JP5319381B2 - Blood purification apparatus and method for removing bubbles - Google Patents

Description

  The present invention relates to a blood purification apparatus for purifying a patient's blood while circulating outside the body, such as dialysis treatment using a dialyzer, and a method for removing bubbles.

  Generally, at the time of dialysis treatment, a blood circuit for circulating the collected patient's blood extracorporeally and returning it to the body is used. Such a blood circuit is, for example, a dialyzer (blood purification means) having a hollow fiber membrane. It is mainly composed of an arterial blood circuit and a venous blood circuit that can be connected to each other. An arterial puncture needle and a venous puncture needle are attached to the tips of the arterial blood circuit and the venous blood circuit, respectively, and are punctured by the patient to perform extracorporeal circulation of blood in dialysis treatment.

  Among these, the arterial blood circuit is provided with a squeezed blood pump, and by driving the blood pump, blood is sent from the patient's body to the dialyzer side, while the arterial blood circuit and the venous blood are supplied. An arterial drip chamber and a venous drip chamber are connected to the circuit so that blood is returned to the patient's body after defoaming.

  In addition, a priming solution supply line (saline solution line) for supplying a physiological saline solution at the time of priming or blood return is provided upstream of the blood pump in the arterial blood circuit (that is, the arterial puncture needle side). Prior to dialysis treatment, the blood circuit and components such as a drip chamber connected to the blood circuit are primed by flowing and filling physiological saline before dialysis treatment. The blood remaining in the circuit or the like is replaced with physiological saline, and the blood is returned to the patient by returning the residual blood to the patient. Note that a dialysis apparatus provided with a priming solution supply line is disclosed in Patent Document 1, for example.

JP 2000-93449 A

  However, in the above conventional blood purification apparatus, at the end of priming, air bubbles are often attached in the drip chamber such as the filtration network of the drip chamber connected to the blood circuit. However, it was necessary to strike the drip chamber lightly by hand and apply an impact. In particular, if air bubbles adhere to the outside of the drip chamber filtration network connected to the venous blood circuit (the side facing the discharge port of the drip chamber), the air bubbles may pass through the venous puncture needle during treatment. Therefore, it was necessary to carefully remove the bubbles. Therefore, there is a problem in that it is difficult for the operator to perform a bubble removal operation and to automate the transition from priming to treatment.

  The present invention has been made in view of such circumstances, and it is possible to automatically remove bubbles adhering to the drip chamber, and blood purification that can easily achieve automation when shifting from priming to treatment. The object is to provide an apparatus and a method for removing bubbles.

  The invention according to claim 1 is composed of an arterial blood circuit and a venous blood circuit, a blood circuit capable of extracorporeally circulating a patient's blood from the tip of the arterial blood circuit to the tip of the venous blood circuit, and the blood A blood flow path that is interposed between the arterial blood circuit and the venous blood circuit of the circuit to purify blood flowing through the blood circuit, and through which a patient's blood flows through a blood purification film for purifying the blood; Blood purification means having a dialysate flow path through which the dialysate flows, a blood pump disposed in the arterial blood circuit, and dialysate introduction connected to the dialysate flow path inlet and outlet of the blood purification means A priming fluid supply line connected to the arterial blood circuit and supplying a priming fluid into the blood circuit, and formed at both ends of the blood purification means. A blood introduction port connected to the side blood circuit to introduce blood into the blood flow path, a blood outlet port connected to the venous side blood circuit to derive blood from the blood circuit, and a side surface of the blood purification means, respectively A dialysate inlet for introducing dialysate into the dialysate flow path connected to the dialysate introduction line, and a dialysate outlet for connecting dialysate from the dialysate flow path connected to the dialysate discharge line A drip chamber connected to the venous blood circuit and having a filtration network formed thereon, and an overflow line extending from the air layer side of the drip chamber and capable of discharging the liquid overflowing the drip chamber to the outside A valve means capable of arbitrarily closing or opening the overflow line, and at the time of priming before treatment, the tip of the arterial blood circuit and the venous blood circuit In the blood purification apparatus that is capable of communicating by connecting to an end, the blood purification apparatus includes control means that can control the blood pump and the valve means, and at the end of priming, the control means closes the valve means while closing the valve means A pressure accumulating step of driving a blood pump to supply a priming liquid from the priming liquid supply line into the blood circuit and accumulating the priming liquid in at least any part of the blood circuit; and the valve means And a release step of releasing the pressure accumulation state of the priming liquid accumulated in the pressure accumulation step so that bubbles attached to the drip chamber can be discharged from the overflow line. Features.

  According to a second aspect of the present invention, in the blood purification apparatus according to the first aspect, an arterial clamp means capable of closing or releasing a flow path in the vicinity of the distal end of the arterial blood circuit, and a distal end of the venous blood circuit. A venous clamp means capable of closing or releasing the flow path, and the control means can control the arterial clamp means and the venous clamp means, and in the pressure accumulation step, the control means A first pressure-accumulating step of driving the blood pump forward while occluding the arterial clamp means and causing the priming fluid to flow in the blood circuit; and occluding the venous clamp means in addition to the arterial clamp means When the blood pump is driven in reverse to perform the second pressure accumulation step in which the priming liquid between the blood pump and the arterial clamp means is accumulated. In, characterized in that to release the arterial clamp means and the venous clamp means in said releasing step.

  According to a third aspect of the present invention, in the blood purification apparatus according to the second aspect of the present invention, the blood purification device further includes a fluid pressure detecting means extending from the drip chamber and capable of detecting the fluid pressure in the drip chamber, and the control means includes The hydraulic pressure detecting means is configured to shift from the first pressure accumulation step to the second pressure accumulation step on condition that a predetermined hydraulic pressure is detected.

