bypass line is made a line through which the anticoagulant flows. Can be diverted.

  Therefore, the priming of the filter 56 can be efficiently performed without further complicating the blood purification circuit, such as adding a new line for introducing an anticoagulant during blood purification. The syringe pump is an example of an anticoagulant injection device that is an apparatus for injecting an anticoagulant into the blood circuit.

  The first blood return line 92 is a line for flowing blood from the blood outlet of the filter 56 to the inlet of the blood return chamber 58 during the treatment.

  The second blood return line 94 is a line that allows blood to flow from the blood return port of the blood return chamber 58 toward the blood return side joint 70a during the treatment. In addition, the second blood return line 94 has a blood return valve attachment portion that is a part to which the blood return valve 34 is attached. As shown in the drawing, a blood return valve 34 is attached to the blood return valve mounting portion.

  The first circulation line 96 is a line through which the priming liquid flows from the blood removal side joint 68b toward the inlet of the recirculation chamber 60 during priming. This part is not attached during blood purification. For the first circulation line 96, the direction from the blood removal side joint 68b to the inlet of the recirculation chamber 60 is the forward direction.

  The second circulation line 98 is a line through which the priming solution flows from the blood return port of the recirculation chamber 60 toward the blood return side joint 70b during priming. The first circulation line 96 is a portion that is not attached during blood purification. For the second circulation line 98, the direction from the blood return port of the recirculation chamber 60 to the blood return side joint 70b is the forward direction.

  In the blood purification circuit of the present embodiment described so far, the blood circuit includes the “blood removal line”, the inside of the filter 56, the “blood return line”, the priming fluid discharge (rapid replacement fluid) line 86, And an anticoagulant (bypass) line 90.

  The “blood removal line” includes a blood removal side joint 68a, a first blood removal line 84, a rapid replacement fluid branch pipe 64, a second blood removal line 88, an anticoagulant branch pipe 66, and a third blood removal line 89. And consists of

  The “blood return line” includes a first blood return line 92, a blood return chamber 58, a second blood return line 94, and a blood return side joint 70a.

  The liquid supply circuit includes a first liquid supply pack 50, a first liquid supply line 72, a second liquid supply pack 52, a second liquid supply line 74, a replacement liquid line 82, a dialysate line 76, The outside of the filter 56, the filtrate line 78, the filtrate pack 54, and the waste liquid line 80 are comprised.

  Further, the circulation circuit includes a blood removal side joint 68b, a first circulation line 96, a recirculation chamber 60, a second circulation line 98, and a blood return side joint 70b. Such a circulation circuit corresponds to an “auxiliary circuit” recited in the claims.

  The circulation circuit is a circuit that is not attached during blood purification. Therefore, for each line constituting the circulation circuit, the direction in which the priming liquid flows is defined as the forward direction.

  Further, the waste liquid tank 100 and the waste liquid tank 102 shown in the figure are tanks for storing priming liquid flowing out from the open end of the circuit at the time of priming.

  The above is the configuration of the blood purification circuit according to the present embodiment.

  Thus, in order to prime a complicated circuit, the procedure is also complicated. For this reason, manual priming not only takes time, but also causes an operational error. By providing the automatic priming mode, it is possible to reduce the trouble of the operator and the risk of operation mistakes, and it is possible to reliably perform priming for safe blood purification.

  Such an automatic priming procedure will be described with reference to FIGS.

  FIG. 3 is a diagram schematically showing the configuration of the blood purification circuit at the time of priming according to the embodiment of the present invention and the positional relationship among the pump, valve, and pressure sensor of blood purification control device 10. The arrows in this figure indicate the forward direction of each line.

  In this figure, the pressure sensor shown in FIG. 2 is omitted. Moreover, in this figure, the same number is attached | subjected about each site | part corresponding to FIG. Therefore, the description here regarding each part is abbreviate | omitted. In addition, the recirculation chamber 60 is placed sideways in the figure for the sake of simplicity, but actually, the recirculation chamber 60 is connected to the inlet side of the recirculation chamber 60 (connected to the first circulation line 96). Is attached to the blood purification control apparatus 10 so that the upper side is vertically upward.

  FIG. 4 is a diagram illustrating an automatic priming procedure executed by the blood purification control apparatus 10 when the automatic priming mode is selected in the present embodiment.

  This figure reads the automatic priming mode information 48a from the control method storage unit 48 when the mode receiving unit 16 of the blood purification control device 10 receives the selection of the automatic priming mode input to the input unit 12 by the operator. The control unit 49 that executes the read automatic priming mode information 48a shows a procedure for controlling each pump and each valve included in the blood purification control apparatus 10.

  FIG. 5 is a diagram collectively showing the circuit state in each procedure during priming according to the present embodiment. Further, FIG. 6 to FIG. 15 are circuit configuration diagrams showing circuit states in respective procedures during priming.