  According to a fourth aspect of the present invention, in the blood purification device according to any one of the first to third aspects, the control means causes the pressure accumulation step and the release step to be repeated a predetermined number of times.

  According to a fifth aspect of the present invention, there is provided a blood circuit comprising an arterial blood circuit and a venous blood circuit, and capable of extracorporeally circulating a patient's blood from the tip of the arterial blood circuit to the tip of the venous blood circuit, and the blood A blood flow path that is interposed between the arterial blood circuit and the venous blood circuit of the circuit to purify blood flowing through the blood circuit, and through which a patient's blood flows through a blood purification film for purifying the blood; Blood purification means having a dialysate flow path through which the dialysate flows, a blood pump disposed in the arterial blood circuit, and dialysate introduction connected to the dialysate flow path inlet and outlet of the blood purification means A priming fluid supply line connected to the arterial blood circuit and supplying a priming fluid into the blood circuit, and formed at both ends of the blood purification means. A blood introduction port connected to the side blood circuit to introduce blood into the blood flow path, a blood outlet port connected to the venous side blood circuit to derive blood from the blood circuit, and a side surface of the blood purification means, respectively A dialysate inlet for introducing dialysate into the dialysate flow path connected to the dialysate introduction line, and a dialysate outlet for connecting dialysate from the dialysate flow path connected to the dialysate discharge line A drip chamber connected to the venous blood circuit and having a filtration network formed thereon, and an overflow line extending from the air layer side of the drip chamber and capable of discharging the liquid overflowing the drip chamber to the outside A valve means capable of arbitrarily closing or opening the overflow line, and at the time of priming before treatment, the tip of the arterial blood circuit and the venous blood circuit In the method for removing air bubbles of the blood purification apparatus, which is capable of communicating by connecting to an end, at the end of priming, the blood pump is driven while the valve means is closed to prime the blood circuit from the priming liquid supply line A pressure accumulating step for supplying the fluid and accumulating the priming fluid in at least any part of the blood circuit; and opening the valve means and accumulating the priming fluid accumulated in the pressure accumulating step And a releasing step of releasing the air bubbles, and the bubbles attached to the drip chamber can be discharged from the overflow line.

  The invention according to claim 6 is the method of removing bubbles in the blood purification apparatus according to claim 5, wherein the artery side clamping means capable of closing or releasing the flow path near the tip of the artery side blood circuit, and the vein side blood circuit And a vein-side clamp means capable of closing or releasing the flow path in the vicinity of the distal end of the blood vessel, and in the pressure accumulation step, the blood pump is driven to rotate forward while closing the artery-side clamp means, A first pressure accumulating step for causing the priming fluid to flow; and the blood pump is driven in reverse while occluding the venous clamp device in addition to the arterial clamp device, and the priming fluid between the blood pump and the arterial clamp device is supplied. A second pressure accumulating step in which the pressure is accumulated, and releasing the arterial clamp means and the venous clamp means in the releasing step. The features.

  A seventh aspect of the present invention is the method for removing air bubbles of the blood purification apparatus according to the sixth aspect, further comprising a hydraulic pressure detecting means extending from the drip chamber and capable of detecting the hydraulic pressure in the drip chamber. It is characterized in that a transition is made from the first pressure accumulation step to the second pressure accumulation step on condition that a fluid pressure of a predetermined value is detected by the fluid pressure detection means.

  The invention described in claim 8 is characterized in that in the method of removing bubbles in the blood purification apparatus according to any one of claims 5 to 7, the pressure accumulation step and the release step are repeatedly performed a predetermined number of times.

  According to the first and fifth aspects of the present invention, at the end of priming, the blood pump is driven while the valve means is closed to supply the priming liquid into the blood circuit from the priming liquid supply line, and at least one of the blood circuits The pressure accumulating step for accumulating the priming liquid at the site and the releasing means for releasing the valve accumulating step and releasing the accumulating state of the priming liquid accumulated in the accumulating step are attached to the drip chamber. Since the air bubbles can be discharged from the overflow line, the air bubbles adhering to the drip chamber (especially the filter screen) can be automatically removed, and automation when shifting from priming to treatment can be easily achieved.

  According to the second and sixth aspects of the present invention, in the pressure accumulation step, the first pressure accumulation step of causing the blood pump to normally rotate while closing the artery side clamp means to flow the priming fluid in the blood circuit, and the artery side clamp means In addition to performing the second pressure accumulation step in which the blood pump is driven in reverse while the vein side clamp means is closed, and the priming fluid between the blood pump and the arterial side clamp means is accumulated, and the release step Since the arterial clamp means and the venous clamp means are released, higher pressure accumulation can be achieved, and air bubbles adhering to the drip chamber can be more reliably removed.

  According to the third and seventh aspects of the present invention, since the first pressure accumulation process is shifted to the second pressure accumulation process on the condition that a predetermined pressure is detected by the liquid pressure detection means, the first pressure accumulation process When the priming solution is allowed to flow in the blood circuit, it is possible to reliably avoid an excessive fluid pressure.

  According to the fourth and eighth aspects of the present invention, the pressure accumulating step and the releasing step are repeatedly performed a predetermined number of times, so that air bubbles adhering to the drip chamber (especially the filter screen) can be more reliably removed.