  In the following, each procedure shown in FIG. 4 will be described, and the state of the corresponding circuit in each procedure will be described with reference to FIGS.

  In the initial state, the blood purification control device 10 is provided with a blood purification circuit in the state as shown in FIGS. 2 and 3, and the priming liquid is stored only in the first liquid supply pack 50. . Further, as shown in the initial state of FIG. 5, it is assumed that the operation of all the pumps of the blood purification control apparatus 10 is stopped and all the valves are opened.

  The control unit 49 opens the liquid supply valve 30 and the blood return valve 34 (S1). As a result, the state of the blood purification circuit is changed to the state 1 shown in FIG. 5, and the first liquid supply line 72 and the second liquid supply pack 52 are supplied with priming liquid (hereinafter, “liquid” in the explanation of the priming procedure). Is filled. The specific state of the blood purification circuit is as shown in FIG.

  Here, FIG. 6 is a diagram showing a state 1 among the states during priming of the blood purification circuit according to the present embodiment. In FIG. 6, a hatched portion in the circuit configuration indicates that the portion is filled with liquid, that is, a primed portion. Moreover, the part which is not hatched shows that the liquid is not yet filled, that is, the part which is not primed. Further, in FIG. 6, the hatched valve is shown in a closed state, and the non-hatched valve is shown in an open state.

  The hatching applied to the circuit and the valve shows the same state in FIGS. Therefore, the description regarding these hatching in each figure is abbreviate | omitted.

  Furthermore, in FIG. 6, all the pumps are not hatched. This indicates that all pumps are stopped. Similarly, in FIGS. 7 to 15, the stopped pump is not hatched, and the operating pump is hatched. Since the hatching of the pump has been described here, the description in each figure is omitted.

From here, it returns to FIG.
The control unit 49 operates the dialysis pump 22 (S2). Thereby, the state of the blood purification circuit becomes the state 2 shown in FIG. 5, and the liquid is supplied to the second liquid supply line 74, the dialysate line 76, and the outside of the filter 56 (part constituting the liquid supply circuit). Filled. The specific state of the blood purification circuit is as shown in FIG.

  The control unit 49 operates the filtrate pump 24 (S3). Thereby, the state of the blood purification circuit becomes the state 3 shown in FIG. 5, and the filtrate line 78 is filled with the liquid. The specific state of the blood purification circuit is as shown in FIG.

  Thus, the dialysis pump 22 is operated (S2), and the filtrate pump 24 is operated after the priming liquid is filled in the dialysis circuit portion of the filter as shown in FIG. 7 (S3). This corresponds to “third control means” recited in the claims.

  The control unit 49 stops the dialysis pump 22 and the filtrate pump 24, operates the replacement fluid pump 26, and closes the liquid supply valve 30 (S4). As a result, the state of the blood purification circuit becomes the state 4 shown in FIG. 5, and the replacement fluid line 82 is filled with the liquid. The specific state of the blood purification circuit is as shown in FIG. Thus, the control unit 49 that operates the replacement fluid pump 26 in a state where the blood return valve 34 is open corresponds to “second control means” described in the claims.

  Thus, the priming liquid is filled in the liquid supply circuit excluding the filtrate pack 54. Subsequently, priming of the blood circuit is started.

  When the replacement fluid line 82 is filled with the liquid and the liquid reaches the supply inlet of the blood return chamber 58, the controller 49 opens the priming fluid discharge valve 36 (S5). As a result, the state of the blood purification circuit becomes the state 5 shown in FIG. 5, and the second blood return line 94, the second circulation line 98, the recirculation chamber 60, the first circulation line 96, and the first The blood is filled in the blood removal line 84 and the priming liquid discharge (rapid replacement liquid) line 86. The specific state of the blood purification circuit is as shown in FIG. Here, since the liquid flows through the blood return chamber 58 in the forward direction, the liquid flows into the blood return chamber 58 at this time, but air remains in the blood return chamber 58.

  The control unit 49 operates the blood pump 20 in the direction opposite to that during blood purification, all the air is removed from the blood return chamber 58, and when the second blood removal line 88 is filled with liquid, the blood return valve. 34 is closed (S6). As a result, the state of the blood purification circuit is changed to the state 6 shown in FIG. 5, and the blood return chamber 58, the first blood return line 92, the inside of the filter 56 (portion constituting the blood circuit), and the third removal. The blood line 89 and the second blood removal line 88 are filled with liquid. The specific state of the blood purification circuit is as shown in FIG. Thus, the control part 49 which closes the blood return valve 34 and operates the blood pump 20 in the state where the replacement fluid pump 26 is operated corresponds to “first control means” described in the claims.

  As shown in FIG. 11, by closing the blood return valve 34 connected to the blood return port of the blood return chamber 58, the priming liquid flowing from the replacement fluid line 82 is filled from the vertically lower side of the blood return chamber 58. . Further, by closing the blood return valve 34 provided in this way, it becomes possible to flow the liquid in the reverse direction inside the filter 56.