The schematic diagram which shows the dialysis apparatus (blood purification apparatus) which concerns on embodiment of this invention. Schematic diagram showing a state where priming (liquid pool generation process (blood pump forward rotation drive)) is performed by the dialysis device Schematic diagram showing a state where priming (liquid pool generation process (blood pump reverse drive)) is performed by the dialysis device Schematic diagram showing a state where priming (first overflow process) is performed by the dialysis machine Schematic diagram showing the state where priming (circulation process) is performed by the dialysis machine Schematic showing a state where priming (overflow process) is performed by the dialysis machine Schematic diagram showing a state where priming (dialysis fluid filling process) is performed by the dialysis machine The flowchart which shows the control content at the time of priming by the control means in the dialysis device The schematic diagram which shows the state in which the bubble removal (1st pressure accumulation process) at the time of the end of priming by the dialyzer is performed Schematic diagram showing a state in which air bubble removal (second pressure accumulation step) is performed at the end of priming by the dialysis device Schematic diagram showing a state where bubbles are removed (release process) at the end of priming by the dialyzer The flowchart which shows the control content of the bubble removal at the time of completion | finish of priming by the control means in the same dialysis device

Hereinafter, embodiments of the present invention will be specifically described with reference to the drawings.
The blood purification apparatus according to this embodiment includes a dialysis apparatus for performing dialysis treatment. As shown in FIG. 1, a blood circuit including an arterial blood circuit 1 and a venous blood circuit 2, and an arterial blood circuit 1. And a dialyzer 3 (blood purifying means) interposed between the venous blood circuit 2 and purifying blood flowing in the blood circuit, a squeezed blood pump 4 disposed in the arterial blood circuit 1, and a venous side A drip chamber 5 connected to the blood circuit 2, a storage means 7 storing physiological saline as a priming liquid, a priming fluid supply line Lc connecting the storage means 7 and the arterial blood circuit 1, and the priming The priming liquid drip chamber 8 is connected mainly in the middle of the liquid supply line Lc.

  An arterial puncture needle a is connected to the distal end of the arterial blood circuit 1 via a connector c, and an iron blood pump 4 is disposed in the middle, while the venous blood circuit 2 includes The vein side puncture needle b is connected to the tip thereof via a connector d, and the drip chamber 5 is connected midway. Then, when the blood pump 4 is driven with the patient punctured with the arterial puncture needle a and the venous puncture needle b, the patient's blood passes through the arterial blood circuit 1 and reaches the dialyzer 3, Blood purification is performed by the dialyzer 3, and bubbles are removed in the drip chamber 5, and then returned to the patient's body through the venous blood circuit 2. That is, the blood of the patient is purified by the dialyzer 3 while circulating externally from the tip of the arterial blood circuit 1 to the tip of the venous blood circuit 2 of the blood circuit.

  The drip chamber 5 is provided with an overflow line 6 extending from the upper part (air layer side) and having the tip opened to the atmosphere, and a liquid overflowing the drip chamber 5 (priming liquid such as physiological saline) is supplied. It is configured to be discharged to the outside. The overflow line 6 is provided with a solenoid valve V6 as valve means, and the overflow line 6 can be arbitrarily closed or opened.

  Further, a filtration network 5a is formed inside the drip chamber 5 so as to cover the discharge port side. During dialysis treatment, blood is supplied by blood circuits (arterial blood circuit 1 and venous blood circuit 2). When circulating outside the body, foreign matter and the like can be captured by the filtration net 5a. Such a filter net 5a may be in any form such as one integrally formed with a resin or one formed with a mesh.

  Furthermore, a hydraulic pressure detection means 17 is formed which extends from the upper part of the drip chamber 5 and can detect the hydraulic pressure (venous pressure) in the drip chamber 5. The fluid pressure detection means 17 can detect a venous pressure during dialysis treatment in real time to detect an abnormality, and is electrically connected to the control means 16 and can transmit a detection signal to the control means 16. It is configured as follows.

  The dialyzer 3 includes a blood inlet 3a (blood inlet port), a blood outlet 3b (blood outlet port), a dialysate inlet 3c (dialysate channel inlet: dialysate inlet port) and a dialysate in its casing. A lead-out port 3d (dialysate flow path outlet: dialysate lead-out port) is formed, of which the arterial blood circuit 1 is connected to the blood introduction port 3a and the venous blood circuit 2 is connected to the blood lead-out port 3b. Has been. The dialysate inlet 3c and dialysate outlet 3d are respectively connected to a dialysate inlet line La and a dialysate outlet line Lb extending from the dialyzer body.

  A plurality of hollow fibers (not shown) are accommodated in the dialyzer 3, and these hollow fibers constitute a blood purification membrane for purifying blood. Thus, in the dialyzer 3, a blood flow path (flow path between the blood inlet 3a and the blood outlet 3b) through which the patient's blood flows through the blood purification membrane and a dialysate flow path through which the dialysate flows. (A flow path between the dialysate inlet 3c and the dialysate outlet 3d) is formed. The hollow fiber constituting the blood purification membrane is formed with a large number of minute holes (pores) penetrating the outer peripheral surface and the inner peripheral surface to form a hollow fiber membrane, and blood is passed through the membrane. It is configured so that impurities therein can permeate into the dialysate.

  The dual pump (not shown) is disposed across the dialysate introduction line La and the dialysate discharge line Lb in the dialyzer body, and from the blood of the patient flowing in the dialyzer 3 to the dialyzer body. A water removal pump (not shown) for removing water is provided. Furthermore, one end of the dialysate introduction line La is connected to the dialyzer 3 (dialyte introduction port 3c), and the other end is connected to a dialysate supply device (not shown) for preparing a predetermined concentration of dialysate. One end of the dialysate discharge line Lb is connected to the dialyzer 3 (dialysate outlet 3d), and the other end is connected to a drain means (not shown), and the dialysate supplied from the dialysate supply device After passing through the dialysate introduction line La to the dialyzer 3, it is sent to the drainage means through the dialysate discharge line Lb.