  The blood pump 20 adjusts the flow rate of the third blood removal line 89, and the replacement fluid pump 26 adjusts the flow rate of the first blood return line 92. Thus, since the pressure applied to the inside (blood circuit portion) of the filter 56 is adjusted by the two pumps, the inside of the filter 56 can be reliably filled with the priming liquid.

From here, it returns to description of FIG.
After the liquid is discarded in the waste liquid tank 102, the control unit 49 stops the blood pump 20 (S7). Thereby, the state of the blood purification circuit becomes the state 7 shown in FIG. 5, and the anticoagulant (bypass) line 90 is filled with the liquid. That is, the anticoagulant (bypass) line 90 is reliably primed. The specific state of the blood purification circuit is as shown in FIG.

  Thus, all the blood circuit is filled with the priming solution. Subsequently, priming of the filtrate pack 54 for which priming has not been completed is started in the liquid supply circuit.

  The controller 49 stops the replacement fluid pump 26, operates the dialysis pump 22 and the filtrate pump 24, opens the blood return valve 34, and closes the priming fluid discharge valve 36 (S8). Thereby, the state of the blood purification circuit becomes the state 8 shown in FIG. 13, and the liquid is accumulated in the filtrate pack 54.

  Thus, all of the blood purification circuit is filled with the priming solution.

  The control unit 49 stops the dialysis pump 22 and the filtrate pump 24, and opens the filtrate valve 32 (S9). Thereby, the state of the blood purification circuit becomes the state 9 shown in FIG. 14, and a part of the liquid accumulated in the filtrate pack 54 is discarded in the waste liquid tank 100. In this way, the control unit 49 that opens the filtrate valve 32 and discards a part of the liquid accumulated in the filtrate pack 54 corresponds to “fourth control means”.

  The blood purification control apparatus 10 at the time of treatment measures the amount of purified blood based on the weight of the second liquid supply pack and the weight of the filtrate pack 54. Thus, by discarding a part of the liquid in the filtrate pack 54, the balance between the weight of the second liquid supply pack 52 and the weight of the filtrate pack 54 is adjusted, so that more accurate blood purification during the treatment is performed. The quantity can be measured.

  Thus, in the blood purification circuit of the present embodiment, not only the blood circuit and the circulation circuit but also the liquid supply circuit can be filled with the priming liquid in a series of procedures. Furthermore, in a series of procedures, the balance between the weight of the second liquid supply pack 52 and the weight of the filtrate pack 54 is automatically adjusted, so that the operation burden required for the operator to prepare for the treatment is reduced. It is possible to prepare for safe treatment without spending time.

  The control unit 49 operates the blood pump 20 (S10). Thus, recirculation is performed by removing the air remaining in the circuit by circulating the priming solution in the blood circuit.

  FIG. 15 is a diagram showing the flow of the priming liquid in the blood circuit according to the present embodiment at the time of recirculation. As shown in FIG. 15, the priming liquid circulates in the blood circuit according to the present embodiment, so that air remaining in the circuit is trapped in the recirculation chamber 60. Such recirculation is continued until the start of the treatment. Thus, the control unit 49 that operates the blood pump 20 and controls recirculation corresponds to “recirculation control means” described in the claims.

  The blood purification circuit of the present invention includes a recirculation chamber in a circulation circuit for making the blood circuit into a circulation structure during priming. With such a blood purification circuit attached, recirculation, that is, circulating the priming liquid in the blood circuit, captures air remaining in the blood circuit after priming in the recirculation chamber. And can be collected. Since the circulation circuit including the recirculation chamber is removed from the blood circuit and discarded at the time of treatment, the air collected in the recirculation chamber is discarded together with the circulation circuit.

  Therefore, by simply providing a recirculation chamber in the circulation circuit, air remaining in the blood circuit is removed without adding a new procedure to a series of work procedures related to blood purification such as priming and treatment. be able to. Therefore, the air in the blood circuit can be removed more reliably without imposing a burden on the operator.

  The embodiment of the present invention has been described above, but the present invention is not limited to this.

  For example, in an embodiment, the anticoagulant (bypass) line 90, which is a bypass line, reduces the pressure applied to the filter 56, so that the pressure of the priming liquid flowing through the blood removal line and the priming liquid flowing through the blood return line are reduced. As an example of a line for reducing the pressure difference, the anticoagulant branch pipe 66 located between the blood inlet of the filter 56 and the blood pump 20 and the outlet of the recirculation chamber 60 are connected.

  In order to reduce the pressure applied to the filter 56, one end of the bypass line may release the pressure applied to the filter 56 to the other line by the blood pump 20 and the replacement fluid pump 26. However, the bypass line is attached so that air does not flow backward during recirculation.

  The annular circuit formed by the blood circuit and the circulation circuit includes a high-pressure side line to which the replacement fluid line 82 is connected and a low-pressure side line to which the rapid replacement fluid line is connected by the blood return valve 34 and the blood pump 20. And divided. The bypass line is connected to such a high-pressure side line and a low-pressure side line.

  That is, the line for reducing the difference between the pressure of the priming liquid flowing through the blood removal line and the pressure of the priming liquid flowing through the blood return line is at one end between the blood pump mounting portion and the blood inlet of the filter 56. 56 is connected between the blood outlet and the blood return valve mounting portion (including the blood return chamber 58), between the replacement fluid pump 26 and the blood return chamber 58, and the other end is upstream of the blood pump 20 in the blood removal line. It suffices if it is connected to any part of the line on the downstream side or the line downstream of the blood return valve 34 of the blood return line.

  More specifically, first, when one end of the bypass line is connected between the blood pump mounting portion and the blood inlet of the filter 56, the other end is connected to the blood pump mounting portion and the blood removal side joint 68a. And the other end is connected to the circulation line, connected between the blood return valve mounting portion and the blood return side joint 70a, or connected to the priming fluid discharge (rapid replacement fluid) line 86. There is. In this case, the embodiment of the present invention is an example in which the other end is connected to the circulation line.

  Second, one end of the bypass line is connected between the blood outlet of the filter 56 and the blood return valve attachment (including the blood return chamber 58), and the other end is connected to the blood pump attachment and the blood removal side joint. 68a, the other end is connected to the circulation line, and may be connected between the blood return valve mounting portion and the blood return side joint 70a or to the priming fluid discharge (rapid replacement fluid) line 86. .

  For example, FIG. 16 is a diagram showing the configuration of a blood purification circuit according to a modification of the present invention. The anticoagulant (bypass) line 106 shown in FIG. Connected to the blood removal line 84. This modification is an example in which the other end is connected between the blood pump attachment portion and the blood removal side joint 68a in the second case.

  Third, one end of the bypass line is connected between the replacement fluid pump 26 and the blood return chamber 58, the other end is connected between the blood pump mounting portion and the blood removal side joint 68a, and the other end is It may be connected to the circulation line, connected between the blood return valve mounting portion and the blood return side joint 70a, or connected to the priming fluid discharge (rapid replacement fluid) line 86.

  Since such a bypass line can be diverted as a line for introducing an anticoagulant during the treatment, a portion suitable for the injection of the anticoagulant may be selected at one end thereof. Even with such a circuit configuration, it is possible to automatically execute priming by a series of controls without attaching and detaching the pack storing the priming solution during the treatment.

  The line to which the other end of the bypass line is connected is preferably a position where it can be easily removed or a position away from the discharge port of the priming liquid discharge (rapid replacement liquid) line 86.

  An example of a position that can be easily removed is a chamber. The other end of the bypass line is removed from the line to attach the anticoagulant infusion device after priming and recirculation. Therefore, the operation up to the treatment can be facilitated by connecting to a position where removal is easy.

  Examples of positions away from the open end of the priming fluid discharge (rapid replacement fluid) line 86 include blood circuits other than the priming fluid discharge (rapid replacement fluid) line 86, that is, a blood pump attachment portion and a blood removal side joint 68a. In the middle of the circulation line, between the blood return valve mounting portion and the blood return side joint 70a.

  At the time of priming, the priming liquid that has passed through the bypass line passes through a part of the blood circuit and is then discharged from the circuit through the priming liquid discharge (rapid replacement fluid) line 86. Therefore, the priming fluid that has passed through the bypass line is used for priming a line that forms from the connection port with the blood circuit to the open end of the priming fluid discharge (rapid replacement fluid) line 86. Therefore, by setting the position away from the open end of the priming liquid discharge (rapid replacement liquid) line 86, the priming liquid can be used for priming of a longer line, and the priming liquid can be used effectively.

(Embodiment 2)
The blood purification control apparatus of the present embodiment has the same functional configuration as blood purification control apparatus 10 of the first embodiment shown in FIG. 1, and has the same circuit configuration as that of the first embodiment shown in FIGS. Controls circuit priming and patient blood purification.

  The difference between the blood purification control apparatus of the present embodiment and the blood purification control apparatus 10 of the first embodiment is that the contents of the automatic priming mode information 48a stored in the control method storage unit 48, that is, the blood purification control apparatus. 10 is a control procedure executed by the control unit 49 included in 10 during priming. Therefore, in the present embodiment, a priming procedure executed by blood purification control apparatus 10 of the present embodiment will be described with reference to FIGS. The blood purification control apparatus 10 of the present embodiment includes a check valve 37 in the anticoagulant (bypass) line 90 as shown in FIGS.

  FIG. 17 is a diagram illustrating an automatic priming procedure executed by the blood purification control apparatus 10 when the automatic priming mode is selected in the present embodiment.