  In the middle of the dialysate introduction line La (between the duplex pump and the dialyzer 3), an electromagnetic valve V4 capable of closing and opening the flow path is connected, and in the middle of the dialysate discharge line Lb (with the duplex pump and An electromagnetic valve V5 capable of closing and opening the flow path is connected to the dialyzer 3). Further, an electromagnetic valve V1 (arterial side clamping means) capable of closing and opening the flow path at the distal end side (near connector c) of arterial blood circuit 1 and the distal end side (near connector d) of venous blood circuit 2 In addition, an electromagnetic valve V2 (vein side clamping means) is connected, and an electromagnetic valve V3 capable of closing and opening the flow path is connected in the middle of the priming liquid supply line Lc.

  Furthermore, an arterial-side bubble detecting means 9 capable of detecting bubbles in the liquid flowing through the site is disposed on the distal end side of the arterial blood circuit 1, and on the distal end side of the venous blood circuit 2, A venous-side bubble detection means 10 that can detect bubbles in the liquid flowing through the region is provided. In the figure, reference numerals 11 and 12 denote blood discriminators disposed on the distal end side of the arterial blood circuit 1 and the distal end side of the venous blood circuit 2, and reference numerals 13, 14, and 15 denote arterial blood circuits. 1 shows tube detectors respectively disposed on the distal end side of 1, the distal end side of the venous blood circuit 2, and in the middle of the priming fluid supply line Lc.

  These solenoid valves V1 to V6 are capable of closing and opening the flow paths at the respective locations by the opening and closing operations as described above, and the opening and closing operations are controlled by the control means 16 such as a microcomputer. It is comprised so that. In particular, the control means 16 in this embodiment can receive a detection signal from the venous-side bubble detection means 10 and can control each of the electromagnetic valves V1 to V5 including the blood pump 4 and the electromagnetic valve V6 as the valve means. Are electrically connected to these components.

  The storage means 7 (so-called “physiological saline bag”) is made of a flexible transparent container and can store a predetermined volume of physiological saline (priming liquid). It is attached to the tip of a protruding pole (not shown). The priming liquid supply line Lc is connected to a site (connecting portion P) between the arterial puncture needle a and the arterial drip chamber 5 in the arterial blood circuit 1 and supplies physiological saline (priming liquid) in the storage means 7. It can be supplied into the blood circuit. A priming liquid drip chamber 8 is connected in the middle of the priming liquid supply line Lc so that the supply (dropping) of physiological saline (priming liquid) can be visually observed.

  However, priming before treatment (priming solution such as physiological saline is washed by flowing in the blood channel or dialysate channel, and the blood channel or dialysate channel is filled with the priming solution in advance. When working), the tip of the arterial blood circuit 1 and the tip of the venous blood circuit 2 are connected to communicate with each other (specifically, the connectors c and d are connected to communicate with each other in the flow path). Yes.

  In the dialysis device (blood purification device) according to the present embodiment, at the time of priming before treatment, the control unit 16 receives the detection signal (bubble detection signal) from the vein-side bubble detection unit 10 as described above, and The solenoid valves V1 to V5 including the blood pump 4 and the solenoid valve V6 as a valve means can be controlled, and a reservoir is generated in the priming drip chamber 8 to generate a reservoir of physiological saline (priming solution). The physiological pump (priming fluid) is weighted from the priming fluid supply line Lc to the drip chamber 5 through the venous blood circuit 2 by stopping the blood pump 4 and opening the electromagnetic valve V6 (valve means). An overflow process in which the blood pump 4 is supplied and discharged from the overflow line 6, and the blood pump 4 is driven in reverse. Circulation that closes the magnetic valve V6 (valve means) and supplies physiological saline (priming liquid) from the priming liquid supply line Lc to the arterial blood circuit 1 via the venous blood circuit 2 and dialyzer 3 (blood purification means). Are sequentially performed with the blood introduction port 3a of the dialyzer 3 (blood purification means) facing upward, and the venous-side bubble detection means 10 detects bubbles in the circulation step and shifts to the overflow step. is there. Further, the control unit 16 according to the present embodiment repeatedly performs the overflow process and the circulation process until the bubble detection by the vein-side bubble detection unit 10 is eliminated.

Hereinafter, the priming process performed by the dialysis apparatus according to the present embodiment will be described based on the flowchart of FIG.
At the time of priming, as shown in FIG. 2, the blood introduction port 3a of the dialyzer 3 is in a state facing upward (fixed by a fixing means (not shown)), and the connector c and the connector d are connected to each other. After communicating, a liquid pool production | generation process (S1-S4) is performed. As shown in FIG. 2, S1 drives the blood pump 4 to rotate forward so that the physiological saline solution (priming solution) in the housing means 7 is connected to the arterial blood circuit 1 via the priming solution supply line Lc. It is a process for leading to.

  Then, it is determined whether or not the blood pump 4 has been normally rotated by a predetermined number (for example, 5 rotations) (S2). After the blood pump 4 is driven in reverse, it is determined whether or not the blood pump 4 is driven in reverse for a predetermined number (for example, two rotations) (S4). When the predetermined number of rotations is reached, the blood pump 4 is stopped and a series of liquid pool generating steps is performed. Ends. As a result, a pool of physiological saline is generated in the drip chamber 8 for the priming solution. When the blood pump 4 is driven forward in S1 and when the blood pump 4 is driven reversely in S3, the solenoid valves V2 and V3 are opened as shown in FIG. V1 and V4 to V6 are closed.

  After that, as shown in FIG. 4, the solenoid valve V6 and the solenoid valve V1 as valve means are opened while maintaining the stop state of the blood pump 4, so that the priming fluid supply line Lc is passed through the venous blood circuit 2. A physiological saline solution (priming solution) is supplied to the drip chamber 5 by its own weight and discharged from the overflow line 6 (overflow step S5). That is, the physiological saline solution (priming solution) in the storage means 7 is caused by its own weight (drop pressure) due to the drop, between the priming solution supply line Lc, the connection part P to the tip of the arterial blood circuit 1, and veins. From the tip of the side blood circuit 2 to the drip chamber 5, it is discharged from the overflow line 6 extending from the top.

  Then, it is determined whether or not a predetermined time (for example, 30 seconds) has elapsed since the overflow process S5 was started (S6). When the predetermined time has elapsed, the process proceeds to S7 and a circulation process is performed. As shown in FIG. 5, the circulation step drives the blood pump 4 in the reverse direction (for example, a driving speed of about 100 (mL / min) is preferable) and closes the solenoid valve V6 and the solenoid valve V3 as valve means. In this step, physiological saline (priming solution) is supplied from the priming solution supply line Lc to the artery side blood circuit 1 via the venous blood circuit 2 and the dialyzer 3. Thereby, the physiological saline solution flows from the lower side to the upper side of the blood flow path in the dialyzer 3, and the bubbles are smoothly moved upward and removed.

  After the circulation step S7 as described above, it is determined whether or not the venous-side bubble detection means 10 has detected a bubble (S8). If a bubble is detected, the process returns to S5, and the process again proceeds to the overflow step S5. As shown in FIG. 6, the overflow process S5 at this time is the same as that shown in FIG. 3 except that the physiological saline is contained in the drip chamber 5. Then, after the overflow process S5 and the circulation process S7 are performed again, it is determined again in S8 whether or not there is a bubble detection. Thus, the overflow process S5 and the circulation process S8 are repeatedly performed until the bubble detection by the vein-side bubble detection means 10 is eliminated.

  When the venous-side bubble detecting means 10 stops detecting bubbles in S8, the process proceeds to S9 and a dialysate filling step (a step called so-called gas purge) is performed. As shown in FIG. 7, the dialysate filling step S <b> 9 is a step in which the double pump is driven while the electromagnetic valves V <b> 4 and V <b> 5 are opened, and the dialysate flow is filled in the dialysate flow path in the dialyzer 3. At this time, the electromagnetic valves V3, V6 are closed, and the electromagnetic valves V1, V2, V4, V5 are open.

  Before proceeding to the dialysate filling process (gas purge) (possible during or after gas purge), the blood pump 4 is driven forward with the solenoid valves V3 and V6 opened, and the priming solution overflows. It is preferable that the gas is discharged while it is discharged. In that case, further cleaning in the dialyzer 3 can be performed. In the dialysate filling process (gas purge), the blood pump 4 may be driven. Further, during the dialysate filling process, the solenoid valve V3 is opened, the blood pump 4 is driven, and the water removal pump of the dialysate pipe is further driven, so that the priming solution is supplied to the blood flow path (hollow fiber) in the dialyzer 3. ) From the blood side to the dialysate side, the hollow fiber membrane can be washed (the hollow fiber pores are washed).

  According to the present embodiment, by passing through the liquid pool generation step, the overflow step and the circulation step, and the dialysate filling step, it is possible to perform washing and priming of the site where blood, dialysate, etc. circulate during treatment, Air bubbles can be reliably discharged outside. Further, in the present embodiment, since the blood introduction port 3a of the dialyzer 3 is directed upward throughout all the priming steps, the upside down operation of the dialyzer 3 is not required, and the priming step is facilitated. In addition to being able to automate, the dialyzer 3 can be quickly and surely vented.

  Furthermore, according to the present embodiment, since the venous-side bubble detection means 10 detects bubbles in the circulation step and shifts to the overflow step, the priming operation can be easily automated and the dialyzer 3 (blood The air purifying means) can be surely and smoothly performed. In particular, at the time of priming, the physiological saline solution (priming solution) is not supplied from the upper side to the lower side with respect to the blood flow path of the dialyzer 3, so that a subsequent air lock or the like can be reliably avoided.

  Further, according to the present embodiment, the overflow process and the circulation process are repeatedly performed until the bubble detection by the venous-side bubble detection means 10 is eliminated, so that the bubbles in the blood circuit can be more reliably discharged to the outside during priming. Can do. Furthermore, before the first overflow step, a liquid pool generating step for generating a pool of physiological saline (priming liquid) is performed in the priming liquid drip chamber 8, so that the liquid pool in the priming liquid drip chamber 8 can be used during priming. Can be generated.

  In addition, according to this embodiment, since priming work can be performed by a series of controls by the control means 16, priming can be easily automated and work by workers can be significantly reduced. . In addition, by changing the control content of the control means 16, the operation as in the present embodiment is possible, so that the blood purification apparatus (dialysis apparatus) according to the present invention can be used by diverting the existing blood circuit almost as it is. it can.