  This figure reads the automatic priming mode information 48a from the control method storage unit 48 when the mode receiving unit 16 of the blood purification control device 10 receives the selection of the automatic priming mode input to the input unit 12 by the operator. The control unit 49 that executes the read automatic priming mode information 48a shows a procedure for controlling each pump and each valve included in the blood purification control apparatus 10.

  FIG. 18 is a diagram collectively showing the circuit states in each procedure during priming according to the present embodiment. Further, FIG. 19 to FIG. 26 are circuit configuration diagrams showing circuit states in respective procedures during priming.

  Hereinafter, each procedure shown in FIG. 17 will be described, and the state of the corresponding circuit in each procedure will be described with reference to FIGS.

  In the initial state, the blood purification control device 10 is provided with a blood purification circuit in the state as shown in FIGS. 2 and 3, and the priming liquid is stored only in the first liquid supply pack 50. . Further, as shown in the initial state of FIG. 18, all the pumps of the blood purification control apparatus 10 are stopped, the liquid supply valve 30 and the filtrate valve 32 are closed, and the blood return valve 34 and the priming liquid discharge valve 36 are Is open. A specific state of the blood purification circuit is the state shown in FIG.

  The control unit 49 opens the liquid supply valve 30 (S11). As a result, the state of the blood purification circuit is changed to the state 1 shown in FIG. Is filled. The specific state of the blood purification circuit is as shown in FIG.

  Here, FIG. 20 is a diagram illustrating a state 1 among the states during priming of the blood purification circuit according to the present embodiment. In FIG. 20, a hatched portion in the circuit configuration indicates that the portion is filled with liquid, that is, a primed portion. Moreover, the part which is not hatched shows that the liquid is not yet filled, that is, the part which is not primed. In FIG. 20, the hatched valve is shown in a closed state, and the unhatched valve is shown in an open state.

  The hatching applied to the circuit and the valve also shows the same state in FIGS. Therefore, the description regarding these hatching in each figure is abbreviate | omitted.

  Furthermore, in FIG. 20, all the pumps are not hatched. This indicates that all pumps are stopped. Similarly, in FIGS. 21 to 26, the stopped pump is not hatched, and the operating pump is hatched. Since the hatching of the pump has been described here, the description in each figure is omitted.

From here, it returns to FIG.
The control unit 49 operates the dialysis pump 22 at 20 ml / min, the filtrate pump 24 at 20 ml / min, and the replacement fluid pump 26 at 60 ml / min, and closes the blood return valve 34 (S12). As a result, the state of the blood purification circuit becomes the state 2 shown in FIG. 18, and the second supply liquid line 74, the dialysate line 76, and the replacement fluid line 82 are filled with liquid. Further, the blood return chamber 58 starts to be filled with liquid. A specific state of the blood purification circuit is as shown in FIG. In this way, the control unit 49 that closes the blood return valve 34 and operates the replacement fluid pump 26 corresponds to “first control means” recited in the claims.

  After this step, the liquid supply valve 30 and the filtrate valve 32 are independently controlled based on the measurement result from the weighing sensor. In FIG. 18, the opening / closing of the liquid supply valve 30 and the filtrate valve 32 from state 2 to state 7 is “*”, which indicates that each is controlled independently. Also, in the diagrams showing the state of the blood purification circuit from FIG. 22 to FIG. 26, it is shown that each of the liquid supply valve 30 and the filtrate valve 32 is controlled independently by adding dots.

  The control unit 49 stops the dialysis pump 22 and the filtrate pump 24 (S13). At this time, the replacement fluid pump 26 operates at 20 ml / min and continues to operate from state 2 onward, but its output is reduced from state 2. As a result, the state of the blood purification circuit becomes state 3 shown in FIG. 18, and the first blood return line 92, the inside of the filter 56 (part constituting the blood circuit), and the blood return chamber 58 are filled with liquid. Is done. The specific state of the blood purification circuit is as shown in FIG. As described above, the control unit 49 that closes the blood return valve 34 and operates the replacement fluid pump 26 corresponds to the “first control unit” described in the claims, similarly to the control unit 49 that executes the control in S12. To do.

  The control unit 49 operates the blood pump 20 at 100 ml / min (S14). At this time, the replacement fluid pump 26 operates at 130 milliliters / minute, continues the operation after the state 3, and increases its power output from the state 3. Thereby, the state of the blood purification circuit becomes the state 4 shown in FIG. 18, and the third blood removal line 89, the second blood removal line 88, the priming fluid discharge (rapid replacement fluid) line 86, and the anticoagulant (bypass). ) The line 90 is filled with liquid. The specific state of the blood purification circuit is as shown in FIG. Thus, the control unit 49 that closes the blood return valve 34 and operates the blood pump 20 and the blood pump 20 together with the replacement fluid pump 26 corresponds to “first control means” described in the claims.