When priming is completed as described above, the following bubble removal is performed in the present embodiment.
That is, at the end of priming, the connection state between the distal end of the arterial blood circuit 1 and the distal end of the venous blood circuit 2 is maintained, and the control means 16 drives the blood pump 4 while closing the electromagnetic valve V6 (valve means). Then, the priming liquid is supplied from the priming liquid supply line Lc into the blood circuit (arterial blood circuit 1 and venous blood circuit 2), and the priming liquid is accumulated in at least any part of the blood circuit. A pressure accumulating step, a solenoid valve V6 (valve means) is opened, and a releasing step of releasing the pressure accumulating state of the priming liquid accumulated in the pressure accumulating step is performed. Bubbles adhering to other locations in 5 can be discharged from the overflow line 6.

  More specifically, the control means 16 can control the electromagnetic valve V1 (arterial side clamping means) and the electromagnetic valve V2 (venous side clamping means), and in the pressure accumulation process, the control means 16 is controlled by the electromagnetic valve V1. The first pressure accumulation step (see FIG. 9), in which the blood pump 4 is driven to rotate forward while the valve is closed, and the priming fluid flows in the blood circuit, and the blood pump 4 is reversed while the solenoid valve V2 is closed in addition to the solenoid valve V1. The second pressure accumulating step (see FIG. 10) that is driven to accumulate the priming fluid between the blood pump 4 and the electromagnetic valve V1 is performed, and the electromagnetic valve V1 is released in the releasing step (see FIG. 11). And the solenoid valve V2 is configured to be released.

  Further, the control means 16 shifts from the first pressure accumulation process to the second pressure accumulation process on condition that the liquid pressure detection means 17 detects a liquid pressure of a predetermined value (for example, about 100 to 200 (mmHg)). The pressure accumulation step and the release step are repeated a predetermined number of times. In the present embodiment, the pressure accumulation process and the release process are configured to be repeated a plurality of times. However, the pressure accumulation process and the release process may be performed only once.

Hereinafter, the bubble removal process at the end of priming performed by the dialysis apparatus according to the present embodiment will be described based on the flowchart of FIG.
When the priming is completed, as shown in FIG. 9, the connection state between the distal end of the arterial blood circuit 1 and the distal end of the venous blood circuit 2 is maintained, and the electromagnetic valve V1 (arterial clamping means) is controlled by the control means 16. While being occluded, the blood pump 4 is driven to rotate forward, and the priming liquid flows in the forward direction (the same direction as the flow direction during treatment) in the blood circuit (first pressure accumulation step S1).

  In the first pressure accumulation step S1, it is determined whether or not a predetermined value of hydraulic pressure (priming liquid pressure) has been detected by the hydraulic pressure detection means 17 (S2), and that the predetermined value of hydraulic pressure has been detected. It progresses to 2nd pressure accumulation process S3 as conditions. In the second pressure accumulation step S3, the blood pump 4 and the electromagnetic valve V1 (arterial artery) are driven in reverse while the electromagnetic valve V2 (arterial side clamping means) and the electromagnetic valve V2 (venous side clamping means) are closed. Priming fluid with the side clamping means).

  According to the second pressure accumulating step S3, it is possible to achieve a pressure accumulation state at a relatively high pressure (between the blood pump 4 and the electromagnetic valve V1, and usually a high pressure such as a rubber button is provided in this part. The unbearable components are not connected). However, in the second pressure accumulation step S3, it is determined whether or not the blood pump 4 has been driven at a predetermined speed, or whether a predetermined time has passed (S4), and it is determined that the predetermined speed has been driven or a predetermined time has passed. Then, it is determined that a predetermined fluid pressure has been accumulated between the blood pump 4 and the electromagnetic valve V1, and the process proceeds to the release step S5. In the second pressure accumulation step S3, it is preferable to perform pressure accumulation so that the amount of liquid delivered by the blood pump 4 is about 4 (mL).

  The release step S5 is a step for opening the electromagnetic valve V6 (valve means) and releasing the accumulated state of the priming liquid accumulated in the pressure accumulation step (second pressure accumulation step S3). In this step, the control means 16 releases the electromagnetic valve V1 (arterial clamping means) and the electromagnetic valve V2 (venous clamping means) almost simultaneously. As a result, the accumulated priming liquid is released at once (open to the atmosphere), and by applying an impact to the drip chamber 5 and the filter net 5a with the water pressure, the other parts in the filter net 5a and the drip chamber 5 are applied. The bubbles adhering to can be discharged to the outside from the overflow line 6 together with the priming liquid.

  After the release step S5 is completed, it is determined whether or not the pressure accumulation step (S1, S3) and the release step S5 have been performed a predetermined number of times (a preset number of times) (S6). On the other hand, if the predetermined number of times has not been reached, the process returns to S1, and a series of bubble removal is started again. In the present embodiment, the pressure accumulation process (S1, S3) and the release process S5 are set to be performed a plurality of times, whereby the pressure accumulation process (S1, S3) and the release process S5 are performed only once. Compared to the above, it is possible to more reliably remove bubbles adhering to the filtration net 5a of the drip chamber 5.

  In the present embodiment, at the end of the priming, the blood pump 4 is driven while the electromagnetic valve V6 (valve means) is closed to supply the priming liquid into the blood circuit from the priming liquid supply line Lc, and at least any of the blood circuits. Pressure accumulation step (the first pressure accumulation step S1 and the second pressure accumulation step) in which the priming fluid is accumulated in this part (between the blood pump 4 and the electromagnetic valve V1 in the arterial blood circuit 1 in this embodiment). Air bubbles adhering to the filtration network 5a of the drip chamber 5 are performed by opening the electromagnetic valve V6 (valve means) and releasing the step S5 for releasing the accumulated state of the priming liquid accumulated in the accumulating step. Can be discharged from the overflow line 6 so that bubbles adhering to the drip chamber 5 (especially the filter screen 5a) can be automatically removed. Automation when shifting from the priming treatment (dialysis therapy including blood removal step) can be easily achieved.