  Further, the flow rate sent out by the replacement fluid pump 26 is larger than the flow rate sent out by the blood pump 20. The replacement fluid pump 26 adjusts the flow rate of the first blood return line 92, and the blood pump 20 adjusts the flow rate of the second blood removal line 88. Since the pressure applied to the inside (blood circuit portion) of the filter 56 is adjusted by the two pumps, the priming liquid can be reliably filled inside the filter 56.

  The anticoagulant (bypass) line 90 is provided with a check valve 37 that allows liquid to flow only from the filter 56 to the recirculation chamber 60. For this reason, air can be prevented from flowing into the anticoagulant (bypass) line 90 from the recirculation chamber 60.

  The control unit 49 operates the dialysis pump 22 at 140 ml / min and the filtrate pump 24 at 110 ml / min, and opens the blood return valve 34 (S15). At this time, the blood pump 20 operates at 110 ml / min, continues to operate from state 4 onward, and increases its power output from state 4. In addition, the replacement fluid pump 26 operates at 140 ml / min, continues to operate from state 4 onward, and increases its power output from state 4.

  Thereby, the state of the blood purification circuit becomes the state 5 shown in FIG. 18, and the second blood return line 94, the first circulation line 96, the recirculation chamber 60, the second circulation line 98, and the first The blood is filled in the blood removal line 84, the outside of the filter 56 (part constituting the liquid supply circuit), and the filtrate line 78. A specific state of the blood purification circuit is as shown in FIG.

  Thus, the control unit 49 that operates the replacement fluid pump 26 in a state where the blood return valve 34 is open corresponds to “second control means” described in the claims.

  In addition, as described above, the control unit 49 that operates the dialysis pump 22 and the control unit 49 that operates the dialysis pump 22 and the filtrate pump 24 correspond to “third control means” described in the claims.

  When the dialysis pump 22 and the filtrate pump 24 operate simultaneously to prime the outside of the filter 56, the flow rate sent out by the dialysis pump 22 is larger than the flow rate sent out by the filtrate pump 24. The dialysis pump 22 adjusts the flow rate sent to the outside of the filter 56, and the filtrate pump 24 adjusts the flow rate sent from the outside of the filter 56. By sending more dialysis pump 22 than filtrate pump 24, the state where a positive pressure is applied to the outside of filter 56 can be maintained. Therefore, air is not taken into the outside of the filter 56 via the filtrate line 78. Moreover, since the liquid flows from the blood return chamber 58 toward the second blood return line 94 by opening the blood return valve 34, the pressure inside the first blood return line 92 and the filter 56 decreases. As a result, the pressure on the outside of the filter 56 becomes higher than that on the inside, so that the liquid outside the filter 56 flows into the inside. At this time, the liquid flows into the hollow fiber membrane between the outside and the inside of the filter 56, so that the air in the hollow fiber membrane can be driven out. Thus, by completely expelling the air in the filter 56, the filter 56 can be surely primed.

  The control unit 49 stops the blood pump 20 and the replacement fluid pump 26 (S16). At this time, the dialysis pump 22 operates at 130 milliliters / minute and continues to operate from state 5 onwards, but its output is reduced from state 5. The filtrate pump 24 operates at 100 milliliters / minute and continues to operate from state 5 onwards, but its output is reduced from state 5. Thereby, the state of the blood purification circuit becomes the state 6 shown in FIG. 18, and the liquid is completely filled in the outside of the filter 56 and the filtrate line 78, and the liquid is accumulated in the filtrate pack 54. A specific state of the blood purification circuit is as shown in FIG.

  As shown in FIG. 25, in the blood purification circuit at this time, the filtrate valve 32 is opened, and a part of the liquid accumulated in the filtrate pack 54 is discarded in the waste liquid tank 100. In this way, the control unit 49 that opens the filtrate valve 32 and discards a part of the liquid accumulated in the filtrate pack 54 corresponds to “fourth control means”.

  The blood purification control apparatus 10 at the time of treatment measures the amount of purified blood based on the weight of the second liquid supply pack and the weight of the filtrate pack 54. Thus, by discarding a part of the liquid in the filtrate pack 54, the balance between the weight of the second liquid supply pack 52 and the weight of the filtrate pack 54 is adjusted, so that more accurate blood purification during the treatment is performed. The quantity can be measured. Thus, all of the blood purification circuit is filled with the priming solution.

  The control unit 49 stops the dialysis pump 22 and the filtrate pump 24, operates the blood pump 20 at 100 ml / min, and closes the priming solution discharge valve 36 (S17). Thus, recirculation is performed by removing the air remaining in the circuit by circulating the priming solution in the blood circuit.

  FIG. 26 is a diagram showing the flow of the priming liquid in the blood circuit according to the present embodiment at the time of recirculation, similarly to FIG. 15 in the first embodiment. As shown in FIG. 26, the priming liquid circulates in the blood circuit according to the present embodiment, so that air remaining in the circuit is trapped in the recirculation chamber 60. Such recirculation is continued until the start of the treatment. Thus, the control unit 49 that operates the blood pump 20 and controls recirculation corresponds to “recirculation control means” described in the claims.

  The blood purification circuit of the present invention includes a recirculation chamber in a circulation circuit for making the blood circuit into a circulation structure during priming. With such a blood purification circuit attached, recirculation, that is, circulating the priming liquid in the blood circuit, captures air remaining in the blood circuit after priming in the recirculation chamber. And can be collected. Then, the blood removal side joint 68a and the blood return side joint 70a of the blood purification circuit are respectively connected to the blood vessels of the patient, and the circulation circuit including the recirculation chamber is removed from the blood circuit and discarded during the treatment (blood purification). Thus, the air collected in the recirculation chamber is discarded along with the circulation circuit.

  Therefore, by simply providing a recirculation chamber in the circulation circuit, air remaining in the blood circuit is removed without adding a new procedure to a series of work procedures related to blood purification such as priming and treatment. be able to. Therefore, the air in the blood circuit can be removed more reliably without imposing a burden on the operator.

  In addition, it is necessary to discard the blood circuit after the blood purification process is completed. However, by connecting the blood circuit including the recirculation chamber to the blood circuit connected to the blood circuit, the blood circuit can be discarded. Liquid leakage when the circuit and the circulation circuit are discarded can be prevented.

  The present invention can be applied to a blood purification control apparatus that automatically executes priming, which is preparation for purifying a patient's blood. In addition, the present invention can be applied to a blood purification control apparatus that executes recirculation for circulating a priming solution through a blood circuit during the period from completion of priming to treatment by a patient.

It is a block diagram which shows the structure of the blood purification control apparatus which concerns on one embodiment of this invention. It is a figure which shows the structure of the blood purification circuit at the time of priming which concerns on one embodiment of this invention, and the positional relationship of the pump of a blood purification control apparatus, a valve | bulb, and a pressure sensor. It is a figure which simplifies and shows the structure of the blood purification circuit at the time of priming which concerns on one embodiment of this invention, and the positional relationship of the pump of a blood purification control apparatus, a valve | bulb, and a pressure sensor. In Embodiment 1, it is a figure which shows the procedure of the automatic priming which a blood purification control apparatus performs when automatic priming mode is selected. FIG. 3 is a diagram collectively showing circuit states in each procedure during priming according to the first embodiment. It is a figure which shows the state 1 among the states at the time of priming of the blood purification circuit which concerns on Embodiment 1. FIG. It is a figure which shows the state 2 among the states at the time of priming of the blood purification circuit which concerns on Embodiment 1. FIG. It is a figure which shows the state 3 among the states at the time of priming of the blood purification circuit which concerns on Embodiment 1. FIG. It is a figure which shows the state 4 among the states at the time of priming of the blood purification circuit which concerns on Embodiment 1. FIG. It is a figure which shows the state 5 among the states at the time of priming of the blood purification circuit which concerns on Embodiment 1. FIG. It is a figure which shows the state 6 among the states at the time of priming of the blood purification circuit which concerns on Embodiment 1. FIG. It is a figure which shows the state 7 among the states at the time of priming of the blood purification circuit which concerns on Embodiment 1. FIG. It is a figure which shows the state 8 among the states at the time of priming of the blood purification circuit which concerns on Embodiment 1. FIG. It is a figure which shows the state 9 among the states at the time of priming of the blood purification circuit which concerns on Embodiment 1. FIG. It is a figure which shows the flow of the priming liquid in the blood circuit which concerns on Embodiment 1 at the time of recirculation. It is a figure which simplifies and shows the structure of the blood purification circuit at the time of priming which concerns on one modification of this invention, and the positional relationship of the pump of a blood purification control apparatus, a valve | bulb, and a pressure sensor. In Embodiment 2, it is a figure which shows the procedure of the automatic priming which a blood purification control apparatus performs when automatic priming mode is selected. It is a figure which shows the state of the circuit in each procedure at the time of priming of Embodiment 2 collectively. It is a figure which shows the state 1 among the states at the time of priming of the blood purification circuit which concerns on Embodiment 2. FIG. It is a figure which shows the state 2 among the states at the time of priming of the blood purification circuit which concerns on Embodiment 2. FIG. It is a figure which shows the state 2 among the states at the time of priming of the blood purification circuit which concerns on Embodiment 2. FIG. It is a figure which shows the state 3 among the states at the time of priming of the blood purification circuit which concerns on Embodiment 2. FIG. It is a figure which shows the state 4 among the states at the time of priming of the blood purification circuit which concerns on Embodiment 2. FIG. It is a figure which shows the state 5 among the states at the time of priming of the blood purification circuit which concerns on Embodiment 2. FIG. It is a figure which shows the state 6 among the states at the time of priming of the blood purification circuit which concerns on Embodiment 2. FIG. It is a figure which shows the flow of the priming liquid in the blood circuit which concerns on Embodiment 2 at the time of recirculation.