  Further, according to the present embodiment, in the pressure accumulation step, the first pressure accumulation step S1 in which the priming fluid is caused to flow in the blood circuit by driving the blood pump 4 in the normal direction while closing the electromagnetic valve V1 (arterial clamp means). In addition to the electromagnetic valve V1 (arterial side clamping means), the blood pump 4 is driven in reverse while closing the electromagnetic valve V2 (venous side clamping means), and between the blood pump 4 and the electromagnetic valve V1 (arterial side clamping means). And the second pressure accumulating step S3 in which the priming liquid is accumulated, and the electromagnetic valve V1 (arterial side clamping means) and the electromagnetic valve V2 (venous side clamping means) are released in the releasing step S5. High pressure accumulation can be achieved, and the air adhering to the filtration net 5a of the drip chamber 5 (particularly, the outside of the filtration net 5a (the side facing the discharge port of the drip chamber 5)). It can be more reliably removed.

  Furthermore, according to the present embodiment, since the first pressure accumulation step S1 is shifted to the second pressure accumulation step S3 on the condition that the fluid pressure detection means 17 detects a predetermined pressure, the first pressure accumulation step S1. When the priming liquid is caused to flow in the blood circuit, it is possible to reliably avoid the liquid pressure from becoming excessive. In the normal blood circuit, since the drip chamber 5 connected to the venous blood circuit 2 is provided with the fluid pressure detecting means 17 capable of detecting the venous pressure, it can be used.

  Although the present embodiment has been described above, the present invention is not limited to this, and at the time of priming before treatment, the tip of the arterial blood circuit 1 and the tip of the venous blood circuit 2 can be connected to communicate with each other. In other words, the priming process may be another process. Further, in the pressure accumulation process (second pressure accumulation process S3), the blood pump 4 is driven while the electromagnetic valve V6 (valve means) is closed to supply the priming liquid into the blood circuit from the priming liquid supply line Lc. It is sufficient if the step of bringing the priming liquid into a state of accumulating at least at any part of the pressure is sufficient, and the pressure accumulating part is “between the blood pump 4 and the electromagnetic valve V1 in the arterial blood circuit 1” as in the present embodiment. In addition to what is set, pressure may be accumulated at other parts.

  Further, in the present embodiment, the first pressure accumulation step S1 is shifted to the second pressure accumulation step S3 on condition that the fluid pressure detection means 17 detects a predetermined value of fluid pressure. You may make it transfer from 1st pressure accumulation process S1 to 2nd pressure accumulation process S3 on the condition that it was made to drive forward by predetermined rotation speed or predetermined time. Furthermore, in the present embodiment, the physiological saline solution as the priming solution is supplied from the storage means 7, but another priming solution different from the physiological saline solution may be supplied. In this embodiment, the present invention is applied to a dialysis apparatus used at the time of dialysis treatment, but is used in other apparatuses that can purify the patient's blood while circulating it outside the body (for example, blood filtration dialysis, blood filtration, AFBF). The present invention may be applied to blood purification devices, plasma adsorption devices, and the like.

  At the end of priming, the blood pump is driven while the valve means is closed to supply the priming liquid from the priming liquid supply line into the blood circuit, and the priming liquid is accumulated in at least one part of the blood circuit; And a release step of releasing the pressure accumulation state of the priming liquid accumulated in the pressure accumulation step, and allowing the bubbles attached to the drip chamber to be discharged from the overflow line. If it is a purification apparatus and its bubble removal method, it can be applied to other forms and uses.

1 Arterial blood circuit 2 Venous blood circuit 3 Dialyzer (blood purification means)
DESCRIPTION OF SYMBOLS 4 Blood pump 5 Drip chamber 5a Filtration network 6 Overflow line 7 Storage means 8 Drip chamber for priming liquid 9 Arterial side bubble detection means 10 Venous side bubble detection means 11, 12 Blood discriminator 13, 14, 15 Tube detector 16 Control means 17 Fluid pressure detection means La Dialysate introduction line Lb Dialysate discharge line Lc Priming fluid supply line V1 Solenoid valve (arterial clamp means)
V2 Solenoid valve (Venous clamp)
V3 to V5 solenoid valve V6 solenoid valve (valve means)

Claims (8)