Explanation of symbols

DESCRIPTION OF SYMBOLS 10 Blood purification control apparatus 12 Input part 14 Display part 16 Mode reception part 20 Blood pump 22 Dialysis pump 24 Filtrate pump 26 Supplementary liquid pump 30 Supply valve 32 Filtrate valve 34 Blood return valve 36 Priming liquid discharge valve 37 Check valve 40 Filtrate pressure sensor 42 Detension blood pressure sensor 44 Inflow pressure sensor 46 Ejection pressure sensor 48 Control method storage unit 49 Control unit 50 First supply pack 52 Second supply pack 54 Filtrate pack 56 Filter 58 Blood return chamber 60 Recirculation Ration chamber 62 Supply fluid branch pipe 64 Rapid replacement fluid branch pipe 66 Anticoagulation branch pipe 68a, 68b Blood removal side joint 70a, 70b Blood return side joint 72 First liquid supply line 74 Second liquid supply line 76 Dialysate liquid line 78 Filtration Fluid line 80 Waste fluid line 82 Fluid replacement line 84 First blood removal line 86 Ply Liquid discharge (rapid replacement fluid) line 88 Second blood removal line 89 Third blood removal line 90 Anticoagulant (bypass) line 92 First blood return line 94 Second blood return line 96 First circulation line 98 Second circulation line 100, 102 Waste liquid tank

Claims (9)

A blood purification control device for controlling a flow of liquid in a blood purification circuit having a filter for purifying blood and a blood return line connected to a blood outlet of the filter,
A blood return valve for opening and closing the blood return line;
A replacement fluid line connected between the blood outlet of the filter in the blood return line and the valve for blood return, for feeding a priming solution;
A first pump that is disposed in the replacement fluid line and sends a priming fluid between the blood outlet of the filter of the blood return line and the blood return valve;
A blood purification control device comprising: first control means for sending a priming solution from a blood outlet of the filter to the filter by operating the first pump while closing the valve for returning blood. . The blood purification circuit further comprises a blood removal line connected to the blood inlet of the filter,
The blood purification control apparatus further includes a second pump capable of sending a liquid to the filter and flowing out of the filter via the blood removal line,
2. The blood purification control apparatus according to claim 1, wherein the first control unit operates the second pump together with the first pump so that a priming solution flows out from the filter. 3. The said 1st control means controls the said 1st pump and the said 2nd pump so that the pressure which the said 1st pump sends out becomes larger than the pressure which the said 2nd pump flows out. 2. The blood purification control apparatus according to 2. The blood purification control device further includes second control means for opening the blood return valve and operating the first pump during priming.
The blood purification control apparatus according to any one of claims 1 to 3, wherein the blood purification control apparatus is characterized. The blood purification circuit further connects each end of the blood return line and the blood removal line which are not connected to the filter via an auxiliary circuit having a chamber in the middle,
The blood purification control apparatus further opens the blood return valve and activates the second pump after the priming of the blood purification circuit is completed, thereby operating the filter, the blood removal line, and the auxiliary The blood purification control apparatus according to any one of claims 1 to 4, further comprising recirculation control means for circulating a priming solution in the circuit and the blood return line. The blood purification control device further includes a third pump for feeding a priming solution from a dialysate inlet of the filter;
The blood purification control apparatus according to any one of claims 1 to 5, further comprising third control means for operating the third pump during priming. The blood purification control apparatus further includes a fourth pump that causes the priming solution to flow out from the dialysate outlet of the filter,
The blood according to claim 6, wherein the third control unit further operates the fourth pump after the priming circuit portion of the filter is filled with the third pump by the third pump. Purification control device. The blood purification circuit further includes a container for storing the priming liquid discharged from the dialysate outlet, a dialysate discharge line connecting the dialysate outlet of the filter and the container, and a priming stored in the container A disposal line for discarding the liquid,
The fourth pump distributes the priming solution through the dialysate discharge line,
The blood purification control device further includes a disposal valve for opening and closing the disposal line,
The priming liquid stored in the container is stored by closing the disposal valve and storing the priming liquid in the container by operating the third pump and the fourth pump and then opening the disposal valve. The blood purification control apparatus according to claim 7, further comprising a fourth control unit that discards a part of the blood purification control unit. A blood purification control program for controlling the flow of liquid in a blood purification circuit having a filter for purifying blood and a blood return line connected to the blood outlet of the filter,
Opening a blood return valve for opening and closing the blood return line, filling the blood return line with a priming solution, closing the blood return valve, and supplying the blood outlet of the filter and the blood return line in the blood return line A replacement fluid pump arranged in a replacement fluid line connected between the valves is operated to supply priming fluid from the blood outlet of the filter to the filter, and the blood pump supplies the fluid in the direction opposite to that during the operation. A blood purification control program for causing a computer to execute a program including one step.

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