A blood circuit comprising an arterial blood circuit and a venous blood circuit, and capable of extracorporeally circulating the patient's blood from the distal end of the arterial blood circuit to the distal end of the venous blood circuit;
A blood flow that is interposed between the arterial blood circuit and the venous blood circuit of the blood circuit to purify the blood flowing through the blood circuit and to which the patient's blood flows through a blood purification film for purifying the blood Blood purification means in which a dialysis fluid flow path through which the passage and dialysis fluid flow is formed;
A blood pump disposed in the arterial blood circuit;
A dialysate introduction line and a dialysate discharge line connected to the dialysate flow path inlet and outlet of the blood purification means;
A priming fluid supply line connected to the arterial blood circuit and capable of supplying a priming fluid into the blood circuit;
Blood that is formed at both ends of the blood purification means, is connected to the arterial blood circuit and introduces blood into the blood flow path, and blood is connected to the venous blood circuit and derives blood from the blood circuit The outlet,
A dialysate introduction port that is formed on each side of the blood purification means and is connected to the dialysate introduction line to introduce the dialysate into the dialysate flow path, and a dialysate discharge line that is connected to the dialysate discharge line. A dialysate outlet for extracting dialysate;
A drip chamber connected to the venous blood circuit and formed with a filtration network;
An overflow line extending from the air layer side of the drip chamber and capable of discharging the liquid overflowing the drip chamber to the outside;
Valve means capable of optionally closing or opening the overflow line;
In the blood purification device that is capable of communicating by connecting the tip of the arterial blood circuit and the tip of the venous blood circuit at the time of priming before treatment,
The control means capable of controlling the blood pump and the valve means, and at the end of priming, the control means,
A state in which the blood pump is driven while the valve means is closed to supply the priming liquid into the blood circuit from the priming liquid supply line, and the priming liquid is accumulated in at least any part of the blood circuit; Accumulating process,
Releasing the valve means and releasing the pressure accumulation state of the priming liquid accumulated in the pressure accumulation step;
The blood purification apparatus is characterized in that air bubbles adhering to the drip chamber can be discharged from the overflow line. Comprising an arterial clamp means capable of closing or releasing the flow path near the distal end of the arterial blood circuit, and a venous clamp means capable of closing or releasing the flow path near the distal end of the venous blood circuit, The control means can control the arterial clamp means and the venous clamp means,
In the pressure accumulation step, the control means is
A first pressure accumulation step of causing the blood pump to rotate forward while occluding the arterial clamp means and causing the priming fluid to flow in the blood circuit;
A second pressure accumulation step in which the blood pump is driven reversely while occluding the vein side clamp means in addition to the arterial side clamp means, and the priming fluid between the blood pump and the artery side clamp means is accumulated. ,
The blood purification apparatus according to claim 1, wherein the arterial clamp means and the venous clamp means are released in the releasing step.   A hydraulic pressure detection means is provided that extends from the drip chamber and can detect the hydraulic pressure in the drip chamber, and the control means detects a hydraulic pressure at a predetermined value by the hydraulic pressure detection means. The blood purification apparatus according to claim 2, wherein the first pressure accumulation step is shifted to the second pressure accumulation step on the condition of   The blood purification apparatus according to any one of claims 1 to 3, wherein the control means repeatedly performs the pressure accumulation step and the release step a predetermined number of times. A blood circuit comprising an arterial blood circuit and a venous blood circuit, and capable of extracorporeally circulating the patient's blood from the distal end of the arterial blood circuit to the distal end of the venous blood circuit;
A blood flow that is interposed between the arterial blood circuit and the venous blood circuit of the blood circuit to purify the blood flowing through the blood circuit and to which the patient's blood flows through a blood purification film for purifying the blood Blood purification means in which a dialysis fluid flow path through which the passage and dialysis fluid flow is formed;
A blood pump disposed in the arterial blood circuit;
A dialysate introduction line and a dialysate discharge line connected to the dialysate flow path inlet and outlet of the blood purification means;
A priming fluid supply line connected to the arterial blood circuit and capable of supplying a priming fluid into the blood circuit;
Blood that is formed at both ends of the blood purification means, is connected to the arterial blood circuit and introduces blood into the blood flow path, and blood is connected to the venous blood circuit and derives blood from the blood circuit The outlet,
A dialysate introduction port that is formed on each side of the blood purification means and is connected to the dialysate introduction line to introduce the dialysate into the dialysate flow path, and a dialysate discharge line that is connected to the dialysate discharge line. A dialysate outlet for extracting dialysate;
A drip chamber connected to the venous blood circuit and formed with a filtration network;
An overflow line extending from the air layer side of the drip chamber and capable of discharging the liquid overflowing the drip chamber to the outside;
Valve means capable of optionally closing or opening the overflow line;
In the method for removing air bubbles of the blood purification apparatus, wherein the arterial blood circuit tip and the venous blood circuit tip can be connected and communicated during priming before treatment,
At the end of priming,
A state in which the blood pump is driven while the valve means is closed to supply the priming liquid into the blood circuit from the priming liquid supply line, and the priming liquid is accumulated in at least any part of the blood circuit; Accumulating process,
Releasing the valve means and releasing the pressure accumulation state of the priming liquid accumulated in the pressure accumulation step;
And removing the bubbles attached to the drip chamber from the overflow line. An arterial clamp means capable of closing or releasing the flow path near the distal end of the arterial blood circuit; and a venous clamp means capable of closing or releasing the flow path near the distal end of the venous blood circuit;
In the pressure accumulation step,
A first pressure accumulation step of causing the blood pump to rotate forward while occluding the arterial clamp means and causing the priming fluid to flow in the blood circuit;
A second pressure accumulation step in which the blood pump is driven reversely while occluding the vein side clamp means in addition to the arterial side clamp means, and the priming fluid between the blood pump and the artery side clamp means is accumulated. ,
6. The method of removing a bubble in a blood purification apparatus according to claim 5, wherein the arterial clamp means and the venous clamp means are released in the releasing step.   Provided with a fluid pressure detecting means extending from the drip chamber and capable of detecting the fluid pressure in the drip chamber, and on the condition that a fluid pressure of a predetermined value is detected by the fluid pressure detecting means. The method of removing bubbles from the blood purification apparatus according to claim 6, wherein the first pressure accumulation step is shifted to the second pressure accumulation step.   The method for removing bubbles in a blood purification apparatus according to any one of claims 5 to 7, wherein the pressure accumulation step and the release step are repeated a predetermined number of times.

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